Kendalle Cobb, Medicine Woman

 

92-141. Kendalle Cobb

Fri, Jun 27, 2025 3:33PM • 34:05

SPEAKERS

Kendalle Cobb, Will Bachman,

 

Will Bachman  00:55

Hello and welcome to The 92 Report, conversations with members of the Harvard and Radcliffe, class of 1992 I’m your host. Will Bachman, you can go to 92 report.com that’s nine to report.com and sign up for the newsletter for the show, where you’ll get, oh, email from me each week, and I’ll send you the show notes so you know who’s been on the show. Case you don’t want to listen every week, but you want to keep track, sign up there today. I’m so thrilled to welcome Kendalle. Cobb, Kendalle, welcome to the show. Thank you will so Kendall, tell us about your journey since graduating from Harvard.

 

Kendalle Cobb  01:35

So I had a few months off after graduating in June of 92 I started at George Washington Medical School in August of 92 in DC, and was there for about four years, actually, exactly four years. And then I went to Southern California, where I did my family medicine residency at Kaiser Fontana, which is in the Inland Empire. Then I went to Boston for a year. I was at BU doing an academic family medicine fellowship, and went back to where I had done my residency. Was on faculty at the residency program there for about four years. During that time, I met my husband, who was teaching at a boarding school in Claremont, California called the web schools. He’s from a suburb of Cleveland, and so, after we got married, moved here, and so have been here for 21 years. And in July,

 

Will Bachman  02:38

ignorant question, which I’m an expert at. Family Medicine. What? How is that different from primary care or pediatrician? What is a family medicine?

 

Kendalle Cobb  02:50

So primary care encompasses internal medicine, pediatrics, med, peds and family medicine. And so Family Medicine, we’re trained to take care of both kids and adults. Huge focus on sort of the psychosocial aspect, so a lot of counseling. So some people say that we can take care of people from cradle to grave, so that that’s the biggest difference. The other difference is that family medicine is meant to be primary care. There are only a few fellowships, adolescent medicine, sports medicine, geriatrics, I think that that’s it, as opposed to like peds or internal medicine, where you can sub specialize in any number of things and tell

 

Will Bachman  03:36

us about your practice in Cleveland. Yeah.

 

Kendalle Cobb  03:39

So I see patients about 50% of the time. I see patients in one of the family health centers. So that is, those are all in the regions, and so I see patients in some place called Solon, which is about 30 minutes southeast of Cleveland. The rest of the time I work in the medical school. I’m a physician adviser. I’m also one of the associate Chiefs of Staff for the clinic.

 

Will Bachman  04:12

Tom and what Tell me about your about your teaching.

 

Kendalle Cobb  04:16

So Cleveland Clinic, Lerner college of medicine doesn’t have grades or test so they get narrative feedback, and then at the ends of yours, it’s a five year program because it’s meant to train people to be physician investigators. So research is woven throughout the five years, and so they write portfolios to defend competency at the end of year one, end of year two and end of year four, in nine different areas, so everything ranging from research and scholarship to personal and professional development to reflective practice, so they get feedback from peers and professors. And then they can choose evidence from those to include in their essay, which then into the promotions committee. So the role of the physician advisor is to attest to the fact that the student didn’t ignore any major themes, and what they wrote was representative of their journey. So I have 14 students currently. I’m getting two first years in just a couple of weeks.

 

Will Bachman  05:28

How is your approach to advising those physician students? How has it evolved? How is it different now than when you first started in that role?

 

Kendalle Cobb  05:39

Yeah, so in 2006 I think that I was more of a stickler a couple of things. One is that I used to make sure that all of my advisees had my cellphone number, and while I give it to them now, I tell them, like, if you have an emergency, call 911, and that I I’m very 20th century. I don’t have my phone with me all the time and I see your text, I’ll respond. I think that I see being an advisor similar to being a family physician. So one of the things that I like about family medicine is sort of accompanying people throughout the joys and challenges of life, and I actually the reason I was late was I was just meeting with a former student who’s just finished her fellowship in neurology and is leaving town to Go to Colorado, and so just reflecting on different challenges that she’s had, both as a medical student and also during residency. She was having some visa issues and so and now she’s a citizen, and so a good time to have that be in place,

 

Will Bachman  07:00

right? Do? And what have you learned about how people learn? Yeah,

 

