We have become highly sensitized to the question of conflict of interest in healthcare—and rightly so.  But the dominant narrative seems to be one-sided:  doctors and scientists getting personally paid by industry sponsors and letting those payments color their judgment, consciously or unconsciously. Personal financial conflict of interest is certainly an important and pervasive problem,…

It doesn’t take great insight to assert that healthcare waste is rampant.  There is an obvious epidemic of testing and treatments that make no difference in patients’ lives or could possible even harm.  But what is the cause of the epidemic and what should be done about it?  In the last decade, a popular narrative…

The healthcare system continues  to inflict “moral injury” on physicians, causing burnout, depression, or apathy.  And, built as it is on a mountain of debt, the edifice may also not provide any long term security for those who choose to remain on board.  Yet the prospect of jumping ship may seem daunting to many. Our…

We spend billions of dollars a year on healthcare yet no one can give a satisfactory definition of health.  Is our inability to articulate what health is precisely the reason for our insanely dysfunctional healthcare systems? Our guest today will give us his very personal reflections on that question.  Pat Caslin is a business strategist…

Doctors are embroiled in a healthcare system they appear to have no control over.  It therefore seems plausible that if they got involved in healthcare policy, they might be in a position to “steer the ship” or at least have a say in how the ship is steered. We discuss the pros and cons of…

Doctors are increasingly asked to follow decision rules, guidelines, and “evidence-based” algorithms.  Is that the right approach to take care of patients?  Are cognitive errors over-emphasized in healthcare? Our guest on this episode is  Gary Klein, one of the most important figures in cognitive psychology in the world.  His pioneering work in the field of…

Did bioethics emerge to defend the interests of patients or to rationalize the needs and actions of the state and its corporate allies?  Are bioethicists too complacent about their grasp of economics?  Do they have sufficient understanding of the complexities of medical decisions to weigh in on them? Are Hippocratic ethics so inadequate that they…

“We’re not going to ask permission to take care of our patients.”  It is with this epiphany, that our guest on this episode became one of the pioneers and leaders of the most hopeful trend in health care today: the direct primary care or DPC movement. Dr. Gross shares with us how the light bulb went…

In 550 BC, the Greek philosopher Heraclitus famously declared: “No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.”  In this episode, we learn from our guest whether scientists can step into the same data pool and obtain the same research results twice. Brian Nosek…

Patients come in all sizes and shapes, and with varying tolerance for complications and risk.  Is it plausible that a single dosing regimen can optimize treatment for everybody?  If not, what is keeping the pharmaceutical industry from endorsing a more dynamic and patient-centered drug dosing regimen? Our guest is Dr. David Norris, a physician, mathematician,…