Today’s episode is not about Covid-19. Instead we’re going to give all of you a break and take you as far away from this as we possibly (and virtually) can. For that, we’re heading to Queensland, Australia to meet Dr. Andrew Peacock, an emergency physician, award winning photographer, accomplished climber and expedition guide for Lindblad expeditions, a travel company contracted with National Geographic.
This conversation takes us everywhere from Antarctica to Nepal, aboard a Russian ice breaker ship, technical climbing in New Zealand, and even a private audience with the Dali Lama. We’ll learn how a lucky break in Antarctica sparked a side career for Andrew in photography. Best of all, we’ll uncover how a busy emergency medical physician has made this life possible, while literally setting the standard for work life balance.
This was simply an incredible episode. We had a blast doing it. With that said, let’s get started.
Speciality: Professor of Law, Associate Dean for Research & Innovation, University of Arizona.
Location: Tucson, Arizona
In January of 2018, Warren Buffett, Jeff Bezos and Jamie Dimon announced the creation of a new, co-venture, to tackle the rising costs of healthcare for their company’s employees. They immediately picked famous writer and surgeon, Atul Gawande to lead it. Short on details but big on promise, just the simple announcement of this venture sent shock waves through the media and the markets. Billions of dollars in stock value for insurance companies and other health sector players vanished over night.
Two years later, we have a name for this venture (Haven Health) but little else. What they’re up to, and what they’re planning, is still a big mystery. Whatever ultimately happens here, it will matter, simply because names like Amazon and Warren Buffet are behind it. The question is, how much will it matter for the rest of us? How much can anyone (even powerful billionaires) really change the American healthcare system?
Today’s guest is Christopher Robertson, Associate Dean for Research and Innovation and Professor of Law at the University of Arizona. His background and research interests overlap many academic disciplines, including bioethics, health law, incentives, behavioral economics and more. His CV includes a PhD in philosophy and a law degree from Harvard.
Unfortunately, Chris doesn’t have behind the scenes access to Haven Health (we know, we asked him). But, he does have a new book exploring some unique ideas and research that should certainly be on their radar, and yours. The book, “Exposed: Why Our Health Insurance is Incomplete and What can be Done About,” also includes a historical overview of our modern American health system, a history often forgotten and overlooked in todays political debates. This was great conversation and we really enjoyed having Christopher on. With that said, let’s get started…
Location: Stanford University, Stanford, California
Specialty: Otolaryngology–head and neck surgery. Dean of the Stanford University School of Medicine
All right, welcome back. Today we have Dr. Lloyd Minor with us on the show. He’s an ENT surgeon, scientist, innovator and currently dean of the Stanford University School of Medicine. We covered his early career path, a surgical treatment he actually developed and his new book, “Discovering Precision Health,” released just this month in March, 2020.
As the leader of one of the nation’s top medical schools, located right in the heart of Silicon Valley, Dr. Minor has a unique lens on medicine’s innovation pipeline. His new book and our conversation offer a glimpse into this world. With that said, let’s get started…
This was a brief conversation between Colin and Keith regarding the COVID-19 pandemic. It was recorded on March, 24th 2020. For all of you on medicine’s front lines, we’re thinking about you every day, and we’re deeply grateful for all you are doing, for all of us. Stay safe and take care.
Specialty: Theoretical physicist and health data researcher
If you’re still around in the year 2061, two things will be true. You’ll enjoy seeing the next passing of Halley’s Comet, and your life insurance company will enjoy having collected four more decades of your life insurance premiums, without a payout. Standing there that day you and your insurance company can be grateful for the work of one man, the exact same man that comet is named for. The English astronomer, mathematician and physicist, Edmond Halley. Why you ask? Well, not only did Halley develop the calculations to predict the comet’s periodicity, he is also developed the early mathematical tools for predicting human longevity, known very well to your insurance company as actuarial science.
