Healthcare Unfiltered

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Episode 38: Updates on NET and Diversity Research With Pamela Kunz Jul 06, 2021

Show notes

To tackle the complicated world of neuroendocrine tumors (NETs), Chadi is joined by Pamela Kunz (@PamelaKunzMD), MD, Director of the Center for GI Cancers at Yale Cancer Center; as well as the Vice Chief of Diversity, Equity, and Inclusion for medical oncology at Yale Cancer Center. Dr. Kunz begins by shedding light on potential reasons for higher incidence of NETs in the past three decades and the boom of FDA approvals in the last decade, as well as the latest therapies and clinical trials with the most potential to move the needle for patient care. Then, Chadi and Dr. Kunz highlight the priorities of a new committee she has helped form for diversity, equity, and inclusion within the institution – including data collection, increasing the diversity of the faculty, and creating a culture of respect.

Episode 37: Press Releases, Pre-Prints, Abstracts, and Papers: Reviewing the Peer-Review Process Jun 29, 2021

Show notes

Vincent Rajkumar (@VincentRK), MD, Mayo Clinic, and Editor-in-Chief of Blood Cancer Journal, rejoins the show to answer some critically important questions related to medical publications and information reliability in the pandemic and post-pandemic world. As a consumer of medical news, which sources of information should you take seriously? Should you ignore press releases and pre-prints in favor of abstracts or papers? Should peer-reviewed literature be your only source of reliable information? Together, Chadi and Dr. Rajkumar put on their critical appraisal hats to rate various sources and determine when to adapt new guidelines or recommendations for patient care.

Episode 36: What to Consider When Considering the Keto Diet Jun 22, 2021

Show notes

Chadi dives into the world of nutrition and dieting with Kevin Bass, MD, PhD student in Texas; Ethan Weiss, MD, cardiologist; and Aaron Goodman, MD, hematologist and current subscriber to the Ketogenic diet. The groups begins with a history of the “Keto” diet and how it has transformed into a popular diet for weight loss, what goes into the traditional Keto diet and how to do it effectively, controversy surrounding the diet and whether it is associated with adverse health effects, reasons to follow and not follow the diet, and numerous misconceptions about low-carb diets in general.

Episode 35: An Update on the COVID Situation in India Jun 15, 2021

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To provide an update on the COVID spike and response in India over the past 6 weeks since Chadi’s previous episode, Aju Mathew (@ajumathew_), MD, oncologist practicing in southern India, joins the show. Dr. Mathew begins by describing the tradeoffs of moving home to practice in India while leaving his academic career behind in the US, offers critical remarks on India’s government use of resources to combat COVID up to and during the “tsunami,” shares how vaccine hesitancy around the world bled into India’s population, provides a status on the current vaccine and resource availability in the country as well as the percentage of the population vaccinated, and plenty more.

Episode 34: Medical Bullying and Physician Suicide: Laura Silinskyte’s Story Jun 08, 2021

Show notes

In early May, a Lithuanian doctor named Laura Silinskyte committed suicide after facing constant bullying from her superiors at her regional hospital. To shed light on the issue of medical bullying and physician suicide, Chadi is joined by two friends of Dr. Silinskyte—Monika Arzanauskaite, a radiologist, and Gil Morgan, a medical oncologist—as well as a personal friend Laurie Gordon, an adult and child psychiatrist with experience treating healthcare workers. Monika and Gil share who Laura was as a person and some insight into her life leading up to her final days, how the outdated and hierarchical structure of the health system in Lithuania likely contributed to her final decision, explain the differences between “bullying” and “mobbing,” and wrap up with what can be done by the medical community to keep a tragedy like this from happening again.