Kendalle Cobb  07:11

so people, many people are very self sufficient and aren’t used to, excuse me, aren’t used to being in a collaborative environment. Aren’t used to asking for help, and sort of, one of the things that I found is that some people will over correct. So I have a student who people didn’t like the fact that she was giving them peer feedback. It was specific, it you know, it was measurable, but people didn’t really like getting corrected, and so she over corrected as far as like her interactions with her peers, because she wouldn’t give any feedback after that, which was not in keeping with what we expect and the school, I think that some people have to like not do well before they’ll listen. I um, and I think that some people, there’s a challenge with our curriculum, because people are used to like getting a grade, and so with our assessment forms, there’s a column for targeted areas for improvement. There’s a column for areas of strength, and people are looking not to have any targeted areas for improvement, but we always, everybody always has things that they can improve upon. And so helping people to realize that they are doing well, even when they have targeted areas for improvement. And also helping people to realize that if in October, their first year in medical school, they’re getting feedback that says, like you need to get better with time management when you’re seeing a patient, well, that’s developmentally appropriate and so helping to normalize expectations for our students.

 

Will Bachman  09:17

Now, I imagine when you were pre med or taking the pre med courses and applying to medical school, you had this idea of what it would be like to be a physician, and I would love to hear you tell us now what describe that, what that vision was like, you know, when you were in college, What you thought it would be like, and what now that you’ve been doing it, what? What is different than what you sort of anticipated? Yeah.

 

Kendalle Cobb  09:50

So I think that when I was in high school and I first thought about being a doctor, what appealed to me was this idea of like, being able to fix something like I had broken my. Goal. And so I had a surgeon who, like, put, you know, nails and screws in my ankle, and, you know, I was then able to go back and do ballet again. So this idea of, like, being able to fix something was really appealing to me. I think that one of the things that I appreciate now is that there’s very little I can fix, but I can accompany people along their path. I can, like, make some things better, but it’s much more of a partnership. As far as what does a patient want to focus on? There’s what you see in the textbook, and then there’s what’s practical for the person that’s in front of you. And so I think that those are some of the things that are, are different. Um, I grew up, uh, watching General Hospital, and so, like, I learned a lot of medicine like Kawasaki syndrome and what a frank breaches and stuff like that from General Hospital. And I think that obviously there’s less drama during the day, but I think that that sense of teamwork and is similar. I think that when I was both in high school, college and medical school, I didn’t really like group projects because and our medical school here depends a lot about on group work. Group work requires a lot of trust and like this sense that everybody’s going to do their part. And that hadn’t been my experience with group work, and I think that definitely medicine is a team sport. No individual can do everything, and so you’re really relying on the people that answer the phones, that send you messages, or that send you refill request to tee things up in such a way that you’re really using your expertise and interacting with patients.

 

Will Bachman  12:11

You mentioned earlier that the big part of family medicine is this counseling piece. Talk to us about kind of the training that you got in counseling and how your own approach to counseling has evolved over over time as you’ve gained more experience with

 

Kendalle Cobb  12:26

1. Yeah, so I my residency had of the three years that we were in residency, one whole year of every Tuesday afternoon, we would have a didactic and then we would have two patients, hour long patients, and there was a family physician and a psychiatrist that were available for us to discuss cases with between patients. And so that was a huge part of my training. But then, in addition to that, increasingly, over the course of the three years, then we had more and more and more clinic. Family Medicine is a little bit different than some, because we had our own panel of patients. And so first year, I might have one half day of clinic per week, and then and only, like six patients per half day, whereas by third year, I had four half days of clinic and I would have 12 patients for half day. So I got to practice a lot the things that I was learning in didactics, we also use something all the 15 there’s a book called The 15 minute hour that sort of gives you some techniques to do counseling in a short period of time. I think that some of the things I’ve learned over time is that, you know, some people, they just want to share what is going on with them. They aren’t necessarily looking to change anything. I had a recent encounter with a patient a few weeks ago where the patient her husband, they had talked for a while about getting a new car, and he had traded in her VW, and came home with a Tesla and she, like, has been in, like, the streets protesting, and then at Tesla dealerships, like, you know, protesting. And so she has a lot of feelings about the fact that, like, now she’s driving around a Tesla, and so we were talking about it. And so, you know, one of the solutions I had proposed was, okay, well, your husband has a different car, which she is uncomfortable driving, but, like, maybe the Tesla can be his car, and you can trade in his pickup truck for a car that that you want. And so, um, that you feel comfortable driving. And so in the course of that discussion, it came up that, like she was more uncomfortable having the conversation. Conversation with him about how she felt about the Tesla than driving the Tesla around. And so like that isn’t something that I would have necessarily realized, but having those conversations with people about options and also about even with it, when it’s something like with their physical health, sometimes when I get frustrated with a patient, I realize that our goals aren’t aligned. And so I’ll ask the question like, well, what are your goals for your health? Right? So their goal is, like, they don’t want to be on any medication. Then my proposing that, like, oh, you could be on this, that and the other to control your cholesterol, your blood pressure, whatever. That’s not going to resonate with them. And so knowing that helps me to like, sort of like, oh, okay, your decision makes complete sense to me. So those are are some of the things, like not having people feel like I have the answers or that they have to make the decision that I would make, but realizing that, like, okay, like the one with the Tesla, she’s making a choice that she’s going to drive Tesla, even though it doesn’t resonate with what’s important to her,

