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Ep. 100 Can We Trust Generic Drugs? The Ranbaxy Whistleblower Narrates the Pharma Scandal of the Century

Dinesh Thakur

Generic drugs represent 90% of the pharmaceutical market. Their use has been encouraged through decades of favorable legislation and subsidies, with authorities claiming they are as safe and effective as brand name drugs. Yet generic preparations tainted with impurities are being reported with increasing frequency. What should doctors and the public know about generic drug manufacture? Our guest is the chemist who was at the center of the most important scandal to rock the global pharmaceutical industry in decades.

GUEST:

Dinesh Thakur Twitter and Website

LINKS:

Bottles of Lies by Katherine Eban

RELATED EPISODES:

Ep. 15 Lethal Regulation: The 1962 FDA Amendments (with guest Mary Ruwart)

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Ep. 99 Health Policy Should Focus on Choice

David Balat

A health policy of choice—not of constraints—is what we need, says our guest David Balat. He is currently the Director of the Right on Healthcare initiative with Texas Public Policy Foundation. He has a broad base of experience throughout the healthcare spectrum with special expertise in healthcare finance. He is a former Congressional candidate in Texas’ 2nd Congressional District and a seasoned hospital executive with more than 20 years of healthcare industry leadership and executive management experience.

David is focused on education and advocacy in an effort to simplify coverage that is too expensive, complicated, and untrustworthy. He is an ardent advocate of Physicians and believes the restoration of the Physician/Patient relationship is critical to fixing our dysfunctional system. He often volunteers of his time to help families navigate their bills and how to understand their benefits.

GUEST:

David Balat: Twitter and Webpage at the Texas Public Policy Foundation

LINKS:

Uninsured by Choice or by Circumstances?” (from The Hill, September 2019)

Free to Care Coalition

RELATED EPISODE:

Ep. 64 Cost Sharing: Paying for Health Care in an Ethical and Sustainable Way (with guest Dale Bellis)

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Make a small donation on our Patreon page and join our discussion group or receive a free book.

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Ep. 98 Psychiatry v. Antipsychiatry

George Dawson, MD, DFAPA

As a medical discipline, psychiatry has often been the target of severe criticism, particularly in the last 50 to 60 years. Is the criticism valid or not? What is the outlook for the science of mental illness and the practice of psychiatry? Our guest today defends his chosen medical specialty.

George Dawson, MD, DFAPA, is a Staff Psychiatrist at the Hazelden Betty Ford Foundation and an Adjunct Professor at the Hazelden Betty Ford Graduate School of Addiction Studies. His clinical interests have been in acute care, geriatric psychiatry, neuropsychiatry, and addiction psychiatry. He currently practices addiction psychiatry, providing psychiatric consultation on patient care to the professional staff, and lectures on the neurobiology, epidemiology, and the clinical aspects of addiction psychiatry.

Dr. Dawson completed his training in psychiatry at the University of Wisconsin where he was a research fellow. Scholarly interests include biological psychiatry, consciousness studies, and the medical, philosophical, and political aspects of psychiatry. In his spare time, he writes a blog about some of these topics called Real Psychiatry.

GUEST:

George Dawson, MD, DFAPA: Twitter and website “Real Psychiatry”

LINKS:

Selected blog posts by Dr. Dawson:

RELATED EPISODE:

Ep. 71 Psychiatry: Past, Present, and Future (with guest Paul McHugh, MD)

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Ep. 97 Evidence-Based Economics: What the Doctor Ordered?

Peter G. Klein, PhD

Will the randomized control trial bring more clarity and certainty to economic science? Is “evidence-based economics” something to be hailed as a welcome innovation or should it be appraised with a more sober attitude? To examine this topic and discuss the relative place of randomized trials in economics and medicine we have as our guest Peter G. Klein, W. W. Caruth Chair and Professor of Entrepreneurship at Baylor University’s Hankamer School of Business. Professor Klein is also the Carl Menger Research Fellow at the Ludwig von Mises Institute. He obtained his PhD in Economics from the University of California Berkeley, and his BA from the University of North Carolina Chapel Hill.

