Ryan is joined by Dr Saurabh Jha to discuss writing and tweeting as a physician, and how medical students can most effectively ease themselves into that world. We discuss a number of Dr. Jha's articles, touch briefly on the future of radiology, and learn about some of Dr. Jha's favorite writers.

Map

3:15 – coming to the U.S and choosing radiology

7:00 – when and why did he become interested in writing about the healthcare system and his first article on the Breast Density Law

10:30 – why share your thoughts publicly if there is a risk in the modern political climate, and how to even start?

14:00 – Twitter as a platform for building a community and getting information

18:30 – where should med students start? – how to get your news, and who to follow

22:15 – Ryan discusses his article on KevinMD and his concerns about alienating others through expressing political opinions

24:00 – how to deal with political topics knowing full well that medicine is wildly political

30:00 – med students are quite savvy these days, and should be entitled to an opinion

32:45 – Dr. Jha’s article on the hospital “Chargemaster” and costs in healthcare; learning from everyone around you, including cabdrivers

42:45 – the field of radiology – where is it heading? Will radiologists be replaced?

50:00 – what would Dr. Jha do if he was starting in 2017? – hint: still radiology, but through global health

52:00 – Dr. Jha’s most popular blog post and tweet

54:25 – what other writers does he read and respect?

58:10 – last thoughts and advice for future physicians

Links

Dr. Jha’s KevinMD portfolio -

https://www.kevinmd.com/blog/post-author/dr-saurabh-jha

Dr. Jha's first article on the Breast Density Law - https://www.kevinmd.com/blog/2013/11/breast-density-laws-based-anecdote.html

Dr. Jha's twitter account -

https://twitter.com/RogueRad

HealthNewsreview.org -

http://www.healthnewsreview.org/

Ryan's first article on KevinMD – https://www.kevinmd.com/blog/2017/10/want-change-medicine-work-finance.html

Dr. Jha’s KevinMD article on the "chargemaster" - https://www.kevinmd.com/blog/2017/07/chargemaster-health-cares-evil-component.html

The Patient Will See You Now (book) – https://www.amazon.com/Patient-Will-See-You-Now/dp/0465054749

Dr. Jha's most popular blog post – topic of public reporting - https://www.kevinmd.com/blog/2015/07/when-a-bad-surgeon-is-the-one-you-want-propublica-introduces-a-paradox.html

Atul Gawande’s Complications (book) – “required reading” according to Dr. Jha

https://www.amazon.com/Complications-Surgeons-Notes-Imperfect-Science/dp/0312421702

Theodore Dalrymple – one of Dr. Jha’s favorite writers - https://en.wikipedia.org/wiki/Theodore_Dalrymple

Dr. Lisa Rosenbaum Twitter -

https://twitter.com/lisarosenbaum17?lang=en

Dr. Anish Koka -

http://thehealthcareblog.com/blog/tag/anish-koka/

On the most recent episode of the Penn HealthX Podcast, we were able to speak with Dr. Dana Kuhn. Dr. Kuhn shared his heartbreaking story of finding out he was infected with HIV after receiving treatment for hemophilia. He then unknowingly passed the virus on to his wife, who then died of AIDS-related pneumonia a few years later.

While taking time to recuperate with his children, Dr. Kuhn found work as a counselor for patients with chronic illnesses. He then turned to patient advocacy, first working on The Trail of AIDS, and fighting to push legislators to clean up the national blood supply.

Dr. Kuhn then founded Patient Services Inc. (PSI), a non-profit organization that helps patients with chronic and rare diseases pay for their insurance premiums and drug co-pays. Premiums and co-pays have been steadily rising over the last number of years, making the affordability for drugs and coverage out of reach of certain patients who fall on hard times.

PSI was meant to be a "short-term" solution, and I think Dr. Kuhn would agree that it's up to future healthcare leaders to design policy and innovate to ensure that the work of PSI becomes obsolete. It's one of the most important challenges the we face in the future of the U.S healthcare system.

Map

3:16 – Dr. Kuhn’s Story

7:30 – Finding out he was HIV positive and losing his wife to AIDS

11:30 – AIDS phobia in the 80’s

15:45 – getting a job counseling patients with chronic illnesses

17:00 – The Trail of AIDS and advocacy – cleaning up the blood bank

23:30 – The motivation for founding Patient Services Inc.

28:45 – The first step – raising money

32:30 – Where do the donations come from?

35:00 – How do you decide what disease types to fund, and which specific patients?

39:30 – Why design the model this way? – PSI was supposed to be a “short-fix”

45:00 – Are pharmaceutical companies being altruistic, or doing it because there’s something in it for them?