 

Will Bachman  16:14

I’d like to you, maybe give me some more examples like that. You know, statement of what are your goals for your health? Like? I’m curious, what are the real tactical phrases or questions that you’ve learned that you put into your kind of bag of tricks or arsenal that you know, just the actual verbatim kind of things that you say? Love to hear more of those.

 

Kendalle Cobb  16:39

Yeah, um, I mean, a big one is people tend to think so as, let’s say that somebody comes in and they’re a smoker, great. Like, the textbooks say that, like, you’re supposed to tell people, like, Oh, you shouldn’t smoke. It’s really bad, you know, like, all that, and, um, I just ask the question, are you ready to quit smoking? And then they’ll say yes or no. And then my follow up question is, well, when you’re ready, there are things that we can do to help you. And so a few years ago, like, maybe two years ago now, a woman that I’ve been taking care of probably for 10 years came in and she shared with me that, like, she was ready to quit smoking, right? But like, if I don’t, tend to have the conversation with people about, like, let’s say they come in with a cough, I’m like, Well, you know, if you didn’t sweat, like, I don’t do that. Or there’s something called the stub toe theory. I think it’s called where, like, somebody comes in and they’ve stubbed their toe, and they happen to have a high body mass index, and then, like, the doctor will tie that the fact that they stub their toe and with their weight. And so I don’t do that right, like, I think that a lot of people, whether it’s related to their gender identity or their disability or their weight, will have really unpleasant interactions with the healthcare system that cause them not to want to engage and so let’s say that somebody hasn’t been eating as healthily as they had been. Then I’ll ask the question, you know, like, what are some of the barriers to like your eating? Or there was a woman several years ago who came in, her blood pressure had always been well controlled, and it was high. And I asked, I was like, any thoughts about why your blood pressure might be high today, it turned out that her abusive ex husband was dying and her adult children were helping to care for him, and I was the first person that she had ever told that this had been an abusive relationship, right? So if I had had the approach of like, oh, you know your blood pressure is high, like, Let’s adjust for medications or whatever. That wouldn’t have been the right approach, right? So I think that remembering that people have very different life paths, and we don’t know like what somebody’s day is like. I gave a talk recently about social drivers of health, and I have a scenario of somebody who came in their blood pressure was high and the doctor adjusted the medication. They came back three months, three weeks later, it was still high, and they were late to the appointment, and then three days later, they were admitted to the hospital. So finding out sort of what are transportation issues, like, you know, like, how did you get here? Knowing that I have a bias that if somebody comes late to an appointment, I make. Certain assumptions that, like, they don’t care about their health. And it’s not just with medicine. Like I remember, I was in a training a few years ago, and this cardiac surgeon came in late to the training, and, like, my my assumption was like, Oh, she doesn’t really care about the training. Well, it turns out she was in the operating room, right? And so similarly, with patients, we don’t know the why behind what caused them to be late, and so I tend to avoid asking the question, why? I tend to ask, like, what factors contributed to you know, which is the same thing, but it tends to make people less defensive to say, like, what factors contributed to your decision, or any thoughts about what might be contributing to your blood pressure being high today.

