On Episode 3 of HardCore Health, Jess & I start off by discussing all of the health tech companies IPOing (Livongo, Phreesia, Health Catalyst) and talk about what that means for the industry as a whole. Zoya Khan discusses the newest series on THCB called, “The Health Data Goldilocks Dilemma: Sharing? Privacy? Both?”, which follows & discuss the legislation being passed on data privacy and protection in Congress today. We also have a great interview with Paul Johnson, CEO of Lemonaid Health, an up-and-coming telehealth platform that works as a one-stop-shop for a virtual doctor’s office, a virtual pharmacy, and lab testing for patients accessing their platform. In her WTF Health segment, Jess speaks to Jen Horonjeff, Founder & CEO of Savvy Cooperative, the first patient-owned public benefit co-op that provides an online marketplace for patient insights. And last but not least, Dr. Saurabh Jha directly address AI vendors in health care, stating that their predictive tools are useless and they will not replace doctors just yet- Matthew Holt
Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site.
Recently, my niece gingerly
confided that she was going to study engineering rather than medicine. I was
certain she’d become a doctor – so deep was her love for biology and her
deference to our family tradition. But she calculated, as would anyone with
common sense, that with an engineering degree and an MBA, she’d be working for
a multinational company making a comfortable income by twenty-eight. If she
stuck with tradition and altruism, as a doctor she’d still be untrained and
preparing for examinations at twenty-eight.
Despite the truism in India that
doctors are the only professionals never at risk of starving, the rational case
for becoming a physician never was strong. Doctors always needed a dose of the
irrational, an assumption of integrity and an unbridled goodwill to keep going.
Once, doctors commanded both the mystery of science and the magic of
metaphysics. As medicine became for-profit, the metaphysics slowly disappeared.
Indians are becoming more
prosperous. They’re also less fatalistic and expect less from their gods and
more from their doctors. In the beginning they treated their doctors as gods, now
they see that doctors have feet of clay, too. Doctors, who once outsourced the
limitations of medicine to the will of Gods, summarized by the famous Bollywood
line “inko dawa ki nahin dua ki zaroorat hai” (patient needs prayers not
drugs), now must internalize medicine’s limitations. And there are many –
medicine is still an imperfect science, a stubborn art, often an optimistic breeze
fighting forlornly against nature’s implacable gale.
In 1999, the Institute of Medicine (IOM) in their landmark report – To Err is Human – estimated that the number of deaths from medical errors is 44 ,000 to 98, 000. The report ushered the Quality and Safety Movement, which became a dominant force in all hospitals. Yet the number of deaths from medical errors climbed. It is now touted to be the 3rd leading cause of death. How easy is it to precisely quantify the number of deaths from medical errors? Not many physicians challenged the methodologies of the IOM report. Some feared that they’d be accused of “making excuses for doctors.” Many simply didn’t have a sufficient grip on statistics of measurement sciences. One exception was Rodney Hayward – who was then an early career researcher, a measurement scientist, who studied how sensitive the estimates of medical errors were to a range of assumptions.
Rod Hayward a Professor of Public Health and Internal Medicine at the University of Michigan and Co-Director of the Center for Practice Management and Outcomes Research at the Ann Arbor VA HSR&D. He received his training in health services research as a Robert Wood Johnson Clinical Scholar at UCLA and at the RAND Corporation, Santa Monica. His current and past work includes studies examining measurement of quality, costs and health status, environmental and educational factors affecting physician practice patterns, quality improvement, and physician decision making. His current work focuses on quality measurement and improvement for chronic diseases, such as diabetes, hypertension and heart disease.
Listen to their conversation on Radiology Firing Line Podcast here.
Can we reduce over diagnosis by re-naming disease to less anxiety-provoking makes? For example, if we call a 4.1 cm ascending aorta “ecstasia” instead of “aneurysm” will there be less over-treatment? In this episode of Radiology Firing Line Podcast, Saurabh Jha (aka @RogueRad) discusses over diagnosis with Ian Amber, a musculoskeletal radiologist at Georgetown University, Washington.
What does it take to create a decision rule? In this episode of Radiology Firing Line podcast Saurabh Jha (@RogueRad) has a discussion with Robert W. Yeh MD MBA about the deep thought and complex statistics involved in creating a decision rule to guide therapy which have narrow risk-benefit calculus, specifically a rule for how long patients should continue dual anti-platelet therapy after percutaneous coronary intervention. They also discuss the motivation behind the legendary, and satirical, parachute RCT published in the recent Christmas edition of the BMJ, which delighted satirists all over the world.
In this episode of Radiology Firing Line Podcast, I speak with Bishal Gyawali MD, PhD. Dr. Gyawali obtained his medical degree from Kathmandu. He received a scholarship to pursue a PhD in Japan. Dr. Gyawali’s work focuses on getting cheap and effective treatment to under developed parts of the world. Dr. Gyawali is an advocate for evidence-based medicine. He has published extensively in many high impact journals. He coined the term “cancer groundshot.” He was a research fellow at PORTAL. He is currently a scientist at the Queen’s University Cancer Research Institute in Kingston, Ontario.
What are the challenges of bringing advanced imaging services to India? What motivates an entrepreneur to start build an MRI service? How does the entrepreneur go about building the service? In this episode, I discuss radiology in India with Dr. Harsh Mahajan, Dr. Vidur Mahajan and Dr. Vasantha Venugopal. Dr. Harsh Mahajan is the founder of Mahajan Imaging, a leading radiology practice in New Delhi, and now a pioneer in radiology research in India.
Listen to our conversation on Radiology Firing Line Podcast here.
Saurabh Jha is an associate editor of THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner.
In this episode of Radiology Firing Line Podcast, Danny Huges and I discuss a JAMA paper: A comparison of diagnostic imaging ordering patterns between advanced practice clinicians and primary care physicians following office-based evaluation and management visits.
Listen to our conversation on Radiology Firing Line here.
Saurabh Jha is a contributing editor to THCB and host of Radiology Firing Line Podcast of the Journal of American College of Radiology, sponsored by Healthcare Administrative Partner