Raise the Line

“I see health systems being systematically disintermediated by certain payers and some tech companies who are eager to take the easy stuff and leave health systems with really complex, sick and often very poor patients,” says veteran healthcare executive Dr. Marc Harrison. “I need a speedboat to change that.” He’s building that speedboat in partnership with venture capital firm General Catalyst, and will leverage his deep experience -- most recently as CEO of Intermountain Healthcare -- to set a new course for healthcare in the US. “Healthcare should be accessible, affordable, of high quality, consumer-centric and a combination of the digital and legacy world,” he tells host Shiv Gaglani.  “A ‘clicks & mortar’ future, as we like to say.” In this thoughtful episode of Raise the Line, Harrison also touches on his own health struggles and discusses his book Possibility Unleashed which examines how to create environments where people get to do their very best work. “How do they get to run hard, run fast, be collaborative and do more in that context than they could ever do on their own?” Don’t miss this wisdom drop from one of the country’s leading figures in healthcare reform.Mentioned in this episode: Dr. Marc Harrison’s book, Possibility Unleashed.  If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

While it’s encouraging that efforts to provide culturally competent care have gained a foothold in the wake of COVID, today’s Raise the Line guest says it is time to expand the conversation to encompass the concepts of cultural safety - which involves awareness of historical power dynamics -- and cultural humility -- which requires an inward look. “Are you reflecting on your own values, beliefs, and background and what you're bringing to the table,” Dr. Raj Sundar explains to host Michael Carrese. Sundar tries to practice all of this himself with patients in his family medicine practice in Washington, but also works at a broader level as a community organizer with culturally diverse populations and reaches an even wider audience through his Health Care for Humans podcast aimed at educating clinicians on cultural safety in healthcare. He acknowledges up front how challenging this work can be, especially because well-intentioned efforts to connect culturally with patients can backfire unless they are well-informed, but it is more than worth the effort. “This work is messy and sometimes doesn't have a black or white answer, but it can provide moments of joy. When patients feel known, seen, and heard they feel like they can trust you.” Sundar is a thoughtful source of guidance in this enlightening look at what can be done at the individual and institutional level to facilitate cultural connection in healthcare. Mentioned in this episode: https://www.healthcareforhumans.org/ If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Our focus on the renaissance in research into psychedelics continues on this episode of Raise the Line, but instead of looking at their potential therapeutic applications, we're going to hear about using them as a tool for learning how the brain works. “We don't have a great idea about the neural basis of self-conception, and psychedelics make us question so many of our fundamental assumptions about the nature of reality,” says Dr. Michael Silver, director of the UC Berkeley Center for the Science of Psychedelics. Dr. Silver, who is also a professor of Optometry, has the advantage of using the extensive knowledge we already have of how visual activity works in the brain as a predicate for his research. “We have the ability to do human neuroimaging and objectively define many areas in the visual cortex, while it’s still unclear how some higher order areas of the brain are defined,” he tells host Shiv Gaglani. The Center was established in 2020 in part to fill a need for credible information about psychedelics and its work is informed by a wide range of disciplines including molecular and cell biology, psychology, neuroscience and journalism. In fact, one of the Center’s founding members is journalist Michael Pollan, author of the bestselling books How to Change Your Mind and This is Your Mind on Plants. This is a truly fascinating conversation on the nature of visual perception, standards for training psychedelic facilitators and the possible recategorization of mental health disorders, among other implications of psychedelic research. Mentioned in this episode:UC Berkeley Center for the Study of PsychedelicsUC Berkeley Online Course: Psychedelics and the MindSam Harris Podcast If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

