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    Health & Fitness

    The Accad and Koka Report

    This is a show for all those who love medicine but have grown weary of this vast boondoggle called the health care system. We produce an episode once a week and we regularly bring in guests that we put on the hot seat. We discuss current topics in medical science, policy, economics, and ethics, always with an eye toward safeguarding the doctor-patient relationship. We bring fresh, provocative insights that resonate with physicians in the trenches who are determined not to let their passion for medicine be ground to a pulp.

    Advertise

    Copyright: © Copyright 2021 Michel Accad and Anish Koka

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    Latest Episodes:
    Ep. 154 Outpatient COVID-19 Therapy: Why the Controversy? Nov 01, 2020
    Show notes

    Our guest is Peter McCullough, MD, MPH, consultant cardiologist and Vice Chief of Medicine at Baylor University Medical Center in Dallas, Texas. He is an internationally recognized authority on the role of chronic kidney disease as a cardiovascular risk state with more than a thousand publications and more than five hundred citations in the National Library of Medicine. His works have appeared in the New England Journal of Medicine, Journal of the American Medical Association, Lancet and other top-tier journals worldwide.

    However, he is not with us to discuss the cardiorenal syndrome nor his many illustrious achievements in cardiology. Rather, he joins us to tell us about an article on the outpatient treatment of COVID-19 of which he is first author. The paper is titled and was published in the American Journal of Medicine online on August 6, 2020.

    GUEST:

    Peter McCullough, MD, MPH: Twitter

    LINKS:

    • McCullough P, et al. “Pathophysiological Basis and Rational for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection” (Open Access in Am J. Med)

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 153 Vinay Prasad: Making Conversations in Medicine Great Again Oct 28, 2020
    Show notes

    Our guest is Vinayak K. Prasad, hematologist-oncologist. He was an associate professor of medicine at the Oregon Health & Science University School of Medicine and in the summer of 2020 moved to the University of California San Francisco.

    He is a prolific researcher with a particular interest in the quality of medical evidence and trial design. He is also author of 2 best-selling books: Ending Medical Reversal (2015) co-authored with Dr. Adam Cifu and Malignant: How Bad Evidence and Bad Policy Harm People With Cancer, released earlier this year.

    We have a broad ranging conversation about the tenor of medical discourse today and about his main ideas regarding the quality of medical evidence.

    GUEST:

    Vinay Prasad: Twitter, Website, and Podcast

    LINKS:

    Note: The Accad and Koka Report participates in the Amazon Affiliate program and may earn a small commission from purchases completed from links on the website,

    • Prasad, V et al. "A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices." Open Access in Mayo Clinic Proceedings with accompanying video of Dr. Prasad
    • Vinay Prasad and Adam Cifu. Ending Medical Reversal. Amazon link.
    • Vinay Prasad. Malignant. Amazon link.

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 152 Underrepresented Minorities in India: The Reservation System Oct 25, 2020
    Show notes

    Our guest is Dr. Somalaram Venkatesh, interventional cardiologist In private practice in Bengaluru, India. He obtained his medical degree and completed his cardiology training at PGI, Chandigarh. He is now director of cardiology at Aster Hospital, Bengaluru. He discusses India's historical legacy of discrimination, and the solution built into the Indian constitution to rectify this : the reservation system.

    GUEST:

    Somalaram Venkatesh, MD: Professional website

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 151 Brain Death: Challenges and Responses Oct 21, 2020
    Show notes

    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 moralhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749302/ 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.

    LINKS:

    • 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 EPISODES:

    Ep. 35 Why Brain Death Isn’t Death: An Introduction to “Shewmon’s Challenge” (with guest Alan Shewmon, MD)

    Ep. 45 Brain Death at the Bedside (with guest Fred Rincon, MD)

    Ep. 146 Diagnosing Brain Death: Clinical and Legal Quagmire (with guests Alan Shewmon and Doyen Nguyen)

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 150 David Cayley on Ivan Illich Oct 16, 2020
    Show notes

    Our guest is David Cayley, author and broadcaster based in Toronto, Canada, whose career focused on the philosophies of major contemporary thinkers and on the history of intellectual thought. For 30 years, he made radio commentaries for the acclaimed Ideas radio series produced by the CBC. He is well known for his close collaboration and friendship with the philosopher and social critic Ivan Illich who is the subject of this episode.

