The Accad and Koka Report: Recent Episodes
Michel Accad, MD
Hosted by Dr. Michel Accad and Dr. Anish Koka, this podcast offers highly engaging interviews on topics that matter to doctors, including medical science, policy, economics, and ethics—always with an eye toward safeguarding the doctor-patient relationship. To learn more, visit their website: AccadAndKoka.com.
Our guest is Dr. Stanley Goldfarb, author of the recently-released Take Two Aspirins and Call Me By My Pronouns, a book that details the intrusion of critical race theory and identity politics into medical education and medical practice. He is a former Associate Dean for Curriculum at the University of Pennsylvania Perelman School of Medicine and returns to the show to discuss his book and the new organization that he is leading to push back against the new trend.
SHOW NOTES Stanley Goldfarb: Twitter
Do No Harm
Related Episode: Ep. 102 Curriculum Subverted: An Academic Leader Pushes Back Against Woke Medicine (with Stanley Goldfarb)
Related Episode: Ep. 140 Amy Wax on Wokeness in Medicine
Related Episode: Ep. 149 James Lindsay: Critical Race Theory, Post-Modernism, and Medicine
Watch the episode on the Accad & Koka Report YouTube channel
Our guest is Tracy Høeg, MD, PhD, who has made remarkable research contributions pertaining to SARS-COV2 transmission in schools and to vaccine-related myocarditis. She has published her findings in the CDC’s MMWR and has given oral testimony to Congress.
SHOW NOTES Tracy Høeg, MD, PhD: Twitter
Watch the episode on the Accad & Koka Report YouTube channel
Our guest is Ben Recht, Associate Professor of Electrical Engineering and Computer Science at UC Berkeley, who recently got hold of and analyzed the raw data from the Bangladesh cluster randomized control trial of masking which made headlines in September.
SHOW NOTES Ben Recht: Twitter and webpage
Ben Recht’s recent blog post: Revisiting the Bangladesh Mask RCT
Michel Accad Why N-of-1 is Enough
Ep. 97 with Peter Klein on “Evidence-Based Economics: What the Doctor Ordered?“
Watch the episode on the Accad & Koka Report YouTube channel
Our guest is Jenin Younes, a Litigation Counsel for the New Civil Liberties Alliance. She joins us to discuss her involvement in advocacy and in legal challenges against vaccine mandates. She holds a B.A. degree from Cornell University and a J.D. from New York University School of Law. She has been featured on several national media outlets for her commentary and she recently penned an op-ed in the Wall Street Journal building the case against mandatory vaccination in children.
SHOW NOTES Jenin Younes: Twitter and webpage
Watch the episode on the Accad & Koka Report YouTube channel
Our guest is Jay Bhattacharya, Professor of Medicine and Health Policy at Stanford University. Professor Bhattacharya is also research associate at the National Bureau of Economics Research, a senior fellow at the Stanford Institute for Economic Policy Research, and director of the Stanford Center on the Demography of Health and Aging.
Dr. Bhattacharya gained international prominence during the COVID pandemic for his contributions to determining the infection fatality rate of the virus, and for his criticism on broad coercive lockdown policies and vaccine mandates. Along with colleagues Martin Kulldorff and Sunetra Gupta, he wrote the Great Barrington Declaration of focused protection which has garnered 860,000 signatures to date.
SHOW NOTES Jay Bhattacharya: Twitter and Stanford page
Watch the episode on our YouTube channel
Our guest is Euzebiusz (Zeb) Jamrozik, MD, PhD, a practicing internal medicine physician and fellow in ethics and infectious diseases at the Wellcome Centre for Ethics and Humanities at the University of Oxford. He is head of the Monash-WHO Collaborating Centre for bioethics at the Monash Bioethics Centre. His academic work on infectious disease ethics is focused on vaccines, vector-borne disease, and drug resistance. Dr Jamrozik is lead author of the report of a Wellcome Trust funded project on ethical and regulatory issues related to human challenge studies in endemic settings.
SHOW NOTES Zeb Jamrozik, MD, PhD: Twitter and Webpage
Jamrozik E and Heriot G. “Imagination and remembrance: What rolw should historical epidemiology play in a world bewitched by mathematical modelling of COVID-19 and other epidemics.” (In History and Philosophy of the Life Sciences free text available)
Jamrozik E and Heriot G. “Not in my backyard: COVID-19 vaccine development requires someone to be infected somewhere.” (In The Medical Journal of Australia free text available)
Euzebiusz Jamrozik and Michael Seldeling. Human Challenge Studies in Endemic Settings: Ethical and Regulatory Issues (Springer, 2020, free text available)
Watch the episode on our YouTube channel
Our guests are Thomas Wingert, a patient, Bogdan Enache, an electrophysiologist at Centre Hospitalier Princesse Grace in Monaco, and Saurabh Jha, an Associate Professor of Radiology at the Perelman School of Medicine and the University of Pennsylvania.
SHOW NOTES Point/Counterpoint on Halting the Implantation of Subcutaneous ICD. Editorial by B. Enache and J. Mandrola in JACC Electrophysiology.
Watch the episode on our YouTube channel
Our guest is Ted Okon, a nationally recognized expert on the policy and politics of cancer care. Mr. Okon has testified before Congress on cancer issues and is frequently on Capitol Hill discussing the nation’s cancer care delivery system.
SHOW NOTES Ted Okon: Twitter and Community Oncology Alliance website
Watch the episode on our YouTube channel
Our guest is Professor David Heymann, an American physician and epidemiologist based at the London School of Hygiene and Tropical Medicine. He has held leading positions at the WHO for more than 20 years, coordinating global responses to epidemics such as Ebola, AIDS, polio, and SARS. He also served as Chairman of Public Health England from 2009 until 2017. Professor Heymann shares his perspectives on post-pandemic life and on opportunities for the public health sector.
SHOW NOTES David Heymann: Professional page and Wikipedia page
Related Episode: Ep. 140. Gabriela Gomes: Why Herd Immunity May Be At Hand
Related Episode: Ep. 148. Herd Immunity Models and Realities, with David Heymann and Paul Fine
Watch the episode on our YouTube channel
Our guest is Dan Morgan, MD, MS, a physician and epidemiologist in Baltimore, Maryland. He is Associate Professor of Epidemiology and Medicine at the University of Maryland School of Medicine, Chief Hospital Epidemiologist at the Baltimore VAMC, and a fellow at the Center for Disease Dynamics, Economics and Policy (CDDEP). We discuss a recent paper he co-authored about probabilistic diagnostic reasoning among clinicians.
SHOW NOTES Dan Morgan Twitter and Website
Morgan D, et al. Accuracy of practitioners estimate of probability of diagnosis before and after testing. JAMA Internal Medicine. 2021.
Watch the episode on our YouTube channel
Our guest is Shawn Whatley, a physician in Canada who is the author of the recently released book When Politics Comes Before Patients: Why and How Canadian Medicare Is Failing. Dr. Whatley is past-president of the Ontario Medical Association and is a senior fellow at the MacDonald-Laurier Institute for Public Policy in Toronto.
SHOW NOTES Shawn Whatley, MD. Blog and Twitter
When Politics Comes Before Patients: Why Canadian Medicare Is Failing
No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments
Dr. Whatley's previous appearance on the show: Ep. 40 Practicing Medicine in Canada: Promises and Realities
Watch the episode on our YouTube channel
Dr. Accad interviews Dr. Koka regarding his latest article entitled “Correlative Adventures with COVID”
SHOW NOTES Anish Koka: “Correlative Adventures with COVID“
Anish Koka: “In Defense of Small Data“
Anish Koka: “The Price of Progress“
Michel Accad: “The Devolution of Evidence-Based Medicine“
Michel Accad: “Why N-of-1 is Enough“
Watch the episode on our YouTube channel
Our guest is Christopher Snowdon, a freelance journalist with a focus on the intrusion of public health into the daily lives of ordinary people. He is the author of many books, including Velvet Glove; Iron Fist, A History of Anti-smoking, published in 2009, and more recently, Polemics, an anthology of articles on economics, politics, science, and culture. He is also Head of Lifestyle Economics at the Institute for Economic Affairs in London. We discuss his position on lockdowns which has surprised many and put him at odds with other libertarians.
SHOW NOTES Chris Snowdon: Website and Twitter
“The Rise of the Coronavirus Cranks” (article in Quilette)
“The Great Lockdown Debate: Chris Snowdon v. Toby Young” (YouTube on talkRadio channel)
Watch the episode on our YouTube channel
Our guest is Charlie Deist, author of Hormetics: Physical Fitness for Free People. We have an engaging and somewhat philosophical conversation on principles of health. How do we identify good nutritional and exercise habits? Amongst the myriad of fads, what rules should guide one’s health choices and behaviors?
SHOW NOTES Charlie Deist: Website and Twitter
Hormetics: Physical Fitness for Free People (on Amazon)
Watch the episode on our YouTube channel
Our guest is Elise Amez-Droz, program manager for the Open Health program at the Mercatus Center at George Mason University, where she also manages the health policy portfolio. Ms. Amez-Droz is a Public Policy Fellow with the Fund for American Studies and a member of the Millennial Cohort of American Enterprise Institute’s Leadership Network.
SHOW NOTES The Mercatus Center website
“Labeling Us ‘Essential’ or ‘Non-Essential’ Makes Us Less Human” (Discourse Magazine)
Related episode: 21. Inside the Swiss Healthcare System (with guest Marc Fouradoulas, MD)
Watch the episode on our YouTube channel
Our guest today is Terence Kealey, Professor Emeritus of clinical biochemistry at the University of Buckingham in the United Kingdom, where he served as Vice Chancellor until 2014. He is also a Research Fellow at the Cato Institute. Professor Kealey trained in medicine at Bart’s Hospital in London and obtained his doctorate at Oxford University following which he pursued a career in clinical biochemistry research, before joining the faculty at Buckingham University.