His field of interest is in the area of the economics of entrepreneurship and business organization. He taught previously at the University of California, Berkeley, the University of Georgia, the Copenhagen Business School, and the University of Missouri, and served as a Senior Economist with the Council of Economic Advisers. He is the author of 5 books and numerous peer-reviewed articles.

GUEST:

Peter G. Klein: Twitter and academic web page

LINKS:

Klein, P. “New Nobel Winners Are Latest Bad Science for Economic Theory” (Article on the Ludwig von Mises Institute website).

RELATED EPISODE:

Ep. 30 Beyond EBM: Case-Based Reasoning and the Integration of Clinical Knowledge (with guest Mark Tonelli, MD)

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Ep. 96 Surprise Billing: What the Policy Wonks Don’t Get

Amy Mecozzi Cho, MD

Do hospital-based physicians benefit from being out-of-network? Are policy wonks who attack “surprise billing” fully aware of the relevant factors? In this second episode on this topic, Dr. Koka leads a conversation with our guest, Dr. Amy Cho, an emergency physician from Minnesota.

Dr. Cho graduated from the University of Michigan with a joint MD/MBA and completed her residency in Emergency Medicine at Advocate Christ Medical Center in Chicago. Prior to medical school, she worked as a management consultant with Bain & Co. and as a product manager with Convio, a venture-funded software company.

GUEST:

Amy Mecozzi Cho, MD: Twitter

LINKS:

High Yield Script (website)

RELATED EPISODE:

Ep. 94. The Trojan Horse of Surprise Billing Legislation (with guest Daniel E. Choi, MD)

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Ep. 95 Polygenic Risk Scoring: An Epidemiologist’s Perspective

A. Cecile Janssens, PhD

Has cardiovascular genetics come of age? Are “polygenic risk scores” ready to inform us in clinically meaningful ways? In the final analysis, who or what are epidemiological data informing? Our guest is A. Cecile Janssens, PhD, Professor of Translational Epidemiology at the Rollins school of Public Health at Emory university in Atlanta, GA.

Professor Janssens’ research concerns the translation of genomics research to applications in clinical and public health practice and focuses on the genetic prediction of common diseases such as diabetes, cardiovascular disease and cancer. She also studies how the predictive ability and utility of genetic testing can best be measured.

GUEST:

A. Cecile Janssens, PhD:  Twitter and website

LINKS:

The following graphs referred to on the podcast are taken from the paper by Torkamani, Wineinger, and Topol: The personal and clinical utility of polygenic risk scores.

 

 

 

 

 

 

 

 

 

 

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Ep. 94 The Trojan Horse of Surprise Billing Legislation

Daniel E. Choi, MD

Are out-of-network physicians deliberately trying to price-gouge patients in need of emergency care? Will “surprise billing legislation” solve the problems of narrow networks in a socially responsible manner? In this episode, Dr. Koka leads a conversation with our guest, Dr. Daniel E. Choi, on the topic of surprise billing legislation.

Dr. Choi obtained his MD degree from Northwestern University Feinberg School of Medicine in Chicago, completed his residency training at Rutgers State Univeristy of New Jersey, and completed a combined neurosurgical and orthopedic fellowship in spine surgery at Harvard Medical School.

GUEST:

Daniel E. Choi MD: Twitter

LINKS:

Fix Surprise Billing (website)

Cho AM: Congress Is About to Give Health Insurance Companies the Nuclear Weapon. Available at: https://www.highyieldscript.com/take-action-against-the-benchmark-solution/. Accessed October 9, 2019.

Corlette S, Hoppe O: New York’s 2014 Law to Protect Consumers from Surprise Out-of-Network Bills Mostly Working as Intended: Results of a Case Study. Available at: https://georgetown.app.box.com/s/6onkj1jaiy3f1618iy7j0gpzdoew2zu9. Accessed October 9, 2019.

New York State: Governor Cuomo Announces Success of New York’s Landmark Out-of-Network Law Protecting Consumers from Surprise Medical Bills. Available at: https://www.governor.ny.gov/news/governor-cuomo-announces-success-new-yorks-landmark-out-network-law-protecting-consumers. Accessed October 9, 2019.

