The Accad and Koka Report

Did bioethics emerge to defend the interests of patients or to rationalize the needs and actions of the state and its corporate allies? Are bioethicists too complacent about their grasp of economics? Do they have sufficient understanding of the complexities of medical decisions to weigh in on them? Are Hippocratic ethics so inadequate that they needed to be replaced by ever-morphing "Kantian" ethics? A fascinating discussion with our guest, Tom Koch, a man whose resumé and whose many books read like great adventure stories. Professor Koch is an author, journalist, historian, philosopher, and educator. He holds an inter-disciplinary PhD in medical cartography, ethics and medicine. He has taught medical ethics to medical students at the University of Toronto. He is a consultant in gerontology. And he has written numerous books both for an academic audience as well as for the general public. His books include Cartographies of Disease, Ethics in Everyday Places, The Wreck of the William Brown, and the volume that will be the focus of our discussion today, Thieves of Virtue: When Bioethics Stole Medicine.

"We’re not going to ask permission to take care of our patients." It is with this epiphany, that our guest on this episode became one of the pioneers and leaders of the most hopeful trend in health care today: the direct primary care or DPC movement. Dr. Lee Gross shares with us how the light bulb went off in his mind that there is no good reason to insure primary care and, in fact, that insuring primary care hurts everybody: patients, doctors, and society. He walks us through his success stories and the efforts he is leading at the state and federal level to remove regulatory barriers to direct care. Dr. Gross is the founder of Epiphany Health in North Port, Florida, and is regularly consulted by lawmakers at the local, state, and national level. He has offered testimony on behalf of the direct care movement for the US Health and Human Services Department, the US Congress, and for the White House. He also serves as president of the Docs 4 Patient Care Foundation and he is the recipient of the 2016 HCA Frist’s Humanitarian Award and of the Beacon Award from the Free Market Medical Association for his leadership in healthcare reform. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, Spotify, or via RSS.

In 550 BC, the Greek philosopher Heraclitus famously declared: “No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.” In this episode, we learn from our guest whether scientists can step into the same data pool and obtain the same research results twice. Brian Nosek is Professor of Psychology at the University of Virginia. He is also the co-founder and Executive Director of the Center for Open Science, an organization dedicated to fostering transparency and collaboration in scientific research. In 2015, Professor Nosek and his team published in the journal Science a widely acclaimed and widely discussed paper that shed light on the extent to which psychological research findings may not be reproducible when the research is conducted anew. More recently, his Center conducted a unique project where a single data set was sent to be analyzed by about 30 independent teams of statisticians for the purpose of answering a single question. The variability in the methods chosen and in the answers obtained was also perhaps sobering, if not perplexing. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Patients come in all sizes and shapes, and with varying tolerance for complications and risk. Is it plausible that a single dosing regimen can optimize treatment for everybody? If not, what is keeping the pharmaceutical industry from endorsing a more dynamic and patient-centered drug dosing regimen? Our guest is Dr. David Norris, a physician, mathematician, and inventor. David operates a scientific and statistical consultancy focused on methodology development for ‎precision-medicine applications. He developed Dose Titration Algorithm Tuning (DTAT), a methodological framework that conceives dose individualization as a seamless learning process, beginning in early-phase trials and continuing throughout the drug development process. Before earning his M.D. at Brown University, he worked in diverse application areas including mathematical finance, operations research and systems engineering. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

The reform of medical education is a usually boring conversation that needs its own reform. The discussion we have on this episode does just that. It goes far beyond the usual proposals to tweak the curriculum and directly addresses the question of what it means to be a physician. Our guest is Dr. Adam Cifu, an award-winning medical educator and author. Dr. Cifu is a Master in the Academy of Distinguished Medical Educators at The University of Chicago. He has been selected as a Favorite Faculty Member by the graduating class of students 14 times. He is the author of Symptom to Diagnosis a manual on diagnostic reasoning, and co-author with Dr. Vinay Prasad of Ending Medical Reversal: Improving Outcomes, Saving Lives, one of the blockbuster medical books of the last few years. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