He is the author of 3 books. The first, published in 1996 and titled The Economic Laws of Scientific Research is a sweeping exploration of the relationship between government and science and argues against public funding of scientific research. The second, Science, Sex, and Profits, published in 2008, continues the same theme and develops the notion that science is not a public good but is organized around what he terms “invisible colleges.” His third book, Breakfast is Your Most Dangerous Meal, was published in 2014 and links government intervention to very unhealthy nutritional advice.
SHOW NOTES Watch the episode on our YouTube channel
Our guest is Professor Stephen Senn, a world renowned statistician whose career has spanned the gamut of activities that involves statistical analysis in medicine, from teaching to research to consultancy. Professor Senn obtained his PhD in Statistics from the University of Dundee and became a Chartered Statistician from the Royal Statistical Society in 1993. He has held professorships at University College London and at the University of Glasgow. He is the author of several books, notably Statistical Issues in Drug Development and Dicing with Death: Chance, Risk, and Health.
SHOW NOTES Stephen Senn, PhD: Twitter and Website
Wood FA, et al. N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side-Effects (Open Access in New Engl J Med)
Araujo, A Julious S, Senn S. Understanding variation in sets of N-of-1 trials (Open Access in PLOS One)
Senn S. Statistical pitfalls of personalized medicine (Open Access in Nature)
Senn S. Mastering Variation: Variance components and personalized medicine (Open Access in Stat in Med)
Does it matter if we call irreversibly comatose patients “dead?” Our guest is Doyen Nguyen, OP, MD, STD. Dr. Nguyen was previously an academic hemato-pathologist and is currently a Catholic moral theologian and bioethicist. She has authored books and articles both in medicine and in moral theology/bioethics and authored a 600-page monograph that takes a critical look at brain death from a variety of perspectives.
SHOW NOTES Nguyen D. The New Definition of Death for Organ Donation: A Multidisciplinary Analysis from the Perspective of Christian Ethics. (2018, Amazon link)
Nair-Collins, M and Miller, FG. “Do the ‘Brain Dead’ merely appear to be alive? (in J of Med Ethics, open access)
Related Episode: Ep. 35. Why Brain Death Isn't Death: An Introduction to "Shewmon's Challenge" (with Guest Alan Shewmon, MD)
Related Episode: Ep. 45. Brain Death at the Bedside (with guest Fred Rincon, MD)
Related Episode: Ep. 146. Diagnosing Brain Death: Clinical and Legal Quagmire (with guests Alan Shewmon and Doyen Nguyen)
Watch the episode on YouTube
Our guests are Professors David L. Heymann and Paul Fine from the London School of Hygiene and Tropical Medicine. Professor Heymann is a physician who held leading positions at the WHO for more than 20 years, coordinating global responses to epidemics such as Ebola, AIDS, polio, and SARS. He also served as Chairman of Public Health England from 2009 until 2017. Professor Fine is also a leading academic figure in epidemiology and public health with broad interests in infectious diseases. Professor Heymann and Professor Fine, along with colleague Ken Eames, have co-authored an landmark review paper on the concept of herd immunity.
SHOW NOTES David Heymann: Professional page and Wikipedia page
Paul Fine: Professional page
Paul Fine, Ken Eames, and David Heymann: “Herd Immunity”: A “Rough Guide (Open Access in Clinical Infectious Diseases)
David Heymann: How SARS Was Contained (Opinion in New York Times)
Related Episode: Ep. 140. Gabriela Gomes: Why Herd Immunity May Be At Hand
Watch the episode on YouTube
Our guest is physician and author Sally Satel, MD. Dr. Satel is a resident scholar at the American Enterprise Institute and staff psychiatrist at a local methadone clinic in the Washington DC area. She earned a bachelor’s degree from Cornell University, a master’s degree from the University of Chicago, and an MD degree from Brown University.
She has written widely in academic journals on topics in psychiatry and medicine, and has published articles on cultural aspects of medicine and science in numerous magazines and journals. She has testified before Congress on veterans’ issues, mental health policy, drug courts, and health disparities. She is the author of numerous books including The Health Disparities Myth: Diagnosing the Treatment Gap with co-author Jonathan Klick and, most recently, Brainwashed: The Seductive Appeal of Mindless Neuroscience co-authored with Scott Lilienfeld.
SHOW NOTES Sally Satel, MD: Twitter and Website
“The Hypocritical Oath” (in Persuasion online community)
The Health Disparities Myth: Diagnosing the Treatment Gap (with co-author Jonathan Klick)
Watch the episode on YouTube
Dr. Damian Carabello discusses the depths insurance companies go to make sure they end up on top.
SHOW NOTES Damian Carabello, MD: Twitter
Anish Koka long read on surprise billing
Damian Carabello “Let’s end surprise billing without a Trojan horse” blog on KevinMD about the problems with benchmarking.
Twitter thread on the history of Ingenix
Andy Slavitt’s involvement with health insurance fraud case
Watch the episode on YouTube
Dr. John Mandrola returns to the show to discuss why doctoring and politics shouldn’t mix and how he got into hot water on Twitter for holding that unacceptable view.
Dr. Mandrola is an electrophysiologist in Louisville, Kentucky. He is is cardiology editor on Medscape where he writes a regular column and produces a weekly podcast.
SHOW NOTES John Mandrola, MD: Twitter and Website
John Mandrola: “Doctoring and Activism“
Sally Satel: “The Hypocritical Oath“
Mandrola et al: The Case for Being a Medical Conservative (in the American Journal of Medicine)
Watch the episode on YouTube
Dr. Mandrola's previous appearances on the show: Ep. 12 and Ep. 107
Our guest is Adam Mortara, lead trial counsel in the case of Students for Fair Admissions v. Harvard University. We discuss the legal aspects of affirmative action in light of the paper by Dr. Norman Wang that set off a storm of controversy in academic medicine.
SHOW NOTES Adam Mortara, JD: Professional page
Watch the episode on YouTube
Norman Wang’s paper: Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America from 1969 to 2019.
Our guest is Robert Yeh, Associate Professor of Medicine at Harvard Medical School and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. We discuss the challenges of outcomes research and his excellent work to improve the reliability of observational studies.
SHOW NOTES Robert W. Yeh, MD: Twitter and professional web page
Watch the episode on YouTube
Strom JB, et al. Use of Administrative Claims Data to Assess Outcomes and Treatment Effects in Randomized Trials of Transcatheter Aortic Valve Replacement (in Circulation)
Faridi KM, et al. Use of Administrative Claims Data to Estimate Treatment Effects for 30 days versus 12 months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention (in Circulation)
Konstam M. Real World Data as trial End Points: Off and Running with a Long Way to Go (editorial in Circulation)
Previous Guest Appearance: Ep. 19 Public Reporting: Necessary Evil or Harmful Fake News?
Our guest is Amy Wax, Robert Mundheim Professor of Law at the University of Pennsylvania Law School. Before attending law school she obtained her undergraduate degree from Yale University in biophysics and biochemistry, graduating summa cum laude. She then attended Harvard Medical School and trained as a neurologist at New York Hospital-Cornell Medical Center before completing her law degree at Columbia University. She is the author of Race, Wrongs, and Remedies: Group Justice in the 21st Century. In 2017, she was the target of academic backlash after co-authoring an opinion piece in the Philadelphia Inquirer on the societal benefits of “bourgeois values.”
SHOW NOTES Amy Wax: Faculty page and Wikipedia entry
Watch the episode on YouTube
Our guest is Gabriela Gomes, Professor of Mathematics at the University of Strathclyde. She specializes in population dynamics and the modeling of herd immunity and her recent work suggests covid-19 herd immunity may be at hand. We discuss how herd immunity thresholds are estimated and why she thinks classic models are flawed and must incorporate a measure of variation in individual susceptibility.
SHOW NOTES Gabriela Gomes, PhD: Twitter and website
Gomes et al. (May 2020 paper), "Individual Variation in Susceptibility or Exposure to SARS-CoV-2 Lowers the Herd Immunity Threshold" in MedRxiv
Aguas et al. (July 2020 paper), "Herd Immunity Thresholds for SARS-CoV-2 Estimated from Unfolding Epidemics" in Medrxiv
Britton et al., "A Mathematical Model Reveals the Influence of Population Heterogeneity on Herd Immunity to SARS-CoV-2" in Science (open access)
Kevin Hartnett, "The Tricky Math of COVID-19 Herd Immunity" in Quanta Magazine
Fine et al., "'Herd Immunity': A Rough Guide" in Clinical Infectious Disease (open access)
Watch the episode on YouTube
A recent article authored by Dr. Norman Wang on the history and current state of affirmative action programs in medical schools and cardiology departments has led to a storm of controversy and to Dr. Wang’s demotion as fellowship program director. To discuss that article and the controversies we are joined by Dr. Martha Gulati, division Chief of Cardiology at the University of Arizona. She is also the best-selling author of Saving Women’s Hearts and editor-in-chief of ACC’s CardioSmart.
SHOW NOTES Martha Gulati: Twitter and Website
The now retracted Wang paper
Journal of the AHA comment on retraction
Regents of Univ. of California v. Bakke, SCOTUS decision
Watch the episode on YouTube
Marion Mass is a pediatrician in the Philadelphia area where she has practiced in hospital, Emergency Room, delivery room, outpatient, and urgent care settings. She graduated from Duke University Medical School and trained in Pediatrics at Northwestern Memorial Hospital in Chicago. She has been writing about life inside medicine, published in the WSJ, Washington Times, and the Philly Inquirer. She is also co-founder of Practicing Physicians for America, a physician lead organization that advances the interests of practicing physicians. She has written extensively on the role of third party intermediaries in medicine.
Dr. Rupali Chadha is a Board Certified Psychiatric Physician who diagnoses and treats mental illness. She is also Board Certified Psychiatric Physician in the specialty area of forensics. She serves the LA Superior Courts in identifying inmates who are incompetent to stand trial and has also served as a forensic expert in criminal trials. She recently traveled to Washington DC to visit the White House and witness signing of a recent Presidential Executive Order on intermediaries in healthcare.