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Ep. 93 Neurosurgery, Health Policy, and the Free Market: A Conversation with Richard Menger

Richard Menger, MD

Can a graduate of the Harvard Kennedy School hold on to free market principles? Evidently so! We talk health policy and economics with our guest Richard Menger, MD, MPA, a neurosurgeon serving as Chief of Complex Spine Surgery at the University of South Alabama.

Dr. Menger completed medical school with honors at Georgetown University School of Medicine where he was elected to the Alpha Omega Alpha Honor Society and received the Barbara Bregman PhD Award. He then trained at Louisiana State University Shreveport and at Columbia University for a fellowship in scoliosis treatment. At the Harvard Kennedy School of Government he completed a Master in Public Administration and was awarded the Hale Champion Public Service Fellowship.

Dr. Menger has authored numerous scientific papers in academic journals and is the lead editor of the textbook The Business, Policy, and Economics of Neurosurgery. His op-ed/policy work has been published in the Wall Street Journal, Forbes, Navy Times, the Hill and others. He has a joint appointment as Assistant Professor of Political Science at the University of South Alabama.

GUEST:

Richard Menger MD, MPA:  LinkedIn

LINKS:

Articles by Richard Menger:

Milton Friedman at the Mayo Clinic: YouTube video

Michel Accad. “The Mayo Clinic and the Free Market” (Mises Institute website)

RELATED EPISODES:

Ep. 10 Free Market Medicine: Ethical, Workable, Unstoppable  (with guest G. Keith Smith, MD)

Ep. 22 Free Markets in Healthcare: Objecting to the Objections (with guest Roman Zamishka)

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Ep. 92 Why Is the Antibiotics Market Broken?

David Shlaes, MD, PhD

Big Pharma is abandoning its R&D efforts for antibiotics. What are the regulatory, scientific, and economic factors responsible for this potentially dangerous trend?

Our guest on this episode is Dr. David Shlaes. Dr. Shlaes is an infectious diseases specialist who trained was formerly professor of medicine at Case Western medical school in Cleveland, Ohio. He left academia in 1996 to become Vice President for infectious diseases at Wyeth Pharmaceuticals. He has been very prominent in the field of antibiotics research and development. In 1998 he was on the cover of Business Week in recognition of his contributions. In 2005 he established a consulting company and has been active in advising companies and policy makers. He has since retired but remains involved in the field. as an editor for the journal Antimicrobial Agents and Chemotherapy and as a blogger on his site called Antibiotics, The Perfect Storm, which is the title of a book that he wrote a few years ago.

GUEST:

David Shlaes, MD, PhD Website

RELATED EPISODE:

Ep. 15 Lethal Regulations: The 1962 FDA Amendments (with guest Mary Ruwart, PhD)

SUPPORT THE SHOW:

Make a small donation on our Patreon page and join our discussion group or receive a free book.

Ep. 91 On Abortion

Niran Al-Agba, MD

This past May, the governor of Alabama signed into law a piece of legislation that imposes great restrictions on abortion. Niran Al Agba recently wrote an op ed about that law and she returns to the show to discuss that op ed and, more generally, to share with us her position on abortion. We are very grateful for her willingness and ability to carry this conversation with utmost civility.

Dr. Al-Agba is a board-certified pediatrician who is also a prolific writer. She speaks widely and openly on a variety of issues, including policy, ethics, and medical practice. She is a regular contributor to the Kitsap Sun, to The Deductible blog, and to a variety of other outlets, including her own blog, MommyDoc. She is a mother of four children who’s been voted best doctor in Kitsap County on multiple occasions. She also serves on the clinical staff and admissions committee at the University of Washington School of Medicine.

GUEST:

Niran Al-Agba, MD Twitter

LINKS:

Niran Al-Agba. “Alabama’s Law Is Not Pro-Life. Here’s Why.” (Kitsap Sun)

Niran Al-Agba’s columns for Kitsap Sun

Niran Al-Agba’s personal blog

Niran Al-Agba’s page on The Deductible

UCSF Bixby Center for Global Reproductive Health: Abortion page

RELATED EPISODE:

Ep. 74 Can We Have a Reasonable Discussion About Vaccines? (with guest Niran Al-Agba)

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Make a small donation on our Patreon page and join our discussion group or receive a free book.