 

Will Bachman  20:53

You mentioned, you know, you mentioned, you know, a patient being overweight. How do you approach that? Do you like, you know, and you probably, as a physician, would love them to lose weight, so do you ask them, well, I shouldn’t actually, what do you do with a patient who’s overweight? Sort of questions do you ask to get at maybe they don’t even want to lose weight. Maybe they’re okay with it, or

 

Kendalle Cobb  21:18

So, typically, they’ll bring it up, right? Like, because I know that people have had lots of different experiences, then I won’t necessarily else. I’ll say, as I’m going through the list of conditions, I’m like, Oh, and one of the conditions that we’re dealing with is your weight, right? Right. Like, I don’t tend to use the word obesity, even though that’s the formal diagnosis. And usually they’ll ask and a lot more now, because the GLP one agonists are advertised every place, then people come in asking, like, Oh, can I get the shot? Some people are very reluctant to use any medication. They feel like they can do it on their own, not realizing that Obesity is a disease. And so it’s not just a matter of, like, oh, eat less, exercise more. Like, it’s far more complex than that. And so one of the things that’s nice is there a lot of different options. If somebody does want to, like deal with it, but I let them raise it. Part of How I ask about it is when somebody comes in for a health maintenance exam or a physical, and the social questions, there’s a question about weight. And usually the way that I phrase it is, how do you feel about your body, right? And then sometimes people say, like, What do you mean by that? I’m like, however you interpret that, right? And so that usually will allow people to to sort of say whether it’s something that they want to talk about. We have lots of different resources, nutritionist, exercise physiologist, medications, so letting them know that they’re like lots of different things. And also, there was somebody recently who they were sort of interested in stopping smoking, but they also were going on a trip to, like, Italy, like, a couple of weeks later. And I was like, you know, it might be easier to quit smoking after you get back from Italy, because, like, at least when my daughter was there a year ago. Like, there, like, smoking is a large part of, um, some of the places where you are, and so, like, I just think that, like, maybe we should wait until you get back. And I felt sort of strange about like, She’s saying she’s ready. I’m like, telling her, like, maybe wait a few weeks. Um, but I’ve taken care of her for a long time, so I feel like I, even though I feel on the fence about I feel like it was the right recommendation, yeah, yeah.

 

Will Bachman  24:16

And you kind of follow that up with for like, well, what have you, you know, if someone says, Well, I’m, you know, not happy with my weight, would you kind of get into, what have you done so far about it? Or, like, what have you tried?

 

Kendalle Cobb  24:30

I’ll do some of that. I mean, the the thing with family medicine is that, like, 20 or 40 minutes for a visit to, like, deal with everything. So, um, it’s not common for me to, like, sort of manage that. Like, my question will be like, do you want help with it? And so then here are the options, do you want it to see, endocrine weight management, and then I’ll tell them a little bit about the offerings there. Um. Um, I don’t tend to do, like, a whole weight history. Um, just because I don’t tend to prescribe the medications. There are other medications, like phentermine, um, that I sometimes prescribe, but they’re like so many different medications, um, that I tend to get them into a sub specialist.

 

Will Bachman  25:22

Yeah, yeah. Tell us about one or two sanitized, of course, examples of patients that you’ve, you know, had under your care, where you feel that, like you’re very, particularly proud of it, where it stands out in your mind, where you feel you really made a difference to those patients. I’m sure there’s been many, many, but like, what are one or two that stand out for you? Um,

 