We revisit the question of brain death, this time with a more practical focus. What should doctors tell families of patients who fulfill neurological criteria for brain death? Joining us on this program is Fred Rincon, MD, who is a Assistant Professor of Neurology at Jefferson University Medical Center in Philadelphia. Dr. Rincon is a neuro-intensivist who, on a day-to-day basis, cares for patients with severe brain injury. He also holds a Master’s in Bioethics from the University of Pennsylvania. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Economic knowledge should not be the sole province of technical experts, but it is—and we seem to accept the way it is. The price we pay for this ignorance is that most people—including doctors—can easily fall prey to the political class and to the technocrats whose economic theory is generally far from sound. Our guest on the show is Jeff Deist, President the Mises Institute, an educational institution that promotes a very noble tradition of economic theory and political thought. Prior to taking the helm of the Mises Institute, Mr. Deist was chief of staff to Congressman Ron Paul for many years and, in that capacity, gained special insights into healthcare “sausage-making” in Washington DC. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Should doctors have something to say about guns? If so, what should they say? A position paper by the American College of Physicians, followed by a blog post and a tweet from the National Rifle Association, have set off a storm of controversy on the issue of medical professionals speaking publicly about guns and gun control. Our guest today is Pradheep Shanker, a radiologist based in Ohio and a prolific writer and conservative commentator who contributes regularly to a number of major national media outlets, including National Review, The American Spectator, Ricochet, and others. He just published a piece entitled “Guns, Doctors, and Staying in Your Lane.” The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Bureaucratic appeal to measurement as a check on personal judgment rules the medical field but also permeates our entire culture. Our guest is the author of a new book that comprehensively treats this unique phenomenon of modern life and brings a valuable historical perspective to the subject. Jerry Z. Muller is Professor of History at Catholic University of America in Washington DC, where he served as Chairman of the department from 2009 to 2015. Professor Muller’s focus is on Modern European Intellectual History and History of Capitalism. His book, The Tyranny of Metrics, was published earlier this year by Princeton University Press. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

The Hospital Readmission Reduction Program is a recent policy designed to save the government money by imposing large financial penalties on hospitals whose readmission rates for certain medical conditions are found to be higher than the national average. Could pushing policy levers on such a grand scale conceivably have negative unintended consequences?… Our guest is Dr. Ankur Gupta, author of a 2017 JAMA article that examined mortality rates in heart failure in the aftermath of the HRRP development and implementation. Dr. Gupta is an interventional cardiology fellow at University of Texas Southwestern Medical Center in Dallas. He holds and MD from the All India Institute of Medical Sciences (New Delhi) and an interdisciplinary PhD in statistics and computational fluid dynamics from the University of Alabama. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

What’s the professional life of Canadian doctors really like? Does the safety and stability of a single-payer system free them from business concerns and allow them to concentrate on patient care? Or do the realities of central planning produce unexpected uncertainty and stress for patients and doctors alike? To help us gain a realistic understanding of the Canadian system, we have as our guest Dr. Shawn Whatley who currently runs a primary care practice in Ontario, Canada. Prior to this position, Dr. Whatley worked for many years as an emergency physician and he is the author of No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments. Dr. Whatley is past-president of the Ontario Medical Association and he is a senior fellow at the MacDonald-Laurier Institute for Public Policy in Toronto. He also publishes a highly trafficked blog where he shares insightful and humorous comments about healthcare in Ontario. In other words, he is the perfect guest to inform us about the realities of healthcare in Canada. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

A recent US Supreme Court decision has struck down the “professional speech doctrine” which was elaborated by lower courts to justify restricting or regulating the activities of anyone offering advice or counsel to another individual. This decision may have far reaching implications across a number of human activities, including health care. To help us understand this decision and what effects it might have, we have as our guest Mr. Paul Sherman, senior attorney at the Institute for Justice and an expert in constitutional cases protecting the First Amendment, economic liberty, property rights and other individual liberties. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Support for a single-payer healthcare system in the United States seems to be growing inexorably. Before we resign ourselves to the inevitable fate of “Medicare-4-All,” it may be prudent to remind ourselves or understand better the arguments against a single-payer system. Our guest on this episode is Sally Pipes, president and CEO of the Pacific Research Institute, a San Francisco-based think tank dedicated to promoting free market principles across a variety of fields, including education, health care, and the environment. Ms. Pipes is widely published on healthcare issues and a regular contributor to Forbes.com. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Peer review by colleagues is an important process by which doctors who misbehave or malpractice can be held accountable and, if necessary, prevented from harming patients. Unfortunately, the process can also be used in bad faith, and many physicians are completely unaware of how career-destroying traps can be set up under the guise of peer review, compromising even the most caring and competent of doctors. Our guest is Lawrence R. Huntoon, MD, PhD, a world expert on the topic of “sham” peer review. Dr. Huntoon is editor-in-chief of the Journal of the Association of American Physicians and Surgeons and he leads the organization’s Committee to Combat Sham Peer Review. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

