The Accad and Koka Report

Latest Episodes:

Ep. 16 The EHR will see you now Jul 22, 2018

Show notes

Ms. Twila Brase

Our guest is Twila Brase, RN, PHN, Executive Director of the Citizen’s Council for Health Freedom. We discuss her freshly released book that reveals the ugly truths about the electronic health records and what can be done to escape from this modern day Panopticon.

GUEST:

Twila Brase, RN, PHN website and Twitter

LINKS:

Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records

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Ep. 15 Lethal regulation: The 1962 FDA amendments Jul 15, 2018

Show notes

Dr. Mary Ruwart

Our guest is Dr. Mary Ruwart, scientist, ethicist, and author of a new book that examines the history of the last 6 decades of drug regulation and highlights the unintended consequences on the 1962 amendments to the FDA. Her meticulous research is an eye opener for anyone interested in health.

GUEST:

Mary Ruwart, PhD website and Twitter

LINKS:

Death by Regulation: How We Were Robbed of a Golden Age of Health and How We Can Reclaim It

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Ep. 14 EBM “India-style,” with Dr. Anupam Singh Jul 10, 2018

Show notes

Dr, Anupam Singh

We took the EBM controversies to India and consulted with Dr. Anupam Singh, Assistant Professor of Medicine at SMC in Ghaziabad. He offered a very sound and intelligent perspective on the proper role of clinical trials and clinical judgment in medical care.

GUEST:

Dr. Anupam Singh’s Twitter and ResearchGate profile

LINKS:

The EBM Wars: Manufacturing Equipoise (part 1)

The EBM Wars: When Evidence has a Price – The ECMO Trials (Part 2)

The Evidence Crisis: Causal Inference–Don’t Be a Chicken (part 3)

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Ep. 13 A buffet of blood pressure guidelines Jun 30, 2018

Show notes

Dr. Swapnil Hiremath

We have fun discussing the controversies about blood pressure guidelines with our 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.

GUEST:

Swapnil Hiremath’s Twitter

NephJC Journal Club

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Ep. 12 John Mandrola: The case for “Less-Is-More” Jun 24, 2018

Show notes

Dr. John Mandrola

We explore the “less-is-more” movement with Dr. John Mandrola, one of its most articulate and popular champions. We 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?

GUEST:

John Mandrola’s website

John Mandrola’s Twitter

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Ep. 11 The case against shared decision-making Jun 16, 2018

Show notes

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. We review the history of this concept and why it is contrary to a sound doctor-patient relationship.

LINKS:

Merchant F., et al. Mandating shared decision-making (JAMA)

Presidential Commission: Making Medical Decisions. (Kennedy Center for Bioethics at Georgetown University)

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Ep. 10 Free-market medicine: Ethical, workable, and unstoppable Jun 09, 2018

Show notes

Dr. G. Keith Smith

We have a terrific interview with G. Keith Smith, co-founder of the Surgery Center of Oklahoma and of the Free Market Medical Association. Keith gives us an overview of his pioneering experience and clearly makes the case that free markets are ethical, workable and, ultimately, unstoppable.

LINKS:

Surgery Center of Oklahoma (Twitter: @SurgeryCenterOK)

G. Keith Smith’s blog

Free Market Medical Association

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Ep. 9 Jade eggs and Francis Bacon Jun 02, 2018

Show notes

We 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.” We look at the question of science and pseudo-science and how it bears on actual medical care.

LINKS:

Jason Fung: Debunking the Debunkers

David Gorski: An Unholy Combination of Methodolatry and Quackery

Michel Accad: Is Medicine a Scientific Enterprise?

Goop.com: Jade Eggs for Healing

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Ep. 8 The dangerous business of public reporting May 26, 2018

Show notes

We discuss the background policies 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.

LINKS:

Blumenthal et al. A Survey of Interventional Cardiologists’ Attitudes and Beliefs About Public Reporting of Percutaneous Coronary Intervention (JAMA Cardiology)

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

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Ep. 7 “No tears for you!” say the pharmascolds May 19, 2018

Show notes

We 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.

LINKS:

Schwartz, LM, and Woloshin, S. A Clear-Eyed View of Restasis and Chronic Dry Eye Disease

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