49:00 – The difficulty with getting individuals to donate vs. companies when you aren’t a well-known charity

52:30 – Is PSI fighting a losing battle? Is it sustainable? How can we make it obsolete?

55:50 – Advice for future innovators

Links

Registration for the Penn HealthX Conference - 12/2/17

http://pennhealthx.com/events/conference#Logo

Dr. Dana Kuhn – President and Founder of PSI

http://www.patientservicesinc.org/Who-We-Are/Leadership

https://www.patientservicesinc.org/Our-Story

And the Band Played On Book and Documentary

https://en.wikipedia.org/wiki/And_the_Band_Played_On

Patient Services Inc. Link

https://www.patientservicesinc.org/

Other Co-Pay Charities Supported by Medicare

https://www.medicarerights.org/pdf/copay_charities.pdf

Kaiser Family Foundation – 2017 Employer Health Benefits Survey

https://www.kff.org/health-costs/report/2017-employer-health-benefits-survey/

Past Coverage of the Relationship between Co-Pay Charities and Pharma

http://www.nytimes.com/2013/12/19/business/shake-up-at-big-co-pay-fund-raises-scrutiny-on-similar-charities.html

https://www.bloomberg.com/news/articles/2017-06-29/charity-funded-by-drugmakers-draws-irs-probe-on-tax-exemption

https://www.usatoday.com/story/news/politics/2016/06/08/drug-co-pay-assistance-programs-facing-increasing-state-federal-scrutiny/85547788/

http://www.fiercepharma.com/pharma/irs-probes-whether-patient-charity-acted-as-a-conduit-for-big-pharma

In this episode, Ryan is joined by the three founders of Spectrum Scores - Phil Williams, Naveen Jain, and Jun Jeon. We discuss how they came up with the idea for Spectrum Scores - a website dedicated to helping LGBTQ+ patients find competent healthcare providers who are able to address their unique healthcare needs - and the experience of getting it off the ground.

Map:

3:30 – October 11th – Releasing Spectrum Scores and National Coming Out Day

5:15 – Phil’s Background

7:00 – Naveen’s Background

9:00 – Jun’s Background

12:00 – forming their HealthX Labs team

15:45 – early ideas for their team

17:30 – coming up with the idea for Spectrum Scores

22:00 – where do you even start one you have your idea?

27:00 – HealthX Labs Demo Day presentation, and getting feedback

34:00 – deciding what the purpose of Spectrum Scores is, and pivoting after feedback

37:00 – How does Spectrum Scores rate healthcare providers?

42:30 – dividing up work and deciding roles

46:00 – getting publicity and marketing Spectrum Scores

50:00 – where is Spectrum Scores now, and what are future directions?

55:45 – what have they learned throughout the process?

Links:

HealthX Conference Registration

pennhealthx.com/events/conference#Registration

Spectrum Scores Website

www.spectrumscores.org/

More on The Founders

www.spectrumscores.org/about

Spectrum Scores Fbook Page

www.facebook.com/SpectrumScores/

NBC Article

www.nbcnews.com/feature/nbc-out/m…e-doctors-n793861

In this bonus episode of The Penn HealthX Podcast, we'd like to share a conversation host Ryan O'Keefe had with Nathan Dollinger, the host of The Future of Healthcare Podcast. Ryan and Nathan discuss why they started their podcasts, some of their favorite guests, and riff on some topics in healthcare that they are passionate about. If you enjoy The Penn HealthX Podcast, you'll love The Future of Healthcare. Thanks to Nathan for letting us share.

Rate the podcast!! Find us on iTunes here:

https://itunes.apple.com/us/podcast/the-penn-healthx-podcast/id1271378904?mt=2

Learn how to rate on iTunes and the podcast app below:

https://pennhealthx.blog/2017/09/05/how-to-rate-the-podcast/

Map: (thanks Nathan for putting this together)

- Who is Ryan O’Keefe and why he started his podcast [6:40]

– Why start a podcast? [10:35]

– Interviewing Dr. David Fajgenbaum [15:45]

– discussing healthcare providers and costs [21:30]

– What’s the focus of Penn HealthX [25:40]

– Figuring out his aspiration through the podcast [29:50]

– A blog, Epi-pen, and prices of healthcare [35:30]

– Health Policy research and Ryan's realization [37:50]

– History of health reforms and where we are today in healthcare [42:55]

– Technology and how it affects healthcare [51:02]

– Bad eating habits, addiction, and how it affects the world today [57:35]

