Explore the Space: Dr. Mark Shapiro on expanding the healthcare conversation through podcasting

Ultramarathons, generation gaps, managing change and Navy SEAL-style tactics for being a better leader — not topics one might expect to delve into everyday as a physician or healthcare professional. However, these and other varied subject are typical conversation starters on Explore the Space, a podcast dedicated to navigating important issues in healthcare and examining how they relate to other challenges, rewards and curiosities in life, hosted by Mark Shapiro, MD, a San Diego-based internist.

"I thought I might be interested in medicine because my father and grandfather were doctors and they'd always spoken highly of the profession," Dr. Shapiro says. "They'd enjoyed their work, they derived tremendous personal and professional satisfaction from it so it seemed like an interesting path." 

However, prior to attending medical school, Dr. Shapiro explored other interests, including earning a history degree and working as a sports writer. He credits this time he took to look into different career paths and passions with helping him become a more well-rounded person. That diverse experience also seems to have informed his current ventures, such as being part of a company that helped design curricula to help hospitalists be better leaders and communicators, which is where he first became involved with podcasting.

"After that I just thought, you know what, I want my own podcast," Dr. Shapiro says. "I love them, they're fun, I listen to them all the time and it doesn't seem like it's all that hard to set up. There are things I want to talk about, there are things I want to learn about, people I want to speak with, so let's go for it."

Dr. Shapiro spoke with Becker's Hospital Review about how his podcast has enabled him to make unexpected connections, change listener perceptions of clinicians and explore new ideas in healthcare.

Editor's note: Interview has been lightly edited for length and clarity.

Question: What does the name Explore the Space mean to you?

Dr. Mark Shapiro: The first piece of it was that I did feel there was a space between clinicians and everyone else. Maybe there's a little bit of confusion about what we're all trying to do, what is the shared purpose of the people providing healthcare and the people accessing healthcare. I thought it would be fun to leverage how much people enjoy podcasts and talk radio to see if that can help smooth out some of those rough edges, maybe bridge some of those gaps, maybe bring those two spheres a little bit closer together and look at what's in there and see if we can just talk about it.

The other part of it is a bit of a nod to pop culture. There's a famous Saturday Night Live sketch with Will Ferrell and Christopher Walken called "Behind the Band." If you scroll all the way to the very bottom of my webpage there's a GIF file of Christopher Walken from that sketch saying "Fellas, explore the space!" We have to recognize where we come from — that skit is hysterical and lots of people know it, and I try to remember this is also supposed to be fun and an adventure to be enjoyed. It's a reflection that this is a fun way to learn and a reminder that there's a sense of humor here, it's relaxed.

Q: You cover a variety of topics on Explore the Space, some of which don't immediately come to mind when thinking about healthcare. Has the show been a vehicle to broaden the conversation? 

MS: It has, in that it's allowed me to comfortably reach out to people who, if I was to just reach out to somebody and say I'd like to talk to you about something, I don't know that I'd kind of get that access. I spoke with the president of American Board of Internal Medicine, I spoke with a retired Navy Seal officer, I spoke with the director of Women of Impact, one of the largest women-led cultural organizations in the country, which focused on realigning the healthcare system to meet the needs of every American. I think if I'd emailed them out of the blue and said, "I've been reading about the work that you're doing and it's very fascinating and I'd like to learn about it," — I don't know they'd necessarily take that call.

But when I can position it as something like "I have a podcast, a medium where we can have a conversation that's scalable for you and your organization and your goals with your project or book, where we can have a really interesting conversation and learn from each other to exchange ideas in a free medium that's easy to download that anyone can access" — I think that makes it much more attractive, and I'm able to leverage it as a tool. I've been really struck by how enthusiastic people have been when I've asked them to come on the podcast. People want to talk and share and distribute ideas. I don't ask anything from them, and I don't get anything for it except the opportunity to have a really stimulating, engaging conversation.