The life of a clinical trialist involves juggling multiple demands. Beyond the purely scientific questions are the clinical interests of the patient and the personal demands on the physician. Our guest on this episode is Ajay Kirtane, MD, Associate Professor of Medicine at Columbia University Medical Center in New York. In this conversation with Anish Koka, Dr. Kirtane shares his professional journey and his perspective on one of the most surprising and hopeful clinical trials in recent times, the COAPT trial of mitral valve repair in patients with congestive heart failure. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

One of the most fundamental questions that a doctor may be asked to answer is the following: Is this man or is that woman dead? And one would think that any substantial controversy regarding the determination of death would feature prominently in the medical curriculum and in basic medical textbooks. Instead, such discussions and debates have been relegated to narrow specialty medical and philosophical journals, and most practicing physicians are remarkably unaware about the state of knowledge on this question. Our guest on this episode is D. Alan Shewmon, MD, Professor Emeritus of Pediatric Neurology at UCLA. His work, comprising decades of well-documented clinical observations and reflections, is now known as “Shewmon’s challenge,” a compelling rebuke to the principal arguments put forth to defend the concept of brain death. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

The arcane procedure patients must follow to file out-of-network claims is an important obstacle for a more widespread embrace of a third-party free medical practice. Could that process be made less daunting? Our guest is Vatsal G. Thakkar, MD, Clinical Assistant Professor of Psychiatry at the NYU School of Medicine, as well as op-ed contributor to Doximity and The New York Times. He is the founder and CEO of Reimbursify, a startup in the out-of-network reimbursement space. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

In a matter of a couple of decades, the concepts of population health and population medicine have taken center-stage in healthcare, displacing the traditional aim of medicine and distorting the doctor-patient relationship. Our guest today is your co-host, Michel Accad, who highlights the errors of the population health theory as revealed in his recently published book Moving Mountains: A Socratic Challenge to the Theory and Practice of Population Medicine. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

In the wake of the #MeToo movement, a sweeping report was recently published by the National Academies of Science, Engineering, and Medicine detailing 30 years of research on the sexual harassment of women in academia. In addition, reports of discrimination and evidence of a pervasive “pay gap” between men and women are also coming to the surface. Our guest is Jane van Dis, MD, an obstetrician-gynecologist who recently co-authored a perspective in the New England Journal of Medicine on the occasion of the NASEM report. Dr. van Dis sheds light on the report and highlights what future steps must be taken. She is the co-founder of Equity Quotient, a data-analytics firm that provides workplace assessments of gender culture to help organizations create equitable work environments. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Physician burnout has attained epidemic proportions. It is highest among all professions and new research indicates that doctors commit suicide at a rate that is twice that of the general population, leading to a loss of approximately one physician per day. And it’s not only doctors who are at risk. Patients too may suffer the consequences, as medical errors have now been linked to the issue of physician depression and burnout. The true causes of this epidemic remain hotly contested but our two distinguished guests have recently published a highly provocative essay whose thesis has resonated with many doctors. Wendy Dean is a psychiatrist who is senior vice-president of program operations at the Henry M. Jackson Foundation for the Advancement of Military Medicine. Simon Talbot is an Associate Professor of Surgery at Harvard Medical School in the Brigham Hospital’s division of plastic surgery. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Can anyone question evidence-based medicine and not be considered some kind of fringe lunatic? Fortunately it’s possible, as will be demonstrated by our guest, Mark Tonelli, professor of medicine from the University of Washington, and one of the earliest, most thoughtful, and most articulate academic critic of the EBM dogma. Dr. Tonelli holds a BA in philosophy form the University of Colorado in Boulder and a medical doctorate from the University of Colorado in Denver. He is the author of numerous peer-reviewed articles and book chapters on various aspects of medical science and medical philosophy. His critique of EBM and his proposal for “case-based reasoning” are both cogent and compelling. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

