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Michel Accad, Anish Koka



Articles by Michel Accad, Anish Koka

A Tougher Pill to Swallow: Roundtable on Generic Drugs

18 hours ago

As a follow-up to the episode on the Ranbaxy Scandal, Accad and Koka are joined by medicinal chemist John Tucker, PhD, and hypertension specialist Swapnil Hiremath, MD. The guests share their perspectives and impressions on the unsettling question of generic drugs.

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Can We Trust Generic Drugs? The Ranbaxy Whistleblower Narrates the Pharma Scandal of the Century

14 days ago

Generic drugs represent 90% of the pharmaceutical market. Their use has been encouraged through decades of favorable legislation and subsidies, with authorities claiming they are as safe and effective as brand name drugs. Yet generic preparations tainted with impurities are being reported with increasing frequency. What should doctors and the public know about generic drug …

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Health Policy Should Focus on Choice

17 days ago

A health policy of choice—not of constraints—is what we need, says our guest David Balat. He is currently the Director of the Right on Healthcare initiative with Texas Public Policy Foundation. He has a broad base of experience throughout the healthcare spectrum with special expertise in healthcare finance. He is a former Congressional candidate in …

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Psychiatry v. Antipsychiatry

21 days ago

As a medical discipline, psychiatry has often been the target of severe criticism, particularly in the last fifty to sixty years. Is the criticism valid or not? What is the outlook for the science of mental illness and the practice of psychiatry? Our guest today defends his chosen medical specialty. George Dawson, MD, DFAPA, is a …

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Polygenic Risk Scoring: An Epidemiologist’s Perspective

October 30, 2019

Has cardiovascular genetics come of age? Are “polygenic risk scores” ready to inform us in clinically meaningful ways? In the final analysis, who or what are epidemiological data informing? Our guest is A. Cecile Janssens, PhD, Professor of Translational Epidemiology at the Rollins school of Public Health at Emory university in Atlanta, Georgia. Professor Janssens’ …

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The Trojan Horse of Surprise Billing Legislation

October 27, 2019

Are out-of-network physicians deliberately trying to price-gouge patients in need of emergency care? Will “surprise billing legislation” solve the problems of narrow networks in a socially responsible manner? In this episode, Dr. Koka leads a conversation with our guest, Dr. Daniel E. Choi, on the topic of surprise billing legislation. Dr. Choi obtained his MD …

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Why Is the Antibiotics Market Broken?

September 26, 2019

Big Pharma is abandoning its R&D efforts for antibiotics. What are the regulatory, scientific, and economic factors responsible for this potentially dangerous trend? Our guest on this episode is Dr. David Shlaes. Dr. Shlaes is an infectious diseases specialist who trained was formerly professor of medicine at Case Western medical school in Cleveland, Ohio. He …

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On Abortion

September 10, 2019

This past May, the governor of Alabama signed into law a piece of legislation that imposes great restrictions on abortion. Niran Al Agba recently wrote an op ed about that law and she returns to the show to discuss that op ed and, more generally, to share with us her position on abortion. We are …

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Why Employer-Funded Health Plans Are Turning to Free Market Medicine

September 5, 2019

How do businesses purchase healthcare services for their employees? What are the factors that bear on their purchasing decisions? These important questions are rarely part of the policy conversation. Our guest on this episode is Jay Kempton, President and CEO of the Kempton Group, helping employers obtain and administer health care benefits for their employees. …

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Bob Graboyes: From Fortress to Frontier in American Healthcare

August 13, 2019

According to our guest, American health care is stuck in a fortress mentality that stifles innovation, constrains medical advances, and yields low quality care. That fortress was erected more than one hundred years ago but, in many ways, is being circumvented by creative actors who are seizing opportunities to make changes outside of the political …

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The Stupidity of the American Healthcare Consumer?

August 5, 2019

The Affordable Care Act was allegedly passed thanks to “the stupidity of the American voter.” The economist who made that claim—and who is also considered to be one of the architects of the law—has recently published a working paper that examines whether better-informed patients make better healthcare decisions. He and his colleagues conclude in the …

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The Opioid Epidemic: Is Pharma To Blame?

June 20, 2019

The Commonwealth of Massachusetts’ lawsuit against Purdue Pharmaceuticals exemplifies a common narrative that lays a large part of the blame for the opioid epidemic at the feet of the manufacturer of prescription opioids for manipulating physicians into prescribing the drugs more liberally. Is there merit to that story? To examine that question, we have as …

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Can 12th-Century Medicine Save 21st-Century Health Care?

May 24, 2019

Is the body a machine? Are doctors mere technicians who simply “fix” biological defects in their patients? In a very real sense, that’s how modern societies conceive of medical practice, so much so that healthcare is now frequently experienced as an industrial process: doctors and nurses churning patients through an assembly line. And that process …

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A Debate on Vaccine Mandates

May 17, 2019

Two distinguished guests join us to debate the issue of vaccine mandates. Dorit Reiss (twitter) is Professor of Law at UC Hastings College of the Law in San Francisco, California. She holds an undergraduate degree in Law and Political Science from the Faculty of Law at Hebrew University in Jerusalem and a PhD in Jurisprudence and …

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Bridging Health and Community with Pritpal Tamber

May 1, 2019

If health is an elusive concept, how much harder it must be to articulate what a healthy community should be. But that should not stop us from grappling with foundational ideas and from sketching a forward-looking vision for a better society. Our guest on this episode is Pritpal Tamber (twitter), a physician who has devoted his career to …

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Can We Have a Reasonable Discussion About Vaccines?

