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Episode 200: All About Ascites. Jesica Mendoza explains the pathophysiology, diagnosis and management of ascites. Dr. Arreaza adds input about early detection and prevention of spontaneous bacterial peritonitis. Written by Jesica Mendoza, OMS IV, Western University, College of Osteopathic Medicine of the Pacific. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Welcome to our episode 200! It is an honor to welcome back a wonderful medical student, her name is Jesica, and she has prepared this topic, and she is excited to share this information with us. Jesica presented in June this year an episode about gestational diabetes (episode 193) and today she will talk about ascites. Jesica, please tell us who you are again. What is ascites?Ascites is the buildup of fluid in between the visceral peritoneum and the parietal peritoneum in the abdomen. This is often caused by cirrhosis of the liver due to the increased portal HTN which leads to increased nitrous oxide (NO) and prostaglandins which then causes splanchnic vasodilation and decreased effective arterial volume. The decrease in arterial volume then causes an increase in the renin–angiotensin–aldosterone system (RAAS) and antidiuretic hormone (ADH) from the renal system which leads to sodium and water retention. This then causes a net reabsorption of fluids and ascites.Evaluation of ascites.Once someone has been found to have ascites the next step will be a diagnostic paracentesis. This includes removing fluid from the peritoneal cavity in order to determine the SAAG (Serum Ascites Albumin Gradient) score. SAAG : (serum albumin) − (albumin level of ascitic fluid). The two values should be measured at the same time.This score helps determine the cause of the ascites with a score >1.1 g/dL indicating portal hypertension usually due to liver disease such as cirrhosis. A SAAG score of 250 PMNS/mL. Fluid should be sent to the lab for culture and then antibiotics should be started. IV 3rd generation cephalosporins are typically used. Fluoroquinolones are also used to prevent the recurrence of SBP.If you desire to learn more about SBP, listen to our episode 123. By the way, propranolol is a frequently used medication to prevent GI bleeding from esophageal varices in cirrhosis and also to decrease the development of ascites. It should be used in patients who have compensated cirrhosis and must be avoided in patients with refractory ascites, hypotension, renal dysfunction or active infection. So, to wrap things up we should remember that once we identify ascites with our physical exam of the patient, we should make sure to obtain a paracentesis as these results will be the main guide for our treatment. The treatment can then range from medical treatment such as spironolactone and/or loop diuretics to TIPS procedures, PleurX or even liver transplant. Always be on the lookout for SBP in patients with ascites and always remember to obtain a culture on the ascitic fluid prior to starting antibiotics. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Ascites, Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/14792-ascites.Huang LL, Xia HH, Zhu SL. Ascitic Fluid Analysis in the Differential Diagnosis of Ascites: Focus on Cirrhotic Ascites. J Clin Transl Hepatol. 2014 Mar;2(1):58-64. doi: 10.14218/JCTH.2013.00010. Epub 2014 Mar 15. PMID: 26357618; PMCID: PMC4521252. https://pmc.ncbi.nlm.nih.gov/articles/PMC4521252/.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
The dangers of Electro-Magnetic Fields — or “EMFs” — are now widely recognized as a serious 21st century health threat by the American Academy of Pediatrics, Consumer Reports, The Cleveland Clinic and independent researchers from Harvard, Columbia and Yale.In 2015, more than 190 independent scientists from 39 countries even got together to warn the public that “EMFs are potentially harmful to all life.” All around the world, these countries are taking action to protect their citizens (especially children) against these abusive levels of EMF pollution.The French, German and Spanish governments have even issued recommendations to ban WiFi from schools because of the developmental problems it could potentially cause in children.This might be because German research dating back from 2004 had found that just 24 hours of EMF exposure can induce more DNA damage than 1,600 chest x-rays.If you live in a nation that isn't all that concerned about your safety, how can you protect yourself?Nicolas Pineault, author of The Non-Tinfoil Guide to EMFs, joins Dr. Friedman to share easy and cheap solutions to reduce dangerous EMF exposure by 95 percent... none of which include living off the grid without electricity or shredding your phone to pieces.
