Health & Veritas

Howie and Harlan are joined by the New Yorker's Dhruv Khullar to talk about his life as a clinician, researcher, and journalist. Harlan looks at how direct-to-consumer healthcare companies like Hims & Hers Health are capitalizing on patients' reluctance to share sensitive issues with traditional providers; Howie reports on the health issues on the ballot in this week's election.  Links: The Loss of Trust and the Rise of Hims & Hers Health hims.com forhers.com “Hims & Hers reports 57% revenue increase, launch of AI offering and more earnings news” “Hims & Hers Health Sees Long-Term Tailwind from Weight Management Business” “FDA approves Eli Lilly’s tirzepatide for weight loss, paving way for wider use of blockbuster drug” “A study of the nature and level of trust between patients and healthcare providers, its dimensions and determinants: a scoping review protocol” Dhruv Khullar Dhruv Khullar: “Why Are We So Bad at Getting Better?" The New Yorker: Articles by Dhruv Khullar “A Program to Prevent Functional Decline in Physically Frail, Elderly Persons who Live at Home” Articles by Atul Gawande Dhruv Khullar: “What a Heat Wave Does to Your Body" Kim Stanley Robinson: The Ministry for the Future Dhruv Khullar: “The Struggle to Define Long Covid" Health on the Ballot “Democrats Take Control of Virginia Legislature” “Ohio Vote Continues a Winning Streak for Abortion Rights” “Mississippi Republican Gov. Tate Reeves wins 2nd term, defeating Democrat Brandon Presley” “Poll: 92% of Mississippi voters concerned about hospital crisis, 72% favor Medicaid expansion” “Marijuana use linked with increased risk of heart attack, heart failure” NIH: Marijuana and hallucinogen use among young adults reached all-time high in 2021 Read an unedited transcript of this episode. Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Melinda Pettigrew of the Yale School of Public Health to discuss the changes needed in the prescription and agriculture use of antibiotics to address the crisis of antimicrobial resistance. Harlan reports on a survey underlining the scale of medical misinformation among Americans; Howie discusses a new tool for the treatment of unhoused people.  Links: Medical Misinformation Harlan Krumholz: “A prescription for the US FDA for the regulation of health misinformation” “Vaccine Confidence Falls as Belief in Health Misinformation Grows” Melinda Pettigrew and Antimicrobial Resistance “Melinda Pettigrew—The next dean of SPH!” “New Law Will Help Combat Growing Threat of Antibiotic Resistance” “Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children” "Gastrointestinal Microbiome Disruption and Antibiotic-Associated Diarrhea in Children Receiving Antibiotic Therapy for Community-Acquired Pneumonia" “Two Yale alum tackle infection diagnostics” “A Review of the Effectiveness of Current US Policies on Antimicrobial Use in Meat and Poultry Production” FDA Fact Sheet: Veterinary Feed Directive Final Rule and Next Steps CDC: Measuring Outpatient Antibiotic Prescribing Treating the Unhoused “Housing Supply and the Drivers of Homelessness” CMS: Place of Service Code Set “New place of service code for treating unsheltered people” Rough Sleepers “‘You Have to Learn to Listen’: How a Doctor Cares for Boston’s Homeless” VA: VA Homeless Programs Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss current issues in healthcare, including burnout at the hospital, the downsides to Medicare Advantage, and how AI is helping radiologists catch tiny blood clots. Links: COVID-19 and Vaccinations  “Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy” CDC: Stay Up to Date with COVID-19 Vaccines “Myocarditis and Pericarditis After mRNA COVID-19 Vaccination” “‘On track’: 3 percent of Americans have gotten the new Covid shot, but the CDC director remains confident” “COVID Shots May Slightly Raise Stroke Risk in the Oldest Recipients” “Evaluation of Stroke Risk Following COVID-19 mRNA Bivalent Vaccines Among U.S. Adults Aged ≥65 Years” “SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels” CDC: COVID Data Tracker—USA  Medicare Advantage  2023 Medicare Open Enrollment Guide “How Health Insurers and Brokers Are Marketing Medicare” “Benchmark Survey: Annual Family Premiums for Employer Coverage Rise 7% to Nearly $24,000 in 2023; Workers Contribute $6,575 on Average Now, But Potentially More Soon” “Elevance Health Reports $13 Billion Profit and Insurer ups Forecast once again” Mental Health in Healthcare “Health