Today’s guest, like Halley is also a physicist, a theoretical physicist to be exact. And like Halley he sees no need to limit his research interests to one academic domain. Laurence Jacobs began is career at MIT pursuing some of the broader mysteries of our universe. Today he’s pursuing another ambitious project, quantifying all of the measures, signs, risk models, data sets, bio-wearable monitoring outputs, health history, genomics and more into (perhaps) one single accessible number. Something you may have heard called a health score. Something that promises to refine our ability to predict longevity, and even improve it.
This was an amazing conversation and not a short one. The potential benefits of developing these tools are huge, but so are the challenges and dizzying complexities. Many of the answers will likely come from surprising and unexpected places. To quote one of our past guests, Dr. Robert Gale, the American physician at Chernobyl, “Progress is often made by those who investigate the boundaries of several areas, instead of having laser-like focus on a single discipline. That’s where many of the answers in science reside.”
That’s exactly where we find Laurence Jacobs today, in Zurich Switzerland where he continues to develop the main concepts and the risk models that underlie the Dacadoo Health Score and the remote disease monitoring and management system, remsmed / EMMA Care.
“Wendy Wood is widely recognized as the authority on the science of habits…” -Adam Grant
Name: Wendy Wood, PhD
Location: University of Southern California. Los Angeles, CA
Specialty: Psychologist and behavioral scientist
It’s no mystery to most of you that poor health behaviors such as smoking, substance abuse, poor nutrition, lack of exercise and patient non-compliance account for a substantial portion of the disease burden, not to mention costs, in the US. Some recent estimates by the CDC and other researchers suggest behaviors account for 40-50% of increased risk associated with deaths before age 75.
The problems are clear. What to do about them isn’t. There’s no “will power” medication to prescribe, and most public health efforts thus far have barely made a dent. But what if old fashioned will power really isn’t the issue? What if something researchers call “introspection illusion,” is causing us to overestimate our own will power, and underestimate the capacities of others?
Today’s guest is psychologist and behavioral scientist, Wendy Wood. She is currently a professor of psychology and business at the University of Southern California, and a visiting professor at the INSEAD Business School in Paris. Wendy has spent much of her career studying what she considers the very building blocks of behavioral change, something we all know as habits. Angela Duckworth describes her as “the world’s foremost expert in the field.” And according to Adam Grant, she is “widely recognized as the authority on the science of habits,”
We’ll explore her research and recent book, “Good Habits, Bad Habits.” Our conversation also touches on what’s commonly called, the replication and reproducibility crisis. Wendy has a unique lens on this issue, having served as one of fifteen distinguished scientists chosen by the American Academy of Sciences to study the problem.
This was a fun episode with a lot of ground covered. With that said, let’s get started…
Today it’s our privilege to have distinguished researcher and statistician, Sir David Speigelhalter. “Sir David” in addition to being knighted by the Queen, is also a fellow of the Royal Society. That calls for a quick digression. Founded all the way back in 1660, The Royal Society is the world’s oldest scientific academy. They published Newton’s “Principia Mathmatica” and Benjamin Franklin’s kite experiment. They even backed James Cook’s journey to Tahiti to track the transit of Venus. Giants such as Newton, Darwin, Eisenstein and Hawking are all all past members. Their motto, “Nullius in verba” means “take nobody’s word for it.” What a great theme for today’s episode.
David is currently Chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge. An ISI highly cited researcher, David has also dedicated much of his time and energy to public education through numerous news appearances, Ted Talks, books such as the one we are discussing today and documentaries such as his recent BBC series geared towards children.
David’s recently published book, “The Art of Statistics: How to Learn from Data,” is a wonderful refresher aimed at fixing the common mistakes and statistical knowledge blind spots many of us have…even highly educated physicians and researchers. He also covers cutting edge subjects such as artificial intelligence, biostatistics, bias and fraud detection, risk, statistical significance, and even black box algorithms. We’ll explore the realistic potential and limits of what can be learned from large multivariate data sets, a.k.a. big data.