What if your mood isn't just in your mind—but in your gut? In this powerful episode, GI psychologist Dr. Daphne Spyropoulos of Cleveland Clinic explains the surprising science behind gut health, serotonin, shame, and self-talk. We unpack how social media affects our self-worth, whyyour inner critic might just be habit, and how small shifts in thought can change everything.You'll also hear the viral “cereal story” thatmakes neuroplasticity (rewiring your brain) easy to understand—and even easier to apply. If you've ever felt anxious, judged, or stuck in self-doubt, this conversation will show you how to build emotional resilience from the insideout.Resource & Links:Bart Berkey: MostPeopleDont.com | LinkedIn
Dr. Carrie Hersh takes us deeper into our exploration of burnout, it's causes, and prevention. She shares her very personal story of how she recovered from this trying experience. Dr. Hersh is a fierce advocate for wellness. She directs the Cleveland Clinic's MS Health and Wellness and Professional Engagement programs. She is Associate Program Director of the MS and Neuroimmunology Fellowship.
New data from the Centers for Disease Control and Prevention found Americans consume more than half of their calories from ultra-processed food. Cleveland Clinic dietitian Julia Zumpano explains the health implications.And, President Trump's new round of tariffs took effect Thursday, with more on the way. MSNBC's Ali Velshi unpacks what this means for global trade.Then, a new alert system in Arizona, called Turquoise Alerts, works to address a crisis of missing and murdered Indigenous people in the state. KJZZ's Gabriel Pietrorazio shares what this means for tribal communities.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy
The ACS welcomed two new medical directors in June—Thomas C. Tsai, MD, MPH, FACS, is the Medical Director for Health Policy Research and Margaret “Megan” C. Tracci, MD, JD, FACS, is the Medical Director for Surgeon Engagement. In this episode, Steven D. Wexner, MD, PhD(Hon), FACS, talks with Drs. Tsai and Tracci about their new roles, including their current projects and strategies to advance the profession. Steven D. Wexner, MD, PhD(Hon), FACS, is a colorectal surgeon from the Cleveland Clinic in Florida Thomas C. Tsai, MD, MPH, FACS, is a minimally invasive gastrointestinal and bariatric surgeon at Brigham and Women's Hospital and Harvard Medical School in Boston Margaret “Megan” C. Tracci, MD, JD, FACS, is an endovascular surgeon at the University of Virginia School of Medicine in Charlottesville Talk about the podcast on social media using the hashtag #HouseofSurgery
Navigating the complexities of dementia care can feel overwhelming. This episode offers a crucial GUIDE to understanding the Medicare GUIDE model, a federal payment initiative designed to revolutionize support for individuals living with dementia and their family caregivers. First, we explain what the GUIDE model is and how it provides access to dementia specialists, personalized care plans, and vital caregiver support, including a significant allowance for respite services. Moreover, learn the essential eligibility requirements for these no-cost benefits. Furthermore, we discuss a groundbreaking partnership between Remo Health and the Cleveland Clinic Medicare ACO, expanding access to comprehensive virtual dementia care in Ohio. This collaboration aims to reach underserved and rural communities, ensuring equitable access to world-class support. We also emphasize the importance of early diagnosis and proactive planning. Ultimately, discover how this innovative approach can alleviate caregiver burden and improve brain health outcomes. Consequently, this discussion serves as an indispensable GUIDE for families seeking crucial resources and support. Our Guest: Sabrina Chugani Sabrina is a co-founder and Chief Growth Officer at Remo Health, where she oversees partnerships, marketing, and account management. Sabrina has deep expertise in value-based care and has spent her career working at the forefront of innovative payment models, including MSSP, CKCC, and Direct Contracting, that change the way care is delivered nationwide. About Remo Health Remo Health is a virtual dementia care company. Our world-class neurologists diagnose and manage all types of dementia. Remo provides peer support, comprehensive and personalized care plans, and 24/7 access to experts for people living with dementia and those who care for them. Remo Health is a trusted participant