The Accad and Koka Report

Latest Episodes:

Ep. 26 Scientific gatekeepers in the age of Twitter: A journal editor’s perspective Sep 05, 2018

Show notes

Dr. Brahmajee Nallamothu

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!

GUEST:

Brahmajee Nallamothu Twitter and Profile

LINKS:

The following articles are all Open Access articles in Circulation Cardiovascular Quality and Outcomes

Robert W. Yeh. Academic cardiology and social media: Navigating the wisdom and madness of the crowd

Michael Thompson. Science and social media: Debating the effects of readmission penalties

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Ep. 23 Buying doctors with lunches: Fact or fiction?

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Ep. 25 Exposing medical students to free market ethics and principles Sep 02, 2018

Show notes

Dr. Beth Haynes

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.

LINKS:

Benjamin Rush Institute website and student-led podcast

Will Craghead and Daniel McCorry. Direct Primary Care: Improving Medical Students Interest in Primary Care. (“White Paper”)

RELATED EPISODES:

Ep. 10 Free market medicine is ethical, workable, and unstoppable
Ep. 22 Free markets in healthcare : objecting to the objections

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Ep. 24 Making the case for Medicare-4-All Aug 29, 2018

Show notes

Dr. Adam Gaffney

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. Our guest today is Adam Gaffney, MD, a longtime supporter of a single-payer system and president-elect of Physicians for a National Health Program. He has kindly agreed to be subjected to our objections.

GUEST:

Adam Gaffney: Twitter and website

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RELATED EPISODES:

Ep. 22 Free markets in healthcare: objecting to the objections
Ep. 10 Free market medicine is ethical, workable, and unstoppable

Ep. 22 Free markets in healthcare: Objecting to the objections Aug 22, 2018

Show notes

Mr. Roman Zamishka

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.

GUEST:

Roman Zamishka: Twitter

LINKS:

Roman Zamishka. A Libertarian’s Case Against Free Markets in Healthcare. (In The Health Care Blog).
Caption-generator video meme: Hitler reacts to 8 years of the ACA

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Ep. 21 Inside the Swiss healthcare system with Dr. Fouradoulas Aug 18, 2018

Show notes

Dr. Marc Fouradoulas

The Swiss healthcare system is frequently proposed as a model for the rest of the world to emulate. Our guest is Marc Fouradoulas who practices medicine in Zurich, Switzerland. He 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, School of Management and Law, in Zurich.

GUEST:

Marc Fouradoulas, MD: Twitter

LINKS:

Marc Fouradoulas. The Swiss Healthcare System: A Model for the US? (Alert and Oriented blog)

Marc Fouradoulas. From Direct Democracy to Centralization: The Swiss Healthcare Experiment (Mises Wire)

Michel Accad. An Economic History of the American Healthcare System. (Alert and Oriented blog)

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Ep. 20 How healthcare systems scapegoat physicians: the Bawa-Garba case Aug 12, 2018

Show notes

Dr. Saurabh Jha

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. Our guest is Dr. Saurabh Jha who returns on the show 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.

GUEST:

Saurabh Jha, MD: Twitter

LINKS:

Saurabh Jha. To Err is Homicide in Britain: The Case of Dr. Hadiza Bawa-Garba (The Health Care Blog).
Saurabh Jha. If Hadiza Bawa-Garba Worked in the US She Would Still Be a Doctor. (The Guardian)
Saurabh Jha. The Doctor Who Thwarted the Charge of the General Medical Council (The Health Care Blog)
Saurabh Jha. Dr. Jonathan Cusack versus the General Medical Council (The Health Care Blog).
Ganfyd site entry of the Bawa-Garba case, with all the relevant facts and court documents.

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Ep. 19 Public reporting: necessary evil or harmful fake news? Aug 11, 2018

Show notes

Dr. Robert Yeh

Public reporting of outcomes aims at improving quality but has also harmed patients and doctors alike. Can any good come out of it? Our guest on this episode is Dr. Robert W. 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. He is an expert on the outcomes of outcome reporting.

GUEST:

Robert W. Yeh, MD: Twitter

Papers by Dr. Yeh and colleagues on public reporting:

http://www.onlinejacc.org/content/65/11/1119– paper suggesting an association between public reporting of PCI mortality and lower rates of PCI especially for high risk patients, and higher mortality for MI patients overall.

https://jamanetwork.com/journals/jamacardiology/fullarticle/2537379 – paper showing that after New York removed cardiogenic shock patients from public reporting of PCI, PCI rates went up and shock-related mortality went down.

https://www.ncbi.nlm.nih.gov/m/pubmed/28249879/ – study showing that hospitals identified as PCI mortality outliers tend to be the large hospitals with CT surgical programs where complex patients are referred. In addition, after being identified as outliers, hospital appeared to improve mortality without worsening risk avoidance.

https://jamanetwork.com/journals/jamacardiology/article-abstract/2680626 – a survey of interventional cardiologists in public reporting states on the extent to which reporting programs have changed their and their colleagues practice.

RELATED LINKS:

Anish Koka. The High Cost of Public Reporting (published in “The HealthCare Blog”)

RELATED EPISODES:

The dangerous business of public reporting.

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Ep. 18 A doctor fights against CON laws Aug 04, 2018

Show notes

Dr. Gajendra Singh

Our guest on this episode is Dr. Gajendra Singh, 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.

GUEST:

Gajendra Singh, MD: Twitter and E-mail

LINKS:

Dr. Singh’s Forsyth Imaging Center: Website and Facebook Page
“Healthcare Favoritism:” The Mercatus Center at George Mason University’s analyses on Certificate of Needs Laws
Article featuring Dr. Singh on Vox.com
Dr. Singh featured on the Institute for Justice’s website

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Free Market Medicine is ethical, affordable, and unstoppable.

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Ep. 17 Hope in the fight against MOC Jul 29, 2018

Show notes

Dr. Westby Fisher

Our guest this week is Dr. Wes Fisher who is leading the fight against the American Board of Internal Medicine and its self-serving tactics to force thousands of physicians to comply with the onerous Maintenance of Certification Program. We learn of Wes’ new initiatives that stand a realistic chance of turning the tide against the quasi regulatory monopoly of the board-certifying agencies.

GUEST:

Westby Fisher, MD website and Twitter

LINKS:

GOFUNDME link to raise funds to complete the pre-litigation investigation.

PRACTICING PHYSICIANS OF AMERICA A grassroots organization co-founded by Dr. Fisher.

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