Episode 9- Wisconsin Needs More Pediatricians! Dr Brilliant Nimmer

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Episode Transcript

(00:00):
Welcome to Pulse Check,Wisconsin.

(00:26):
Hello, good morning, goodevening, whatever it may be for
you.
This is Chris Ford again fromPulseCheck Wisconsin, and I want
to thank you for joining usagain today.
Thank you so much forsubscribing, for liking, for
giving us all your comments andquestions up until this point.
PulseCheck Wisconsin.

(00:48):
For those of you new to thechannel, what we do is we try to
give you information.
About the intersection of publichealth and healthcare in
general.
So anything that would be usefulto keep you out of the ER, give
you explanations of things thatare going on in the community,
both here in Milwaukee.
As well as throughout the stateof Wisconsin.

(01:08):
What I want to do today is Iwant to emphasize a point that
we brought up before, and thatis to give folks an idea and to
pull back the veil a little bitabout what it takes to go into
healthcare and opportunitiesavailable for folks who are
interested in going intohealthcare.

(01:29):
I was very fortunate to have ona.
Colleague of mine, one of mygood friends Dr.
Nimmer, who is an associatedirector at children's hospital.
She's currently the, Associateprogram director at medical
college of Wisconsin pediatricresidency program.
She's a pediatrician in thecommunity with children's

(01:50):
hospital, Wisconsin, and shecurrently serves.
In the D and I realm at themedical college of Wisconsin.
I want to allow her to give yousome more information about
things that she does and some ofher background.
It was an amazing interview thatI had with her about where she
came from here in Milwaukee, aswell as think that she's hoping

(02:12):
to do in the future and thingsthat she's hoping to continue to
build on She has told me oncebefore that she is going to take
over post check and become my cohost.
So we're gonna, we're gonna herto do the.
case this week.
So with that being said, I hopeyou enjoy the case presented to

(02:32):
you by Dr.
Brilliant Nimmer.

(03:04):
greetings, PulseCheck Wisconsinlisteners.
My name is Dr.
Brilliant Nimmer, and I am acommunity pediatrician, and I
have the privilege today topresent this episode's case.
The case is an adaptation from areal patient case with no
identifying information.
So let's get into this case.
The patient is a two month oldmale infant presenting to a

(03:27):
community hospital emergencydepartment for fussiness.
First time parents report thattheir baby has been fussy for
the past two days.
The baby seems to be in pain.
They're always holding the baby,and if they put him down, he
starts crying.
The crying episodes last for upto one hour.
The baby is formula fed anddrinks about six ounces every

(03:48):
two hours.
And parents report that he spitsup a lot.
He is stooling twice a day, andit's soft.
The parents have not been ableto follow up with their primary
pediatrician since birth becausetheir clinic that was in their
neighborhood was closed, andthey do not have reliable
transportation to the newlocation.
The infant has not receivedtheir first vaccinations yet.

(04:11):
The parents do not endorse afever or any other cold
symptoms.
As you review the history, theinfant was born at that hospital
at 8 pounds 2 ounces, which isin the 83rd percentile for its
weight.
The infant was born full term at39 weeks gestation, vaginally,
with no pregnancy or birthcomplications.

(04:32):
On physical exam, the vitals arenormal.
The weight is now 11 pounds, 6ounces, which is now in the 30th
percentile.
The infant is alert, cryingtears, and moving around
vigorously on the exam table.
And the rest of his exam isnormal.
After wrapping the baby up backin his blanket and handing him
to parents, the infant is easilyconsoled.

(04:55):
He feeds well from a bottle andis well hydrated.
He's then discharged home withparents with the diagnosis of
fussiness and instructed tofollow up with his primary care
pediatrician.
The pediatrician receives thenote from the ED visit and
contacts Social Work to helpparents get transportation to
the clinic.
Now this is a very commonexperience that parents have

(05:16):
with their infants, especiallyfirst time parents.
At this time, at two months ofage, you're still trying to
figure out your baby's needs.
And honestly, being a parentmyself, infants make some weird
sounds and movements that cancause a lot of anxiety.
Babies communicate by crying andparents are having to figure out
what those cries mean.
Does that mean my baby's hungry?

(05:36):
Does that mean that they need topoop?
Do they need their diaperchanged?
Do they just want to be cuddled?
And then sometimes you startgetting worried and you're
thinking, Is my baby in pain?
Is there something more seriousgoing on?
And if you're at this point,it's a good time you should call
your pediatrician.
Many offices have great nursesthat can triage these situations
and determine next steps.

(05:57):
They can figure out if we canmonitor this baby at home, do
home cares need to be done, doesthis baby need to come to a
clinic to be seen today or thenext day, or does the baby need
to go to an emergencydepartment?
The parents in this case wereworried, and they decided to go
to their closest doctor, whichhappens to be their community
emergency department.
And I will never fault a parentfor taking their baby to an

(06:18):
emergency department.
However, emergency medicinephysicians are trained very
differently from pediatriciansand are thinking mostly of
emergency situations that couldbe causing the fuzziness in this
baby and what needs to happenimmediately that would require
an intervention or treatment forthat baby.
So the differential diagnosisfor fussiness in a two month old

(06:40):
in an emergency center settingis very different than from in a
primary care setting, especiallyif the baby is appearing sick.
That doctor might be thinking,is this fussiness or is this
irritability?
Irritability is different fromfussiness.
An irritable infant is very hardto console.
Now you have to start thinkingabout things like infection.

(07:01):
Does this baby have sepsis?
Does this baby have meningitis,an infection in their brain or
their spinal cord?
Does the baby have a mass intheir brain, something like a
tumor or a hemorrhage?
Does this baby suffer some typeof injury?
And then the doctor is alsothinking about, is this baby
spitting up or is this vomiting?

(07:22):
Things like pyloric stenosis,which is a narrowing of the
opening of your stomach, cancause projectile vomiting in a
baby.
If you have an obstruction inyour intestine somewhere, such
as malrotation, volvulous, orintussusception, that can cause
vomiting in a baby.
Is this baby having an allergyto their formula?
Are they just not toleratingtheir formula?

(07:45):
The exam showed that this babywas well appearing and was
discharged home and told tofollow up with their
pediatrician.
Most parents leave the situationunsatisfied, especially after
waiting likely a long time inthe emergency department and
feel like the emergencydepartment didn't do anything to
help them.
However, many People don'tunderstand the expectations of

(08:05):
our emergency departmentcolleagues.
They are typically triagingmultiple patients that require
emergent care and do not havethe time to take a detailed
history and provide educationand need to make decisions
quickly for patients.
Do those patients need to be inthe hospital?
Are those patients safe enoughto be discharged home?
Which happened in this case.