in the Centers for Medicare & Medicaid Services' Guiding an Improved Dementia Experience (GUIDE) Model. ++++++++++++++++++++++++++++++++++++++++ Related Episodes: The Future of Dementia Care: Beyond Clinic Walls The Brain's Fountain of Youth: Innovative Paths to Dementia Prevention ++++++++++++++++++++++++++++++++++++++++ Sign Up for more Advice & Wisdom - email newsletter. Please help us keep our show going by supporting our sponsors. Thank you. ++++++++++++++++++++++++++++++++++++++++ Make Your Brain Span Match Your LifeSpan Relevate from NeuroReserve With Relevate nutritional supplement, you get science-backed nutrition to help protect your brain power today and for years to come. You deserve a brain span that lasts as long as your lifespan. ++++++++++++++++++++++++++++++++++++++++ Feeling overwhelmed? HelpTexts can be your pocket therapist. Going through a tough time? HelpTexts offers confidential support delivered straight to your phone via text message. Whether you're dealing with grief, caregiving stress, or just need a mental health boost, their expert-guided texts provide personalized tips and advice. Sign up for a year of support and get: Daily or twice-weekly texts tailored to your situation Actionable strategies to cope and move forward Support for those who care about you (optional) HelpTexts makes getting help easy and convenient. ++++++++++++++++++++++++++++++++++++++++ List of the Top 20 Alzheimer's Podcasts via FeedSpot! See where we rank. Join Fading Memories On Social Media! If you've enjoyed this episode, please share this podcast with other caregivers! You'll find us on social media at the following links. Instagram LinkedIn Facebook Contact Jen at hello@fadingmemoriespodcast.com Or learn more at Our Website
Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives
On July 31, 2025, Eli Lilly and Company announced topline data from the SURPASS‑CVOT trial comparing tirzepatide (Mounjaro) to dulaglutide (Trulicity) in adults with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD). According to the data, tirzepatide met the primary non‑inferiority endpoint for 3-point major adverse cardiovascular events (MACE) (hazard ratio [HR], 0.92; 95.3% CI, 0.83 to 1.01), while also showing additional benefits in A1C, weight reduction, renal preservation, and a 16% reduction in all‑cause mortality (HR, 0.84; 95.0% CI, 0.75 to 0.94). In the latest episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, unpacked the top-line results of the SURPASS-CVOT trial. Eli Lilly and Company owns both drugs, which belong to the incretin class, but tirzepatide is a dual GIP/GLP-1 receptor agonist, while dulaglutide is a GLP-1 RA. The trial included over 13,000 adults with type 2 diabetes and either established cardiovascular disease or at high risk. During a median follow-up of 4.5 years, the primary endpoint, which was a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke, was reduced by 8% in the tirzepatide group relative to dulaglutide. However, the result did not reach statistical superiority due to the confidence interval crossing unity. Isaacs and Bellini also highlighted significantly greater A1c (-1.73% vs -0.9%) and weight loss (12% vs 4.95%) with tirzepatide. Additional prespecified analyses comparing data with the placebo-controlled REWIND trial suggest tirzepatide could offer up to 28% MACE and 39% mortality risk reduction compared to theoretical placebo—findings that hint at broader cardiometabolic benefit. Before concluding, hosts speculated about the potential subgroup analyses of interest for the trial, including heart failure and renal outcomes, as well as a brief discussion around Eli Lilly and Company's intent to submit a regulatory application for a cardiovascular indication before the close of 2025. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. References: Eli Lilly and Company. Lilly's Mounjaro (tirzepatide), a GIP/GLP-1 dual agonist, demonstrated cardiovascular protection in landmark head-to-head trial, reinforcing its benefit in patients with type 2 diabetes and heart disease. July 31, 2025. Accessed July 31, 2025. https://investor.lilly.com/news-releases/news-release-details/lillys-mounjaro-tirzepatide-gipglp-1-dual-agonist-demonstrated
In this episode of Medicine Grand Rounders, we're joined by Dr. Bret Lashner, director of the Center for Inflammatory Bowel Disease (IBD), who explores the fundamentals of IBD, including diagnostic nuances and treatment strategies. Moderated by: Anthony Gallo.