“I'm betting it's going to be more good than bad, but I have some big concerns about where things are headed,” warns Dr. Matthew Johnson of Johns Hopkins University when prognosticating about what impact the use of psychedelics in mental health treatment will have on society at large. As he tells host Shiv Gaglani, once these compounds are more widely available, there is real potential for unscrupulous actors to take advantage of people and cults to form. “One of the critiques is about this “new religion” component. I've been really concerned about that because I see even within the deepest layers of science, it’s very difficult to trust people with the magnitude of effect psychedelics have in people.” It's perhaps surprising for one of the scientists responsible for the renaissance in psychedelic research to articulate those concerns, but Dr. Johnson notes there is a long history, going back centuries, of psychedelics waxing and waning due to social and political factors. For now, he is focused on the efficacy of psychedelics in combating nicotine addiction, an area he pioneered starting a decade ago. Preliminary results of a study building on his early work indicate psychedelic-assisted therapy may be twice as effective as the leading nicotine replacement therapy. Up next is a multi-site trial on nicotine, plus studies on using LSD to treat chronic pain and psylocibin to deal with opioid addiction and PTSD. Don’t miss this thoughtful, nuanced and super informative discussion on one of the most interesting areas in medical science today.  If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

For our 400th episode we’re happy to be diving into one of our favorite topics -- direct-to-consumer healthcare -- with a leading force in the space, Dr. Kapil Parakh. In his role as senior medical lead at Google, Dr. Parakh has led projects to expand access to health information and help people achieve their fitness goals using Fitbit and other means. He’s also helped launch products that reach a billion people and pioneered partnerships with a range of organizations, including the World Health Organization and the American Heart Association. “I've found my passion around innovation and digital health, and the intersection of consumers and health,” he tells host Shiv Gaglani. Tune in to gain from Parakh’s broad insight into how AI and digital tools are making a difference in the science of health, and the opportunities for wearables and other digital tools to help doctors and patients work together to improve health. “You can take these consumer-grade tools and intelligently use them in many different clinical and population health settings. You just have to understand what that data means and how to use it.”Mentioned in this episode: https://www.google.com/fit/ If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

“We don't have a shortage of nurses in this country. We have a shortage of nurses willing to practice in the healthcare environments as they are today,” says Rebecca Love, an educator, innovator and leader who has devoted her career to improving the profession of nursing from multiple angles. She’s currently pursuing one of those efforts as chief clinical officer at IntelyCare, an app which smooths out the scheduling process for nurses looking to pick up extra shifts. “We created a platform that allows nurses more of a credentialing passport to work anywhere they want, when they want to.” Love is also involved in a broader effort to change how nurses are paid, correcting an historical artifact of their services being included in the daily rate of a hospital room instead of being billed as a separate service, as she explains to host Michael Carrese. “Nursing is still the only healthcare profession that does not have a billable service which makes them a cost center to hospitals and as long as that’s the case, healthcare systems are never going to invest in anything to make the lives of nurses better.” Tune in for a powerful perspective shift on one of the biggest challenges facing healthcare today from a leading advocate for the nursing profession.Mentioned in this episode: https://www.intelycare.com/ If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Twenty years ago, health outcomes in Eastern North Carolina lagged behind state averages but those deficits have largely been erased, and Dr. Mike Waldrum, Dean of the Brody School of Medicine at East Carolina University, thinks he knows why. “We’ve done it primarily with a community-based focus and taking students only from North Carolina that we know have a propensity to want to practice medicine in the environments that we're here to serve. That's kind of our sauce,” he tells host Shiv Gaglani. Building on that approach, the university started a rural residency program in recent years, and out of four graduates in its first cohort, two have agreed to stay in the communities in which they trained. And while that kind of incremental progress on the ground level is important, Dr. Waldrum knows change is needed at the system level as well. Some things ECU Health can do on its own, such as implementing a unified electronic medical record across all of its care sites that allows it to model where health needs are and intervene early. But what he sees as the necessary restructuring of how the healthcare system is organized and financed will take a group effort. “We need Medicare, Medicaid, the insurance industry and others as partners in how we transform the system.” Tune in for a thoughtful look at the challenges of improving healthcare in rural communities, and the special role academic “safety-net” health systems play in that effort. Mentioned in this episode: https://medicine.ecu.edu/ If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

