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The Nocturnists

The Gilded Age of Medicine with Dhruv Khullar, MD

Jan 23, 2025
Dhruv Khullar, a physician and health policy expert who writes for The New Yorker, explores the complexities of modern medicine, comparing it to a Gilded Age. He discusses how groundbreaking innovations often obscure deep systemic issues like rising costs and misaligned incentives. The conversation dives into the effects of private equity on healthcare, the pitfalls of Medicare Advantage, and the significance of clinicians engaging in health policy debates. Khullar emphasizes the need to address access and equity in the healthcare system.
42:49

Episode guests

Podcast summary created with Snipd AI

Quick takeaways

  • Modern medicine, despite advancements, faces systemic issues like rising costs and misaligned incentives that jeopardize patient care quality.
  • The impact of private equity in healthcare exacerbates inefficiencies and ethical concerns, particularly evident in the financial exploitation within Medicare Advantage plans.

Deep dives

The Illusion of Innovation in Healthcare

Despite significant medical advancements such as curative treatments for hepatitis C and innovative cancer therapies, the healthcare system is facing serious underlying issues of inefficiency and high costs. The term 'gilded age of medicine' encapsulates this paradox, as public perception of rapid medical progress often obscures a mismanaged, profit-driven system. This situation has led to widespread frustration, particularly as private equity influences hospital management, leading to reduced patient care standards amidst the pursuit of profitability. The pressing need for a more equitable healthcare approach is evident, as these systemic problems continue to affect patient experience and outcomes.

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