(08:25):
So the baby ends up following upwith their primary care
pediatrician.
The pediatrician is nowthinking, what is causing this
fussiness?
What is making them spit up, andwhy has this growth percentile
decreased?
Additional diagnoses forfussiness in a well appearing
two month old in a primary caresetting could be, Is this just a
normal baby?
Normal babies are fussy here andthere.

(08:47):
We expect that.
Is this Fussiness increased.
And we think about is this acolicky baby or is this a baby
that's going through a period ofpurple?
And the period of purple is aperiod, a growth period for
babies in which they cry a lotmore and it starts at two weeks,
really gets worse at about twomonths, and then goes away
completely by four to fivemonths.

(09:09):
During that period, babies cryfor longer periods.
They might cry during periods ata certain time, usually at
night, and they, for the mostpart, just want to be held a lot
more.
Or is this reflux?
Is the reflux causing some painin the baby because they're
spitting up so much?
Is the baby having milk proteinintolerance to their formula?

(09:30):
Are parents at this time,struggling with some postpartum
depression and the baby's justcrying normally, but because the
parents are struggling, theythink the baby is fussy?
The baby is well appearing attheir pediatrician visit.
Parents are stressed with thetransition to parenthood, but
feel well supported.
They are mixing their standardformula from WIC correctly.

(09:51):
They are reassured about the,about the baby, and that the
baby is going through the periodof purple.
It was discussed not giving sixounces, of formula to a two
month old.
At this time, a lot of parentsend up doing that during the
period of purple because theythink the crying means that
their baby's hungry, but that istoo big of a volume for a baby

(10:12):
for a two month old, so it wasdiscussed to reduce that volume
to two to four ounces and thenfeed the baby more frequently
and to come back in a week for aweight check.
The baby comes back in a weekand he continues to grow well.
He's now in the 40th percentilefor weight and he's less fussy
and spinning up less.
What this case illustrates isthat families having access to a

(10:33):
pediatrician is key for healthypatients and families.
Pediatricians have the time andexpertise to educate and provide
reassurance.
I learned that in my medicaltraining, that 80 percent of
pediatrics is reassurance.
And it's a skill that you reallyneed to have and be able to hone
in on as a pediatrician.
And I believe it's even becomemore important now with all the

(10:55):
information that you can find onthe internet, which you can
Google and all themisinformation that's on social
media sites.
Parents nowadays, I think evenneed more reassurance and
reassurance is so powerful.
It helps relieve anxiety andsupport parents and it
encourages them and let themknow that they're doing a great
job.
Thanks so much for letting mediscuss this pediatric case
today and listening today.

(11:17):
I hope you were all able tolearn something.
Peace.
Thank you, Dr.
NImmer for sharing the case.
And now we're go ahead andtransition into our interview
with Dr.
Nimmer thanks for having me,Chris.
My name is Brilliant Nimmer.
I am a pediatrician.
I do pediatric primary care forchildren's Wisconsin.

(11:40):
And then I'm also have aacademic appointment.
I am associate program directorfor the pediatric residency at
the medical college ofWisconsin.
I like it.
I like it.
Our alma mater.
So just for some backgroundhere, and I'm going to try to
clean it up as much as I can forthis one, but right.

(12:01):
And I go back to like day one ofmedical school, like
orientation.
Like this was my ACE bro.
So without brilliant, I wouldnot be where I am.
I could tell you that much.
man, likewise man.
Like, I mean, like we were, wewent way back to like before
medical stu started, like thisis when Facebook groups were,
were a thing.
Like things would come fullcircle for us.

(12:22):
So this is awesome.
Full circle.
Well, I'm very proud of you andthank you for all that you do
both in the community.
I mean, your whole family is, isparamount to the success of
Milwaukee right now.
Her husband Shake is doing goodthings in the communities too.
So I'm very proud of both of youall, man.
Thanks so much, man, man.
Thank you.
And thank you.
Thank you for coming back toMilwaukee.

(12:42):
I'm glad I was able to recruityou back.
We need you.
My city needs you.
So.
Thanks for coming back andthanks for doing all you're
doing for Milwaukee and the, andthe state of Wisconsin.
So thanks for everything you'redoing in regards to the maps for
policy.
I think like you've reallyinspired me to think of things
like further down, down theline, streamline things, and
really policy is where it's atto really make some, some

(13:05):
movements for, for change.
So thank you for that.
That's what we're gonna makesome movement.
We'll get it right.
Don't worry.
Yes.
So could you just share likewith our audience, like what was
your own personal journey tomedicine?
Like you're from Milwaukee, butlike where'd you grow up, your
college residency, things likethat, just to kind of give
anyone perspective from thecommunity.

(13:25):
You know what they should belooking out for if they're
interested in kind of going thesame pathway that you did,
right?
So yes, I'm a Milwaukee lifer.
So through and through, like, Ilove Milwaukee so much.
I am Milwaukee.
I feel like hometown glory forsure.
I I grew up here.
So I actually grew up initiallyon the south side.
I lived in South Lawn.

(13:47):
Shout out to public housing.
Public housing in a very likediverse community and just a
community that really looked outfor each other and cared for
each other.
And I think like that's whatreally made me really want to
stay in the community.
I think that being able to livein a community where it's just
like the village cared for eachother was something that is
important for me and importantfor, for my career.
So yeah, that's, Shout out toSouth Lawn and shout out to the

(14:09):
South side.
I went to Milwaukee publicschools all my life, so I'm a
Milwaukee public school graduateand then ended up staying here
in Milwaukee for college.
I went to Mt Mary university inWauwatosa, and then I took a,
about a four year break inbetween college and then
attending medical school.
And during that time.
I got to work at the medicalcollege of Wisconsin being a

(14:32):
research coordinator in varioussections.
So I, I worked initially inpediatric palliative care at
children's and then ended updoing work in the cystic
fibrosis clinic at children'sbefore getting into medical
school.
And then went to medical schoolat the medical college of
Wisconsin.
And decided from there to thengo into pediatrics so then did a

(14:55):
pediatric residency here atChildren's Wisconsin too.
And really wanted to stay herein Milwaukee.
And a lot of that made me in alot of my just family to made me
really want to stay here inMilwaukee.
So really have been a lifelongMilwaukee resident and love
Milwaukee.
And so my career path, I've beenreally lucky to just have people

(15:16):
that Have cared for me andwanted to see me win in life and
really just great mentors in thecity.
And being able to access a lotof just like the pipeline
programs here in Milwaukee to,to make me think about a career
in medicine.
So I've been really lucky inthat.
So now I'm looking for childrennow for about seven years, I've
been a pediatrician in thecommunity and I'm so privileged

(15:39):
and so honored to do that.
And it's really cool because Iget to see people that I've
grown up with, I've get to see,you know, people that are
friends with my mother in lawand friends with my brother and
just all, all walks of life thatI've gotten to encounter
throughout my lifetime and thenget to see their children and
grandchildren or nieces andnephews.
And so it's been really cooljust to be able to practice in a

(16:00):
community where, you know,everybody.
It's so dope, man.
And so, you know, the, the thingthat comes up oftentimes,
especially we had a couple ofpeople on like from Milwaukee.
We had our former healthcommissioner Jeanette Kowalik
that came on.
It was also from Milwaukee.
Could you speak to a little bitabout like what you mentioned?
You said that coming from thecommunity, how important that is

(16:21):
and the influence that you canhave and the perspective that's
different.
For someone say that is not asnow a practicing pediatrician,
how does, how do you feel likethat has changed your practice
and your perspective on things?
Yeah, I think it's, it's givenme so much perspective.
I think Milwaukee is so uniquein itself and just like the
history of Milwaukee and howMilwaukee kind of came about.