If you were to make a word cloud based on this episode of Raise the Line, community would be the most prominent term.  For starters, Dr. Allison Brashear was attracted to Buffalo for its reputation as a welcoming community -- a city of good neighbors, as she puts it -- which reminded her of her roots in the Midwest.  She was also encouraged that the University at Buffalo Jacobs School of Medicine already had a well-established reputation as a community partner.  And, as she tells host Derek Apanovitch, she has seen the impressive strength of the Buffalo community in the wake of the deadly, racially motivated shooting at a supermarket last May. Part of the school’s response to that tragedy has been developing an anti-racist curriculum and focusing students on addressing health inequities. “There's an elective where students can go provide healthcare in the neighborhood, so they actually kind of walk in a patient's shoes... because if you don't understand the social determinants of health of your patient, then you're not going to be able to make a difference.” Brashear adds that the school’s wide variety of partners -- from the VA to community-based primary care clinics -- further enriches the educational experience. “There's a wealth of opportunities to learn here in Buffalo, and that's one of the things that makes it really great.” You’ll also learn about Brashear’s efforts to boost the number of graduates who stay in the region to practice medicine, the University’s research strengths, and her own work as an internationally renowned researcher in several rare neurologic disorders in this in-depth conversation.Mentioned in this episode: medicine.buffalo.edu/atp1a3  If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

“We thought it was the end of psychedelic research, and the great dreams we had were for some future generation,” says Dr. Bill Richards, referring to the 1970s when the Nixon administration criminalized psychedelic compounds.  At that point, he could not have imagined there would once again be the thriving interest in psychedelics for both therapeutic and non-clinical purposes that we see today. On this episode of Raise the Line with host Shiv Gaglani, we take a unique, multi-generational look at psychedelic research with two guests who happen to be related to each other. Dr. Bill Richards' extraordinary contributions to the field started sixty years ago and he was instrumental in helping Dr. Roland Griffiths reignite psychedelic research in 1999 at Johns Hopkins University after decades of dormancy. His son, Dr. Brian Richards, has made his own significant mark in the space, contributing to some of the original research administering psilocybin with cancer patients and healthy normal adults. He also teaches and mentors students at the California Institute for Integral Studies, the leading psychedelic medicine certificate program worldwide. They’re currently colleagues working with cancer patients at Sunstone Therapies, a company focused on defining the standards for optimal delivery of psychedelic-assisted therapy. You’ll hear about the range of patient experiences they’ve witnessed, the critical role of therapists who guide the sessions, what it’s like to work together and whether they think the US is ready to integrate psychedelics into medical care, among many other dimensions to this fascinating issue. Mentioned in this episode:https://www.sunstonetherapies.com/Sacred Knowledge by William A. Richards If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

“After an hour in this machine, I learned more about my health than the health system had told me my entire life.” That’s our Raise the Line guest Andrew Lacy describing a full body MRI scan he underwent several years ago in Canada that sparked the idea for the company he subsequently founded, Prenuvo, which uses advanced MRI technology for preventive screenings. Growing curiosity about the state of his health as middle age approached had prompted Lacy to undergo a diagnostic gauntlet: colonoscopy, genetic screening, blood tests and more. But he didn’t get the comprehensive answer he was seeking until the MRI. “Seeing the results of that scan felt like I was seeing the future of healthcare. From that moment on, my mission was to figure out how can I take this and bring it to the world,” says Lacy, a serial entrepreneur, investor and advisor in a wide range of industries. He has taken big steps toward fulfilling that mission by raising $70 million to establish scanning centers in nine locations in North America with plans for many more. Prenuvo’s MRI technology candetect solid cancer at Stage 1 as well as 500 other medical conditions, and has already proven to be invaluable for many clients, as he tells host Shiv Gaglani. “There's a potential to have a lifesaving diagnosis in one out of every twenty people who are scanned.”  Tune in to learn how Prenuvo is hoping to deepen our understanding of aging and early disease progression, shift the healthcare system toward a prevention-first model and help people take control of their own health. Mentioned in this episode: https://www.prenuvo.com/Use this promo code for a $300 discount on a whole-body scan: OSMOSIS If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast