Health & Veritas

In this discussion, physician-entrepreneur Alexi Nazem shares insights from his journey co-founding Nomad Health and now investing in healthcare at AlleyCorp. He recounts how his Yale experience and mentors shaped his approach to healthcare improvement. Alexi highlights pressing challenges in healthcare quality measurement and reflects on the pandemic's dual impact on staffing. He also delves into the potential of AI in healthcare, emphasizing caution in investment strategies and the need for innovative solutions in a rapidly changing landscape.

Joined by Ryan Schwarz, a Yale-trained MD-MBA and leader at MassHealth, the discussion dives into the critical shortage of primary care doctors in the U.S. Ryan highlights challenges like burnout, unrealistic workloads, and the need for innovative care models. He advocates for team-based approaches, integrating various health professionals, and reforming payment systems to relieve clinician burdens. With a focus on sustainable solutions, Ryan expresses optimism for systemic change in primary care.

Mark McClellan, a physician-economist and former FDA commissioner, shares insights on healthcare policy and payment innovations. He reflects on the lessons learned from the U.S. COVID-19 response, emphasizing the need for a bipartisan review to enhance public health. McClellan discusses the evolution of Medicare Advantage, the impact of payment models on care delivery, and explores the challenges faced by the CMS Innovation Center in controlling costs. He advocates for better data and accountable payment designs to drive down expenses and improve outcomes.

Howie and Harlan check in on health issues in the news, including the big bet that went wrong for Walgreens, prohibited words at federal health agencies, the weaknesses of a much-discussed study suggesting that people age in bursts, and the long-term impact of the HPV vaccine. Links: Walgreens "Walgreens to Be Bought by Private Equity Firm in $10 Billion Deal" "Walgreens is heading down a risky path" "Walgreens to Be Acquired by Sycamore Partners: Where Did the Retail Giant Go Wrong?" "Amazon, CVS, and Walgreens went all in on primary care. Their bets are bleeding money." Cuts to the ACA "Trump administration plans to restrict Obamacare enrollment period" "DACA recipients worry about being ensnared in Trump's immigration crackdown" Medicaid "Cutting Medicaid?" "WATCH: Dr. Jay Bhattacharya testifies at Senate confirmation hearing for NIH director" "'Wrong,' 'misleading,' and 'reasonable': How Jay Bhattacharya became, for some, the least bad option to run NIH" "The Debate Over Federal Medicaid Cuts: Perspectives of Medicaid Enrollees Who Voted for President Trump and Vice President Harris" "Medicaid's True Improper Payments Double Those Reported by CMS" "Hundreds of Billions in Medicaid Savings from Financing Schemes" Prohibited Words "C.D.C. Suggests Terms Like 'Race' and 'Health Equity' Are Off-Limits, Then Backtracks" "For Google, health equity becomes 'health optimization' as Trump targets DEI" Aging "Do We Age Steadily, or in Bursts?" "Nonlinear dynamics of multi-omics profiles during human aging" "What does it take to be a super-ager?" The HPV Vaccine "Trends in Cervical Precancers Identified Through Population-Based Surveillance — Human Papillomavirus Vaccine Impact Monitoring Project, Five Sites, United States, 2008–2022" "People Have Been Having Less Sex—whether They're Teenagers or 40-Somethings" "RFK Jr. says he'll stop collecting fees from HPV vaccine lawsuit, but other ethics questions remain" Norovirus "An oral norovirus vaccine tablet was safe and elicited mucosal immunity in older adults in a phase 1b clinical trial" "How to Prevent Norovirus" The Measles Outbreak CDC: Expanding Measles Outbreak in the United States and Guidance for the Upcoming Travel Season "Texas measles cases grow to 223, mostly among children and teens" "West Texas measles outbreak expands to three states" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Yale neonatologist Sarah Taylor to discuss our growing understanding of breastfeeding, including the active role that infants play in shaping the composition of breast milk. Harlan discusses the rapid growth of Hims & Hers Health, which provides treatment and medication over the internet; Howie reports on the promising initial results from a pilot program in North Carolina that seeks to reduce healthcare costs by providing support in non-medical areas like food security and housing. Links: Hims & Hers "Why Hims & Hers Stock Has Further to Fall: Heard on the Street" "Hims & Hers Super Bowl Spot Draws Drug-Industry Backlash" "Why We Don't Trust Doctors Like We Used To" Breastfeeding Sarah Taylor and Howard Forman: "No such thing as a free lunch: The direct marginal costs of breastfeeding" Sarah Taylor: "Infant factors that impact the ecology of human milk secretion and composition—a report from 'Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)' Working Group 3" Sarah Taylor: "Parent and grandparent neonatal intensive care unit visitation for preterm infants" Sarah Taylor: "Quantifying the Association between Pump Use and Breastfeeding Duration" The North Carolina Healthy Opportunities Pilot Program "Reflecting on Nearly Two Years of North Carolina's Healthy Opportunities Pilots" Health & Veritas, Episode 97: Mallika Mendu: Improving Operations "Medicaid Spending and Health-Related Social Needs in the North Carolina Healthy Opportunities Pilots Program" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by infectious disease specialist Michael Dunne to discuss the growing problem of antimicrobial resistance and what's needed to incentivize the development of new antibiotics. Harlan reflects on the controversy sparked by the release of his study on post-vaccination syndrome; Howie provides an update on the measles outbreak in Texas. Links: Post-Vaccine Syndrome Harlan Krumholz: "Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination" "A small study on Covid vaccine safety sparks an online tempest" "Scientists Describe Rare Syndrome Following Covid Vaccinations" Antimicrobial Resistance and New Antibiotics "New bill would create a subscription payment model to jumpstart antibiotic development" Antimicrobials Working Group H.R.4127—DISARM Act of 2021 S.1355—PASTEUR Act of 2023 CDC: Antimicrobial Resistance Facts and Stats Michael Dunne: "Impact of Empirical Antibiotic Therapy on Outcomes of Outpatient Urinary Tract Infection Due to Nonsusceptible Enterobacterales" Michael Dunne: "A multicenter analysis of trends in resistance in urinary Enterobacterales isolates from ambulatory patients in the United States: 2011-2020" CDC: Core Elements of Antibiotic Stewardship "Crisis Looms in Antibiotics as Drug Makers Go Bankrupt" "Bill & Melinda Gates Medical Research Institute Initiates Phase 3 Clinical Trial of Tuberculosis Vaccine Candidate" Michael Dunne: "Replacing serum with dried blood microsampling for pharmacokinetics, viral neutralisation and immunogenicity bioanalysis supporting future paediatric development of RSM01, a candidate respiratory syncytial virus neutralising monoclonal antibody" The Measles Outbreak "An unvaccinated child has died in the Texas measles outbreak" CDC: Measles, Mumps, Rubella (MMR) Vaccine Safety WHO: Measles "Consequences of Undervaccination—Measles Outbreak, New York City, 2018-2019" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by legal historian Paul Lombardo to discuss his work exploring the role of the legal and medical establishments in eugenics and sterilization in the United States. Harlan reports on his new research on post-vaccination syndrome, a constellation of chronic symptoms experienced by some people after getting the COVID-19 vaccine; Howie discusses the science behind a measles outbreak in Texas. Links: Anxiety in Academia Yale Office of the President: Our commitment to our research mission Post-Vaccination Syndrome Harlan Krumholz: "Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination" "Immune markers of post vaccination syndrome indicate future research directions" Eugenics in America U.S. Supreme Court: Buck v. Bell, 274 U.S. 200 (1927) Paul Lombardo, New England Journal of Medicine: "'Ridding the Race of His Defective Blood'—Eugenics in the Journal, 1906–1948" "Clarence Thomas tried to link abortion to eugenics. Seven historians told The Post he's wrong." Paul Lombardo: Three Generations, No Imbeciles In the Name of Eugenics Paul Lombardo: "Republicans, Democrats, & Doctors: The Lawmakers Who Wrote Sterilization Laws" Measles and Herd Immunity "West Texas measles outbreak grows to 58 cases, including some people who said they were vaccinated" "Supreme Court rejects challenge to Connecticut law that eliminated religious vaccination exemption" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Deborah Rhodes, a Yale internist and expert in molecular breast imaging, shares groundbreaking advancements in breast cancer screening, particularly for women with dense breast tissue. She discusses the need for better detection methods and the challenges of gaining widespread adoption. The conversation touches on the ethical dilemmas surrounding commercialization in medical research and the impact of government funding cuts on innovation. Rhodes also highlights the historical context of screening techniques and the importance of improving patient safety in healthcare.