Nutritionist Leyla Muedin discusses the recently released 2025 report on the best overall diets. She critiques the methodology behind nutritional research, emphasizing issues such as recall bias and the reliability of food frequency questionnaires. Leyla then provides an in-depth review of the top ten diets listed in the report: Mediterranean, DASH, Flexitarian, MIND, Mayo Clinic, TLC, Menopause, Dr. Andrew Weil's Anti-inflammatory, Volumetrics, and Cleveland Clinic diets. She argues that many of these diets are misrepresented, particularly regarding their fat content and sustainability claims. Leyla also offers her insights on what constitutes a truly effective and sustainable diet.
In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Tinestamps: 00:45 – PAH management 03:05 – Hypoxia 06:42 – Decompensated PAH 10:06 – At-home treatments 12:44 – Multidisciplinary teams 14:50 – Novel therapies
In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Timestamps: 01:05 – Diagnostic workflows 03:58 – Non-invasive tools 05:37 – Right heart catheterisation values 09:05 – Vasoreactivity testing 11:10 – Genetic testing 13:08 – Innovative diagnostics
Fresh off a $243 million fundraise from Oak HC/FT and A16Z, Ambience Healthcare is on a mission to kill medical billing — and build “Iron Man suits for doctors.”Today we sit down with co-founder and CEO Mike Ng to talk about how Ambience is tackling one of healthcare's most painful problems: the administrative burden that eats up 73% of a clinician's day. We cover:
Join medical students Binal Patel and Aashka Sheth as they discuss adolescent gynecology with pediatrician Dr. Shreeti Kapoor. Specifically, they will discuss: What exactly is adolescent gynecology. The proper approach to taking a comprehensive history for a pediatric patient with a gynecologic chief complaint. The various causes of dysmenorrhea in the early menarche period and its presentation. The diagnostic approach to dysmenorrhea in adolescents. The approach to treatment of dysmenorrhea in a pediatric population. And how to approach addressing safe sex practices and sexually transmitted infections with adolescents. References: 21 reasons to see a gynecologist before you turn 21. ACOG. (n.d.). https://www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-21 Adams Hillard P. J. (2008). Menstruation in adolescents: what's normal?. Medscape journal of medicine, 10(12), 295. Breehl L, Caban O. Physiology, Puberty. [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534827/ Centers for Disease Control and Prevention. (n.d.). About heavy menstrual bleeding. Centers for Disease Control and Prevention. https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html Primary dysmenorrhea in adolescents. UpToDate. (n.d.). https://www.uptodate.com/contents/primary-dysmenorrhea-in-adolescents?search=Primary+Dysmenorrhea+&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2 professional, C. C. medical. (2024, September 20). Pediatric gynecology. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/24574-pediatric-gynecology professional, C. C. medical. (2025, February 18). Puberty. Cleveland Clinic. https://my.clevelandclinic.org/health/body/puberty Sachedin, A., & Todd, N. (2020). Dysmenorrhea, endometriosis and chronic pelvic pain in adolescents. Journal of Clinical Research in Pediatric Endocrinology, 12(1), 7–17. https://doi.org/10.4274/jcrpe.galenos.2019.2019.s0217 Sexuality, Sexual Health, and Sexually Transmitted Infections in Adolescents and Young Adults. (2020). Topics in Antiviral Medicine, 28(2). https://pmc.ncbi.nlm.nih.gov/articles/PMC7482983/pdf/tam-28-459.pdf UpToDate. (n.d.). Abnormal uterine bleeding in adolescents. https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-adolescents-evaluation-and-approach-to-diagnosis?search=heavy%2Bbleeding&usage_type=default&source=search_result&selectedTitle=3~150&display_rank=3
Bloomdaddy discusses the near 400% rise in Achilles injuries across major sports. Dr. James Rosneck from the Cleveland Clinic to discuss it. Plus Politics Left, Right, Center with Councilman Mike Polensek and Pastor James Davis.