(16:43):
And I think, especially when itcomes to the segregation of
Milwaukee, as many of you knowthat Milwaukee is one of the
most segregated cities in ourcountry.
So understanding that and, andliving in that, I think and
really understanding kind of howthat all happened is important.
And I think it's important foryou to recognize that,

(17:04):
especially when you're thinkingabout your patients and families
and the barriers that they haveto continue to Experience to
access healthcare and any inmany other social determinants
of health.
So I think that has been so keyto me being able to care for my
patients for sure.
And I think that understandingthat really helps you really

(17:29):
understand what your patientsare having deal with a day to
day.
Yeah.
And, you know, nothing that canbe more effective than putting
yourself in that perspective andkind of walk in that walk with
your patients and know thoseintangibles that we talked about
over and over and over again,those social determinants of
health things, you know, why ismy patient not picking up the

(17:49):
medication?
Why are they not showing up toclinic?
Right?
Like all those things are thingsthat you can understand to a
certain extent, if you're notfrom the community, but.
to actually have lived thatexperience and having known, you
know, those are legit barriers.
You know, if somebody is 15minutes late because the bus
ain't come right, or if they'representing again and again and
haven't followed up, you know,those things are, you know,

(18:11):
super important in terms of kindof grasping the whole picture of
your patient's health and theoverall health.
Absolutely.
So true.
So one of the things that we wewe talked about I just recently
you invited me thank you so muchfor inviting me to a lecture
with the pediatric residency.
One of the things that thatyou're doing right now is trying

(18:33):
to break down some of thebarriers and some of the
challenges, particularlychildren's right now in your
position.
In terms of increasing theamount of diversity again, we
talked about to get moreproviders in that same light of
work, walking that experiencewith their patients and having
that that sort of base to touchto have that common ground.
What are some of the barriersthat you're facing to promote

(18:55):
that diversity?
What are some of the things thatyou guys are doing right now in
your program?
Right.
Oh man, that's such a greatquestion.
Oh, wow.
I think we have to start fromthe pool of applicants that we
have in general.
And I think that's an importantpoint to just touch on is that
pediatrics is such a greatspecialty.
And however, has now over thepast five years, we have now

(19:20):
seen a decrease in the amount ofapplicants that want to train
and become pediatricians.
So over the past five years, wejust kind of got data from what
is what is it?
ACGME and they pretty much saidthat for MDs, for students that
are graduating from medicaldegree schools, those the

(19:43):
percentage of applicants thatare wanting to go into
pediatrics has now decreased byabout 13%.
That's also the same for,international medical graduates.
So those that are, that aregraduating medical school from a
different country.
However, we are seeing anincrease in the DO students that
are wanting to go intopediatrics, which has been a
great thing.

(20:04):
But overall, over the past fiveyears, we've now seen a decrease
in about 16 percent of medicalstudents that are now wanting to
go into pediatrics.
So when you think about that,just that overall decrease of
applicants wanting to go intopediatrics but however, there's
still more now medical schoolsand it's now worrisome.

(20:26):
Because now our applicant pool,especially when it comes to
diversity, is getting even less.
And so really trying to, reallybefore even medical school
pipeline programs, we're justnow understanding that pipeline
programs are really a lot ofpeople are already making
decisions about their careers.
And so really trying to, Getinto pipeline programs is really

(20:47):
key.
So, you know, the medicalcollege of Wisconsin definitely
has programs in which, MPSstudents get to come to the
medical college over the summerand do a summer program.
We also have that for collegestudents.
We also are trying to getmedical students that are
underrepresented in medicine.
To do a way rotation at ourmedical school in pediatrics.

(21:09):
So we have funds to pay for thatbecause as you know, doing an
away rotation costs money foryou to go to another institution
for a month and be able to do arotation there.
So we, and we understand.
You know, students that areunderrepresented in medicine
typically have more barriers inregards to resources and costs
to get these things theseexperiences and opportunities.

(21:31):
So we have that in place.
And then also for our residentsand medical students were really
trying to do a job of recruitingdiverse applicants from our
school and then introducingpediatrics right away.
And so now our alma mater MCWhas the fusion program, which a
lot of medical student schoolsdo now, where they introduce The

(21:54):
first year medical student intothe clinical space right away.
And so with that, we're hopingthat we now will get medical
students that will come intopediatrics and be introduced to
pediatrics their first year, andhopefully wanting to do
pediatrics as a career, becausethey've been introduced to that
earlier.
So really trying to, before weeven get to the residency
application, get people excitedabout pediatrics.

(22:16):
So then we can have a morediverse pool of applicants that
want to.
Complete residency and trainingis, is important.
I think with Milwaukee, I thinkwe're so lucky with Milwaukee
because Milwaukee is such adiverse city.
And, you know, now we're like aminority majority city.
Right.
So like being able, I really usethat as a selling point.

(22:37):
Like you're going to be able tosee such a diverse.
population of people.
If you come here to, for yourmedical training, I mean, our
institution is a hugeinstitution, you know, with
pretty much every pediatricspecialty at it.
And we have a huge hospital withmany floors of ICUs and
inpatient and an emergencydepartment where you get a high

(23:01):
volume of diverse patients.
So I think really Having that Ithink is, is important for
people's medical training ingeneral to experience that.
And I think that's a really goodway to also recruit some diverse
applicants to, to our city.
Yeah.
Yeah.
And you bring up a good point,especially with Milwaukee now
officially being majorityminority, you know, there,

(23:24):
there's going to be that needfor more minority applicants and
more minority matriculants aswell.
You know, they, there, there's,Data, which is, you know,
standardized and verified, thatshows that patients who are seen
by doctors who come from thesame communities, doctors who
share the same community ofinterest.
So religion, ethnicity, thingsof that nature, those patients

(23:46):
have better outcomes.
And especially as we're seeingthings in Milwaukee.
Like infant mortality, maternalmortality, things of that
nature.
It's going to be even morecritical now we're in the quote
unquote post COVID era to kindof have those positions in place
to improve those outcomesbecause, you know, we can do as
much as we, we, we can from apolicy standpoint.