Episode 33: The Oncologist as a Caretaker: A Husband and Wife Story Jun 01, 2021

Show notes

For this special episode, Chadi invites John Marshall (@marshalj23), MD, Chief of the Division of Hematology/Oncology, Medstar Georgetown University Hospital, and his wife Liza Marshall, a lawyer by training who was diagnosed with triple-negative breast cancer 15 years ago. John and Liza co-wrote a book, titled Off Our Chests, about their shared experience of overcoming her diagnosis – told from the perspective of the caregiver as well as the patient. The couple open up about their individual experiences through treatment, how difficult it was to speak candidly about their feelings in the moment, the struggles of remaining an objective physician when a spouse is the patient, the sometimes impractical nature of shared decision-making, and a host of personal anecdotes along the way.Visit the Off Our Chests website to order the book https://www.offourchestsbook.com/View Chadi’s review of the book on The Health Care Blog https://thehealthcareblog.com/blog/2021/05/27/off-our-chests-no-secrets-left-behind/

Episode 32: Should CNS Prophylaxis be Given to DLBCL Patients? May 25, 2021

Show notes

Chadi welcomes “Papa Heme,” or Aaron Goodman (@AaronGoodman33), MD, hematologist at University of California San Diego, and Matt Wilson (@mattwilson2287), MD, Beatson West of Scotland Cancer Centre (UK), to debate the importance and utility of CNS prophylaxis for patients with DLBCL. The trio explain the origins of the debate, who the high-risk patients are in the first place, whether better systemic control is a better strategy for these patients, how to weigh the benefits against the toxicities and other negative effects, and so much more. You don’t want to miss this informative and at times contentious dialogue.

Episode 31: Optimizing Clinical Trial Design with Bishal Gyawali May 18, 2021

Show notes

Bishal Gyawali (@oncology_bg), MD, PhD, Queen’s University Cancer Research Institute (Canada), joins the show to discuss the measurement of clinical benefit of new therapies and optimizing clinical trial design. Dr. Gyawali recaps a presentation he gave at last year’s ESMO Annual Meeting on clinical trial characteristics leading to artificial improvement of ESMO-MCBS scores for cancer drugs, goes on to list in detail the ten trial design characteristics that inflate the scores (including the use of surrogate endpoints and quality of life reporting, among others), and wraps up with a comment on future opportunities for clinical trial reform.View Dr. Gyawali’s recent publication on clinical trial design https://www.esmoopen.com/article/S2059-7029(21)00075-2/fulltext

Episode 30: COVID Vaccine Passports: Necessary or Nefarious? May 11, 2021

Show notes

Recurring guests Saurabh Jha (@RogueRad), MD, radiologist in Philadelphia, and Vinay Prasad (@VPrasadMDMPH), MD, MPH, hematologist/oncologist in San Francisco, seek to settle the debate surrounding COVID vaccine passports. Both scholars defend their recently published viewpoints – Dr. Jha arguing for passport mandates and Dr. Prasad arguing against them. Will requiring proof of vaccination be driven by the business sector, local or federal governments, or anywhere in between? Will vaccines help jump start or continue to stall economies? When is the right time to impose a vaccine passport, if ever at all? This is a real barn-burner of a discussion that you won’t want to miss.View Dr. Jha’s publication on The Health Care Blog https://thehealthcareblog.com/blog/2021/04/29/the-market-forces-behind-vaccine-passports/View Dr. Prasad’s publication in Medscape https://www.medpagetoday.com/blogs/vinay-prasad/92107

Episode 29: COVID-19 and the Tragedy in India: The Real Story May 04, 2021

Show notes

To truly understand the gravity of the somber COVID situation in India, Chadi hosts Parameswaran Hari, MD, MRCP, chief of oncology, Medical College of Wisconsin, and Nikita Mehra, MD, associate professor of medical oncology, Cancer Institute Adyar (India). Dr. Hari begins by providing a ground-floor perspective of the COVID situation in India from his visit there just a few weeks ago, including how the country fared in 2020 compared to the current day and how hospital systems are managing in different parts of the country. Dr. Mehra then joins the show to share how shocked India has been with the second wave. The trio discuss the “hypotheses” of why COVID never hit India that hard last year, initial stages of vaccine hesitancy among health care workers and trust levels with the central government, and whether or not the situation is dire enough to consider rationing care on a patient-by-patient basis. The conversation wraps up with comments on the US actions to support India during this crisis. Spoiler alert: all three are very critical.

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