True Grit at Lost Rivers. Saving a hospital from the brink with CEO, Brad Huerta.

peerspectrum podcast- brad huerta-lost rivers medical center

Name: Brad Huerta, MPA

Location: Lost Rivers Medical Center. Arco, ID

Specialty: Hospital CEO

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.

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Crossing Medicine’s Last Perimeter. Aging and Longevity with Harvard Geneticist, David Sinclair, PhD.

peerspectrum podcast- david sinclair

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!

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Lockdown. Inside Prison Medicine with ER Physician, Dr. Jeffrey Keller.

peerspectrum podcast- Jeffrey Keller

 

Name: Jeffrey E. Keller, MD

Location: Idaho Falls, Idaho.

Specialty: Emergency Medicine.

 

 

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.

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Trading Places. Do Doctors Make Better Patients? MIT Economist, Jonathan Gruber, PhD.

Name: Jonathan Gruber, PhD

Location: Cambridge, MA. Massachusetts Institute of Technology (MIT)

Specialty: Economist. Public Policy Advisor.

All right welcome back. If you could pick the ideal patient population, armed with the best knowledge, fluent in medical jargon, generally healthy and willing to comply with recommended treatments, who would you pick? How about doctors? Doctors may not be perfect patients but at least they should outperform similar non-clinicians, right?

Surprisingly, little to no research has actually been done comparing the care, compliance and outcomes of doctors to comparable groups of non- physicians. For reasons we’ll soon see, this is actually a difficult question to tackle, but it’s a very important question with broader implications.

Today’s guest is MIT economist, Jonathan Gruber. He recently co-authored a study using a unique data source to examine just how good doctors and their family members are when they find themselves in the patient seat. Spoiler alert, obviously if the results aren’t surprising, we probably would not be here talking about it.

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The American Doctor at Chernobyl, Part II. Dr. Robert Gale.

peerspectrum podcast- peter gale- 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.”
Robert Peter Gale, MD, PhD

 

Name: Robert Peter Gale, MD, PhD

Location: Los Angeles, CA

Specialty: Internal Medicine, Hematology and Oncology. International Nuclear Accident Expert.

All right welcome back for part II of the American Doctor at Chernobyl with Dr. Robert Gale. As you heard last time, Dr. Gale (a bone marrow transplant specialist from UCLA) rose to international prominence after being the first American physician invited by the Soviet Union to treat patients suffering acute radiation trauma, only days after the horrific incident at Chernobyl.

Our journey continues as Dr. Gale is flown in by helicopter to personally survey the Chernobyl nuclear power-plant. This only weeks after the meltdown of reactor number four. We’ll see what it was like walking through the eerily empty streets of Pripyat. This was literally one of the most dangerous and heavily restricted areas on the planet. For an outsider, especially an American, to be personally inspecting this area, actually treating patients, all during the height of the cold war, was simply unthinkable… until it actually happened.

For those of you who enjoyed the recent hit HBO series on Chernobyl, we’ll spend a little more time there. Then we’ll move on to subsequent nuclear incidents such as Tokiamura and Fukushima, and Dr. Gale’s first hand experience with those. We’ll discuss his lessons learned and his thoughts on the future of nuclear energy. We’ll also see what he’s up to today.

It’s an incredible part II for this rare series. With that said, let’s get started.

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The American Doctor at Chernobyl: Dr. Robert Gale, Part I

peerspectrum podcast- peter gale- 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.”
Robert Peter Gale, MD, PhD

 

Name: Robert Peter Gale, MD, PhD

Location: Los Angeles, CA

Specialty: Internal Medicine, Hematology and Oncology. International Nuclear Accident Expert.

 

Thirty three years after the worst nuclear disaster in human history, the name Chernobyl rings ominously, and continues to inspire fear, outrage, debate and grim curiously. It’s a captivating story now being re-told dramatically, though not completely accurately, through HBO’s new and very popular mini-series.

We’ve had some pretty unique people on this program but perhaps today’s guest is more unique than most. Dr. Robert Gale is an academic physician who’s spent his career researching and treating patients with Leukemia and other bone marrow disorders. He’s published over 800 research articles and books, he’s an international expert on nuclear disaster response, and get this…he’s even written for, and appeared in several Hollywood movies. Oh, he’s also the shared recipient of an Emmy award for his work in a, “60 Minutes” piece.

As you heard in the opening news clip, Dr. Gale rose to international prominence after being the first American physician invited by the Soviet Union to treat patients suffering from acute radiation trauma after Chernobyl. It’s where our journey begins on this special two part episode. With that said, let’s get started.

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Meditation Head-On: Neurosurgeon and Buddhist Priest, Dr. Patrick Codd

dr patrick codd- peerspectrum podcast

I actually find it easier to do an endoscopic brain surgery than it would be to sit and meditate for that long…”

-Dr. Patrick Codd

Name: Patrick J. Codd, MD

Location: Duke University Medical Center. Durham, NC

Specialty: Neurosurgeon. Professor of Neurosurgery. Ordained Buddhist Priest.

Keith and I have long considered doing an episode on meditation. What held us back was our goal (as it is with every episode) to answer these two questions: how would the episode specifically benefit you, the physicians and medical professionals in our audience, and how would we avoid simply rehashing a well worn topic explored elsewhere? As you know, we’re not big on chasing trends here. So we tabled it, until just recently, when we came across today’s guest.

Dr. Patrick Codd earned his M.D. in the Harvard Medical School/MIT Health Science & Technology Program. He then completed his residency in Neurosurgery at the Massachusetts General Hospital/Harvard Medical School. Patrick then served as the Director of the North Neurosurgical Service at Massachusetts General Hospital, and an Instructor in Surgery at Harvard Medical School before joining the neurosurgery staff at Duke University Medical Center where we find him today.

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