(24:07):
But.
Putting that seed into kids mindthat, you know, this is
something that you can attain.
This is something that, youknow, that needs to be a pillar
in the community.
Someone who needs to be there tohelp facilitate that care, you
know, it's going to be paramountand going forward.
Absolutely.
And you're right.
Like patient outcomes.
I mean, it's life or death forour patients at the end of the

(24:28):
day.
And so like, that's what I sayis that, I mean, having a
provider that is.
Similar to you or a shareinterest or of the same racial
ethnic religious background isis so key and is really life or
death for a lot of our patients.
So I especially tell that to,you know, my friends and

(24:49):
families that are looking fordoctors that let's share that
share the same either backgroundas them.
In trying to find doctors thatare more diverse.
I am like, don't feel bad aboutthat.
Like, this is really your lifeor death.
Like you will most likely getbetter care and it's important
for your health.
Yeah.

(25:09):
And just to provide someperspective.
So there was a study that wasdone the aamc, they essentially
will Put out like all of theirnumbers for you know, ethnic
groups for age, things like thatfor the makeup of each
matriculating class.
But as of 2018, you know, whenthey looked at the breakdown of
ethnicities monks, all thematriculants, all the

(25:29):
applicants, you know, 56.
2 identified as white.
And if you look down the list interms of, Hispanic Americans,
American Indian you know,African American, we're talking
about 5.
8 percent for HispanicAmericans, about 5 percent for
African Americans and about 1percent for, Native American
matriculants.
So all these folks that arecoming into medicine, you know,

(25:51):
we're still representing a verysmall number.
Even though, again, as you said,Milwaukee is majority minority
at this point in time.
You know, I could tell you fromthe time that we were in medical
school, you know, there, therewas a handful of us that were in
the minority bucket, right.
And I will say, you know, it's alittle bit more than what we
had, but you know, we still havea lot of work to do.

(26:13):
And with taking place at thestate level, to put barriers in
place with DEI.
You know, improving thatmatriculate number, we're, we're
something that we're gonna haveto continue to work on to, to
improve that, because even withDEI in place, even with these
pipelines, we're still sittingat about five or 6 percent in
terms of that minority applicantmatriculants.
So one thing that I want to talkabout, so I know personally, and

(26:35):
you may have felt this too inresidency, being the only person
in medical school and in medicaltraining and residency of a
certain ethnicity or of acertain minority group can be
really challenging, especiallyif you're not used to being in
those environments.
In the past, probably one of thereasons why we were so close,
right?
Because like, we come fromsimilar communities and, you
know, it was like, Hey, you cancome over, you can be my best

(26:58):
friend.
Right.
Can you discuss like anyspecific efforts, you know, that
now that you're a part of theresidency program.
That the program is doing thatyou're doing to help create a
more supportive environment forresidents of diverse
backgrounds.
Yeah, absolutely.
And like one of them is what youjust said, Chris, like, Hey,
like, come here.

(27:18):
Like, we're like, come here.
You're my best friend.
Like, that's literally somethingthat we're doing for, for our
residents.
And so for our residents in theDEI space that identify with a
certain group, what we're, whatwe do is we, what's really cool
is that our DEI residentcommittee, which has like, shout
out to them, this Committeepretty much after George Floyd

(27:41):
was formed and has really done alot in regards to recruitment of
diverse talent to our to ourprogram and just other type of
programs to help be moreinclusive.
At MCW.
So one thing that they do issomething called pride mentors.
And with that, they match uppeople with shared identities.

(28:03):
So in turn with one of thesenior residents.
And so just to give that personanother person to talk to about
pretty much anything, likeeither, whether it's like, where
should I live in Milwaukee to,you know, how do I maneuver?
You know being at the hospitaland that culture at the hospital
and how do I maneuver, you know,being the only person of color
or like, how do I maneuver allthose situations?

(28:26):
And so linking up just a peermentor who in that situation
won't be judgmental and bereally able there to give them
advice.
I think Has been great for ourincoming interns that have been
coming into the class.
We also are actually this yearstarting the same thing for our

(28:47):
residents to have then a facultymember.
So we are doing the same kind ofmentor program, but then also
having a faculty member andhaving that faculty member,
especially in case.
The residents have any sharedinterest in regards to research
or quality improvement projectsor any other type of community
organizations that they wantedto work with.

(29:08):
So having a faculty mentor andmentorship is, I think, really
key when you have people thatare coming in and in that DEI
space.
I think that's so important forthem to have mentorship.
And so that's one thing thatwe're, we're doing, as a
strategy to really help makepeople feel like included and

(29:28):
belong, but then also hopefullyto retain that talent.
You know, I think what a lot ofprograms do eventually is really
trying to be diverse and they'lllook at numbers and they'll look
at people and I'm like, okay,these people bring diversity.
But then when it comes toretaining those, that talent, A
lot of us have a tough timedoing that.
And it's because we really don'thave that culture in place yet

(29:50):
to make them feel included inbelonging.
And so I think that's somethingthat we, we definitely need to
work on at, at our institutionin particular.
And I think that becomes trickywhen you have a medical school
and then a hospital system andthen a community, like it
becomes very tricky to do.
But I think that's anotherimportant piece that we have to
work on.

(30:11):
We also make sure that.
We do for like duringrecruitment season.
So when we really try in when wedo our interview process for our
applicants, we are doing aholistic review of our
applicants.
So You know, you remember thosedays when we had to apply for
all these things and it was likeboard scores and publications.

(30:31):
And what are you the chair of?
And are you in certain,societies?
Are you AOA?
And so, a lot of that we are, weIt's on your application and we
see it, but we really try and doa holistic review.
We're not excluding peoplebecause of certain board scores.
We're not excluding peoplebecause they failed boards.

(30:53):
We are really trying toholistically look at applicants
and see their strengths in, in,in instead of just looking at
scores for everything and whatthey got in certain classes, if
you've got, you know, highpasses.
I pass.
We kind of, we have now.
Gotten rid of and really justtry and make sure that we all

(31:15):
are on the same mission oftrying to have, pediatric
residents that are going to beable to care for our community.
And so I think that is what welook at now more instead of
looking at all those scores,which is important.
Like you cannot get a, youcannot get a sense of a person
from just.

(31:35):
An application like you can makeit look really great.
Exactly.
And like coming up, you know,when we came up in medicine, we
were kind of like the last classthat had the, the, the weighted
step one score.
So for everybody listening, whenyou're, when you're applying for
allopathic medicine licensing,you have three steps.
So step one, step two, stepthree.
that you'll take in order to getyour license.