Discover a groundbreaking non-opioid pain medication aimed at revolutionizing pain management and tackling the opioid crisis. Learn about the impact of AI in mammography, enhancing cancer detection rates while navigating workforce challenges. Dive into the cultural effects of legalized sports gambling during the Super Bowl and its implications for public health. Lastly, grapple with vaccination skepticism and the ongoing need for clear communication regarding flu vaccine effectiveness. A blend of health innovations and societal shifts!

Howie and Harlan are joined by Lisa Rosenbaum, a cardiologist and the national correspondent for the New England Journal of Medicine, to discuss her writing illuminating critical topics in medicine. Harlan reports on the companies claiming to prevent illness through a non-invasive full-body scan; Howie explains the healthcare impact of the Trump administration's freeze of federal aid. Links: Body Scanning "Neko Health raises $260M to expand body scan service, fund R&D" Neko Health "Kim Kardashian Promotes $2,500 Body Scan—Here's What To Know And Why Some Experts Warn Against It"" "Daniel Ek's body scanning startup hits £1.4 billion valuation with 100,000 people lining up to pay £299 for a health check" "The rise and fall of Theranos: A timeline" Lisa Rosenbaum Lisa Rosenbaum: "Gray Matters: Analysis and Ambiguity" Lisa Rosenbaum: Not Otherwise Specified podcast Lisa Rosenbaum: "Beyond Moral Injury—Can We Reclaim Agency, Belief, and Joy in Medicine?" Lisa Rosenbaum: "Being Well while Doing Well—Distinguishing Necessary from Unnecessary Discomfort in Training" "The Case Against the Trauma Plot" "The Rise of Therapy-Speak" Lisa Rosenbaum: "On Calling—From Privileged Professionals to Cogs of Capitalism?" "The Moral Crisis of America's Doctors" The Ezra Klein Show: "Democrats are Losing the War for Attention. Badly." IMDB: The Doctor The New Administration "Kennedy, Polarizing Pick for Health Secretary, Makes His Senate Debut" "WATCH: Sen. Elizabeth Warren questions RFK Jr. in confirmation hearing" "Trump aid freeze stirs chaos before it is blocked in court" "Trump administration rescinds order attempting to freeze federal aid spending" "Uncertainty Causes Chaos as Trump Threatens Funding Pause for Schools" "Read the Memo Pausing Federal Grants and Loans" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.