As tuberculosis is on the rise once again in this country, it remains *the* cause of death around the world. But thanks to fans of the famous vlogbrothers, John and Hank Green, the world has some additional tools to fight a disease which we've been able to cure for decades, lacking only the will to do it. And Dave tells what he learned this week about Katalin Karikó, the Hungarian-born researcher who, despite being cast aside as a crank in the 1980s, received the Nobel Prize in 2023 for 40+ years of work that saved millions of lives in just a couple short years--and which is now about to revolutionize medicine.

As another physician shortage looms, M2s Jeff and Olivia and M1 Fallon look at the reasons–the market forces, political issues, and the missing incentives. There is some good news–a shortage of physicians means that residents get a ton of solicitations for post-training jobs. Elon Musk’s Neuralink might be bad for monkeys, but the FDA has cleared the way for human trials to begin. What place do techbros–who have a rep for “moving fast and breaking things”– have in medicine where lives are at stake? And Dave gives a pop quiz on this year’s Ig Nobel Prize winners--listen to learn more about the latest technology in excretion analysis!

Physician Associate (formerly Physician Assistant) students learn the preclinical curriculum right along side their Doctor of Medicine colleagues here at Iowa. Of course, that means they learn the same things, but also the level of trust and mutual understanding between the two professions is that much more explicit. October 6 to 12 is Physician Associates Week, and PA1 producer Noah Vasquez rounded up some classmates--Olivia Quinby, Emily Sarvis, and Noah Herkert--to talk about how they chose their future profession, what they're learning, and what their plans are after they graduate.

The beginning of the 20th century brought huge changes to medicine; we’re still trying to cope with them. Special guest Dr. Adam Rodman, visits with M1s Jeff, Faith, and Linda and PA1 Kelsey, to talk about “path dependency,” the idea that a complex system (like medical education) is almost impossible to change without starting over. The path we have taken to today constrains what we can do tomorrow. We discuss the founding of medical education as we know it today and how that has created an academic medicine system that values facts, science, and publication more than things like equity, empathy, and work-life balance. The good news is that very dedicated people are working to make the sorely needed adjustments to these areas and more…without burning it all down and starting again.

Motherhood is a revered institution in many cultures, but in the good old US of A there's one area where mothers are being failed: medicine. Maternal mortality continues to increase to alarming levels, especially among people of color. We explore our thoughts on why, and what doctors can do in an environment in which financial profit is a prime motivator for health systems, rural areas are losing OBs, and nurse staffing levels are too low. Plus, we hear from some influencers with their health advice in a game of unnecessary censorship.

How should Thomas choose between his great career options? We’ve all been there: faced with some good options, which one do we choose? Listener Thomas wrote in with his dilemma: he studied and loves engineering, but what about medicine? M1s Jacqueline Nielson, Fallon Jung, and Sri Nandakumar discuss what they studied as undergrads, what made them realize that medicine is the right path, and how to become certain about that. Also, women surgeons are better than male surgeons, according to yet another study, and a supermarket’s chatbot recommends meals for busy people, like delicious chlorine gas.

Why docs don’t like the word “provider,” and the surprise dealt to the AAMC by OB residency programs

a Delaware-based health system, is taking a stand against the use of the term “provider” to describe physicians. The AMA agrees, saying they oppose the term “provider” as inadequate and urging MDs to insist on being identified as "physicians." Co-hosts Nicole (Pathology Extern), Riley (MD/PhD student), and Jeff (M2) discuss why "provider" might not capture what doctors do. In the mid 90s, OB/Gyn residencies helped to pilot the Association of American Medical Colleges’ Electronic Residency Application Service, or ERAS. This year, to the “surprise and dismay” of the AAMC, the OB residencies are jumping ship this year and starting their own system. Despite the oft-repeated trivia, urine isn’t sterile. I know! mind blown.

Why do we struggle to change when our world changes around us? Philadelphia’s Mütter Museum is beloved by its visitors. Styled as an homage to Victorian displays of medical and biological curiosities, its exhibits include human remains with extreme pathologies…and sometimes dubious provenance. Once such items were joyfully collected by rich men to fill their cabinets of curiosities. But times have changed since the museum opened in 1863. The museum’s leaders have decided to reassess the exhibits’ ethical and moral qualities, despite the anger of devoted fans who like it fine the way it is, thanks. Dave, M2 Jeff Goddard, and new co-host M1 Fallon Jung discuss our all-too-human resistance to change, as well as a proposal by a consumer group to open access to a ‘secret’ database of state medical boards’ disciplinary actions against physicians, which they hope will prod medical boards to do their jobs better.

AI chatbots can help brainstorm ways to communicate more compassionately. We’ve talked about the study that found patients rated responses by the recent generation of AI chatbots significantly better in both quality and empathy than physicians. We decided to test ourselves on our efforts to bring up awkward topics with patients and others by comparing our answers to those provided by Anthropic’s Claude-2. Did M2 Jeff Goddard, M3 Betty Tu, M2 Yumi Engelking, and MD/PhD student Riley Behan-Bush do better than a bot? Betty and Yumi told us about CCOM’s new First Generation and Low-income in Medicine Association chapter. And we review some of the health advice found on social media, including videos by Tik Tok’s urmomstoering, angelapharmd, heyitskikiiiiii, and mirandaksmith.

Meet one doctor working to counter once-fringe anti-vax conspiracy theorists. M2 Jeff Goddard invited internationally-renowned virology and immunology expert Dr. Paul Offit on the show to talk about his lifelong struggle to fight vaccine misinformation. MD/PhD Students Riley Behan-Bush, and Madi Wahlen join Jeff to talk with Dr. Offit about his work educating politicians and policy-makers (as well as battling anti-vaxxers like 2024 presidential candidate RFK, Jr.) and with the Vaccine Education Center at Children’s Hospital of Philadelphia. One thing is for certain: though fear and doubt about vaccines have existed since the first smallpox vaccine, in the age of social media educating the public about vaccines and science hasn’t gotten any easier.

More about our guest:

Website: PaulOffit.com

Substack newsletter: Beyond the Noise