(31:57):
And so for us, when we weregoing through medical school,
step one was it, right?
So like, if you didn't get aparticular score on step one,
and you couldn't apply forcertain specialties is because a
lot of specialties had thatcutoff that bar none.
So they've since moved to thisstandard of, you know, we're,
we're just going to do a passfail for step one, but some
programs will still look at steptwo.

(32:18):
But what happens is you get thisgroup of applicants that are
really good at takingstandardized testing.
We know that, you know, for alot of minority communities and
a lot of communities in general,you know, standardized testing
may not be a strong point for alot of people for myself
personally, I'm dyslexic.
So that ain't, that ain't whatI'm going to shine.
Right.
But, you know, what we need todo, as I remember was saying is

(32:39):
we were now moving towards,changing the pendulum saying,
Hey, we need to look at theentire applicant because other
things are going to shine andmany applicants application
overall, you're able to see thewhole, whole person and you're
able to see the physician that,you know, they are going to
become.
Right.
And so you know, I'm glad that alot of standardized institutions

(32:59):
are doing that and having folkslike Dr.
Nimmer and, and those places andthose spaces are, it's going to
be key in terms of getting notonly the best doctor that the
institution can get, but thebest doctor for the community
and the best doctor for,wherever they're going to be
working.
Absolutely.
And I think We know that we knowthat like step scores has no
correlation to you completing aresidency.
No, are you passing your boardsfor that for that specialty.

(33:22):
So holistic reviews are reallyimportant.
And I think that's what we donow, which I'm really happy and
proud of.
And I think that having Diversepeople at the table when it
comes to making match lists.
I think in ranking applicants isimportant and so we make sure
that we do that at ourinstitution for our residency

(33:45):
program The residents are reallyawesome because they do Dei
recruitment mixers, so they'llhave these zooms where they have
opportunities for medicalstudents to ask just the
residents themselves about theexperience that they have there
and then what kind ofopportunities are available in
the DEI space, which I think hasbeen a really great place for

(34:08):
our residents to shine and thenalso for us to kind of promote
our program to the medicalstudents in a, in a different
way.
So I think that's been a greatthing.
We also sent our residents to goto different conferences for the
year.
So our residents got to go tothe SMMA conference this year in
New Orleans.

(34:28):
So, and then we also try, youknow, are recruiting from our
medical schools that are HBCUs.
And so really trying to finddiverse applicants to, in, to
come to Milwaukee, I think is,is, is what you have to do to, I
mean, like finding thoseapplicants is what you have to
do, making sure you're in thosespaces and being able to talk

(34:48):
about Milwaukee and Wisconsin.
I think a lot of people don'tknow how diverse our city is.
I mean, a lot of times you justhear like, what?
Like, so even like when we haveOur interview days and we talk
about Milwaukee.
Everyone's like in shock aboutjust the diversity of it all.
So I think being able to go outin those spaces and promote
ourselves because we're a prettycool city.

(35:09):
And I think we definitely have alot to show.
And so I think going out thereand recruiting people is is
where What needs to happen to Ithink it's been really great
because really after the, ourresidents have started their DEI
committee since then, we've hadabout, for the most part, every
year since about 2020 now, abouta 20 percent of our class is

(35:33):
underrepresented in medicine,which is the 5%, but not, you
know, up to the 40 percent or 50percent that our city is at, but
still, I think it's, it's animprovement and I think Our
program is definitely doing alot of things to make sure that
we're, we're getting diversetalent and hopefully getting
them to stay.
And that's the thing, right?

(35:54):
Retention too.
And, and you, you touched on ita little bit but one, one thing
I wanted to get into, I knowpersonally kind of coming
through medicine you, you,again, being that outsider into
a majority homogenous, you knowdiscipline.
There are a lot of systemicbiases.
There's some discrimination thatcan happen.
Both kind of institutionally, aswell as, patient interactions,

(36:17):
things like that.
I won't share all my storieshere, but there's been some
stories.
Everybody who, everybody who'sunderrepresented in the garbage
can or two, you know, it's beena thing, right?
So what, what kind of safeguardsor, you know program, based
things are present of yourprogram that will check for
that, or we'll be there tosupport residents that are DUI.

(36:39):
Right.
And so that is so huge.
And I think that's what reallybuilds like the culture part in,
in getting people to stay.
I think one thing that the, oneof the residents and along the
faculty members have started issomething at our institution.
And is that a, are you A coupleother residency programs is we
have a microaggression tool andwhich is a reporting system.

(37:01):
So residents have theopportunity in any space that
they are training in to report amicroaggression.
And so that could be amicroaggression that is that
they have experienced themselvesor if they have a witness to
microaggression, they can reportthat to this tool.
And which is.

(37:21):
Great about this is that it isanonymous.
However, if you do want to kindof not be anonymous, you can
also just so that we can supportyou.
And with that, it really gives,I feel like it gives the
opportunity for residents to, tospeak up.
And as you know, residents are,it's a power dynamic, right?
Like they are training.
And so some of the people thatare committing the

(37:43):
microaggressions are attendings.
And so being able to speak upduring an, at an attending.
is a hard thing for a residentto do, especially when they know
they're going to be evaluated bythat person, especially when
they know that they might haveto work with this attending
again.
And they might be trainingsomewhere for three years.
So they definite, it gives themopportunity, to speak up, but

(38:05):
then also gives us theopportunity to go back to our
attendings or nurses or.
Whoever that may be that is,that have been the aggressor in
that situation to then educatethem.
And so we really try to make ita tool where we say like, a lot
of times microaggressions areunintentional and you not have
any mouse behind that saying,however, like it hurt the person

(38:27):
that has experienced it.
And so let's educate you andtell you why that is wrong.
So why was it wrong that youcalled a black woman?
Physician aggressive in thatmoment, like, well, it's not
that term, you know, so let'stalk about why that's why that
is hurtful to that person.
And so I feel like that is a waythat we're trying to impact

(38:49):
culture and really get people.
To stay and then get people tolearn, like, we're not here to
be punitive.
Like none of that goes to HR orgoes any goes anywhere like
that.
But it, it definitely givesopportunity for, for residents
to say something and not have tokind of deal with that all by
themselves and then gives us theopportunity to teach people at
the end of the day, like weknow, like.

(39:11):
We know we're going to commit amicroaggression.
I commit microaggressions too,right?
And like no one is abovelearning and doing better.
And so I think that's one waythat our program tries to
address the culture piece is themicroaggressions.
We also have.
One of our faculty members, youmet him at the, our DEI retreat

(39:31):
that you came to DeMarco Bowen.
So Dr.
Bowen also, he does amicroaggression upstander
training.
So it's for all of ourresidents.
And so all of our residents gothrough this training in which
if they, they witness amicroaggression that they then.
Stand up to that in that momentis really what we are
encouraging residents to do.