– How to truly prevent health conditions (better than drugs) [1:03:40]

– Gamification and getting people addicted [1:06:30]

– Creating a world where being healthy is easy [1:10:00]

– How biohacking plays a role [1:12:00]

– Controversial medicine and pseudoscience [1:13:45]

– Book that influenced Ryan - America's Bitter Pill [1:19:20]

– If Ryan could change anything about our healthcare and fitness space what would that be and why? [1:26:08]

– Ryan’s advice for future health professionals. [1:27:30]

– End of interview [1:31:25]

Links:

The Future of Healthcare website

https://wearethefutureofhealthcare.com/

Nathan's Twitter

https://twitter.com/NathanDollinger

Ryan's Article on Kevin MD

http://www.kevinmd.com/blog/2017/10/want-change-medicine-work-finance.html

New Yorker - How Medicare Was Made (article)

https://www.newyorker.com/news/news-desk/medicare-made

Stephen Down/Tincture (writes for Medium)

https://tincture.io/@stephenjdowns?gi=c4dc56f07a90

America's Bitter Pill by Steven Brill (Ryan's recommendation)

https://www.amazon.com/Americas-Bitter-Pill-Politics-Healthcare-ebook/dp/B00LYXY05S

Hooked by Nir Eyal

https://www.amazon.com/Hooked-How-Build-Habit-Forming-Products/dp/1591847788

Drug Channels - pharmaceutical supply chain blog

http://www.drugchannels.net/

NYTimes Article on Obesity in Developing Countries https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html?_r=0

Dr. Paul Offit - (addressing pseudoscience and alternative medicines)

http://paul-offit.com/

BA Sillah joins the Penn HealthX Podcast to discuss getting an MBA, and investing in healthcare in Africa.

3:00 – The MBA year at Wharton

7:30 – deciding not to go into residency

15:30 – rising interest in business in medicine

19:00 – working in Africa

26:00 – addressing problems unique to the healthcare systems of emerging countries

33:00 – the downside to charity care

38:40 – working for Excelsior and investing to benefit a community

Links

BA's LinkedIn

https://www.linkedin.com/in/barthalomew-sillah-5433b614/

King's Sierra Leone Partnership

http://kslp.org.uk/

Excelsior Group

http://excelsior-group.com/

Ghana National Health Insurance Website

http://www.nhis.gov.gh/

Eric Heil joins the Penn HealthX Podcast to discuss his career, passion for systems engineering, and experience founding, and eventually exiting, RIghtCare Solutions. RightCare, a company focused on reducing acute care hospital readmissions, was acquired by NaviHealth.

2:45 – growing up in Iowa

4:00 – going to Penn to play basketball

5:45 – playing in the NCAA tournament

7:15 – choosing to study engineering

8:45 – what is systems engineering?

10:15 – why focus on the healthcare space?

11:45 – other jobs Eric took on after graduating from Penn

17:00 – from VC to becoming an entrepreneur

22:00 – the idea to start RightCare

24:45 – rationale for getting an MBA

27:20 – what exactly did RightCare do, and what problems did it solve?

34:45 – challenges of being the leader of a health-tech company

39:45 – exiting RightCare – being bought by NaviHealth (a Cardinal Health company)

41:45 – starting a new project – trying to make lightning strike twice with BehaveCare

44:35 – lessons learned from successfully leading BehaveCare

Links:

Eric’s Linkedin

https://www.linkedin.com/in/eheil/

Kathy Bowles – co-founder of RightCare

https://ldi.upenn.edu/expert/kathryn-h-bowles-phd-rn-faan-facmi

RightCare Solutions Exit (article)

https://medcitynews.com/2015/12/rightcare-solutions-acquisition/

Domain Associates (website)

https://www.domainvc.com/

BehaveCare (website)

https://www.behavecare.us/about-us

A Past Interview with Eric

http://executiveleadersradio.com/heil-eric-4297.aspx

Letters to a Young Entrepreneur by Ricardo B Levy (Book)

https://www.amazon.com/Letters-Young-Entrepreneur-Succeeding-Business/dp/0996670602

JP Morgan Healthcare Conference (old link)

https://www.jpmorgan.com/global/healthcareconference

Tim Carlon joins us to talk about his MBA year, and his interest in value-based care. We touch on ACO's, bundled payments, MACRA, and other fun acronyms like MIPS. If you plan on being a physician, you will undoubtedly be impacted by the shift to value-based care. Take notes.

4:45 – Tim’s interest in IR

6:10 – why get the MD/MBA?

