The Accad and Koka Report

Latest Episodes:

Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn’t Mix Sep 05, 2020

Show notes

Dr. John Mandrola returns to the show to discuss why doctoring and politics shouldn't mix and how he got into hot water on Twitter for holding that unacceptable view.

Dr. Mandrola is an electrophysiologist in Louisville, Kentucky. He is is cardiology editor on Medscape where he writes a regular column and produces a weekly podcast.

GUEST:

John Mandrola, MD: Twitter and Website

LINKS:

John Mandrola: "Doctoring and Activism"
Sally Satel: "The Hypocritical Oath"
Mandrola et al: The Case for Being a Medical Conservative (in the American Journal of Medicine)

PREVIOUS GUEST APPEARANCES:

Ep. 12 John Mandrola: The Case for "Less-Is-More"

Ep. 107 Independent Nurse Practitioners: Public Health Threat or Libertarian Step Forward?

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Ep. 143 Adam Mortara on Litigating Affirmative Action Sep 01, 2020

Show notes

Our guest is Adam Mortara, lead trial counsel in the case of Students for Fair Admissions v. Harvard University.We discuss the legal aspects of affirmative action in light of the paper by Dr. Norman Wang which set off a storm of controversy in academic medicine.

GUEST:

Adam Mortara, JD: Professional page

LINK:

Norman Wang's paper: Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America from 1969 to 2019.

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Ep. 142 Robert Yeh on Harnessing Real World Evidence Aug 28, 2020

Show notes

Our guest is Robert 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. We discuss the challenges of outcomes research and his excellent work to improve the reliability of observational studies

GUEST:

Robert W. Yeh, MD: Twitter and professional web page

LINKS:

Strom JB, et al. Use of Administrative Claims Data to Assess Outcomes and Treatment Effects in Randomized Trials of Transcatheter Aortic Valve Replacement (in Circulation)
Faridi KM, et al. Use of Administrative Claims Data to Estimate Treatment Effects for 30 days versus 12 months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention (in Circulation)
Konstam M. Real World Data as trial End Points: Off and Running with a Long Way to Go (editorial in Circulation)

PREVIOUS GUEST APPEARANCE:

Ep. 19 Public Reporting: Necessary Evil or Harmful Fake News?

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Ep. 141 Amy Wax on Wokeness in Medicine Aug 21, 2020

Show notes

Our guest is Amy Wax, Robert Mundheim Professor of Law at the University of Pennsylvania Law School. Before attending law school she obtained her undergraduate degree from Yale University in biophysics and biochemistry, graduating summa cum laude. She then attended Harvard Medical School and trained as a neurologist at New York Hospital - Cornell Medical Center before completing her law degree at Columbia University. She is the author of Race, Wrongs, and Remedies: Group Justice in the 21st Century. In 2017, she was the target of academic backlash after co-authoring an opinion piece in the Philadelphia Inquirer on the societal benefits of "bourgeois values."

GUEST:

Amy Wax: Faculty page and Wikipedia entry

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Ep. 140 Gabriela Gomes: Why Herd Immunity May Be at Hand Aug 16, 2020

Show notes

Our guest is Gabriela Gomes, Professor of Mathematics at the University of Strathclyde. She specializes in population dynamics and the modeling of herd immunity and her recent work suggests COVID-19 herd immunity may be at hand. We discuss how herd immunity thresholds are estimated and why she thinks classic models are flawed and must incorporate a measure of variation in individual susceptibility.

GUEST:

Gabriela Gomes, PhD: Twitter and Website

LINKS:

Gomes et al. (May 2020 paper): Individual variation in susceptibility or exposure to SARS-CoV-2 lowers the herd immunity threshold in MedRxiv
Aguas et al. (July 2020 paper): Herd immunity thresholds for SARS-CoV-2 estimated from unfolding epidemics in Medrxiv
Britton et al. A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2 in Science (Open Access)
Kevin Hartnett. The Tricky Math of COVID-19 Herd Immunity in Quanta Magazine
Fine et al. "Herd Immunity": A Rough Guide in Clinical Infectious Disease (Open Access)

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

Ep. 139 Diversity in Cardiology, with Martha Gulati Aug 13, 2020

Show notes

A recent article authored by Dr. Norman Wang on the history and current state of affirmative action programs in medical schools and cardiology departments has led to a storm of controversy and to Dr. Wang's demotion as fellowship program director. To discuss that article and the controversies we are joined by Dr. Martha Gulati, division Chief of Cardiology at the University of Arizona. She is also the best-selling author of Saving Women's Hearts and editor-in-chief of ACC's CardioSmart.