SHOW NOTES White House Executive Order
Overview of third parties that suck up most of the health-care dollars
The rebates that may fuel higher drug prices
John Arnold in statnews discusses the role of Pharmacy benefit managers (PBM)
A detailed look at Group Purchasing Organizations and PBMs
Needle stick story referenced in the podcast
Watch the episode on YouTube
Anish Koka and Michel Accad discuss lockdowns in light of the experience of the last few months.
SHOW NOTES Michel Accad: It’s Not About Trade-OffsWatch the episode on YouTube
Joshua Gottlieb is an economist who co-authored a recent paper examining the effect of government policy and physician income. The paper was recently presented at a conference co-sponsored by the NBER and NIA and its pre-publication has generated significant controversy among doctors.
SHOW NOTES Joshua Gottlieb, PhD: Twitter and WebsitePaper: Who Values Human Capitalists’ Human Capital? Healthcare Spending and Physician Earnings Watch this episode on YouTube
Manny Sethi is a trauma surgeon running to be the next senator from the state of Tennessee. He is the son of immigrants, and an unabashed conservative who discusses his journey from medicine to politics, as well as his views on healthcare.
SHOW NOTES Manny Sethi: Twitter and BioWatch this episode on YouTube
Reopening schools in the midst of a pandemic is a controversial topic. FREOPP, a non-partisan think tank founded by Avik Roy recently released a plan for reopening schools. We discuss some of the data from around the globe, as well as practical considerations related to opening schools.
SHOW NOTES FREOPP: Reopening America’s Schools and Colleges During COVID-19Iceland Study (NEJM)Dutch National Institute StudySupreme Court Decision on school fundingWatch this episode on YouTube
Dr. Leamer is a Professor of Economics and Statistics at UCLA who comes on the show to discuss the recent arrival of econometric analyses in medicine. He is a longstanding skeptic of the robustness of conclusions derived from econometrics and has some advice for clinicians puzzling over what to do with these analyses.
SHOW NOTES Ed Leamer warns of the science of econometrics in 1983The Credibility Revolution in Empirical Economics: How Better Research Design is Taking the Con out of Econometrics – Angrist and Pischke argue in 2010 that new econometric tools : pseudorandomization, instrumental variables, and natural experiments mark a credibility revolution for the fieldTantalus on the Road to Asymptopia- Ed Leamer responds to Angrist/PischkeWatch this episode on YouTube
Our guest is Rohin Francis, MD. Dr. Francis is a Cardiologist in London, who also hosts a popular YouTube channel. He recently discussed what COVID may tell us about racism in science and medicine, and comes on the show for a wide ranging discussion on racism in medicine, COVID in Britain, and how minority groups have fared in Britain.
SHOW NOTES Watch Rohin’s video on Racism in Science and MedicineWatch the episode on YouTube
Marilyn Singleton, MD, JD joins the Accad and Koka Report.
Dr. Singleton comes from a long line of American physicians. She shares with us her fascinating family history and her insights into the rich history of Black physicians in America. We also discuss the deleterious effects of race victimization manifest today.
Dr. Rao is an interventional cardiologist and researcher who has been at Duke University for over 10 years. He also works in the Veteran’s hospital in Durhum, is a leader in the cardiology social media community with 16k followers on Twitter, and is also editor-in-chief of the journal Circulation Interventions. In this podcast he discusses his perspective on the recent retractions of papers involved in the Surgisphere scandal.
Links Article from the-scientist on Lancet/NEJM retractions
Our guests Mary Davenport and George Delgado have developed a treatment protocol that can reverse the effects of the abortifacient mifepristone and be given to women who change their mind after a medical abortion. They tell us the story of their pioneering work and of the international network of physicians that is now in place to provide the therapy. We discuss the challenges that remain when the medical establishment is ideologically resistant to supporting women in their second choice.
Links: Abortion Pill Rescue websiteDelgado, G, et. al. A Case Series Detailing the Successful Reversal of Mefiprestone Using Progesterone (In Issues in Law and Medicine)Creinin, M, et al. Mifepristone Antagonization with Progesterone to Prevent Medical Abortion: A Randomized Clinical Trial (free access in Obstetrics and Gynecology)Graham, R. A New Front in the War Over Reproductive Rights: “Abortion-Pill Reversal” (in The New York Times)Grossman D and White K. Abortion “Reversal”: Legislating Without Evidence (in New England Journal of Medicine)
In the wake of the murder of George Floyd, Dr. David Howard comes on the show to discuss his experiences in America, and more broadly racism in America.
Dr. David Howard was originally born in Jamaica and immigrated to the U.S. at the age of eighteen. He received his Bachelor of Arts in Psychology from the Johns Hopkins University and then pursued his Md and PhD in Epidemiology through the Medical Scientist Training Program at the Johns Hopkins School of Medicine. He completed an internship at the New York Presbyterian Hospital followed by a residency in Obstetrics and Gynecology at the University of Missouri-Kansas City. He also completed a post-doctoral fellowship in Epidemiology at the University of North Carolina Chapel Hill. He is currently a Board Certified Obstetrics/Gynecology Specialist practicing in Las Vegas, Nevada, and is affiliated with several different hospitals in the area.
Our guest is Neurosurgeon Chengyuan Wu. Dr. Wu specializes in functional neurosurgery, a field that focuses on using brain surgery to restore function to patients. He discusses Elon Musk’s initiative to create a new brain-human interface using implants in the brain that communicate with the environment.
What does it mean to promote a politically conservative vision for health care? Our guest is Dr. Leo Valentin, a radiologist running as a Republican candidate for US Congress in Florida’s District 7.
Our guest is Eric Weinhandl, an epidemiologist whose investigation of a JAMA paper on dialysis patients lead to its retraction—and subsequent republication.
Eric discusses the steps leading to the paper’s eventual retraction, and what this signals about the larger research enterprise. Eric also discusses the role of bias, conflicts of interest, big data and home dialysis, as well as some thoughts on the field of epidemiology during the COVID pandemic.
Eric Weinhandl is an epidemiologist with fourteen years of research experience in kidney disease, mostly regarding dialysis and pharmaceuticals. Eric worked at the United States Renal Data System (USRDS) Coordinating Center between 2004 and 2015 and has conducted studies with Amgen, Baxter, DaVita, NxStage, Sigma Tau, and the Peer Kidney Care Initiative.
He recently worked for Fresenius Medical Care, one of the major dialysis companies in the United States, and currently works with the chronic disease research group as part of the Hennepin County Medical Center.
Our guest is Gregg Gonsalves, Assistant Professor of Epidemiology at Yale University Medical School as well as Associate (Adjunct) Professor of Law and Research Scholar in Law at Yale Law School. His research focuses on the use of quantitative models for improving the response to epidemic diseases and he will help us understand better what a strategy of testing and contract tracing might look like, and what the challenges ahead are.
Our guest is Adam Rodman, host of the podcast Bedside Rounds, a great show on the history of medicine. With his deep knowledge of the vagaries of medical thought, Dr. Rodman sheds light on the COVID-related challenges that clinicians are now confronting.
Our guest is Andrew Althouse, statistician at the Center for Clinical Trials and Data coordination in Pittsburgh. He holds an undergraduate degree in Statistics and a PhD in Epidemiology from the University of Pittsburgh. His main area of interest is the design of randomized control trials. He discusses adaptive randomized control trials, and dissects the recent news of the positive Remdesivir trial.
Our guest is Dorit Reiss, Professor at UC Hastings College of the Law in San Francisco, California. She holds an undergraduate degree in Law and Political Science from the Faculty of Law at Hebrew University in Jerusalem and a PhD in Jurisprudence and Social Policy from the University of California, Berkeley. She is a legal authority on the question of vaccines and vaccine mandates. She has published numerous articles on this topic in a variety of law review journals and her expertise is recognized around the world.
Our guests are Dr. Swapnil Hiremath for the University of Ottawa and Saurabh Jha from the University of Pennsylvania. We discuss the controversies surrounding the COVID-related opinions and research findings of John. P.A. Ioannidis, the notorious Stanford data scientist and physician.
Our guest is Dr. Anupam Singh, Assistant Professor of Medicine at Santosh Medical College and Hospital, one of the designated COVID hospitals in Ghaziabad, Utter Pradesh, India. He returns to the show for a great conversation about the surprising aspects of the pandemic in the Indian subcontinent.
Should we wait for COVID testing benchmarks to be met before we can reopen the economy? What if testing remains imperfect and uncertainty remains high? Our guest is Avik Roy, head of the Foundation for Research on Equal Opportunity. He returns to the show to discuss FREOPP’s plan to bring people back to work.
Our guest is economist Ryan McMaken, senior editor at the Mises Institute. He was the economist for the Colorado Division of Housing from 2009 to 2014. He is also the author of Commie Cowboys: The Bourgeoisie and the Nation-State in the Western Genre — a book that reveals his aptitude for analyzing economic events in their broader cultural context.
Additional Reading Thanks to Lockdowns, State and Local Tax revenues Are PlummetingThe Fed’s Balance Sheet Skyrockets As It Doubles Down on Inflating Asset PricesAnother Right Abolished by the Government’s COVID Lockdown: The Right to a Speedy TrialColorado County Says It Will Arrest All Tourists, Including Those Who Own Property ThereThe COVID Lockdowns Are What Twenty-First Century Mob Rule Looks Like
Our guest is Jeff Deist, President of the Mises Institute. We discuss the unprecedented governmental response to COVID, the trade-offs that are unaccounted for, and the inability of local communities to set their own course when, in fact, “all crises are local.”
Additional Reading "End the Shutdown" by Mises.org Editors
"What Governors Can Do" by Jeff Deist
"All Crises Are Local" by Jeff Deist
Our guest is Dr. Nicole Saphier. She is a radiologist and a breast imaging specialist at Memorial Sloan Kettering, Monmouth, New Jersey. She appears frequently as a medical contributor on Fox News, and comments on a variety of medical as well as health policy issues. She comes on today to discuss her new book – Make America Healthy Again.
