She came in on the bus. An 84-year-old woman, independent antwenty years, wa her health for d diligent abouts sitting in my waiting room for four and a half hours with a blood pressure of 222 over 104. Her insurer had dropped her long-standing doctor. The next available appointmentwith a covered provider was five months away. She was on $60 a day. She couldn't afford to pay out of pocket. So her blood pressure medication lapsed.

This is preventable. It happens every week. And it is a direct consequence of how the US healthcare system is structured.

In this episode, Dr Cois — Emergency Physician and creator of drcois.com — breaks down why the US spends more on healthcare than any other nation and still ranks last on outcomes, and walks through three serious proposals to fix it: Medicare for All, the Trump Great Healthcare Plan, and the EMBRACE plan from Annals of Internal Medicine.

In this episode:

— Why the US pays $13,500 per person annually — twicepeer nations — for worse outcomes

— Five structural drivers of cost: fragmentation,high prices, fee-for-service, the uninsured, and monopolisation

— Medicare for All: the Lancet evidence, thetrade-offs, and the political barrier

— The Great Healthcare Plan: what the KFF analysissays about what it leaves unanswered

— EMBRACE: a tiered universal coverage model with anindependent governance board — and why it may be the most realistic pathforward

— Three healthcare reform myths busted with evidence:physician pay, VA quality, and the free market track record

— What you should do this week — clinically andpolitically

This is a Tier 1 issue. Pillar 5 of our blueprint,s that accessible. For too many Americans, it doesn't.

Fewer bad days. More good decades.

Companion blog post + full references at drcois.com

The gut microbiome is one of the most talked-about — and most misunderstood — topics in modern health. In this episode, Dr. Cois cuts through the noise with a clear, evidence-based breakdown of what your gut microbiome actually does, how to support it, and why some popular dietary trends may be doing more harm than good.

We start in the Emergency Department, where a 33-year-old woman with Crohn's disease arrived in crisis, after following carnivore diet advice she found on social media. It's a case that perfectly illustrates the gap between what the science shows and what goesv iral online.

In this episode:

• What the gut microbiome is and why microbial diversitymatters

• The gut-brain axis — the science behind how your gutaffects your mood, cognition, and mental health

• Short-chain fatty acids, butyrate, and why fibre is themost evidence-backed intervention for gut health

• Gut microbiome testing — what commercial stool testscan (and can't) tell you

• The evidence-based toolkit: fibre, fermented foods,exercise, sleep, and probiotics

• Misinformation Watch: applying the prebunking toolkitto the carnivore diet and the 'gut reset' claim

Compassionate, nuanced, and grounded in peer-reviewed science — this is the gut health episode you've been waiting for.

Free resources at DrCois.com   |  Follow along: @drcois

Overheard in the Emergency Room — fewer bad days, more good decades.

In this episode of *Overheard in the Emergency Room*, Dr. Adrian Cois breaks down one of the most misunderstood medical conditions in modern healthcare: obesity.
Starting with a real case from the Emergency Department, we explore why obesity is not a failure of willpower but a chronic, biologically regulated disease. Drawing from major clinical guidelines and landmark studies, this episode walksthrough the science of weight regulation, the role of hormones like leptin and ghrelin, and why the body actively resists weight loss.
You’ll also learn about the two‑tier framework for obesity treatment:
Tier 1 – Foundational lifestyle interventions including nutrition, exercise, sleep, stress management, and multidisciplinary care.
Tier 2 – Evidence‑based medical treatments such as GLP‑1 medications like semaglutide and tirzepatide, as well as bariatric surgery.
We examine the data from major randomized controlled trials including STEP‑1 and SURMOUNT‑1, discuss long‑term outcomes from bariatric surgery studies, and tackle an often overlooked issue: weight stigma in healthcare.
Finally, we break down common myths promoted by wellness influencers and show how to spot misinformation when it comes to weight loss.

If you want to understand the real science of obesity — and what evidence‑based treatment actually looks like — this episode is for you.
For free health resources and training guides visit:
DrCois.com
If you enjoyed this episode, please follow the show and share it with someone who wants fewer bad days and more good decades.