April 23, 2019

Does the vaccine debate have to be polarized according to “Pro-Vaxx” or “Anti-Vaxx” camps? Is it possible to have a reasonable discussion about harms and benefits of vaccines? Are public health concerns about unvaccinated children sufficient to trump individual liberty? Exploring the question with us is Dr. Niran Al-Aqba (twitter), a board-certified pediatrician in private …

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Conservative Means to Progressive Ends? Avik Roy on Healthcare

April 13, 2019

Is there a conservative path to universal healthcare? Our guest certainly believes so. Avik Roy (twitter) is one of the most influential conservative voices in healthcare. A graduate from MIT and Yale Medical School, Avik spent many years with the investment firm Bain Capital. In 2009, in response to the debates leading up to Obamacare, …

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Taking the USMLE to Task

April 2, 2019

Should a pass-fail exam designed to determine a student’s competence to practice medicine be scored numerically and used for residency selection? Every year, thousands of students sink an increasingly large number of hours and dollars to prepare for “Step 1” of the US Medical Licensing Examination, a task which seems to be disproportionate to the relevance …

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Psychiatry: Past, Present, and Future

March 30, 2019

Despite its many scientific and therapeutic advances, the field of psychiatry remains lacking in coherence or cohesiveness as compared to other areas of medicine. Part of the issue undoubtedly has to do with the intractable mind-body problem, but part of it may also be due to the effort of standardization of diagnosis set in motion …

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The Opioid Epidemic: A Solo Physician’s Hopeful Response

March 20, 2019

Effective pharmacological treatment for opioid dependence was introduced more than 15 years ago, yet the opioid epidemic continues to ravage our country and there are still important barriers that prevent patients from receiving the care that they need. The expansion of health insurance does not seem to mitigate this problem and, in fact, health insurance …

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MD vs NP: Patient Protection or Turf War?

March 20, 2019

A massive push to increase the number of nurse practitioners and physician assistants and to extend their scope of practice is under way. The stated goal is to address a real or perceived shortage of primary care physicians. This effort worries many doctors who are concerned that patients are getting short-changed in the process. But …

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66. Cardiology Health Policy: The Clinicians Strike Back

March 1, 2019

Bright clinicians who are also trained as rigorous scientists can put healthcare policy under scrutiny and show that the wisdom of the wonks frequently falls short. Our guest on this episode is Dr. Rishi Wadhera (twitter), a prolific cardiology fellow currently in training at Brigham and Women’s Hospital in Boston and part of a team of …

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65. James Heathers: Why Science Needs Data Thugs

February 23, 2019

Will it take data vigilantes to restore some order in the House of Science? With the replication crisis showing no sign of letting up, some committed scientists have taken it upon themselves to find ways to sniff out cases of egregious fraud. As it turns out, identifying scientific misbehavior is surprisingly easy! Our guest is …

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64. Cost Sharing: Paying for Healthcare in an Ethical and Sustainable Way

February 21, 2019

There was a time when communities took care of the medical needs of their members without the intervention of governments and without the corrupting influence of health insurance. Can we ever go back to a system of mutual aid at a time when healthcare costs have grown astronomical? Our guest today shows us that the …

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63. A Voice for Freedom in Medicine

February 16, 2019

In the mind of the public, American physicians are represented by one prominent organization, namely, the American Medical Association. Yet, only a minority of American physicians currently belong to the AMA, which has long grown comfortable with political and government intrusions into healthcare. Who should represent physicians when doctors may hold very divergent views on …

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62. Radiology Makeover, with Saurabh Jha

February 13, 2019

Radiology holds a special place in the medical ecosystem. Radiologists are “the doctors’ doctors” and the treatment of a patient rarely proceeds without a radiologist furnishing an opinion. But the field of radiology also faces challenges: the crusade against “wasted imaging,” the rise of artificial intelligence, the dependence of radiology on hospital systems, and the …

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61. The Ups and Downs of Drug Prices: An Economist’s View

February 6, 2019

Some drugs cost more than diamonds, though their health benefit seems marginal. Others cost less than a package of M&Ms, though they are demonstrably life-saving. Some drug prices have spiked to three-fold, four-fold, or even ten-fold from what they were just a few years ago. Drug pricing seems to be an irrational and incomprehensible aspect …

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60. Three Cardios Talk Keto

February 1, 2019

For decades, the academic cardiology community has focused its attention on pharmacological interventions to prevent heart disease. Our guest is an accomplished clinician-scientist who tells us his personal story that led him from the lab bench to becoming interested in dietary interventions and in the ketogenic diet in particular. Dr. Ethan Weiss (twitter) is Associate Professor …

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