care workers report increase in burnout, harassment since the COVID pandemic: CDC” “Health Workers Face a Mental Health Crisis” “Suicide Risks of Health Care Workers in the US” “Stabbed. Kicked. Spit On.Violence in American Hospitals Is Out of Control.” Artificial Intelligence in Healthcare “Prospective Evaluation of AI Triage of Pulmonary Emboli on CT Pulmonary Angiograms” “Artificial intelligence for breast cancer detection in screening mammography in Sweden: a prospective, population-based, paired-reader, non-inferiority study” “AI Risk Score on Screening Mammograms Preceding Breast Cancer Diagnosis” What’s a Normal Temperature? “Defining Usual Oral Temperature Ranges in Outpatients Using an Unsupervised Learning Algorithm”   Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by health economist Katherine Baicker of the University of Chicago to discuss her career in academia and government, the landmark Oregon Health Insurance Experiment, and the optimal design for universal healthcare coverage. Harlan asks why life expectancy in the U.S. increasingly lags behind peer nations; Howie discusses the politics threatening the PEPFAR program, which has saved millions of lives around the world.  Links: U.S. Life Expectancy “How does U.S. life expectancy compare to other countries?” The American Health Care Paradox: Why Spending More is Getting Us Less Healthcare Policy Katherine Baicker: “Oregon Health Insurance Experiment” Katherine Baicker: “The Oregon Experiment—Effects of Medicaid on Clinical Outcomes” “How to Use the Oregon Medicaid Study to Your Ideological Advantage” Katherine Baicker: “Workplace wellness programs can generate savings” Katherine Baicker: “Health And Economic Outcomes Up To Three Years After A Workplace Wellness Program: A Randomized Controlled Trial” We’ve Got You Covered: Rebooting American Health Care Katherine Baicker: “A Different Framework to Achieve Universal Coverage in the US” Yale President Howard K. Lamar’s 1993 Baccalaureate Address: “An Honorable Theatre of Action: Using A Yale Education in the 21st Century” PEPFAR The United States President’s Emergency Plan for AIDS Relief “PEPFAR Reauthorization: The Debate About Abortion” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

In the 100th episode of Health & Veritas, Howie and Harlan are joined by Peter Salovey, the president of Yale University and a pioneering psychology scholar. They discuss Salovey’s tenure as president, which ends in 2024; the future of the newly independent Yale School of Public Health; and Salovey’s influential research on emotional intelligence.  Links: “Statement regarding YSPH transitioning to an independent school at Yale” Peter Salovey: “Emotional Intelligence” Yale School of Medicine: “Medical school and health system form a new affiliation” “President's house will be a home” For Humanity: the Yale Campaign Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Marc Auerbach, a professor of pediatric emergency medicine at Yale, to discuss his work using standards and simulation to improve the treatment of children in emergency departments throughout the United States. Harlan reflects on the importance of simple, well-designed clinical trials to make rapid improvements to care; Howie reports on a congressional study asking whether the Centers for Medicare and Medicaid Innovation Center has succeeded in lowering costs and increasing quality.  Links: Timely Clinical Trials “Dexamethasone in Hospitalized Patients with Covid-19” “Now is the time to fix the evidence generation system” “The Clinical Trials Enterprise in the United States: A Call for Disruptive Innovation” The Yale Paxlovid for Long COVID (PAX LC) Trial Pediatric Emergency Medicine CDC: Emergency Department Visits Among Children Aged 0–17 by Selected Characteristics: United States, 2019–2020 “Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care” “The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physician” Connecticut Emergency Medical Services for Children: Innovation and Improvement Center Centers for Medicare and Medicaid Innovation Center CMS: About the CMS Innovation Center “Accelerating Care Delivery Transformation—The CMS Innovation Center’s Role in the Next Decade” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss the inspiring story behind the Nobel Prize in medicine, the settlement in the Cigna false billing case, and new research providing more evidence for the effectiveness of statins in reducing cardiovascular risk.  