For most doctors, Hippocrates is a quaint figure of the past with hardly any relevance to the modern practice of medicine. We may label him as the “father of medicine,” but we have no idea what really connects us to him. We may occasionally and sanctimoniously proclaim “first, do no harm!” but we ignore the origin and real significance of that phrase. Some of us may have taken some modified version of the Oath of Hippocrates upon graduating from medical school, but few of us think of it as a serious pledge with any real consequence for our day-to-day practice. And, over the last decades, most bioethicists have openly set aside the Hippocratic tradition, deeming it inadequate to help us deal with the moral quandaries that arise in the age of scientific medicine. So, is there are any reason, besides historical curiosity, to become familiar with Hippocrates, let alone take him seriously? To help us sort this out we have a distinguished guest Thomas Cavanaugh who is the author of a brand-new book entitled Hippocrates’ Oath and Asclepius’ Wound: The Birth of the Medical Profession, published by Oxford University Press. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Are doctors patsies for the medical device industry? Are patients put in harm’s way for lack of tough standards on new device approvals? We examine the question with Jeanne Lenzer, award-winning investigative journalist and author of The Danger Within Us: America’s Untested, Unregulated Medical Device Industry and One Man’s Battle to Survive It. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Coronary heart disease remains shrouded in mystery as to its causes and natural history. Our guest is Dr. William Rothstein, Professor Emeritus of Sociology at the University of Maryland, who has just published The Coronary Heart Disease Pandemic of the Twentieth Century: Emergence and Decline in Advanced Countries. This fresh look at the patterns of coronary mortality rates throughout the world over the last 8 decades calls into question received notions about this disease. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Are medical journals still needed in the age of the internet and social media? Our guest is Brahmajee Nallamothu, editor of the journal Circulation Cardiovascular Quality and Outcomes. We have a wide ranging conversation, covering everything from the financial incentives of publishing, ideological biases in medical journals, the peer review process, the Twitter effect, and a new editorial position of independent troller! The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

US medical schools overwhelmingly support centralization of healthcare and health care decision-making. That is not a surprise since, over the decades, academic institutions have greatly benefited from healthcare policy. Because centralization of health care is detrimental to the doctor-patient relationship, students who begin their training motivated by a genuine desire to practice medicine in a meaningful and personal way can easily fall into disabuse or disillusion or may adopt a more cynical attitude toward their profession. Our guest today is Beth Haynes, medical director of the Benjamin Rush Institute, a non-profit organization dedicated to offering medical students an alternative perspective on healthcare and its possibilities by exposing them to free-market principles and ethics, centered on the supremacy of the doctor-patient relationship. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

For an increasing number of Americans today, a single payer system seems to be the only conceivable next step in the cataclysmic and ruinous history of our healthcare system. Adam Gaffney, MD, a longtime supporter of a single-payer system and president-elect of Physicians for a National Health Program, joins Michel and Anish to defend a single-payer healthcare system. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Do medical journals apply scientific standards selectively? On the subject of the effect of pharmaceutical lunch gifts on physician behavior, all that may be required from a paper is that the conclusions drawn be compatible with the expected narrative—even if the data presented suggests the opposite. Rafael Fonseca and John Tucker share their eye-opening analysis of a recent article published in JAMA Internal Medicine and the fascinating reaction to their analysis from journal editors and from the community at large. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Many ardent supporters of free markets still believe that healthcare is an exception where government intervention is, for some reason, necessary. Our guest on this episode is Roman Zamishka, a financial analyst and medical school applicant who authored a witty and carefully constructed article titled “A Libertarian’s Case Against Free Markets in Healthcare.” The piece garnered a lot of positive comment on The Health Care Blog where it was published. Mr. Zamishka kindly agreed to be cross-examined about the points he made. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