LINKS:

The now retracted Wang paper: https://www.ahajournals.org/doi/pdf/10.1161/JAHA.120.015959

Journal of the AHA comment on retraction: https://www.ahajournals.org/doi/10.1161/JAHA.119.014592

Regents of Univ. of California v. Bakke, SCOTUS decision: https://supreme.justia.com/cases/federal/us/438/265/

GUEST:

Martha Gulati: Twitter and Website

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Ep. 138 How Health Care Intermediaries Profit Aug 12, 2020

Show notes

GUESTS:

Marion Mass is a pediatrician in the Philadelphia area where she has practiced in hospital, Emergency Room, delivery room, outpatient, and urgent care settings. She graduated from Duke University Medical School and trained in Pediatrics at Northwestern Memorial Hospital in Chicago. She has been writing about life inside medicine, published in the WSJ, Washington Times, and the Philly Inquirer. She is also co-founder of Practicing Physicians for America, a physician lead organization that advances the interests of practicing physicians. She has written extensively on the role of third party intermediaries in medicine.

Dr. Rupali Chadha is a Board Certified Psychiatric Physician who diagnoses and treats mental illness. She is also Board Certified Psychiatric Physician in the specialty area of forensics. She serves the LA Superior Courts in identifying inmates who are incompetent to stand trial and has also served as a forensic expert in criminal trials. She recently traveled to Washington DC to visit the White House and witness signing of a recent Presidential Executive Order on intermediaries in healthcare.

WATCH ON YOUTUBE:

Watch the episode on our YouTube channel

LINKS:E

White House Executive Order: https://www.whitehouse.gov/presidential-actions/executive-order-lowering-prices-patients-eliminating-kickbacks-middlemen/

Overview of third parties that suck up most of the health-care dollars: https://www.medpagetoday.com/publichealthpolicy/healthpolicy/84795

The rebates that may fuel higher drug prices: https://www.washingtontimes.com/news/2019/feb/10/a-bipartisan-opportunity-to-cut-drug-prices/

John Arnold in statnews discusses the role of Pharmacy benefit managers (PBM): https://www.statnews.com/2018/08/27/pharmacy-benefit-managers-good-or-bad/

A detailed look at Group Purchasing Organizations and PBMs: https://practicingphysician.org/scrubs-vs-suits-the-battle-inside-the-nations-hospitals-part-2/

Needle stick story referenced in the podcast: https://nebula.wsimg.com/9e87fe4c7de204baccc77a2bc373daf1?AccessKeyId=62BC662C928C06F7384C&disposition=0&alloworigin=1

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

Accad/Koka on Lockdowns Aug 11, 2020

Show notes

Anish Koka and Michel Accad discuss lockdowns in light of the experience of the last few months.

GUESTS:

Anish Koka, MD: Twitter

Michel Accad, MD: Twitter

LINK:

Michel Accad: It's Not About Trade-Offs

YOUTUBE:

Watch the episode on our YouTube channel

Ep. 137 Joshua Gottlieb on Government Policy and Physician Income Aug 06, 2020

Show notes

Joshua Gottlieb is an economist who co-authored a recent paper examining the effect of government policy and physician income. The paper was recently presented at a conference co-sponsored by the NBER and NIA and its pre-publication has generated significant controversy among doctors.

GUEST:

Joshua Gottlieb, PhD: Twitter and Website

LINK:

Paper: Who Values Human Capitalists’ Human Capital? Healthcare Spending and Physician Earnings

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Ep. 136. Manny Sethi. Trauma Surgeon & US Senate Candidate Jul 29, 2020

Show notes

Manny Sethi is a trauma surgeon running to be the next senator from the state of Tennessee. He is the son of immigrants,and an unabashed conservative who discusses his journey from medicine to politics, as well as his views on healthcare.

GUEST:

Manny Sethi: Twitter and Bio

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.