Our guest is Per Bylund, Assistant Professor of Entrepreneurship at Oklahoma State University where he holds the Records-Johnston Professorship of Free Enterprise in the School of Entrepreneurship. We talk about regulations in the age of COVID, and he also shares his perspective on Sweden’s response to the pandemic.
Our guest is Aaron Kheriaty, MD, Associate Clinical Professor of Psychiatry at the University of California, Irvine, where he is Director of the Bioethics Program. Dr. Kheriaty is the chair of his hospital’s ethics committee and is presently working on a task force with the University of California Office of the President to prepare for the possibility that a surge in demand for intensive care due to the coronavirus pandemic will outstrip the supply of equipment and staff. He is the author of numerous articles in peer-reviewed journals and in the lay press, many of which are focused on end-of-life issues.
Our guest is intensive care specialist Mark Tonelli, Professor of Medicine at the University of Washington Medical Center in Seattle. He shares with us the encounter with the COVID-19 pandemic as it emerged from a nursing home in King County, Washington, and how the Seattle area medical community has responded to this first US cluster of cases.
Accad and Koka welcome Dr. Paul Offit, an expert on vaccines, immunology, and virology. He is the Maurice R. Hilleman Professor of Vaccinology, Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania, and Director of the Vaccine Education Center at The Children’s Hospital of Philadelphia. He shares his thoughts on the response to the COVID pandemic, a response that should take into account the health costs of a severe economic downturn.
Anish discusses the COVID19 pandemic with Dr. Daniel Jafari, an emergency physician and surgical critical care specialist working at the North Shore University Hospital in New York. Dr. Jafari speaks to us about watching the pandemic unfold, the problems being wrestled with, the remarkable response, and what’s needed in the coming weeks.
Anish Koka discusses the COVID19 pandemic with Christos Argyropoulos, Chief Nephrologist at the University of New Mexico.
Dr. Argyropoulos has been warning for some time about COVID19. Here he discusses from where his early concerns emerged, missteps by the US in handling the virus early on, and what to do now.
Hordes of independent nurse practitioners are on the horizon. Many physicians are raising the alarm bell, but Dr. John Mandrola views things differently.
Geoffrey Rose published The Strategy of Preventive Medicine in 1992, and thus gave birth to the “Population Health” movement. In this podcast episode, Dr. Michel Accad critically examines Rose’s influential ideas.
Dr. Bob Gill, producer of the documentary The Great NHS Heist, discusses what life in the National Health Service is like, how it differs from practice in the United States, and most importantly, his fears of what is undermining the mission of the NHS — a hostile takeover by American corporate interests.
Many physicians feel ambivalent about assisted suicide and neither endorse the practice nor outright condemn it. As a result, they also avoid discussing the topic altogether. Accad and Koka's guest is Dr. Adam Cifu, who kindly agreed to engage in a conversation on this difficult question. Dr. Cifu is author of Ending Medical Reversal and Symptom to Diagnosis.
Accad and Koka's guest is the highly successful and widely respected blogger who writes anonymously under the pen name “Skeptical Scalpel.” He is a former Chairman of Surgery at an academic institution, and they discuss the state of surgical education and its present-day challenges.
Should the medical school curriculum include health inequity, climate change, and gun control? Accad and Koka interview Professor Stanley Goldfarb, author of a recent and controversial op-ed in the Wall Street Journal on the politicization of medical education.
As a follow-up to the episode on the Ranbaxy Scandal, Accad and Koka are joined by medicinal chemist John Tucker, PhD, and hypertension specialist Swapnil Hiremath, MD. The guests share their perspectives and impressions on the unsettling question of generic drugs.
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, Dinesh Thakur, is the chemist who was at the center of the most important scandal to rock the global pharmaceutical industry in decades.
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.
As a medical discipline, psychiatry has often been the target of severe criticism, particularly in the last fifty to sixty 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 (RealPsychiatry) about some of these topics
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 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 five books and numerous peer-reviewed articles.
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.
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, Georgia.
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.
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.
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.
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.
How do businesses purchase healthcare services for their employees? What are the factors that bear on their purchasing decisions? These important questions are rarely part of the policy conversation. Our guest on this episode is Jay Kempton, President and CEO of the Kempton Group, helping employers obtain and administer health care benefits for their employees. He relates his professional journey, shares his insights as a third-party administrator, and tells us about his recent efforts to turn employers away from the wasteful and corrupt health insurance benefit model.
Mr. Kempton is one of the founding members of the Free Market Medical Association, a board member of the Society of Professional Benefit Administrators, and a member of the Health Care Administrators Association. He obtained a Bachelor of Science degree in Business Administration from Oklahoma State University and holds Life, Health, AD&D, and Property and Casualty Insurance licenses in multiple states.
According to our guest, American health care is stuck in a fortress mentality that stifles innovation, constrains medical advances, and yields low quality care. That fortress was erected more than one hundred years ago but, in many ways, is being circumvented by creative actors who are seizing opportunities to make changes outside of the political process.
Bob Graboyes is Senior Research Fellow at the Mercatus Center at George Mason University. He holds a PhD in Economics from Columbia University, and has held a number of academic positions in higher education in Virginia. He is the author of “Fortress and Frontier in American Health Care,” a booklet which offers many examples of individuals adopting a risk-tolerant frontier attitude to compete with insiders and pave the way to the future without having to rely on political reform. Prior to focusing his career on healthcare, Bob Graboyes was regional economist and director of education at the Federal Reserve Bank of Richmond.
The Affordable Care Act was allegedly passed thanks to “the stupidity of the American voter.” The economist who made that claim—and who is also considered to be one of the architects of the law—has recently published a working paper that examines whether better-informed patients make better healthcare decisions. He and his colleagues conclude in the negative.
To help us gain a better perspective on that paper, we’ve invited Dr. Keith Smith back to the show. Dr. Smith is the co-founder of the Surgery Center of Oklahoma, a pioneering institution in free market medicine. As such, he has direct knowledge of the behavior of healthcare consumers, and offers us his insights into the chasm that exists between the way healthcare policy makers conceive of medical practice and how ordinary patients actually seek the best possible healthcare value for themselves.
President Trump’s July 10, 2019, "Executive Order on Advancing American Kidney Health" may represent a major turning point in regard to how patients with chronic kidney disease are treated. We have the pleasure of having as our guest Dr. Joel Topf.
Dr. Topf is a nephrologist in private practice and a popular blogger and leader in medical social media. He is an adviser to the American Society of Nephrology and was present at the signing of the executive order. He joins Anish Koka to share his insights on the good and bad of the executive order, and on the state and future of kidney disease in the United States.
Hospital executives with a conscience may have a tough time navigating the corrupting waters of our healthcare system. Mr. John Chamberlain is a self-described "recovering" hospital CEO with over thirty-five years of experience as a hospital and physician practice executive. In this interview with Anish Koka, he relates how his attempts to do right by the patient became increasingly arduous.
Mr. Chamberlain eventually saw the light of free market medicine and currently serves as Chairman of Citizen Health, an organization dedicated to "rebuilding healthcare for the next generation."
President Trump’s June 24, 2019, Executive Order on health care transparency contains a key provision regarding direct primary care. Koka and Accad welcome back on the show Dr. Lee Gross, a family physician in North Port, Florida, and a pioneer and a leader in the DPC movement.
Dr. Gross and colleagues were instrumental in getting the White House to clarify a prior ambiguity regarding how direct primary care membership fees ought to be considered from a tax standpoint. Dr. Gross discusses this effort and the implications for the growth of the direct care movement.
Dr. Gross is a health care consultant to physician practices, medical organizations, insurance groups, hospitals, and private businesses. He founded and serves as President of the Docs 4 Patient Care Foundation, and he is chairman of a new lobbying organization called DPC Action.
What can we learn from the experience of a 90-year-old patient who is told point-blank, “You’ll be dead in a year!”—and who survives to tell the story?
This is a first of its kind in the annals of the Accad and Koka Report. The episode starts with a 15-minute interview conducted by Dr. Koka with a patient of his about her journey through the healthcare system. After the interview, Accad and Koka have an in-depth conversation—prompted by the patient’s testimony—about what to take into consideration when making decisions for elderly patients who contemplate expensive and risky procedures.
It is commonly believed that healthcare is a sector plagued by “market failure.” A heavy dose of government intervention is therefore necessary to optimize the needs of society. A paper most commonly cited in support of that view is one published in 1963 by Nobel Prize winner Kenneth Arrow, one of the giants of economic theory in the twentieth century, and titled “Uncertainty and the Welfare Economics of Medical Care.”
But how does economic theory arrive at the concept of market failure and how do economists conceive of health care when they apply their theoretical models to medical practice?
To help sort this out, we have as our guest Robert P. Murphy, economist, teacher, and author of many books. Dr. Murphy obtained his PhD from NYU and is Senior Fellow at the Mises Institute. He is co-host with Tom Woods of the popular podcast Contra Krugman, and he is also host of The Bob Murphy Show, “a podcast promoting free markets, free minds, and grateful souls.”
The episode is in two parts. In the first part, we reviewed the theoretical framework that forms the background to Arrow’s paper. In this second part, we delve into the paper itself, discuss how economists conceive (or misconceive) of medical care, and what the implications have been for the US healthcare system as a whole.
It is commonly believed that healthcare is a sector plagued by “market failure.” A heavy dose of government intervention is therefore necessary to optimize the needs of society. A paper most commonly cited in support of that view is one published in 1963 by Nobel Prize winner Kenneth Arrow, one of the giants of economic theory in the twentieth century, and titled “Uncertainty and the Welfare Economics of Medical Care.”
But how does economic theory arrive at the concept of market failure and how do economists conceive of health care when they apply their theoretical models to medical practice?
To help sort this out, we have as our guest Robert P. Murphy, economist, teacher, and author of many books. Dr. Murphy obtained his PhD from NYU and is Senior Fellow at the Mises Institute. He is co-host with Tom Woods of the popular podcast Contra Krugman, and he is also host of The Bob Murphy Show, “a podcast promoting free markets, free minds, and grateful souls.”