In this episode, Dr. Cois examines the science behind LDL cholesterol and heart disease. Through a real Emergency Room case, we explore how plaque forms, what ApoB means, why “lower for longer” matters, and how randomized trials have shaped modern prevention.
We also tackle common myths about saturated fat and statins — and explain how to spot misinformation online.
This is a data-driven, calm, evidence-based breakdown designed to help you makesmarter decisions about your health.
Learn more and download free resources at DrCois.com.

In this episode of Overheard in the Emergency Room, we break down metabolic syndrome and type 2 diabetes using a clear, evidence-based two-tier framework.
We cover:

• What metabolic health actually means• Why diabetes is so common in Australia and the U.S.• The real pathophysiology of insulin resistance• What the best meta-analyses show about diet and lifestyle• Medications like metformin, SGLT2 inhibitors, and GLP‑1 receptor agonists• Prevention strategies that actually scale
No hype. No diet camps. Just evidence and practical action.
Visit www.drcois.com for free resources and episode notes.

A 75‑second guided box breathing reset you can use anytime your body feels stuck in fight‑or‑flight.
Inhale 3 • Hold 3 • Exhale 3 • Hold 3 (repeat).

Disclaimer:Educational content only; not medical advice. If you have severe symptoms (e.g., chest pain with exertion, fainting, severe shortness of breath, new neurologic symptoms, or thoughts of self-harm), seek urgent medical care or call your local emergency number.

In this episode, Dr Cois breaks down the biology of stress: how your eyes and amygdala can flip the body into fight-or-flight, why panic feels so physical, and what chronic ‘on-edge’ does to sleep, mood, blood pressure, and the gut.

Through two ER cases—a first-time panic attack and an 8-year-old with stress-triggered abdominal pain—you’lllearn practical tools to tap the brakes: box breathing, downshift exhales, progressive muscle relaxation, and a 2-minute meditation that even non-meditators can do.
Educational only; not medical advice. If symptoms are severe or persistent, seek medical care.

Next episode: Metabolic red flags—insulin and glucose.

I flipped from night shifts to days for my kids’ soccer and school events and felt “fine”… until my wearable gave me a literal skull recovery score. That screenshot did what no lecture ever did: it made sleep feel urgent.
In this episode, we cover Sleep Basics — what sleep is (NREM/REM cycles), how it’s regulated (sleep pressure + circadian rhythm), and how melatonin, cortisol, light exposure, meal timing, temperature, activity, social schedules, and alcohol shape sleep quality. Then we take a quick world tour of large cohort studies (UK Biobank, MESA, Whitehall II, China Kadoorie Biobank and more), break down a practical “Core Four” circadian habit framework, and finish with an 80/20 Tier 1 sleep plan you can start tonight.
We’ll also tee up a later episode that goes deep on shift-work sleep — because nights are a different game with different rules.Educational only — not medical advice. If you have symptoms of a sleep disorder (e.g., loud snoring, witnessed apneas, severe daytime sleepiness), please seek care from a qualified clinician.

G’day team! Episode 3 is all about exercise: what to do, how much to do, and why it matters for living with "less bad days and more good decades".
We build around the Two-Tiered Longevity Blueprint:

• Tier 1 (foundations): weekly cardio targets, 2 days of strength, and everyday movement (NEAT/steps).
• Tier 2 (upgrades): VO₂max work, smarter programming, power/balance as you age, and how athletes train - scaled to real life.
We’ll cover the US + Australian physical activity guidelines, the evidence linking cardiorespiratory fitness to lower mortality, why resistance training protects independence (falls + bone density), and an 80/20 weekly plan you can actually stick to.Educational only - this is not personal medical advice. If you have health concerns, talk with your clinician before starting a new program.

In Episode 2 of Overheard in the Emergency Room, Dr. Cois breaks down diet as the first Tier 1 pillar in a two-tier blueprint for longevity. Using real ED cases—including incidental fatty liver and severe hypertension—he explains what major dietary guidelines consistently agree on, why nutrition science often gets misunderstood online, and what the biggest cohort studies reveal about long-term health.

You’ll leave with an ED-ready “elevator pitch” for eating well (the 80/20 plate) and a 3-step plan you can start this week: build an anchor meal, do three protein swaps, and create a friction-proof backup plan for busy days.

https://youtu.be/c2mJQT109-s