It's worth it because it's an exchange of ideas on a level playing field, and it's positioned where I'm not just accessing physicians or targeting a physician audience — I'm targeting an audience of anybody that has interest in a subject that applies to everyone. Everyone has some level of interest in healthcare and what's going on in it because at some point we're going to be a patient or someone in our family will be a patient. Getting that kind of response is motivating and makes me want to keep trying for new, different guests.

Q: You do have quite a few guests on the show that don't come from clinical backgrounds. Has it been your experience that people outside of healthcare can impact healthcare?

MS: No question about it. It's been a fun opportunity for me to leverage insights and opinions across the spectrum. For example, I found out about Regina Holliday, an artist and patient rights arts advocate who founded the Walking Gallery, from a USA Today article. We connected through social media and she came on my podcast. The work she is doing is unprecedented with respect to patient engagement and the patient voice. It was just tremendous to speak to her. She's had a tremendous impact already, and it's only going to grow because people gravitate to things like this. She's not clinical, she tells her story on the episode and is very forward about not coming from a medical background, but explains how she came to have an interest in patient safety and became a nationally recognized advocate for people in the midst of dealing with their own healthcare issues. For me, it was a thrill to talk to someone like that and have that conversation and recognize that the work she is doing is so scalable and so important.

I'm new at this but I've tried to be conscious of having a nice mixture of doctors, people in leadership, people of varying ages, men and women, journalists and students to mix it up and keep people guessing about what they might hear. It won't just be another doctor coming on to talk about heart failure — my latest episode was an interview with a general surgeon who is an ultra-triathlete talking about overcoming limitations and maintaining a balanced life. I enjoy that dynamism and unpredictability.

Q: Do you think the show gives patients an opportunity to see clinicians in a different light?

The sense that I've gotten is that the majority of my audience are non-clinical people. They're not doctors or nurses or even in health or the sciences. They've gravitated toward the podcast because someone recommended it or they did an iTunes search for a specific topic. But I think it does help give a little bit of perspective that the people who are engaged in healthcare do have a good sense of the world around them, they're human, they're fallible, they're engaged, they're interested and they do interesting things.

I do think that people enjoy hearing from doctors in a way they may not be used to and just talking about something they're doing that they enjoy. One of my earlier episodes was an interview with an emergency physician who went to Sierra Leone to work with Ebola patients, and to hear that sort of a story really personalizes and helps make real a crisis that everyone's following in the news.

Going back to that disconnect between healthcare providers and regular people, just in the sense of what's in the popular media, I think that that's an easy trope to hammer — that physicians and hospital systems and pharmaceutical companies have this agenda and the patient or the family has another, and that may not be true. It's fun to be able to say we do actually have similar agendas, we have similar ideas, we are trying to all learn together, to teach each other and always improve.

Q: What has it been like to grow your audience so far? What are your future plans for Explore the Space? 

MS: Right now the growth of it is very organic. I don't do a lot of promotion. For a podcast, the numbers are small, but I look at the amount of downloads, and the states and countries around the world where people are listening, and I can't believe it. It's thrilling and motivating. I'm curious to see where the show will go, and feedback from listeners helps me with that.

I don't get money for this and I'm not seeking notoriety, but as a doctor I take a lot of pride in what I do and I love being a part of the healthcare continuum for people when they're sick. I love talking about things that are important for people when they're well, to help them stay well because it applies to me and my family and friends, too. That's part of the joy of being a professional in something you derive satisfaction from. It's been so interesting and so much fun doing the show, and I've had conversations with people I never would've dreamed of speaking to, so I'm going to let it go and see what it wants to do.

In the same spirit, I don't script my interviews. I go in with a general sense of what I want to talk about, but the conversation goes where it wants to go. If someone says something interesting, it doesn't matter what I have written on a piece of paper — we need to talk about and explore what they just said. The best interviews are the ones where the person asking the questions is there to learn and to dive into what the guest has to offer. I tell people why I want to have them on the show, but warn them that the conversation is going to tell us what it wants to do, and I'll facilitate it and put my own opinions out there. We can debate and discuss, but it's not going to be scripted. That has definitely served me well and I think it serves the show well because it has allowed for some really exciting, spontaneous, challenging conversations. 

Listen to Explore the Space here.

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