The episode is in two parts. In this first part, we review the theoretical framework that forms the background to Arrow’s paper. In the upcoming second part, we will delve into the paper itself, discuss how economists conceive (or misconceive) of medical care and what the implications have been for the US healthcare system as a whole.
The Commonwealth of Massachusetts’ lawsuit against Purdue Pharmaceuticals exemplifies a common narrative that lays a large part of the blame for the opioid epidemic at the feet of the manufacturer of prescription opioids for manipulating physicians into prescribing the drugs more liberally. Is there merit to that story?
To examine that question, we have as our guest Jacob James Rich, a policy analyst at Reason Foundation. Mr. Rich holds master’s degrees in economics and mathematics from Eastern Michigan University. Prior to joining Reason, he conducted research for the Cato Institute focused on opioids and the drug war.
Is the healthcare mess so hopeless that physicians should either leave it or wait for it to collapse? Are there legislative steps that doctors can take to tangibly improve the practice of medicine? And, if so, how should physicians act within the problematic framework of “organized medicine” to bring about such changes?
Our guest is Dr. Marcelo Hochman (twitter), who is sharing with us some hopeful successes in introducing important legislation by working in conjunction with his local and state medical societies. The three issues he has focused on are 1) a repeal of certificate-of-need laws, 2) a ruling against “non-compete clauses” in physician contracts, and 3) a tax deduction for charitable work provided by physicians. All three issues appeal to the notion that expanding the settings in which physicians can be free to practice will benefit both doctors and society.
Dr. Hochman is an independent solo pediatric facial plastic surgeon who practices in Charleston, South Carolina. He has specialized in the treatment of congenital vascular anomalies. He is a recipient of the Order of the Palmetto, South Carolina’s highest civilian award, and of other national and local professional and community honors. He currently serves as the President of the Charleston County Medical Society, as Chair of the Coalition to Repeal CON (Certificate of Need), and as Director of The Hemangioma Treatment Foundation.
Is the body a machine? Are doctors mere technicians who simply “fix” biological defects in their patients? In a very real sense, that’s how modern societies conceive of medical practice, so much so that healthcare is now frequently experienced as an industrial process: doctors and nurses churning patients through an assembly line. And that process is taking a huge economic, physical, and mental toll on everyone.
The mechanical model on which modern medicine is based has obviously brought technological wonders to the practice of medicine—and it should be celebrated for these extraordinary achievements. But have we become so wedded to the machine metaphor that we ignore more fundamental aspects of human reality? Can another way of conceiving of health and life be brought to bear on the practice of medicine positively, without discarding the achievements of the scientific age?
Our guest is Dr. Victoria Sweet, author of the best-sellers God’s Hotel and Slow Medicine, two of the most important books on medicine in recent times. Those books were inspired by Dr. Sweet’s rediscovery of the medical texts of Hildegard of Bingen, a 12th-century mystic and nun whose practical approach to medicine may well contain the very principles that can help cure 21st-century health care from its seemingly irremediable predicament.
Quality ratings of hospitals and physicians: help or hindrance? Surely, the general public demands and is entitled to an assessment of hospital quality based on sound methodology. And ratings coming from the private sector are far more likely to be unbiased and to adjust to an ever changing healthcare landscape than those coming from the government and public policy sector. But is there a downside to scrutinizing the healthcare enterprise?
We have a fascinating conversation with one of the most knowledgeable persons on the topic. Ben Harder is Chief of Health Analysis at US News and World Report and oversees the team of analysts and statisticians who produce the most recognized ranking of hospitals in the country. Ben holds a Bachelor of Science in Biological Anthropology from Harvard University and began his career in health and science journalism before taking the job of quality czar at US News and World Report.
Two distinguished guests join us to debate the issue of vaccine mandates.
Dorit Reiss (twitter) is Professor of Law at UC Hastings College of the Law in San Francisco, California. She holds an undergraduate degree in Law and Political Science from the Faculty of Law at Hebrew University in Jerusalem and a PhD in Jurisprudence and Social Policy from the University of California, Berkeley. She is a legal authority on the question of vaccines and vaccine mandates. She has published numerous articles on this topic in a variety of law review journals and her expertise is recognized around the world.
Jonathan Howard (twitter) is Assistant Professor in the Departments of Neurology and Psychiatry at New York University Langone. He is Director of the Neurology Service at Bellevue Hospital and Director of Clerkship Director for the Clinical Neurological Sciences at NYU.
Dorit and Jonathan have co-authored a book chapter entitled “The Anti-Vaccine Movement: A Litany of Fallacy and Errors,” in Pseudoscience: A Conspiracy Against Science.
A short episode commenting on a recent piece in Medscape, one of the most influential bioethicists of the last forty years.
See "No, Patients Are NOT Consumers, and MDs Are NOT Providers" by Arthur L. Caplan.
If health is an elusive concept, how much harder it must be to articulate what a healthy community should be. But that should not stop us from grappling with foundational ideas and from sketching a forward-looking vision for a better society. Our guest on this episode is Pritpal Tamber (twitter), a physician who has devoted his career to better understanding what it means to live in a healthy community.
Dr. Tamber is the former Physician Editor of TEDMED, TED’s dedicated health event, a former editor at the British Medical Journal, and the former Medical Director of Map of Medicine, a company that tried to improve the flow of patients through health care on the basis of clinical evidence. Through his work with TEDMED, and informed by his insights into clinical evidence and system change, Dr. Tamber is convinced that the glamorous, tech-led world of health innovation is unlikely to have much impact on the patients with the worst health—those lower down the socioeconomic gradient.
Since 2013, he has spent time with numerous community projects—principally in the US and the UK, but also in The Netherlands, New Zealand, and Mexico—to explore and understand the realities of the work. Through his work he has described 12 recurring principles that offer a practice-based structure for how the health sector can work with communities. Collectively, these principles describe an inclusive and participatory process, effectively illustrating that people are sick because they have little influence over their lives. Social epidemiologists have called this "having a sense of control", and it is something that requires agency—the ability to make purposeful choices.
Does the vaccine debate have to be polarized according to “Pro-Vaxx” or “Anti-Vaxx” camps? Is it possible to have a reasonable discussion about harms and benefits of vaccines? Are public health concerns about unvaccinated children sufficient to trump individual liberty?
Exploring the question with us is Dr. Niran Al-Aqba (twitter), a board-certified pediatrician in private practice in Washington State, an area hit by the recent outbreak of measles. Dr. Al-Aqba is a prolific writer who 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 admission committee at the University of Washington School of Medicine.
Is there a conservative path to universal healthcare? Our guest certainly believes so. Avik Roy (twitter) is one of the most influential conservative voices in healthcare. A graduate from MIT and Yale Medical School, Avik spent many years with the investment firm Bain Capital. In 2009, in response to the debates leading up to Obamacare, Avik started a blog to share his insights. Those were soon noticed by the media and the policy world, and he quickly became the go-to policy wonk on healthcare among conservatives.
In 2012, Roy joined the campaign of Mitt Romney as policy adviser and later went on to advise Texas Governor Rick Perry, as well as Senator Marco Rubio. In 2016, he founded FREOPP, the Foundation for Research on Equal Opportunity, a conservative public policy think tank based in Austin, Texas. He continues to edit his blog, The Apothecary, now hosted by Forbes where he serves as Senior Opinion editor.
Should a pass-fail exam designed to determine a student’s competence to practice medicine be scored numerically and used for residency selection? Every year, thousands of students sink an increasingly large number of hours and dollars to prepare for "Step 1" of the US Medical Licensing Examination, a task which seems to be disproportionate to the relevance the test bears to the practice of medicine.
Our guest on this show is Bryan Carmody, MD, (on twitter) a pediatric nephrologist who practices at the Children’s Hospital of the King’s Daughter in Norfolk, VA, and teaches medical students at the Eastern Virginia Medical School. Bryan himself has recently spent countless hours studying and blogging about the machinations that constitute licensing examination in the United States.
Despite its many scientific and therapeutic advances, the field of psychiatry remains lacking in coherence or cohesiveness as compared to other areas of medicine. Part of the issue undoubtedly has to do with the intractable mind-body problem, but part of it may also be due to the effort of standardization of diagnosis set in motion by the Diagnostic and Statistical Manual. Is there a way to move forward?
Our guest is optimistic. Paul McHugh, MD, is one of the most important figures in academic psychiatry of the last thirty years. He is University Distinguished Professor of Psychiatry at Johns Hopkins University School of Medicine where he was department chairman from 1975 until 2001. He is the author or co-author of several academic books and texts of psychiatry.
Mention the phrase “industry-sponsored clinical trial” and many eyes will immediately roll back. But is the reaction justified? Are academic leaders who participate in Phase 3 trials simply figureheads hired to rubber-stamp protocols designed by Pharma and spin the results in a positive way?
Our guest on this show has strong opinions on this question. Dr. Milton Packer is an internationally recognized clinician, teacher, and scientist in the field of heart failure research. He has served as Chief of Cardiology at Columbia University in New York City and, subsequently, as Chair of the Department of Clinical Science at the Southwestern Medical School in Dallas. He is currently the Distinguished Scholar in Cardiovascular Science at Baylor University Medical Center.
Dr. Packer has received many teaching awards, mentored dozens of young clinical investigators, completed innumerable successful research projects, and served as a leader in many professional organizations. He is now also well known and admired for his regular column on MedPage Today, “Revolution and Revelation” in which he mixes wisdom and polemics to the delight of his many readers.
A massive push to increase the number of nurse practitioners and physician assistants and to extend their scope of practice is under way. The stated goal is to address a real or perceived shortage of primary care physicians. This effort worries many doctors who are concerned that patients are getting short-changed in the process. But is this concern justified or is it simply motivated by protectionist interests?
