We tackle issues that matter to doctors

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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Ep. 32 Sexual harassment and bias in medicine: Will metrics help?

Jane van Dis, MD

In the wake of the #MeToo movement, a sweeping report was recently published by the National Academies of Science, Engineering, and Medicine detailing 30 years of research on the sexual harassment of women in academia.  In addition, reports of discrimination and evidence of a pervasive “pay gap” between men and women are also coming to the surface.

Our guest is Jane van Dis, MD, an obstetrician-gynecologist who recently co-authored a perspective in the New England Journal of Medicine on the occasion of the NASEM report.  Dr. van Dis sheds light on the report and highlights what future steps must be taken.  She is the co-founder of Equity Quotient, a data-analytics firm that provides workplace assessments of gender culture to help organizations create equitable work environments.

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Ep. 31 Is moral injury the cause of physician burnout?

Wendy Dean, MD

Physician burnout has attained epidemic proportions.  It is highest among all professions and new research indicates that doctors commit suicide at a rate that is twice that of the general population, leading to a loss of approximately one physician per day.  And it’s not only doctors who are at risk.  Patients too may suffer the consequences, as medical errors have now been linked to the issue of physician depression and burnout.

The true causes of this epidemic remain hotly contested but our two distinguished guests have recently published a highly provocative essay whose thesis has resonated with many doctors.

Simon Talbot, MD

Wendy Dean is a psychiatrist who is senior vice-president of program operations at the Henry M. Jackson Foundation for the Advancement of Military Medicine.  Simon Talbot is an Associate Professor of Surgery at Harvard Medical School in the Brigham Hospital’s division of plastic surgery.

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Ep. 30 Beyond EBM: Case-based reasoning and the integration of clinical knowledge

Mark Tonelli, MD

Can anyone question evidence-based medicine and not be considered some kind of fringe lunatic?  Fortunately it’s possible, as will be demonstrated by our guest, Mark Tonelli, professor of medicine from the University of Washington, and one of the earliest, most thoughtful, and most articulate academic critic of the EBM dogma.

Dr. Tonelli holds a BA in philosophy form the University of Colorado in Boulder and a medical doctorate from the University of Colorado in Denver.  He is the author of numerous peer-reviewed articles and book chapters on various aspects of medical science and medical philosophy.  His critique of EBM and his proposal for “case-based reasoning” are both cogent and compelling.

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