    GUEST:

    David Cayley: Website

    LINKS:

    Note: The Accad and Koka Report participates in the Amazon Affiliate program and may earn a small commission from purchases completed from links on the website.

    • "David Cayley. "Questions about the current pandemic from the viewpoint of Ivan Illich." (blog post, April 8, 2020)
    • Ivan Illich. Limits to Medicine: Medical Nemesis; The Expropriation of Health (Amazon link)
    • David Cayley and Ivan Illich. Rivers North of the Future: The Testament of Ivan Illich (Amazon link)

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 149 James Lindsay: Critical Race Theory, Post-Modernism, and Medicine Oct 10, 2020
    Show notes

    An American-born author, mathematician, and political commentator, Dr. James Lindsay has written books spanning a range of subjects including religion, the philosophy of science and postmodern theory. He is the co-founder of the website New Discourses and is currently promoting his new book "Cynical Theories". Enjoy a wide ranging discussion on the Post-Modern movement and how it impacts Medicine

    GUEST:

    James Lindsay: Twitter and New Discourses Web page

    SHOW NOTES:

    Amazon book link: Cynical Theories

    John Stuart Mill Essay: On Liberty

    Anish's article in Quilette on the Real Gender gap in Cardiology: https://quillette.com/2019/06/12/the-real-gender-gap-in-heart-disease/

    New Discourses website: https://newdiscourses.com/

    Podcast on race and estimated GFR: https://podcasts.apple.com/us/podcast/race-and-estimated-gfr/id1461664501?i=1000488650915

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 148 David Heymann and Paul Fine: Herd Immunity Models and Realities Oct 04, 2020
    Show notes

    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.

    GUESTS:

    David Heymann: Professional page and Wikipedia page

    Paul Fine: Professional page

    LINKS:

    • 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 EPISODES:

    Ep. 140. Gabriela Gomes: Why Herd Immunity May Be At Hand

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 147 Sally Satel: Should Med Schools Teach Antiracism? Sep 29, 2020
    Show notes

    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.

    GUEST:

    Sally Satel, MD: Twitter and Website

    LINKS:

    • "The Hypocritical Oath" (in Persuasion online community)
    • The Health Disparities Myth: Diagnosing the Treatment Gap(with co-author Jonathan Klick)

    RELATED EPISODES:

    Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn't Mix

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 146 Diagnosing Brain Death: Clinical and Legal Quagmire Sep 19, 2020
    Show notes

    Our guests are Doyen Nguyen, OP, MD, STD and D. Alan Shewmon, MD. They join us to discuss troubling development on the legal treatment of brain death.

    Dr. Nguyen was previously an academic hematopathologist 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.

    Dr. Shewmon is 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.

    LINKS:

    • Shewmon DA. "Chronic “brain death”: Meta-analysis and conceptual consequences." (in Neurology, 1998)
    • Lewis A, et al. "Determination of Death by Neurologic Criteria in the United States: The Case for Revising the Uniform Determination of Death Act" (in J. of Law, Medicine, and Ethics, 2019)
    • President's Commission for the Study of Ethical Problems in Medicine, Biomedical and Behaviora Research. "Defining Death" (1981)
    • Nguyen D. The New Definition of Death for Organ Donation: A Multidisciplinary Analysis from the Perspective of Christian Ethics. (2018, Amazon link)
    • Nguyen, D. "Does the Uniform Determination of Death Act Need to Be Revised?" (2020, Linacre)

    RELATED EPISODES:

    Ep. 35 Why Brain Death Isn't Death: An Introduction to "Shewmon's Challenge" (with guest Alan Shewmon, MD)

    Ep. 45 Brain Death at the Bedside (with guest Fred Rincon, MD)

    WATCH ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


    Ep. 145 Damian Carabello on Surprise Billing: Through the Looking Glass Sep 11, 2020
    Show notes

    Dr. Damian Carabello discusses the depths insurance companies go to make sure they end up on top.

    GUEST:

    Damian Carabello, MD: Twitter

    LINKS:

    • 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 ON YOUTUBE:

    Watch the episode on our YouTube channel

    SUPPORT THE SHOW:

    Make a small donation on our Patreon page on and join our discussion group or receive a free book.


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