Our guest is Dr. Rebekah Bernard (twitter), a successful family physician from Fort Myers, Florida. She is board member of Physicians for Patient Protection, an organization calling for more transparency regarding the difference in training between physicians and non-physician providers, and advocating for legislative action to avoid misrepresentation of the capabilities and knowledge-base of nurse practitioners.
Effective pharmacological treatment for opioid dependence was introduced more than 15 years ago, yet the opioid epidemic continues to ravage our country and there are still important barriers that prevent patients from receiving the care that they need. The expansion of health insurance does not seem to mitigate this problem and, in fact, health insurance may be a hindrance for proper care.
What if the solution is to simply let doctors help patients directly and personally? Our guest today gives us an extraordinary testimony of what can be accomplished when physicians are free to care for patients privately, without the stigma associated with addiction and rehabilitation clinics.
Dr. Molly Rutherford (twitter) graduated from Eastern Virginia Medical School in 2003 and completed a Family Medicine Residency in Portsmouth, Virginia, in 2006. She and her family moved to Kentucky after residency so that she could practice rural medicine. In 2008, she obtained her DATA 2000 waiver to treat opioid dependence with buprenorphine, and she became Board Certified in Addiction Medicine in 2012.
After a series of frustrations with employment and the dysfunctional health care system, she started her practice with the goal of providing comprehensive, individualized care to her patients at an affordable price, without the interference of third-party payers. Dr. Rutherford is past president of the Kentucky Chapter of ASAM and current president of the Kentucky Academy of Family Physicians. Dr. Rutherford is also a member of the US Health and Human Services Pain Management Best Practices Inter-agency Task Force. She lives with her husband, a homicide detective with Louisville Metro Police Department, and their 2 sons in LaGrange, Kentucky.
The lure of physician employment seems irresistible and, on the surface, the arguments to justify it are also compelling. But are physicians selling themselves short? Are they really better off if they become employees of the hospital? Do they become more efficient? Are they putting themselves in ethical quandaries? And what is the way forward when the forces at play seem so overwhelming?
Our guest is Dr. Arvind Cavale (twitter), an entrepreneurial endocrinologist from Pennsylvania who is bucking the trend with great success, showing that small private practice can remain nimble, adopt technology, and deliver high quality care efficiently. He shares with us his experience and tips for political advocacy.
Bright clinicians who are also trained as rigorous scientists can put healthcare policy under scrutiny and show that the wisdom of the wonks frequently falls short. Our guest on this episode is Dr. Rishi Wadhera (twitter), a prolific cardiology fellow currently in training at Brigham and Women’s Hospital in Boston and part of a team of health policy investigators at the Smith Center for Outcomes Research in Cardiology. Dr. Wadhera obtained his medical degree from the Mayo Clinic, a Master’s in Public Health from the University of Cambridge, and a Master’s in Public Policy from the Harvard Kennedy School of Government. He joins us to discuss two of his most recent papers which have made a big splash in the media.
Will it take data vigilantes to restore some order in the House of Science? With the replication crisis showing no sign of letting up, some committed scientists have taken it upon themselves to find ways to sniff out cases of egregious fraud. As it turns out, identifying scientific misbehavior is surprisingly easy!
Our guest is a full-time research scientist, author/consultant at Northeastern University in Boston in a Computational Behavioral Science lab. James Heathers (twitter) completed his undergraduate work in Psychology and Industrial relations from the University of Sydney and obtained his doctorate degree on the topic of methodological improvements in heart rate variability at the same institution in 2015.
He and a couple of his colleagues have captured the limelight after exposing problems in the work of a world-famous nutrition researcher, which led to the retraction of 5 papers. These “data thugs” have since designed a couple of tools that can identify suspicious data through a simple analysis of descriptive statistics.
There was a time when communities took care of the medical needs of their members without the intervention of governments and without the corrupting influence of health insurance. Can we ever go back to a system of mutual aid at a time when healthcare costs have grown astronomical?
Our guest today shows us that the idea of cost sharing is not only viable but is a lived reality for thousands of families across the United States. Dale Bellis began his work in healthcare in 1988 as an administrator with the first cost-sharing ministry ever begun in modern times. He was instrumental in passing legislation in 11 states exempting cost sharing ministries from insurance regulations. He also introduced technology and administrative techniques to streamline person to person cost-sharing. In 2012, he founded Liberty Healthshare, which provides an opportunity to live free from insurance and government-mandated healthcare to a large and growing number of American families that share fundamental values and a strong belief in personal responsibility.
In the mind of the public, American physicians are represented by one prominent organization, namely, the American Medical Association. Yet, only a minority of American physicians currently belong to the AMA, which has long grown comfortable with political and government intrusions into healthcare.
Who should represent physicians when doctors may hold very divergent views on matters of politics, economics, ethics, and even science? Should there be one voice or a plurality of voices? Our guest today is the executive director of the Association of American Physicians and Surgeons (AAPS), an organization that sprung up in the 1940s as an alternative to the AMA and to staunchly defend private medicine free of government interference or coercion.
Dr. Jane Orient (twitter) obtained her medical degree from Columbia University and is in a solo internal medicine practice in Tucson, AZ. She is a prolific writer, having penned hundreds of op-eds in national and local media outlets. She is the author of numerous books, notably Your Doctor is Not In: Healthy Skepticism About National Health Care and Sutton’s Law, a novel about where the money is in medicine. She is also the editor of the famous textbook Sapira’s Art and Science of Bedside Diagnosis, now in its 4th edition.
Radiology holds a special place in the medical ecosystem. Radiologists are “the doctors’ doctors” and the treatment of a patient rarely proceeds without a radiologist furnishing an opinion. But the field of radiology also faces challenges: the crusade against “wasted imaging,” the rise of artificial intelligence, the dependence of radiology on hospital systems, and the de facto barrier that separates radiologists from patients.
What does the future hold for radiology and what could one wish for it? Returning to the show is Dr. Saurabh Jha (twitter), Associate Professor of Radiology at University of Pennsylvania Perelman School of Medicine. He shares his perspective with his characteristic wit and humor.
Some drugs cost more than diamonds, though their health benefit seems marginal. Others cost less than a package of M&Ms, though they are demonstrably life-saving. Some drug prices have spiked to three-fold, four-fold, or even ten-fold from what they were just a few years ago. Drug pricing seems to be an irrational and incomprehensible aspect of our economy.
To help us gain clarity on the matter, we have as out guest Amitabh Chandra (twitter), the Malcolm Wiener Professor of Public Policy at the Harvard Kennedy School of Government and the Henry and Allison McCance Professor of Business Administration and the Harvard Business School. He is among the best decorated healthcare economists alive, having received the highest awards in the field. He is an elected member of the National Academy of Medicine, a member of the Congressional Budget Office panel of health advisors, and a research associate at the National Bureau of Economic Research.
Professor Chandra has published seminal papers in the most highly ranked journals of economics and medicine. His research has been featured in The New York Times, The Washington Post, CNN, Newsweek, and on National Public Radio and has testified to the US Senate on matters of healthcare policy.
For decades, the academic cardiology community has focused its attention on pharmacological interventions to prevent heart disease. Our guest is an accomplished clinician-scientist who tells us his personal story that led him from the lab bench to becoming interested in dietary interventions and in the ketogenic diet in particular.
Dr. Ethan Weiss (twitter) is Associate Professor of Medicine at the University of California San Francisco. He has a stellar academic pedigree, having received his MD degree from Johns Hopkins Medical School, where he also trained as part of his internship and residency. He completed his fellowship in cardiology at UCSF and has had an illustrious career as a basic science investigator at UCSF, studying the relationship between heart disease and metabolism. He is also the co-founder of a start up company, Keyto, to help people measure their blood ketone levels in real time as part of a diet management program.
Doctors have been suspected, accused, or convicted of fraud since time immemorial. But, in the era of third-party payment for health care, such charges have taken on an entirely new form, particularly when the third party in question is the federal Medicare program. How does the government proceed to establish that Medicare fraud has taken place? How does it distinguish fraud from poor judgment or incompetence? And what does that mean for the practicing physician who submits thousands of claims a year to Medicare?
To help shed light on the legal procedures, tactics, and tricks that can send a physician to a federal jail, our guests are Kyle Clark and Andrew George, defense attorneys who specialize in white collar crime and healthcare fraud. Clark and George work for the global legal firm Baker Botts, LLP, and they recently authored an op-ed in the Wall Street Journal on this subject entitled “A Second Opinion Becomes a Guilty Verdict”.
For a few decades in the mid-twentieth century, the American Medical School represented the pinnacle of academia and its faculty were mightily engaged in the “triple threat” of research, teaching, and patient care. Today, however, the medical ivory tower is subordinated to hospital systems, overburdened with the menial task of “generating revenue,” and is but a pale image of its former self. On this episode, our guest helps us trace the history of the American medical school from its humble 19th century beginnings to its present day turmoils.
Dr. Milton Packer is an internationally recognized clinician, teacher, and scientist in the field of heart failure research. He has served as Chief of Cardiology at Columbia University in New York City and, subsequently, as Chair of the Department of Clinical Science at the Southwestern Medical School in Dallas. He is currently the Distinguished Scholar in Cardiovascular Science at Baylor University Medical Center.
Dr. Packer has received many teaching awards, mentored dozens of young clinical investigators, completed innumerable successful research projects, and served as a leader in many professional organizations. He is now also well known and admired for his regular column on MedPage Today, “Revolution and Revelation”, in which he mixes wisdom and polemics to the delight of his many readers.
How do we know that a treatment works or not? Billions of healthcare dollars are at stake in the answer to that question. For decades, that answer has largely hinged on theories from a field of human inquiry that combines the precision of mathematics with the accuracy of astrology. We are talking of course, about statistics and statistical inference.
To help us understand better this mystical science, we have as our guest Dr. Michael Acree who has spent his entire career working for the University of California San Francisco as a data scientist and a teacher of statistical science, helping countless researchers make sense of the data they had obtained. Michael is now retired and is completing a book on the history and philosophy of statistical inference. He joins us to tell us the whole truth about what is sometimes referred to as the science of mendacity!