Links: The Nobel Prize “Press Release: The Nobel Prize in Physiology or Medicine”  The Daily: “The Unlikely Pioneer behind MRNA Vaccines” “Halting Progress and Happy Accidents: How mRNA Vaccines Were Made” “How Our Brutal Science System Almost Cost Us A Pioneer Of mRNA Vaccines” Katalin Karikó and Drew Weissman: “Suppression of RNA Recognition by Toll-like Receptors: The Impact of Nucleoside Modification and the Evolutionary Origin of RNA” “The Karikó problem: Lessons for funding basic research” Cigna and Medicare Advantage “Cigna Group to Pay $172 Million to Resolve False Claims Act Allegations” “Overpayments to Medicare Advantage Plans Could Exceed $75 Billion in 2023, USC Schaeffer Center Research Finds” Health & Veritas: “Helen Burstin: Research with an Impact” The Cigna Group (CI) Stock Price, News, Quote & History Humana Inc. (HUM) Stock Price, News, Quote & History HIV and Cardiovascular Outcomes “Pitavastatin to Prevent Cardiovascular Disease in HIV Infection” Health & Veritas: “Dr. Amy Justice: Unlocking the Insights in Healthcare Data” “Shifting from “Morbid Obesity” to “Class III Obesity”” Healthcare Data “Officials Struggle to Regulate Pop-Up Covid Testing Sites—and Warn Patients to Beware”   Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Mallika Mendu to discuss how innovations in operations can lead to improved inpatient care and her work as both a practicing nephrologist and associate chief medical officer at Brigham and Women’s Hospital. Harlan highlights the Lasker Award in medicine; Howie reports on a promising $650 million pilot in North Carolina to comprehensively address the social determinants of health. Links: US Bureau of Labor Statistics | Skilled Nursing Facilities Employment “What Went Right? A Mixed-Methods Study of Positive Feedback Data in a Hospital-Wide Mortality Review Survey” “The Advancing American Kidney Health Initiative: The Challenge of Overcoming the Status Quo” Haven Free Clinic | Home Page “A Holy Grail — The Prediction of Protein Structure” Wikipedia on AlphaFold “Lasker Award for Revolutionizing Protein Structure Predictions” “A.I. Predicts the Shape of Nearly Every Protein Known to Science” NC Medicaid Managed Care Healthy Opportunities Pilot Fee Schedule and Service Definitions Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems NCDHHS | Healthy Opportunities Pilots “In North Carolina, a radical experiment targets social determinants of health with fresh produce and safe housing” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Nita Ahuja, a Yale surgeon and researcher, to discuss new methods in for detecting and treating cancers and the barriers faced by women surgeons. Harlan answers questions about an FDA panel’s finding that the decongestant phenylephrine is ineffective; Howie looks at the trends making hospital finances unsustainable.  Links: “FDA clarifies results of recent advisory committee meeting on oral phenylephrine” “Phenylephrine vs. Pseudoephedrine: What’s the Difference?” “Why Has a Useless Cold Medication Been Allowed on Shelves for Years?” “Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries” “Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden” “Age, Gender And Ability To Listen: Who Listens Best?” “Women surgeons are punished more than men for the exact same mistakes, study finds” “Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights” “Board of Supervisors denies Greenwood Leflore Hospital’s $1 million request” “Money and ambition split up Dana-Farber and Brigham” Dana-Farber Cancer Institute, Inc. and Subsidiaries: Consolidated Financial Statements and Supplementary Information Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

In a special episode, Howie and Harlan are joined by the virologist and advocate Peter Hotez to discuss his new book, The Deadly Rise of Anti-Science: A Scientist’s Warning. This interview was recorded in late August. Links:  Peter Hotez: The Deadly Rise of Anti-Science: A Scientist’s Warning Peter Hotez: Vaccines Did Not Cause Rachel’s Autism “Red Covid, an Update” “The Red/Blue Divide in COVID-19 Vaccination Rates Continues: An Update" “Swiss study finds connection between watching Fox News and vaccination rates going down" “The Paranoid Style in American Plutocrats" “Wakefield’s article linking MMR vaccine and autism was fraudulent" “Peter Hotez is not alone: Online harassment of doctors is a public health issue" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.