The Swiss healthcare system is frequently proposed as a model for the rest of the world to emulate. Marc Fouradoulas joins hosts Anish Koka and Michel Accad to discuss and explain why the country has set the precedent for a universal healthcare system. Dr. Fourandoulas practices medicine in Zurich, Switzerland, and is a board-certified internist who holds a Master’s degree of advanced studies in managed health care and health economics from the Winterthur Institute of Health Economics. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Hadiza Bawa-Garba was convicted of involuntary manslaughter by a British court for her role in the care of a patient in a hospital setting fraught with system failures. Dr. Saurabh Jha returns to the Accad and Koka Report to share his insights on this case. Dr. Jha trained in the NHS but practices in the United States as Assistant Professor of Medicine at University of Pennsylvania Perelman School of Medicine. He is intimately familiar with the details of the Bawa-Garba case, and has recently returned from London where he attended the most recent legal proceedings in the physician’s appeal of the General Medical Council’s decision. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Public reporting of outcomes aims to improve service quality, but has also harmed patients and doctors alike. Can any good come out of it? Dr. Robert W. Yeh is Associate Professor of Medicine at Harvard Medical School, and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. He is an expert on the outcomes of outcome reporting. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Dr. Gajendra Singh is a well-respected surgeon who decided to provide affordable ultrasound, CT, and MRI imaging to his community. A few months into his endeavor, he was confronted by his state’s “certificate of need” laws telling him that providing affordable healthcare was illegal. His response: to sue the government. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Dr. Wes Fisher is leading the fight against the American Board of Internal Medicine and its self-serving tactics that force thousands of physicians to comply with the onerous Maintenance of Certification Program. Wes outlines the new initiatives that stand a realistic chance of turning the tide against the quasi-regulatory monopoly of the board-certifying agencies. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Guest Twila Brase is an RN, PHN, and is Executive Director of the Citizen’s Council for Health Freedom. She discusses her freshly released book that reveals the ugly truths about electronic health records, and what can be done to escape from this modern day Panopticon. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Dr. Mary Ruwart’s meticulous research is an eye opener for anyone interested in health. Her new book examines the history of the last 6 decades of drug regulation and highlights the unintended consequences of the 1962 amendments to the FDA. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad take the EBM controversies to India and consult with Dr. Anupam Singh, Assistant Professor of Medicine at SMC in Ghaziabad. Singh offers a very sound and intelligent perspective on the proper role of clinical trials and clinical judgment in medical care. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad have fun discussing the controversies about blood pressure guidelines with guest Dr. Swapnil Hiremath, Assistant Professor of Medicine at the University of Ottawa and Co-founder of NephJC, a highly successful Twitter-based journal club. Dr. Hiremath sits on the Canadian blood pressure guideline committee and shares his insights about the question of BP management. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad explore the “less-is-more” movement with Dr. John Mandrola, one of its most articulate and popular champions. They discuss the problem of practices that have no scientific justification and the conundrum of out-of-control costs. What is the best way to curtail unwarranted therapies? Should there be more top down regulations or is it possible that more health care freedom will lead to less utilization? The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Shared decision-making (SDM) has become a sacred cow of medical ethics almost overnight. What’s more, doctors are now being forced to practice it in order to get paid for certain procedures. Anish Koka and Michel Accad review the history of this concept and why it is contrary to a sound doctor-patient relationship. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad have a terrific interview with G. Keith Smith, co-founder of the Surgery Center of Oklahoma and of the Free Market Medical Association. Keith recounts his pioneering experience and clearly makes the case that free markets are ethical, workable and, ultimately, unstoppable. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad discuss a blog post by obesity therapy guru Jason Fung, in which he pushes back against “debunkers” and self-appointed guardians of “science-based medicine.” They look at the question of science and pseudo-science and how it bears on actual medical care. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad discuss the effects of public reporting of outcomes on the behavior of physicians, and the reactions to a paper that was just published on this topic.Anish shares a real-life experience of a patient of his who was a tragic victim of these misguided healthcare policies. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad discuss a tweet and a paper claiming that pharmaceutical companies don’t even need to produce effective drugs anymore. All they need is “an effective marketing campaign” and billions of dollars in annual sales soon follow. This is a very dubious claim on the face of it, but Anish did some investigating of his own. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad take to task healthcare policy wonks who lament that the government can no longer mandate hospital systems to participate in new “value-based” payment schemes. These alternative payment plans have been a disaster from the get-go, but it seems that central planners never lose hope. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad have a free-wheeling and fun conversation with Dr. Saurabh Jha on the philosophical question of “what is normal.” The conversation was prompted by an editorial by John Ioannidis who thinks that “Big Data” could help clinicians get a handle on the vexing problem of normal values. Anish, Michel, and Dr. Jha discuss the merits of that idea. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

There precise rationale invoked by the courts to prevent Alfie Evans’ parents from transferring the child out of the UK is widely misunderstood. In many ways it worse than what many people imagine. Anish Koka and Michel Accad discuss this chilling case and the ethical doctrine that informs the courts’ decision. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad discuss a “white paper” jointly written by Jeffrey Flier, former dean at Harvard Medical School, and Jared Rhoads, from the Dartmouth Institute, calling for some deregulation of the apparatus that rules the supply of physicians and their scope of work. We touch on the question of safety, patient sovereignty, alternatives to licensing, and whether protectionism is ever a legitimate option. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

Anish Koka and Michel Accad have a fun chat with Professor Darrel Francis, from Imperial College in London and the UK’s National Heart and Lung Institute. Dr. Francis takes the “pro” side and Michel the “con” side in regards to evidence-based medicine. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.

After an opinion piece in JAMA Internal Medicine once again showed the influence of drug company payments on physician practices, co-host Dr. Anish Koka comes clean about his relationship with Big Pharma. Anish and co-host Dr. Michel Accad discuss that potential conflict of interests but place it in the context of broader COIs in health care that no one ever talks about. The Accad and Koka Report podcast, hosted by two MDs, focuses on free-market approaches to medicine and health. Subscribe on iTunes, Android, Stitcher, or via RSS.