The Preventive Medicine Podcast

This is a re-cast of an episode originally aired in June of 2020. This was an incredible episode that deserves to be heard by all new listeners! In this episode we discuss the role of resistance training for both patients and as a prescription by providers, the evidence behind various practices in prevention, the harms of over-screening, and much more!. Whether in the hospital inpatient floors or his clients in the gym, Dr. Baraki brings evidence-based information and suggestions to help those he works with.

Dr. Baraki is board certified in Internal Medicine, an assistant professor of medicine, and well known for his role with Barbell Medicine. 

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Show Notes

Question 1:  What is Barbell Medicine, why did you decide to get involved and what are it's goals?

Question 2: Why did you decide to go into Internal Medicine given your athletic history and interest in exercise?

Question 3: What do you think other physicians that do not lift weights can learn from Barbell medicine, should they attend your seminars?

Question 4: Does the population of those attending your Barbell Medicine seminars trend more towards physicians or healthcare professionals?

Question 5: There are many silly ideas surrounding preventive medicine and other aspects regarding medicine, can you speak to the use of evidence when it comes to recommendations in preventive health?

Question 6: What does preventive medicine mean to you?

Question 7: Why is the allure of more screening with regards to preventive care problematic?

Question 8: How do you balance limiting the allure of physicians to use screenings widely as a way to "check-off" preventive care and patients that desire screening based on false notions of prevention?

Question 9: How do you communicate to patients who come in wanting to get unneeded screening such as a whole-body scan to determine all potential problems?

Question 10: Why is it important that patients are educated and develop a level of self-efficacy?

Question 11: Do you think helping patients develop a positive self-narrative is beneficial in the scope of preventive medicine?

Question 12: Do you think we do a poor job of letting our patients know that they should be striving to develop a more robust exercise program based on the current guidelines?

Question 13: How do we bridge the gap between personal trainers and physicians in bringing exercise programs and nutritional counseling to patients?

Question 14: In 2 minutes what do you tell someone who asks you "how do I get healthy?"

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It's 2023. It's time we separate our weight from our health. Everywhere we look, health and weight has been synonymous leading to body dysmorphia, poor relationships with food, and many other issues. Well, there's many more benefits to eating well and physical activity! 

In this podcast, I go over some of the highlights from the podcast for the last year, some of my life events from 2022, podcast goals for this year, and then dive into dividing out health from fitness and nutrition.

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Show Notes

* Top Episodes Links:

*  Dealing with Burnout, and ICU Physician Tells All - Jeremy Topin, MD: https://thepreventivemedicinepodcast.com/episode-58/

* The Dogma of Diets and Nutritional History - Alan Flanagan, MsC: https://thepreventivemedicinepodcast.com/episode-57/

* Are We Really in Control of Our Diet? - Stephen Guyenet, PhD: https://thepreventivemedicinepodcast.com/episode-56/

* Article Suggestions:

*  The Beginner Prescription by Barbell Medicine

*  Health Priorities by Barbell Medicine

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If you listen to this podcast, you likely pay some sort of membership fee either for coaching, the gym, or another health related item. You get access to the facility, time with the coach, and whatever else is included in the fee. What if medicine was practiced the same way? Enter concierge medicine.

Dr. Ari Levy is a serial entrepreneur and physician who founded SHIFT which is a concierge medicine practice focused on integrating all aspects of health under one roof. In this episode we discuss what SHIFT is, what concierge medicine is, how Dr. Levy's vision seems to be the gold standard when it comes to being mindful of prevention, and lastly the pitfalls of concierge medicine. 

Go check out: https://shiftlife.com/ for more information on SHIFT and to see if you would like to make the SHIFT! 

Episode Outline

* What does preventive medicine mean to you?

* What is SHIFT and what inspired you to start this practice? What differentiates it from what people usually think of as their doctor?

* Do you think physicians should get involved with advising patients on lifestyle modification or should we just focus on the medicine?

* What results have you seen with the “life” package through SHIFT? Do people take advantage of their resources?

* How does the model of concierge medicine work? Does this mean members don’t need insurance at all?

* What does it take to have these kinds of services available for those of lower socioeconomic standing?

* How do you keep it all evidence based when you hire for different positions?

* If you were waiting for your coffee at Starbucks and someone who recognizes you asks “how do I get healthy,” what do you tell them in the 2 minutes you have?

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The holidays is a time for getting together with family, relaxation, and celebration until it's not. There are many instances of holidays being ruined by preventive injuries and many unfortunate mortalities. In this episode, I take you through common holiday causes of morbidity and mortality for things to keep in mind during this festive time.