(39:52):
If, you know, they, they don'tfeel comfortable doing that
because of power dynamics orwhatnot, or just because of the
situation you know, wedefinitely tell them like, you
have the opportunity to comeback to that situation to
discuss it to stand up for theperson that is being
microaggressed is important.
And so we're training.
Residents on how to do that,too.
And so I think giving ourresidents the opportunity to

(40:17):
practice that and then to say,like, we want you to do that.
Like, we are, we are encouragingyou to do that in these
situations, I think isimportant, too, because I feel
like a lot of times they feelAnd a lot of us in medicine feel
like we have to assimilate and,you know, not say anything and
just kind of put our heads downand get through the day.
And, and so I think giving themthat, that tool to do it.

(40:40):
And then I think encourages themto, to change and stand up and
say something.
Exactly.
And I know, you know, we, we cankind of speak from personal
experience.
You know, there are people whowe went through medical school
with that didn't make it rightbecause they had an interaction
with an attending or professoror whatever.

(41:00):
And a lot of that has to dowith, you know, kind of that,
that perspective that, that howyou deal with disagreements in
one community may be differentthan how you deal with it in
another.
Right.
And so, you know, havingDiscipline having, you know,
organizations like this in placehaving barriers in place like
this that can allow a safe spaceto, you know, allow both sides

(41:22):
to kind of, you know, learn fromthe experience and, and, and
offer, you know, a place that isnot punitive.
Like you said, this is not goingto get anybody's job taken.
This can save another pocket ofpositions that we may have been
working with.
We may have called them ourcolleagues, right?
Like if everything had gone acertain way.
So yeah, those, those arevaluable and it's really good
that children's and that you arespearheading that too.

(41:44):
Yeah.
So I think that's, I thinkthat's a great way to impact
culture.
We also really try and supportour, our DEI space.
We do have like a budget forresidents to go to conferences.
We also have, we also encourageour residents.
for certain DEI leadershipprograms that are with certain
organizations.

(42:04):
So we do have a budget for that.
And so we've had every year, atleast two of our residents go
through the association forpediatric.
Program directors aims program.
And so really encouraging ourresidents to Get into that space
and See what and do some careerdevelopment in that I think is

(42:26):
is important to like to showthem like what kind of careers
are available For you, what canyou do with that?
Is Really great for ourresidents, and I'm glad that our
program is able to support ourresidents in that space.
I think one of the big thingsthat we're really trying to get
our residents to do, they have,they get a community pediatrics
rotation that they are able todo that, that everyone is

(42:47):
actually required to do.
It's, it's four weeks out in thecommunity, and they go to
various places.
They go to WIC, they go to, youknow, the schools, they go to
really a lot of communitycommunity organizations, they go
to the health department andthey experience what's out in
the community.
And I think we'll, we're reallytrying to do is trying to get

(43:08):
more kind of communityconnections and giving the.
Residents, more opportunities tobe out in the community.
It's something that we reallyare trying to work on this year
because they really love thatexperience.
And I think you know, caring forour community, they need to know
what community organizations areout there to, to really impact
our patient's health, like somany of our organizations here
are doing so much for our, forour patient's health.

(43:30):
So really having the opportunityto have those resources and to
be able to build thoseconnections, I think is, is key
to for our residents.
Absolutely.
And kind of on the other side ofthat coin with regards to the
organizations in the communityeducational institutions.
Are there any that you guys areworking with to kind of help
shut students into thehealthcare field or into

(43:52):
pediatrics?
I don't know if there's any inparticular.
I know.
I know our groups does thingswith and I know that during the
community pediatrics program,they do things with an extra
foundation.
They do stuff with a with ayounger school age kids.
They also do things with theMilwaukee Academy of Sciences.

(44:12):
And so I'm not quite sure onwhat other organizations that
The residents are working withcurrently but those are the two
kind of school age based kidsthat they get to work with
currently, which is great andthose are huge.
Like, especially I just did a anevent with black men, white
coats.

(44:32):
And one thing that we talkedabout.
Was, you know, you can't be whatyou can't see.
Right.
And so I know myself growing up,you know, I was very fortunate
to have both of my parents thatwere very much advocating for
education and how they can getyou out of circumstances, etc,
etc.
But I can, you know, onlyremember one African American
doctor.
That I saw, like, in theentirety of my childhood, right?

(44:54):
And so they could, my parentscould only advocate to a certain
extent, but they didn't know,you know, what it was like to
study for the MCAT.
They didn't know, you know, whyI was in a library for eight
hours, right?
Like, trying to put in, put inthis work, right?
So, but, you know, havingsomeone that you can see and
that you can model that you canask direct questions, you know,
what is AMCAS?
Like, what is, you know, what,what are these applications we

(45:15):
need to do?
What's the personal statement,right?
Like all those things areinvaluable and things that other
communities have already inplace, right?
There's pipelines for schoolsand for folks who have parents
that are physicians, et cetera,et cetera.
But to have that now with thoseprograms, even at that age is,
is paramount and kind ofchanging the numbers that we're
having right now.

(45:36):
Absolutely.
And it is so important.
You're right.
Like just that, that advice forour young people, I think,
especially now with, you know,the Supreme Court making a
ruling in regards to affirmativeaction and, you know, what, You
know, really trying to shine inthose places.
Like, and honestly, some GMEplaces now blind everything in
regards to diversity.

(45:57):
So there are some residencyprograms out there that because
of their institutions, policies,or, and they are blinding
applicants.
Diverse information anddemographics.
And so telling them ways of howto, you know, describe
themselves and their personalstatements and other ways to get
around really trying to show howdiverse people are is man, that

(46:21):
advice is so important for ouryoung people nowadays, because
they really are going to have tomaneuver a lot because of that
ruling.
Yeah, absolutely.
And, and what's going on statesthat too, right?
Like there's a huge polarizationin this movement away from it.
And as we said before, at thetop of the hour, you know, a lot
of it is even with thoseparameters in place to improve,

(46:41):
you know, matriculation andimprove DI opportunities, we're
still at five or 6%.
So you putting this in place,so, so that's too much for you?
Like what do we say Exactly,exactly, exactly.
Like that's just gonna beanother barrier for Right, for
our.
Students trying to get intocollege now and trying to get

(47:02):
into other graduate programs.
And so really having to bemindful of how to get through
that nowadays is, is.
It's something you people needlike really good advice on and
really how to make themselvesshine on their applications in
different ways to show howdiverse they are is going to be

(47:24):
something that we have to reallyadvise our advise our young ones
on what to do.
Yeah.
Speaking of kind of diversebackgrounds, one of the things
you mentioned was that there issupport for folks that may be
coming from internationalprograms, what additional kind
of additional challenges orbarriers do folks that are
coming from that internationalapplicant pool, what, what are

(47:46):
some of the things that they'refacing?
And what are some of the thingsthat you guys are doing to help
support them in those in thoseapplication cycles?
Right.
I think that I think that is aspace that really meet like
deserves more work, especiallyat our institution.
If you're an internationalmedical graduate, it is very, it

(48:08):
requires a lot of work just toget over here.
Honestly, I mean, the visaprocess is you.
Is very tricky trying tomaneuver a visa process and then
really what you need to justlive here after that, you know,
like making sure you're able toget your driver's license and
like things like that is verycomplex.

