We tackle issues that matter to doctors

Ep. 42 The Tyranny of Metrics: A Historian Weighs In

Jerry Z. Muller

Bureaucratic appeal to measurement as a check on personal judgment rules the medical field but also permeates our entire culture.  Our guest is the author of a new book that comprehensively treats this unique phenomenon of modern life and brings a valuable historical perspective to the subject.

Jerry Z. Muller is Professor of History at Catholic University of America in Washington DC, where he served as Chairman of the department from 2009 to 2015.  Professor Muller’s focus is on Modern European Intellectual History and History of Capitalism.  His book, The Tyranny of Metrics, was published earlier this year by Princeton University Press. Read more

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Ep. 41 Healthcare Policy in the Crosshairs: The Hospital Readmissions Reduction Program

Ankur Gupta, MD

The Hospital Readmission Reduction Program is a recent policy designed to save the government money by imposing large financial penalties on hospitals whose readmission rates for certain medical conditions are found to be higher than the national average.  Could pushing policy levers on such a grand scale conceivably have negative unintended consequences?…

Our guest is Dr. Ankur Gupta, author of a 2017 JAMA article that examined mortality rates in heart failure in the aftermath of the HRRP development and implementation.  Dr. Gupta is an interventional cardiology fellow at University of Texas Southwestern Medical Center in Dallas.  He holds and MD from the All India Institute of Medical Sciences (New Delhi) and an interdisciplinary PhD in statistics and computational fluid dynamics from the University of Alabama.

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Ep. 40 Practicing Medicine in Canada: Promises and Realities

Shawn Whatley, MD

What’s the professional life of Canadian doctors really like?  Does the safety and stability of a single-payer system free them from business concerns and allow them to concentrate on patient care?  Or do the realities of central planning produce unexpected uncertainty and stress for patients and doctors alike?

To help us gain a realistic understanding of the Canadian system, we have as our guest Dr. Shawn Whatley who currently runs a primary care practice in Ontario, Canada.  Prior to this position, Dr. Whatley worked for many years as an emergency physician and he is the author of No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments.

Dr. Whatley is past-president of the Ontario Medical Association and he is a senior fellow at the MacDonald-Laurier Institute for Public Policy in Toronto.  He also publishes a highly trafficked blog where he shares insightful and humorous comments about healthcare in Ontario.  In other words, he is the perfect guest to inform us about the realities of healthcare in Canada.

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Ep. 39 Freedom of speech regained: How NIFLA v. Becerra could impact medical practice

Paul Sherman

A recent US Supreme Court decision has struck down the “professional speech doctrine” which was elaborated by lower courts to justify restricting or regulating the activities of anyone offering advice or counsel to another individual.  This decision may have far reaching implications across a number of human activities, including health care.

To help us understand this decision and what effects it might have, we have as our guest Mr. Paul Sherman, senior attorney at the Institute for Justice and an expert in constitutional cases protecting the First Amendment, economic liberty, property rights and other individual liberties.

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Ep. 38 Sally Pipes: The case against single-payer healthcare

Sally Pipes

Support for a single-payer healthcare system in the United States seems to be growing inexorably.  Before we resign ourselves to the inevitable fate of “Medicare-4-All,” it may be prudent to remind ourselves or understand better the arguments against a single-payer system

Our guest on this episode is Sally Pipes, president and CEO of the Pacific Research Institute, a San Francisco-based think tank dedicated to promoting free market principles across a variety of fields, including education, health care, and the environment.  Ms. Pipes is widely published on healthcare issues and a regular contributor to Forbes.com.

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Ep. 37 Hospital sham peer review: what doctors need to know

Lawrence R. Huntoon, MD, PhD

Peer review by colleagues is an important process by which doctors who misbehave or malpractice can be held accountable and, if necessary, prevented from harming patients.  Unfortunately, the process can also be used in bad faith, and many physicians are completely unaware of how career-destroying traps can be set up under the guise of peer review, compromising even the most caring and competent of doctors.

Our guest is Lawrence R. Huntoon, MD, PhD, a world expert on the topic of “sham” peer review.  Dr. Huntoon is editor-in-chief of the Journal of the Association of American Physicians and Surgeons and he leads the organization’s Committee to Combat Sham Peer Review.

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Ep. 36 Conversation with a clinical trialist

Ajay Kirtane, MD

The life of a clinical trialist involves juggling multiple demands.  Beyond the purely scientific questions are the clinical interests of the patient and the personal demands on the physician.

Our guest on this episode is Ajay Kirtane, MD, Associate Professor of Medicine at Columbia University Medical Center in New York.  In this conversation with Anish Koka, Dr. Kirtane shares his professional journey and his perspective on one of the most surprising and hopeful clinical trials in recent times, the COAPT trial of mitral valve repair in patients with congestive heart failure.

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Ep. 35 Why brain dead isn’t dead: An introduction to “Shewmon’s Challenge”

D. Alan Shewmon, MD

One of the most fundamental questions that a doctor may be asked to answer is the following:  Is this man or is that woman dead?  And one would think that any substantial controversy regarding the determination of death would feature prominently in the medical curriculum and in basic medical textbooks.  Instead, such discussions and debates have been relegated to narrow specialty medical and philosophical journals, and most practicing physicians are remarkably unaware about the state of knowledge on this question.

Our guest on this episode is D. Alan Shewmon, MD, Professor Emeritus of Pediatric Neurology at UCLA. His work, comprising decades of well-documented clinical observations and reflections, is now known as “Shewmon’s challenge,” a compelling rebuke to the principal arguments put forth to defend the concept of brain death.

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Ep. 34 Free-market solutions in a world of third-party payers

Vatsal Thakkar, MD

The arcane procedure patients must follow to file out-of-network claims is an important obstacle for a more widespread embrace of a third-party free medical practice.  Could that process be made less daunting?

Our guest is Vatsal G. Thakkar, MD, Clinical Assistant Professor of Psychiatry at the NYU School of Medicine, as well as op-ed contributor to Doximity and The New York Times.  He is the founder and CEO of Reimbursify, a startup in the out-of-network reimbursement space.

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Ep. 33 Moving mountains: The folly of population medicine

Michel Accad, MD

In a matter of a couple of decades, the concepts of population health and population medicine have taken center-stage in healthcare, displacing the traditional aim of medicine and distorting the doctor-patient relationship.

Our guest today is your co-host, Michel Accad, who highlights the errors of the population health theory as revealed in his recently published book Moving Mountains: A Socratic Challenge to the Theory and Practice of Population Medicine.

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