As you’ll see, David is a gifted teacher and a real joy to talk with. With that said, let’s get started.
We’ve all heard the bad news about rural hospitals in the U.S. 60 million of our fellow citizens rely on these small hospitals, often known by their designation as critical access facilities. According to a recent analysis conducted by the consulting firm, Navigant, 21% of rural hospitals today are at a severe risk of closure. That includes 430 hospitals across 43 states, representing 21,000 staffed beds, 150,000 employees and $21 billion in revenue. When one of these hospitals closes (and 95 have so far since 2010) critical access to care isn’t the only casualty. These hospitals are often largest employers and drivers of economic activity in their communities. The ripple effects are felt wide and deep every time a hospital shuts its doors.
OK, that’s the bad news. How about some good news? Today we’re making the trip to a remote town in Idaho, known as Arco. With a population of only 900, Arco is small. You won’t find many restaurants, you won’t even find a Walmart but you will find a hospital. A small 14 bed hospital called Lost Rivers (by the way, what a cool name for a hospital, right). Its existence and survival in the face of overwhelming odds is the story of today’s episode. When our guest, CEO Brad Huerta, took over in 2013, he wasn’t there to save Lost Rivers, he was there to shut it down. With over three million dollars in debt, pending bankruptcy, and only seven thousand dollars of cash in the bank, the situation was beyond grim. Today this same hospital is cash positive, free of every dime of debt, running six years with a yearly profit, and getting ready to open a new surgery center. How is this possible and what happened after Brad arrived? Well, it’s one heck of a ride and one hell of a story. So buckle in and get ready. With that said, let’s get started.
All right welcome back. Today we’re heading to the front-lines of research testing and challenging one of the most basic truths of the human experience…we all get older and we all eventually die. Today’s guest doesn’t buy this. In fact, he actually views aging as a diagnosable disease, a disease that can be managed today, and one day fully treated.
Now, before you start rolling your eyes, let’s meet today’ guest. David Sinclair is a professor of genetics at Harvard Medical School and co-director of the Paul Glenn Center Biological Mechanisms of Aging. He is widely considered one the world’s foremost experts on longevity research. A co-founder of the journal Aging and several biotech companies, he also holds 35 patents. A recipient of more than 25 awards and honors, including being knighted in the Order of Australia, and Time Magazine’s top 100 most influential people. Besides his peer-reviewed research, his work is featured in five books, two documentary movies, 60 Minutes, Morgan Freeman’s, “Through the Wormhole,” and other media.
David’s newest book, “Lifespan, Why We Age and Why We Don’t Have To,” is to quote the blurb on the cover, “an elegant and exciting book that deserves to be read broadly and deeply.” That comes from Siddhartha Mukherjee, the famous Columbia University oncologist, and winner of the Pulitzer prize. Not bad!
All right welcome back. Here’s a quick trivia question, which group of US patients are constitutionally guaranteed access to free medical care? And no this is not a trick question. The answer…prisoners.
Today we’re jumping into an area of medicine few, if any of us, know much about. Let’s be honest, how many of you out there have even seen the inside of a prison of jail? Not many, we guess. Criminal records and professional medical licensing don’t mix well.
For those of you who’ve been with us for awhile, you know this isn’t a political program. I say this because I’m going to read a few stats here. Don’t worry, we’re not gearing up for a policy discussion on prison reform. It is an important issue, but outside the scope of our conversation today.
As of 2016, there were 2.1 million people incarcerated in the US. That makes us the world leader both in the total number incarcerated and a per-capita incarceration rate (655 per 100,000). That rate beats everyone, even places like China, North Korea, Russia, Kazakhstan and Saudi Arabia. As of 2015, the US population represented only 4.4% of the global population, while we held a whopping 21% of the global prison population.
We’re reading these stats to show just how big US prison medicine is. That’s over two million people who are constitutionally guaranteed free medical care. Just imagine how many doctors, nurses and other medical professionals it takes to deliver that amount of care. Today’s guest is one of them.