We have become highly sensitized to the question of conflict of interest in healthcare—and rightly so. But the dominant narrative seems to be one-sided: doctors and scientists getting personally paid by industry sponsors and letting those payments color their judgment, consciously or unconsciously.
Personal financial conflict of interest is certainly an important and pervasive problem, but there are many aspects of COI that get less attention and may be equally harmful to society at large. To discuss this topic, our own Anish Koka engages Michel Accad in a lively discussion that tries to probe the topic in depth, even when such probing reveals uncomfortable truths.
It doesn't take great insight to assert that healthcare waste is rampant. There is an obvious epidemic of testing and treatments that make no difference in patients' lives or could possible even harm. But what is the cause of the epidemic and what should be done about it? In the last decade, a popular narrative has emerged, claiming that the waste has obvious causes and remedies. That narrative, however, overlooks the complexities of the problem and the trade-offs and potential harms of the remedies proposed.
Our guest to discuss the “Less-Is-More” movement is Lisa Rosenbaum, MD, one of the best medical writers of our generation. Dr. Rosenbaum is a national correspondent for the New England Journal of Medicine, a cardiologist at the Brigham and Women’s Hospital, and an Assistant Professor of Medicine at Harvard Medical School.
The healthcare system continues to inflict “moral injury” on physicians, causing burnout, depression, or apathy. And, built as it is on a mountain of debt, the edifice may also not provide any long term security for those who choose to remain on board. Yet the prospect of jumping ship may seem daunting to many.
Our guest today shares with us her personal story of how she did abandon the titanic and forged for herself a successful path to professional sanity.
Kathleen M. Brown, MD, obtained her medical degree from the Eastern Virginia School of Medicine and practiced dermatology and internal medicine for several years in Maryland. In 1997, she and her family moved to the coast of Oregon to join a multi-specialty group of which she was a partner in the group until mid-2011. This group was a good fit but the administrative and financial burdens of the system were increasingly taking a toll on her enjoyment of medicine.
After passage of the Affordable Care Act in 2010, she saw that continuing to stay within an insurance-contracted system would make her style of medical practice impossible. In July, 2011, with help from her husband, Jack, she opened a direct pay Dermatology practice with a transparent fee schedule. Within a month of opening she had a full schedule and a restored sense of professional satisfaction.
We spend billions of dollars a year on healthcare yet no one can give a satisfactory definition of health. Is our inability to articulate what health is precisely the reason for our insanely dysfunctional healthcare systems?
Our guest today will give us his very personal reflections on that question. Pat Caslin is a business strategist from Dublin, Ireland, who’s had a successful career nationally and internationally, working for a variety of financial and business development institutions. Eleven years ago he was diagnosed with relapsing-remitting multiple sclerosis. Five years ago the disease became progressive and he lost his ability to walk.
Instead of letting the illness take over his life, Pat went through a profound change of perspective regarding his health and what it means to be healthy. As a result, he has been sharing his insights, both in writing and in speaking engagements, with students, with physicians, with patients, and with the public at large. He was recently selected to give a TEDx talk in Dún Laoghaire, Ireland.
Doctors are embroiled in a healthcare system they appear to have no control over. It therefore seems plausible that if they got involved in healthcare policy, they might be in a position to “steer the ship” or at least have a say in how the ship is steered.
We discuss the pros and cons of healthcare policy in general—and of a doctor’s involvement in such policy—with Aamir Hussein (twitter), a fourth year medical student at the University of Chicago Pritzker School of Medicine.
A native of Farmington, Connecticut, Mr. Hussain also holds a master’s degree in public policy from the University of Chicago Harris School of Public Policy and a BA from Georgetown University in Government. He writes frequently about interfaith dialogue, Islam, and the intersections between healthcare and spirituality and has given lectures around the United States on these topics. He has been interviewed by The New York Times, Al Jazeera, and PBS, and his writings have been featured in medical journals and several online outlets including Religion News Service and The Huffington Post.
Doctors are increasingly asked to follow decision rules, guidelines, and “evidence-based” algorithms. Is that the right approach to take care of patients? Are cognitive errors over-emphasized in healthcare?
Our guest on this episode is Gary Klein, one of the most important figures in cognitive psychology in the world. His pioneering work in the field of naturalistic decision-making has become a major challenge to the established schools of thought on how experts make good decisions.
He is a leader of a growing research community focused on understanding how human beings acquire and apply knowledge to complex situations under uncertainty. He has developed novel explanatory models and training methods for decision-making that are widely recognized as ground-breaking. He is the author of numerous books, including the best-sellers Streetlights and Shadows: Searching for the Keys in Adaptive Decision-Making and Seeing What Others Don’t: The Remarkable Ways We Gain Insight. He is notorious for having gained the respect and admiration of his intellectual opponent, Nobel Prize winner Daniel Kahneman, with whom he co-authored a widely read paper contrasting their somewhat divergent views.
Did bioethics emerge to defend the interests of patients or to rationalize the needs and actions of the state and its corporate allies? Are bioethicists too complacent about their grasp of economics? Do they have sufficient understanding of the complexities of medical decisions to weigh in on them? Are Hippocratic ethics so inadequate that they needed to be replaced by ever-morphing "Kantian" ethics? A fascinating discussion with our guest, Tom Koch, a man whose resumé and whose many books read like great adventure stories.
Professor Koch is an author, journalist, historian, philosopher, and educator. He holds an inter-disciplinary PhD in medical cartography, ethics and medicine. He has taught medical ethics to medical students at the University of Toronto. He is a consultant in gerontology. And he has written numerous books both for an academic audience as well as for the general public. His books include Cartographies of Disease, Ethics in Everyday Places, The Wreck of the William Brown, and the volume that will be the focus of our discussion today, Thieves of Virtue: When Bioethics Stole Medicine.
"We’re not going to ask permission to take care of our patients." It is with this epiphany, that our guest on this episode became one of the pioneers and leaders of the most hopeful trend in health care today: the direct primary care or DPC movement.
Dr. Lee Gross shares with us how the light bulb went off in his mind that there is no good reason to insure primary care and, in fact, that insuring primary care hurts everybody: patients, doctors, and society. He walks us through his success stories and the efforts he is leading at the state and federal level to remove regulatory barriers to direct care.
Dr. Gross is the founder of Epiphany Health in North Port, Florida, and is regularly consulted by lawmakers at the local, state, and national level. He has offered testimony on behalf of the direct care movement for the US Health and Human Services Department, the US Congress, and for the White House. He also serves as president of the Docs 4 Patient Care Foundation and he is the recipient of the 2016 HCA Frist’s Humanitarian Award and of the Beacon Award from the Free Market Medical Association for his leadership in healthcare reform.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, Spotify, or via RSS.
In 550 BC, the Greek philosopher Heraclitus famously declared: “No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.” In this episode, we learn from our guest whether scientists can step into the same data pool and obtain the same research results twice.
Brian Nosek is Professor of Psychology at the University of Virginia. He is also the co-founder and Executive Director of the Center for Open Science, an organization dedicated to fostering transparency and collaboration in scientific research.
In 2015, Professor Nosek and his team published in the journal Science a widely acclaimed and widely discussed paper that shed light on the extent to which psychological research findings may not be reproducible when the research is conducted anew.
More recently, his Center conducted a unique project where a single data set was sent to be analyzed by about 30 independent teams of statisticians for the purpose of answering a single question. The variability in the methods chosen and in the answers obtained was also perhaps sobering, if not perplexing.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Patients come in all sizes and shapes, and with varying tolerance for complications and risk. Is it plausible that a single dosing regimen can optimize treatment for everybody? If not, what is keeping the pharmaceutical industry from endorsing a more dynamic and patient-centered drug dosing regimen?
Our guest is Dr. David Norris, a physician, mathematician, and inventor. David operates a scientific and statistical consultancy focused on methodology development for precision-medicine applications. He developed Dose Titration Algorithm Tuning (DTAT), a methodological framework that conceives dose individualization as a seamless learning process, beginning in early-phase trials and continuing throughout the drug development process. Before earning his M.D. at Brown University, he worked in diverse application areas including mathematical finance, operations research and systems engineering.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
The reform of medical education is a usually boring conversation that needs its own reform. The discussion we have on this episode does just that. It goes far beyond the usual proposals to tweak the curriculum and directly addresses the question of what it means to be a physician.
Our guest is Dr. Adam Cifu, an award-winning medical educator and author. Dr. Cifu is a Master in the Academy of Distinguished Medical Educators at The University of Chicago. He has been selected as a Favorite Faculty Member by the graduating class of students 14 times. He is the author of Symptom to Diagnosis a manual on diagnostic reasoning, and co-author with Dr. Vinay Prasad of Ending Medical Reversal: Improving Outcomes, Saving Lives, one of the blockbuster medical books of the last few years.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
We revisit the question of brain death, this time with a more practical focus. What should doctors tell families of patients who fulfill neurological criteria for brain death? Joining us on this program is Fred Rincon, MD, who is a Assistant Professor of Neurology at Jefferson University Medical Center in Philadelphia. Dr. Rincon is a neuro-intensivist who, on a day-to-day basis, cares for patients with severe brain injury. He also holds a Master’s in Bioethics from the University of Pennsylvania.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Economic knowledge should not be the sole province of technical experts, but it is—and we seem to accept the way it is. The price we pay for this ignorance is that most people—including doctors—can easily fall prey to the political class and to the technocrats whose economic theory is generally far from sound.
Our guest on the show is Jeff Deist, President the Mises Institute, an educational institution that promotes a very noble tradition of economic theory and political thought. Prior to taking the helm of the Mises Institute, Mr. Deist was chief of staff to Congressman Ron Paul for many years and, in that capacity, gained special insights into healthcare “sausage-making” in Washington DC.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Should doctors have something to say about guns? If so, what should they say? A position paper by the American College of Physicians, followed by a blog post and a tweet from the National Rifle Association, have set off a storm of controversy on the issue of medical professionals speaking publicly about guns and gun control.