(48:30):
And I think that's a whole issuejust figuring out how to that
visa process and how to gethere, I think, is something
that, you know, our.
Medical school and our graduatemedical education does, but I
think once our internationalmedical graduates get here, I
mean, entering our culture isvery shocking.

(48:50):
And, and I think it's somethingthat our international medical
graduate students like.
struggle with so hard is, is nowyou're entering this country
with, and I, and in a lot ofpeople do not understand just
like the racism that isentrenched in every single thing
and every system and thoseinteractions, like they have a

(49:14):
very hard time understandingthat.
And I think that's the hard partfor our international medical
graduates is reallyunderstanding like how much
racism is really entrenchedinto.
Everything that happens in thiscountry.
Everything.
Period.
I think that's a hard one forthem to understand.
Because, you know, like I've hadstudents from, you know, Nigeria

(49:38):
and they're like, they're inshock.
Like, they're like, why do theycall everything, like, this is
the first black person that didthis?
And I'm like, they're like,Every black person in Nigeria
has done these things.
Like we've had black doctors andblack scientists and like, so
they're kind of in shock by likehow much race is involved in a

(49:58):
lot of what we do.
And so I think that's a piece ofit that is very hard for our
international medical graduatesto kind of deal with.
And I don't know if we have agood thing in place for, to
support them, honestly.
And I, And I've seen, you know,programs.
I mean, there was a program inNew York, maybe a couple of

(50:20):
years ago where they're enteringclass like for, you know, for
their, International medicalgraduates had died by suicide
just, and it was just like, whatare we doing to really support,
to support that?
I know there was a lovely, Iwent to a conference recently in
Chicago and there was a therewas a lovely mentorship program

(50:42):
and then they had like, youknow, weekly, not weekly,
monthly dinners and just likehaving that community, I think
is really important for, forpeople.
And so I think we need to domore of that though.
We definitely, especiallybecause now, especially in
pediatrics, we need to recruitmore from international medical
group graduates and DOs tosupport that.

(51:03):
I think we really need to do abetter job of figuring out ways
on how to support them when,when they come to this country.
It's a shot coming into thisculture and then having a
medical culture on top of that,right.
Like I remember when I first,when I first came to Milwaukee
from Chicago, I was fortunate tohave Brillant and Shake showed

(51:24):
me the ropes and everything.
So like that, just go fromChicago that I couldn't even
imagine what it was like, likefor international students to
come here and then be immersedin, you know, a lot of the
barriers that are in place rightnow.
From an historical standpoint,even here in the city,
Milwaukee, is one of the mostsegregated cities in America,
right?

(51:44):
Period.
Bar none.
And a lot of that has to do,with redlining over time with
the companies that were placedfor home ownership in Milwaukee.
And so these are things that aregenerationally generational
barriers for a lot of ourpatients.
And so, kind of like we talkedabout in the beginning.
They don't understand, you know,how to, how to, how to walk in
those shoes.
Why aren't you getting thatmedication?

(52:05):
Why aren't you doing thesethings?
Right.
But all of those things are inthe context of those historical
barriers that have been in placeand trying to help them navigate
that first off, and thennavigate in some cases, the
language barrier and someplaces, the socioeconomic
barrier.
You know, all those things arethings that institutions like
children's and institutions likeMCW you know, are trying to put

(52:26):
resources in place andmentorship in place to kind of
help with.
Yeah, and, and I do, I do, I doa noon conference with the
residents and we talk about allthat in Milwaukee, just like the
red lining and how that, youknow, Cause segregation here,
but just even like how thefreeway system was built here.
And like, like that is like nowreally concentrated poverty to

(52:47):
the central city and how peoplecan just drive around that and
not even recognize andunderstand the level of poverty
in Milwaukee in regards to bigcity is like the second after
Detroit.
So I think people don't evenrecognize that that five minutes
from your house, it is, is apretty impoverished community.

(53:07):
And That needs resources and howconcentrated that that is here
in our city with regards toleadership opportunities.
Let's say like if you go toChildren's and you have hope to
be like chief resident one dayor, you know, be in your
position right now.
What, what, What rules are putin place and what kind of

(53:29):
programs are put in place tomake sure that residents or
applicants are able to receiveequitable opportunities and
advancement at a place likeChildren's.
Right.
I think, and I really, I thinkthe residents have a great
opportunity to get beyond that,you know, that Dr.

(53:51):
Ford but I think, and I thinkwe're being more mindful of
that, honestly, now now, and Ithink we are really Making sure
that our residents haveopportunities and making sure
that we're saying that ourdiverse residents have
opportunities because weunderstand the inequities that
lie with even going to aconference, you know, like

(54:11):
making sure that we're able tosend our residents to a
conference, like the cost ofthat, like having to put that on
your credit card for a month,you know, like, that's that's a
lot of time.
Yeah.
So, like, making sure that wehave, like, we have those things
in place for our residents tomake sure that they're able to

(54:32):
present their research, go toconferences, go to career
development programs.
Like we have, That in place forour residents.
And then we also have likecommittees for our residents to
gain leadership into.
So we really want to make surethat our residents are our, our
leaders of their committees.
And so really we want to workwith them and then, but we

(54:54):
really want to say like, theseare your committees.
We want to support you in it,but we really want you guys to
take the lead and reallystrategize your priorities for
the year.
And And giving them thoseopportunities to say what they
need from our program.
And then from our committees, Ithink are, is really key.
And I think that's somethingthat our program does a great

(55:15):
job of is giving our residents avoice in those committees for
sure.
And so I think giving them thoseopportunities to do that is.
important and we really need tomake sure that we're giving
residents those opportunities.
It's hard as a resident becauselike, man, you're working like
70 hours a week.
You know I think those are soneeded.

(55:36):
And I really think, I mean, as aphysician, like you will always
be a leader and you really needto make sure we are getting
those leadership skills.
for our careers and I think Ireally think that like all of us
honestly like in as physiciansour leaders are really I really
try and think about leadershipand and igniting leaders and
just like igniting those skillsfor our leaders and for our

(55:59):
residents that are gonna one daybecome attendings.
Absolutely.
And are going to be the peoplethat are going to continue to
push, you know, to, to a moreequitable future for all of us.
Right.
That's, that's the goal.
That's my goal.
That's the goal.
And I mean, like, and I'minspired by them.
I think the, the future isbright for sure.
Like they the residents, I thinkare.