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Show Notes:

Toy related injuries - https://www.cpsc.gov/s3fspublic/ToyRelatedDeathsandInjuries2021.pdf

Transportation related Injuries - https://injuryfacts.nsc.org/home-and-community/safety-topics/deaths-by-transportation-mode/

Red Cross Fire Safety - https://www.redcross.org/content/dam/redcross/atg/PDF_s/Preparedness___Disaster_Recovery/Disaster_Preparedness/Home_Fire/FireHolidayFactSheet.pdf

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We know smoking is bad for us, we've been hearing it for decades at this point. Unfortunately it wasn't always this way. The use of cigarettes and smoking in general has changed dramatically within the last several decades and many still struggle with the addiction or with its chronic effects. In this episode, Dr. Baldassarri dives into smoking, cigarettes, addiction, and much more. 

Dr. Baldassarri completed his residency in Internal Medicine from the Yale School of Medicine before completing a fellowship in pulmonary and critical care medicine also from Yale. He is also board certified in addiction/preventive medicine and currently serves as an assistant professor of medicine at the Yale School of Medicine. He has appeared on other podcasts and is well-published on topics relating to smoking, addiction, and sleep.

Show Outline

* How did you get interested in smoking cessation and addiction medicine with your pulmonary/crit care background?

* What does preventive medicine mean to you?

* How has the use of cigarettes changed in the last several years? Has the gap been filled by other devices such as vapes or by marijuana?

* What interventions have helped bring the use of cigarettes down? How do you approach the conversation?

* For those who have quit but have a significant smoking history, what can be done to reduce their risk of chronic lung disease?

* Marijuana has gained a lot of popularity as an alternative medicine, what are the risks associated with marijuana use either through vape or smoking it?

* If you’re at a coffee shop and someone asks you “how do I get healthy?” what do you tell them in the 2 minutes you’re waiting for your coffee?

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There is a lot more to health to health than what happens in an examination room. The decisions that are made at the municipal, state, and national levels make incredible impacts that often times can either make or break the health of a population at large. In fact, preventive medicine at the highest level has more to do with politics and policy than the supplement being touted on your feed as a miracle. 

In this episode, I talk with Dr. Abdul El-Sayed who has had many roles throughout his career; so many that he has a wikipedia page! Dr. El-Sayed trained as a physician with a gap to complete his PhD at Oxford in Public Health after which he became an assistant professor at Columbia University within the Department of Epidemiology. He then went on to become the youngest Health Director and Executive Director of the Detroit Health Department at just 30 years old before running for governor of Michigan in 2018. Unfortunately, he did not win that race but has continued writing and speaking about the relationship between politics and health through his two published books, podcast, and newsletter. He is a political commentator on television and continued to be active in improving the landscape for public health.

Dr. El-Sayed's Links:

Abdul's Website

The America Dissected Podcast

The Incision Newsletter

Abdul's Books

Instagram

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Show Outline

* You have held a lot of roles and do many things, why do you do what you do?

* What does preventive medicine mean to you?

* What responsibilities does a top official of a health department have compared to a practicing physician? How much of an impact on the day to day lives of people does this role have?

* Why did you decide to run for governor of Michigan and how much impact can someone in this role have in the health of their constituents?

* What does the landscape for healthcare reform look like on the political level? Do politicians realize the issues that regular people face?

* If someone asks you how to get healthy while you are waiting for your coffee at starbucks, what do you tell them in 2 minutes?

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Hospitals do a lot for their patients, but what about others in the community? The Boston Medical Center has made it it's mission to provide healthcare to everyone despite ability to pay; furthermore, the Health Equity Accelerator to transform the landscape of health equity within the Boston community.

Led by Dr. Elena Mendez-Escobar and Dr. Thea James, the Health Equity Accelerator focuses its resources on maternal and child health, infectious diseases, behavioral health, chronic conditions, oncology, and end-stage renal disease through reaching those who otherwise would not receive as equitable care. In this episode, learn more about what the program is, what hospitals can do to help their communities, and a lot more about health equity! 

The Health Equity Accelerator Links:

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Show Notes

* What are your roles within BMC? What do you do on a day to day basis?

* What does preventive medicine mean to you?

* How did the health equity accelerator come about? What does it do?

* Do you believe that hospitals have an obligation to their communities in reaching “hard to reach” patients?

* Given some of the deep origins of health inequities, how can hospitals and hospital initiatives make quantitative change within the community such that the stats actually change?

* Where does the money come for programs such as the health equity accelerator given the capitalistic and profit-driven nature of many hospitals?

* How can the health equity accelerator be replicated in other cities? What are the barriers to more widespread adoption?