Kendalle Cobb  25:48

so I think I, I’m gonna take go back to when I was in California. So typically, it’s not uncommon for me to take care of many generations of one family. Oh, and, so in this particular case, one of the adult daughters, like, she’s probably, like 30, was pregnant, and I took care of, like, her parents also. And so, like, you know, it’s her business. I didn’t tell but then, you know, when the time came that they did know that she was pregnant, I felt like I knew that they knew at a later date. And one of the things that the mother said to me was, you know, this is sort of, there are two places where, like, what you say is confidential, one is like at church, and the others in the doctor’s office. And so this understanding of, even though I take care of many of the people like this, relationship is sacred. So that comes to mind, and then another that comes to mind is there’s a family that’s currently in my care where their four daughters, adult daughters, mother, stepfather, and then I was taking care of, like, two of the brothers in law. And so anyway, there was, like, some some health problems, and two of the daughters have died in the last few years, but the widower of one of them asked to be my patient. And then he has, like, since, like, asked if I would be his sister’s doctor. And so like that, it’s very hard when a patient dies that you’ve known for a long time. And so this idea that this family, like I just saw like a different widower’s like new girlfriend is like a patient. So this like fact that they entrust me with, like, their loved ones is really special. And then I think, just like the the grace that some patients show, there was a patient a few years ago who had a lymphoma and and, like, I didn’t realize she had a lymphoma, and then she had a chest X ray and it showed up, and I was like, you know, sorry, I didn’t catch that. And she, she was very kind. And I remember when I was in residency, like, somebody would come in and they’d have symptoms for a long time, and we make the diagnosis of leukemia or whatever, and the family were so grateful that they had an answer for what was going on. So I think that that probably that the trust and gratitude and grace that patients show are the things that stick with me.

 

Will Bachman  29:02

Talk to us a little bit about outside of being a doctor, what else do you have going on in your life? Yeah, big hobbies or family, stuff that you want to share and talk yeah.

 

Kendalle Cobb  29:12

So we have a 17 year old daughter actually just got back a couple of days ago from doing a whirlwind college trip, we did eight campuses in five days in the middle of the heat wave. So that was exciting. So enjoy time, spending time with her. I do yoga. I still watch General Hospital. We tend to watch a lot of documentaries. And reading non fiction. I’m reading Jeremy runners memoir, and then I also have book called let them which is next to be read. I tend to read more non fiction than fiction. I. Uh, yeah, those are some of the things I’m involved with my church. Um, yeah. So

 

Will Bachman  30:08

when you say involved in your church in what way or beyond attending or helping, yeah?

 

Kendalle Cobb  30:13

So, um, last year I was the worship department chair. I’ve been President of Council. This year I’m like head of the nominating committee, so finding people to serve in lay leadership positions. Yeah, which is interesting because my second cousin recently moved to town, so I didn’t know him, because he’s probably about 20 years younger than I am, but his father and my father regularly get together to go golfing, and so my cousin would sort of tag along with them to their timeshare So, and unbeknownst to me, until the last year or so, when he was looking at colleges then my father was like regularly calling him trying to go to Harvard, He didn’t end up going. He didn’t end up going he ended up going someplace else. But so his grandmother my grandfather were siblings, and so he is the senior minister at a different church than my church. And so not infrequently, I’ve been going over to his church because he’s just really skilled preacher. And so people at my church are asking, like, Well, are you going to leave? And so, like, not at this time. So yeah,

 

Will Bachman  31:30

talk to us about any courses or professors that you had at Harvard that continue to resonate with you in some way that you still think about.

 

Kendalle Cobb  31:38

Yeah, Michael McCormick was one. He was a history professor. He came probably sophomore year, but a lot of my smaller classes were with him, and I just learned a lot about analyzing primary sources and developed a lot of confidence in, sort of my analysis skills. Um, so he’s, he’s one that comes to mind. He’s probably the, the biggest one like,

 

Will Bachman  32:14

but what topic? What topic areas?

 

Kendalle Cobb  32:17

Yeah, so medieval and early modern European history, yeah. And then he a few years later, he told me that he was teaching some history of science courses. And so he thought of me because, you know, I was even though, as a history major, I used my lactose from pre med requirements,

 

Will Bachman  32:39

so any activities you were involved in at Harvard that continued.

 

Kendalle Cobb  32:44

I was, I don’t remember what my original role was. I wasn’t a teacher in city stuff, but I was somebody that was responsible for, like fundraising, and so I remember that we had organized a formal that I want to say was in mem Hall, so it was like there’s a big at least at that time. I know that it’s been changed since then. But anyway, so we had a movie set, kind of setting with red velvet drapes, and then we had that’s dancing playing on a screen throughout the formal so I remember that. I remember one of our classmates helping me to seal and address the invitations for the city set ball late into the night, one night. So yeah, like, city stuff is probably the big thing

 

Will Bachman  33:47

for listeners who want to find you online. Where would you point them?

 

Kendalle Cobb  33:52

LinkedIn is probably the easiest way to find me.

 

Will Bachman  33:57

Amazing. Kendall, thank you so much for joining today.

 

Kendalle Cobb  34:01

Thank you Will you?