Harnessing the habitual mind. Psychologist & behavioral scientist, Wendy Wood, PhD

“Wendy Wood is widely recognized as the authority on the science of habits…” -Adam Grant

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…

Continue reading

Nullius in verba. Understanding uncertainty with statistician, Sir David Speigelhalter, PhD

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.

Continue reading

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.

Continue reading

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!

Continue reading

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.

Continue reading

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.

Continue reading

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.

Continue reading