Our guest today is Pradheep Shanker, a radiologist based in Ohio and a prolific writer and conservative commentator who contributes regularly to a number of major national media outlets, including National Review, The American Spectator, Ricochet, and others. He just published a piece entitled “Guns, Doctors, and Staying in Your Lane.”
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
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.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
For most doctors, Hippocrates is a quaint figure of the past with hardly any relevance to the modern practice of medicine. We may label him as the “father of medicine,” but we have no idea what really connects us to him. We may occasionally and sanctimoniously proclaim “first, do no harm!” but we ignore the origin and real significance of that phrase.
Some of us may have taken some modified version of the Oath of Hippocrates upon graduating from medical school, but few of us think of it as a serious pledge with any real consequence for our day-to-day practice. And, over the last decades, most bioethicists have openly set aside the Hippocratic tradition, deeming it inadequate to help us deal with the moral quandaries that arise in the age of scientific medicine.
So, is there are any reason, besides historical curiosity, to become familiar with Hippocrates, let alone take him seriously? To help us sort this out we have a distinguished guest Thomas Cavanaugh who is the author of a brand-new book entitled Hippocrates’ Oath and Asclepius’ Wound: The Birth of the Medical Profession, published by Oxford University Press.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Are doctors patsies for the medical device industry? Are patients put in harm’s way for lack of tough standards on new device approvals? We examine the question with Jeanne Lenzer, award-winning investigative journalist and author of The Danger Within Us: America’s Untested, Unregulated Medical Device Industry and One Man’s Battle to Survive It.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Coronary heart disease remains shrouded in mystery as to its causes and natural history. Our guest is Dr. William Rothstein, Professor Emeritus of Sociology at the University of Maryland, who has just published The Coronary Heart Disease Pandemic of the Twentieth Century: Emergence and Decline in Advanced Countries. This fresh look at the patterns of coronary mortality rates throughout the world over the last 8 decades calls into question received notions about this disease.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Are medical journals still needed in the age of the internet and social media? Our guest is Brahmajee Nallamothu, editor of the journal Circulation Cardiovascular Quality and Outcomes. We have a wide ranging conversation, covering everything from the financial incentives of publishing, ideological biases in medical journals, the peer review process, the Twitter effect, and a new editorial position of independent troller!
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
US medical schools overwhelmingly support centralization of healthcare and health care decision-making. That is not a surprise since, over the decades, academic institutions have greatly benefited from healthcare policy.
Because centralization of health care is detrimental to the doctor-patient relationship, students who begin their training motivated by a genuine desire to practice medicine in a meaningful and personal way can easily fall into disabuse or disillusion or may adopt a more cynical attitude toward their profession.
Our guest today is Beth Haynes, medical director of the Benjamin Rush Institute, a non-profit organization dedicated to offering medical students an alternative perspective on healthcare and its possibilities by exposing them to free-market principles and ethics, centered on the supremacy of the doctor-patient relationship.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
For an increasing number of Americans today, a single payer system seems to be the only conceivable next step in the cataclysmic and ruinous history of our healthcare system. Adam Gaffney, MD, a longtime supporter of a single-payer system and president-elect of Physicians for a National Health Program, joins Michel and Anish to defend a single-payer healthcare system.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Do medical journals apply scientific standards selectively? On the subject of the effect of pharmaceutical lunch gifts on physician behavior, all that may be required from a paper is that the conclusions drawn be compatible with the expected narrative—even if the data presented suggests the opposite. Rafael Fonseca and John Tucker share their eye-opening analysis of a recent article published in JAMA Internal Medicine and the fascinating reaction to their analysis from journal editors and from the community at large.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Many ardent supporters of free markets still believe that healthcare is an exception where government intervention is, for some reason, necessary. Our guest on this episode is Roman Zamishka, a financial analyst and medical school applicant who authored a witty and carefully constructed article titled “A Libertarian’s Case Against Free Markets in Healthcare.” The piece garnered a lot of positive comment on The Health Care Blog where it was published. Mr. Zamishka kindly agreed to be cross-examined about the points he made.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
The Swiss healthcare system is frequently proposed as a model for the rest of the world to emulate. Marc Fouradoulas joins hosts Anish Koka and Michel Accad to discuss and explain why the country has set the precedent for a universal healthcare system. Dr. Fourandoulas practices medicine in Zurich, Switzerland, and is a board-certified internist who holds a Master’s degree of advanced studies in managed health care and health economics from the Winterthur Institute of Health Economics.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Hadiza Bawa-Garba was convicted of involuntary manslaughter by a British court for her role in the care of a patient in a hospital setting fraught with system failures. Dr. Saurabh Jha returns to the Accad and Koka Report to share his insights on this case. Dr. Jha trained in the NHS but practices in the United States as Assistant Professor of Medicine at University of Pennsylvania Perelman School of Medicine. He is intimately familiar with the details of the Bawa-Garba case, and has recently returned from London where he attended the most recent legal proceedings in the physician’s appeal of the General Medical Council’s decision.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Public reporting of outcomes aims to improve service quality, but has also harmed patients and doctors alike. Can any good come out of it? Dr. Robert W. Yeh is Associate Professor of Medicine at Harvard Medical School, and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. He is an expert on the outcomes of outcome reporting.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Dr. Gajendra Singh is a well-respected surgeon who decided to provide affordable ultrasound, CT, and MRI imaging to his community. A few months into his endeavor, he was confronted by his state’s “certificate of need” laws telling him that providing affordable healthcare was illegal. His response: to sue the government.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Dr. Wes Fisher is leading the fight against the American Board of Internal Medicine and its self-serving tactics that force thousands of physicians to comply with the onerous Maintenance of Certification Program. Wes outlines the new initiatives that stand a realistic chance of turning the tide against the quasi-regulatory monopoly of the board-certifying agencies.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Guest Twila Brase is an RN, PHN, and is Executive Director of the Citizen’s Council for Health Freedom. She discusses her freshly released book that reveals the ugly truths about electronic health records, and what can be done to escape from this modern day Panopticon.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Dr. Mary Ruwart’s meticulous research is an eye opener for anyone interested in health. Her new book examines the history of the last 6 decades of drug regulation and highlights the unintended consequences of the 1962 amendments to the FDA.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad take the EBM controversies to India and consult with Dr. Anupam Singh, Assistant Professor of Medicine at SMC in Ghaziabad. Singh offers a very sound and intelligent perspective on the proper role of clinical trials and clinical judgment in medical care.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad have fun discussing the controversies about blood pressure guidelines with guest Dr. Swapnil Hiremath, Assistant Professor of Medicine at the University of Ottawa and Co-founder of NephJC, a highly successful Twitter-based journal club. Dr. Hiremath sits on the Canadian blood pressure guideline committee and shares his insights about the question of BP management.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad explore the “less-is-more” movement with Dr. John Mandrola, one of its most articulate and popular champions. They discuss the problem of practices that have no scientific justification and the conundrum of out-of-control costs. What is the best way to curtail unwarranted therapies? Should there be more top down regulations or is it possible that more health care freedom will lead to less utilization?
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Shared decision-making (SDM) has become a sacred cow of medical ethics almost overnight. What’s more, doctors are now being forced to practice it in order to get paid for certain procedures. Anish Koka and Michel Accad review the history of this concept and why it is contrary to a sound doctor-patient relationship.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad have a terrific interview with G. Keith Smith, co-founder of the Surgery Center of Oklahoma and of the Free Market Medical Association. Keith recounts his pioneering experience and clearly makes the case that free markets are ethical, workable and, ultimately, unstoppable.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad discuss a blog post by obesity therapy guru Jason Fung, in which he pushes back against “debunkers” and self-appointed guardians of “science-based medicine.” They look at the question of science and pseudo-science and how it bears on actual medical care.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad discuss the effects of public reporting of outcomes on the behavior of physicians, and the reactions to a paper that was just published on this topic.Anish shares a real-life experience of a patient of his who was a tragic victim of these misguided healthcare policies.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad discuss a tweet and a paper claiming that pharmaceutical companies don’t even need to produce effective drugs anymore. All they need is “an effective marketing campaign” and billions of dollars in annual sales soon follow. This is a very dubious claim on the face of it, but Anish did some investigating of his own.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad take to task healthcare policy wonks who lament that the government can no longer mandate hospital systems to participate in new “value-based” payment schemes. These alternative payment plans have been a disaster from the get-go, but it seems that central planners never lose hope.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad have a free-wheeling and fun conversation with Dr. Saurabh Jha on the philosophical question of “what is normal.” The conversation was prompted by an editorial by John Ioannidis who thinks that “Big Data” could help clinicians get a handle on the vexing problem of normal values. Anish, Michel, and Dr. Jha discuss the merits of that idea.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
There precise rationale invoked by the courts to prevent Alfie Evans’ parents from transferring the child out of the UK is widely misunderstood. In many ways it worse than what many people imagine. Anish Koka and Michel Accad discuss this chilling case and the ethical doctrine that informs the courts’ decision.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad discuss a “white paper” jointly written by Jeffrey Flier, former dean at Harvard Medical School, and Jared Rhoads, from the Dartmouth Institute, calling for some deregulation of the apparatus that rules the supply of physicians and their scope of work. We touch on the question of safety, patient sovereignty, alternatives to licensing, and whether protectionism is ever a legitimate option.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
Anish Koka and Michel Accad have a fun chat with Professor Darrel Francis, from Imperial College in London and the UK’s National Heart and Lung Institute. Dr. Francis takes the “pro” side and Michel the “con” side in regards to evidence-based medicine.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.
After an opinion piece in JAMA Internal Medicine once again showed the influence of drug company payments on physician practices, co-host Dr. Anish Koka comes clean about his relationship with Big Pharma. Anish and co-host Dr. Michel Accad discuss that potential conflict of interests but place it in the context of broader COIs in health care that no one ever talks about.
The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.