First Opinion Podcast

Terry Wilcox's grandmother lived in an isolated house at the top of a hill overlooking the magical mountains and valleys of the Ozarks until, as she tells it, "the day we literally had to drag her off of it." Home health care services have helped keep Wilcox's family healthy and safe — and reduce her stress — but they aren't equally accessible to everybody. Wilcox, a co-founder and CEO of the nonprofit advocacy group Patients Rising, discusses how that uneven ground is now being further threatened by Medicare's proposal for deep cuts and clawbacks to payments made during the pandemic for home health care.

After years of deliberation, the FDA recently announced a new set of rules it proposes to regulate claims on food packaging that a product is "healthy." The most basic rule: the product must actually contain food, not just ingredients. This may seem intuitive, but as professor and nutrition policy expert Marion Nestle points out, the food industry works hard to sell their products. This week, Nestle explains the purported intentions behind the confusing food labels, and how it all got so complicated in the first place.

It took the U.S. Supreme Court just seven days last June to set back public health by 50 years. Several cases before the court this term could continue that assault. This week, law professor Lawrence O. Gostin explores how these cases — some of which are not explicitly about public health — might worsen the myriad health inequalities that became so evident throughout the Covid-19 pandemic.

Modern wheelchairs with standing technology have amazing capabilities that can be game-changing for wheelchair users looking to take care of themselves independently whenever they can. This week, two wheelchair users, Paul Amadeus Lane and Jim Meade, talk about how shortsighted it is that Medicare — the primary health insurer for older adults as well as for many people with spinal cord injuries, muscular dystrophy, ALS, and other long-term disabilities — doesn’t cover the cost of wheelchairs equipped with these technologies because they aren't "primarily medical in nature."

The Supreme Court's decision to overturn Roe v. Wade opened the door to allow states to ban or severely restrict abortion. But as biotech CEO Aoife Brennan and her colleagues are coming to realize, it will also affect how — and perhaps where — clinical trials are conducted. This week on the "First Opinion Podcast," Brennan, of Synlogic, talks about how the Supreme Court's ruling is forcing people involved in clinical research to rethink something as simple as pregnancy tests, which had once been taken for granted, and plan for the possibility that research sponsors and study sites will be required to share pregnancy and outcome data with state officials.

Polio has exploded back into Americans' consciousness after being out of the spotlight in the U.S. for half a century or so: In late summer, it paralyzed an adult in New York state, and the poliovirus has been detected in New York City's wastewater. This week on the "First Opinion Podcast," doctors Sallie Permar and Jay Varma make the case that pediatricians are the frontline for fending off this "old foe," but they need help.

Christopher Hartnick never expected his work as a doctor to intersect with political discussions about abortion and the right of pregnant people to make choices about their own bodies. Yet as a pediatric ear, nose, and throat physician who specializes in treating babies and children who have difficulty breathing, he's had up-close looks at how prospective parents make life-or-death decisions over the course of a pregnancy. This week, Hartnick discusses a risky procedure performed at birth for which parents must choose, at multiple stages, whether to prioritize the mother's life or the child's.

During his long career as a pediatric oncologist and cancer researcher, William Woods thought highly of the FDA's work evaluating and approving new cancer drugs. But his opinion of the agency changed when he was diagnosed with amyotrophic lateral sclerosis, or ALS, a progressive disease that damages nerves in the brain and spinal cord. This week on the "First Opinion Podcast," Woods talks about living with ALS, and watching what he sees as the glacial pace of approving an experimental ALS drug called AMX0035.

The number of children who become orphans because of Covid-19 rises each week: over 10.5 million children around the world have lost a parent or other caregiver living in the home, a staggering and heart-breaking figure. For comparison, it took 10 years years to create as many orphans as Covid-19 created in just two years.  Seth Flaxman and Susan Hillis have been tracking this grim statistic as part of their work with Global Reference Group on Children Affected by Covid-19. These losses can reverberate for years. This week, Flaxman and Hillis discuss the trials of children who have lost parents during the pandemic, and what can be done to help keep them safe and healthy.

For two decades, nurses have been considered the most trustworthy professionals in the country, above physicians. Yet the rigid hierarchy within hospitals and health systems places physicians at the top, creating a fraught power dynamic and a double standard when it comes to discipline. This week, nurses and educators Michelle Collins and Cherie Burke discuss this double standard as it relates to the recent cases of a former nurse and another former physician.