14:45 – becoming interested in value-based care payment models

22:20 – explaining ACO’s

27:00 – how have ACO’s been doing?

30:45 – what can med students and young physicians bring to the table?

32:55 – bundled payments

36:00 – What is MACRA?

45:00 – should doctors be worried?

Links

Tim's LinkedIn

https://www.linkedin.com/in/timothy-carlon/

CMS Page on MACRA, MIPS, and APMS

http://go.cms.gov/1Gb6GDL

CMS Page on ACO's

http://go.cms.gov/2nf9mvC

Penn Bundled Payments Press Release

http://bit.ly/2ivGtZc

Gregg Khodorov and Julia Tartaglia, the co-presidents of the Biomedical Entrepreneurship Network (BEN) at the Rutgers Robert Wood Johnson Medical School, join me to discuss their interests, BEN, and The Scientista Foundation.

Map:

4:00 – Gregg – getting the MBA before med school

7:11 – working for Pfizer

9:45 – undergrad at GW and deciding to go into medicine

12:15 – Julia’s path to medicine – studying human behavior, getting a post-bacc

15:45 – starting the Scientista Foundation

20:05 – barriers she faced, and barriers women face in STEM careers

24:00 – what does the Scientista Foundation do?

28:00 – BEN, the summit, and cross-disciplinary programs

37:00 – integrating business and innovation skills into medical school curriculum

45:00 – things Gregg and Julia are looking forward to in the next year

Links

Gregg's LinkedIn

https://www.linkedin.com/in/greggkhod/

Julia's LinkedIn

https://www.linkedin.com/in/juliatartaglia/

BEN Website

http://benrwj.com/

BEN Facebook

https://www.facebook.com/BENRWJMS/

Scientista Foundation Website

http://www.scientistafoundation.com/

Wharton Business in Healthcare Conference - last year's site

http://www.whcbc.org/conf2017/

Nora Becker joins me to discuss her research on the ACA and it's effects on contraceptive usage.

Map:

5:15 – her time at Pomona and becoming interested in public health

7:15 – deferring acceptance to Penn’s MD/PhD program to work for the Obama Campaign

10:00 – doing research at Wharton and getting a PhD not in basic science

13:00 – the value in appreciating health policy these days and how quickly health policy news/narratives/discussions can change

17:45 – Nora’s research – How the ACA has impacted contraceptive usage

24:00 – does contraceptive use save insurers money?

28:00 – paying for care specific to women’s health

35:00 – does being a mother change perspective on these issues?

38:45 – having your research tweeted by Obama, and the perils of your research becoming political and/or misinterpreted

47:30 – the fickle nature and frustrations of dedicating your life to researching health policy

54:00 – how we think about and frame healthcare spending

58:00 – how do you convince people it’s good to pay for other people’s health care?

Links:

Nora's Old Bio

https://hcmg.wharton.upenn.edu/profile/norab/

List of Essential Health Benefits

https://www.healthcare.gov/coverage/what-marketplace-plans-cover/

The Oregon Medicaid Health Insurance Experiment

https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment

Her Papers

http://content.healthaffairs.org/content/34/7/1204.abstract

Coverage of Her Work

https://ldi.upenn.edu/new-penn-contraceptives-and-aca-study-gets-wide-media-pickup

http://www.npr.org/sections/health-shots/2015/07/08/421140260/women-are-saving-money-thanks-to-expanded-birth-control-coverage

https://www.cnbc.com/2015/07/07/birth-controls-big-cost-control-gains-from-obamacare.html

https://www.nytimes.com/2015/07/08/health/after-health-care-act-sharp-drop-in-spending-on-birth-control.html

Wharton Healthcare Management site

https://hcmg.wharton.upenn.edu/

Dr. Debbie Kelly joins us to speak about her career, and the decision to leave clinical practice to work in pharma.

Map:

5:30 – finding ophthalmology

9:45 – things that she didn’t like about clinical practice

12:30 – learning about GSK, industry, and the options for MD’s

21:00 – shifting to Pharmacovigilance

28:30 – getting contacted by the headhunter and going to Spark

34:15 – mulling the decision to leave clinical practice

45:00 – choosing one path vs. the unknown

51:00 – finding work-life balance in medicine and in industry

54:30 – challenges of pioneering gene therapy development

Links:

LinkedIn

https://www.linkedin.com/in/deborah-kelly-47963922/

Pharmacovigilance

https://en.wikipedia.org/wiki/Pharmacovigilance

Spark Therapeutics

http://sparktx.com/

Lancelot the Dog

http://www.blindness.org/glossary/lancelot