(56:20):
I think this generation has beenvery just outspoken about many,
many things.
And so I'm really encouragedabout just how they speak up
about our physician well being.
I think really great in, intheir advocacy for saying like,
Hey, like, It's not right towork on his hours like it's not
safe, you know, like it's notnormal.

(56:42):
It's not a normal relationship,right?
Our well being is important.
You know, I think they've reallyeven gotten into great, great
conversations aboutcompensation.
And really like advocating forcompensation.
Our, our last group ofresidents, like signed contracts
and they all shared their salarynumbers with each other.
So to make sure that they'relike, Hey, we're getting paid.

(57:03):
Like, and I think that'simportant.
I think that, you know, when wewere coming out of medical
school, it was like, Oh, don'tspeak about your salary.
No, nothing financial, nothingfinancial at all.
Right.
Which is totally asinine,especially like you consider we
come out essentially illiterateabout finances.
Like everything is medicine,medicine, medicine.

(57:23):
We don't know how to think thebill.
We don't know how to, you know,preauthorizations.
I didn't learn about that untilI came out.
Like, what are you talkingabout?
What are you calling me for?
Right.
So these are things that, youknow, like you said, your
residents are talking about now,and that puts them in a better
space and a better mindset toactually make a functional
change.
Right.
Right.
Exactly.
So I'm really, I'm reallyencouraged by them and I'm

(57:43):
really glad that I get to, like,continue to learn from, from
our, our next generation.
They, they definitely inspire metoo.
So I'm really glad that yeah,they're speaking up and they're
doing a lot of good stuff.
Absolutely.
Well, I'm gonna close it outhere.
So, you know, for anyone outthere who is interested in
pediatrics, wonderful for you.

(58:05):
What is any advice that you wantto leave anybody with?
Parting advice that you wouldhave for for anyone interested,
anyone in the city who hasinterest in medicine or doing
anything in a secondaryeducation?
Right.
Oh, my gosh.
Oh, great.
So man, I'm going to say like, Ilove being a community
pediatrician.
I think it's honestly the bestjob in the world.

(58:29):
I think being able to watch achild grow and having the
privilege to like be a part ofthat and be a part of it.
Like families and watching achild grow is like one of the
greatest shows on earth andpeople, you know, people that
are parents will definitely likedefinitely probably feel the
same way.
But I think having that thehonor to do that is something

(58:52):
that is so rewarding andsomething that I definitely like
if.
If you're in one do medicine, orI would definitely say like
pediatrics is where it's at.
Kids are so funny.
They're so hilarious.
They say that they're so greatto work with.
And so I think pediatrics isalso just so fun just brings me

(59:14):
so much joy and being able tosee kids bring me so much joy.
So if you want our career that'sjust going to be Just joyful to,
I think, pediatrics is, is agreat career.
In Milwaukee, I, man, like,there are just definitely a lot
of opportunities at the MedicalCollege of Wisconsin for, and I
would say, like, go on theirwebsite, look at all the

(59:35):
pipeline programs, apply forone.
And then I also just like withinour, I know a lot of the Mocky,
some of the Mocky public schoolsalso have pipeline programs at
it.
So if you are a student at oneof these schools, make sure that
you're attending them, make surethat you are listening at them

(59:56):
definitely do that.
I think there is also justopportunities for you to, you
know, go to.
The hospital volunteer at thehospital volunteer at a
community organization, like getout there in the community.
I think it is so important for,for you because you know,
medicine is, is great.
And a lot of what medicine isreally understanding like what's

(01:00:20):
happening.
For our patients outside of theclinic doors and understanding
that man, 80 percent of that iswhat is determining our patients
health.
And so really going out in thecommunity, I think, is something
that I would encourage people.
That want to go into medicine todo because you have to really

(01:00:40):
understand the community to, tomake it a medicine.
Absolutely.
And we need y'all man.
Come on out.
Yes, yes, we need you so bad.
We need you out here.
Man.
Me and Dr.
Ford need to retire guys, likewe need to be a wrap, bro.

(01:01:01):
We need to be out of your 80.
Well, I appreciate you comingout.
Dr.
NImmer is always we will makesure we post any resources that
you want to provide for anyone,any of those programs, things
like that.
So.

(01:01:21):
Again, thanks as always.
I'll see you soon.
I would imagine.
Yes.
Yeah.
Yeah.
Oh my gosh.
Thanks for having me.
Oh my gosh.
This has been such a great time.
I am still kind of upset thatyou didn't give me a budget for
this episode.
Cause I did, I did want my ownpodcast studio for this, but
It's you, bro, bro.

(01:01:52):
Have a good one.
So I want to thank Dr.
Nimmer today for coming out andjoining us here at Pulse Check.
As always, thank you, thank you,thank you so much, Dr.
Nimmer, for everything that youdo in the community, as well as
for being an invaluable friendAnd again, I'm so grateful for

(01:02:13):
everything that she and herfamily has been able to do,
throughout the city of Milwaukeeall the great things to come.
So looking forward to have you.
Dr.
Nimmer back on the show at somepoint in time to help us dig
into some of the issues that areaffecting us here in the city of
Milwaukee, as well as throughoutthe state of Wisconsin.
I want to thank\ you forlistening today.
Please join us for our nextepisode.

(01:02:35):
We're going to have more hardhitting healthcare topics that
affect you in your day to day.
We want to make sure that thisis interactive.
So feel free.
To reach out to us, feel free tosubscribe.
We got a new YouTube channelthat is up and live as we're now
moving more so towards our videoproduction as well.
Our video end of the podcast.

(01:02:57):
Feel free to reach out to us associal media, feel free to reach
out to us on the website.
I'm going to have someinformation up for you guys
about some of the informationthat Dr Nimmer spoke to today
regarding how to get involved insome of those programs or some
of the summer programs of you orany of your kids or anyone that
you know is interested.
Medical College of Wisconsin hasmany programs that are available

(01:03:19):
that get your foot in the doorfor anyone like myself.
If you didn't really have thatmuch healthcare experience
beforehand, before you decidedto go into medicine or go to
medical school, this is perfectfor you to get involved in.
And this is perfect for you to,again, put a name to a face and
get your foot in the door.
You never know where theseconnections will lead you,
especially if you have aninterest in going into

(01:03:40):
healthcare.
So again, I want to thankeverybody for listening.
As always, be sure to take careof yourselves, be sure to take
care of each other, and if youneed me, come and see me.