* For those from a lower socioeconomic status - if someone were to ask you “How do I get healthy” while you were waiting for your coffee, what do you tell them in 2 minutes?

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Climate change has been happening for some time and, while we may not actively notice it, has been harming the health of millions across the globe for some time now. Dr. Kristie Ebi is a professor of Global Health and Environmental & Occupational Health Sciences at the University of Washington and a globally renowned expert in the effect of heat on our health. 

In this episode we dive into how climate change impacts our health, why the heat is so dangerous, who and where the majority of the effects take effect. We also talk about how to prepare from the individual level all the way to the global level.

This episode is like none other that we have on the podcast!

Episode Outline

* Can you briefly describe what you do and areas you are actively researching?

* What does prevention mean to you?

* Can you explain what kind of climate change we are seeing and what we expect to see within the next 50 years?

* Why is excess heat so dangerous to our health?

* Who is going to suffer the effects of climate change the most and what kinds of health issues/outcomes will they be facing?

* What can we do to prepare and prevent excess morbidity and mortality related to climate change on a personal level?

* How do communities and countries prepare for and prevent the excess morbidity and mortality related to climate change?

* What does the forecast look like for health outcomes? How bad is it going to get? There are those who are very apocalyptic about our future and those who have unrivaled optimism. What’s your take?

* If you’re waiting for your coffee at Starbucks and someone asks you “how do I prepare for climate change?” What do you tell them in 2 minutes?

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Most of us are very privileged when it comes to healthcare. We expect not only to get better from whatever ails us, but that we have easily accessible care equipped with all the necessary medicines, diagnostic tools, and staff. Unfortunately, many parts of the world have much less in the way of healthcare! 

Dr. James Sanders is a global health expert having practiced in setting such as Zambia, The Republic of Georgia, and Southeast Asia among other locations. In this episode, Dr. Sanders shares his insights on what preventive care, or just medical care in general, looks like in various parts of the world and the lessons he applied from his travels to his care as a local physician. This episode is fully of many stories so make sure to listen to the whole thing!

Dr. Sander's doesn't have social media!

Show Notes

* Can you tell us a little bit about your career and why you were interested in global health at a time it wasn’t really popular?

* What does preventive medicine mean to you?

* What is the MPH degree, why did you get it on top of the MD, and how did you utilize it during your career?

* Given the vast differences in resources, what are the biggest differences in care when it comes to the wealthy and the poor? Many people say that those who are poor have worse health because of personal choices, is this the case?

* What does healthcare look like in a country like Zambia which did not have a family medicine training program until your arrival? Many of our listeners might not even know what that looks like!

* In the united states we talk about preventive medicine from a very privileged position largely with nutrition, exercise, yearly checkups, etc. What does preventive medicine look like in a country with lesser resources such as The Republic of Georgia?

* How do impoverished populations differ in other parts of the world than in the united states?

* What lessons have you learned during your career as a clinician that are guiding your decisions now on the insurance side of things?

* If someone asked you how to get healthy while you were waiting for your coffee at starbucks, what would you tell them in 2 minutes?

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Science has gone under attack and many silly or harmful ideas have taken hold in society under the guise of "science." The thing is, there's a lot more to science than just claiming something to be scientific. In this episode, you'll hear all about what it means to follow the scientific method, what it means to be scientific, and what to do about those who erroneously claim science. 

Dr. Grimes earned his PhD in ultraviolet radiation physics followed by a post doctoral fellowship in medical physics and oncology but now largely operates as a science communicator. He is the author of the book "Good Thinking - why flawed logic puts us all at risk and how critical thinking can save the world." He is also often seen as a panelist and contributor on news stations such as BBC world news, CBS, CNN, and also in written mediums such as the New York Times, Guardian, and Washington Post among others. 

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Show Outline

* How did you go from being a cancer researcher to broad science communicator? Tell us a little bit about why you are so passionate about what you do?

* What does preventive medicine mean to you?

* Can you talk about the history of the scientific method and why “scientific” people would believe in things like the 4 humors of the body or leeches? How did we go from there to where we are now?

* What does it mean to follow the scientific method?

* Why do even prolific scientists like Dr. Linus Pauling who you write about in your book, fall into certain dogmas

* Misinformation seems to condense into a very vocal minority that has outsized effects on public discourse - can you speak to why this seemingly always ends up being the case?

* What do we do about misinformation? It seems exhausting to be constantly combatting it and relies on the “good” scientists to work 10x as hard.

* How can science literacy be increased - for those in applied science (doctors etc.), and the lay person?

* How do you find good information? How do you sift through the garbage?

* If someone asks you how to get healthy, what do you tell them in 2 minutes?

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