Why won't the Browns come clean on the entire Brook Park plan, including who owns the stadium? Learn more about your ad choices. Visit megaphone.fm/adchoices
The idea might seem like something out of a fantasy, but “Foreign Accent Syndrome” is a genuine, albeit very rare, neurological condition! It sees a person begin to speak with an accent different to the one they had prior to having a stroke; one which makes them sound like they come from an entirely different country! Since the first case was discovered in France in 1907, there have only been about 100 documented cases worldwide, according to the Cleveland Clinic. But certain cases have attracted the attention of the media and scientific researchers alike. One dates back to 1941 in Oslo, Norway, during a period of German occupation. What is the foreign accent syndrom? What exactly happens in the brain in such cases? How serious can the syndrome be? In under 3 minutes, we answer your questions! To listen to the last episodes, you can click here: How to spot, prevent and treat heatstroke ? What are the strangest reactions caused by an orgasm? How can I learn 1000 words in a new language? A podcast written and realised by Amber Minogue. First Broadcast: 10/1/2025 Learn more about your ad choices. Visit megaphone.fm/adchoices
In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research.
In the second episode of our Rare Lung Diseases podcast mini-series, host Saranya Ravindran delves into the complexities of pulmonary arterial hypertension (PAH) with Neal Chaisson, Assistant Professor of Medicine at the Cleveland Clinic. Chaisson shares insights into why PAH remains under-recognised, the nuances of detection and diagnosis, and what the latest advancements mean for patients and clinicians. The discussion covers everything from early warning signs to future directions in PAH management and research. Timestamps: Part 1: 01:00 – What is PAH 02:34 – Risk factors 04:21 – Misdiagnoses 07:13 – Pathophysiology 10:44 – World Symposium classification
If just thinking of spiders is enough to make the hairs stand up on the back of your neck, or you jump any time you see one, the chances are you suffer from arachnophobia. It affects up to 15% of people according to the Cleveland Clinic, making it one of the most common phobias out there. As it turns out, human fear of spiders may well be down to evolution. Researchers from Germany, Austria and Sweden looked into the question in more detail for a study published in Frontiers in Psychology in 2017. This may be because such creatures have historically provided a threat. Some other studies have also backed up the idea of an inherited fear of spiders. But my friend keeps pet spiders; why doesn't she have the same fear as me? So can it be cured? In under 3 minutes, we answer your questions ! To listen to the latest episodes, click here: Will the British museum finally give back the Parthenon marbles? What did the Jane Collective do for US women's rights? What is tagskryt, the Scandinavian sustainable travel trend? A podcast written and realised by Joseph Chance. First Broadcast: 21/9/2022 Learn more about your ad choices. Visit megaphone.fm/adchoices
Thanks to our Partners, NAPA TRACS, and Today's Class This episode features Brakes for Breasts co-founders Leigh Anne Best and Laura Frank, along with Cleveland Clinic researcher Dr. Justin Johnson, as they celebrate the automotive industry's role in raising over $2 million for breast cancer vaccine research. They share the initiative's grassroots beginnings, its 100% donation to research model, and provide an update on the vaccine's progress, highlighting the completion of Phase One trials and the upcoming launch of Phase Two. A key highlight of the campaign: During October, independent auto repair shops across the U.S. offer free brake pads to customers. For every brake service performed, the customer receives their brake pads at no cost and only pays for labor and other parts. In turn, each participating shop donates 10% of the brake service total to the Cleveland Clinic Breast Cancer Vaccine Research Fund. The episode also shares the inspiring story of Jennifer Davis, the first vaccine recipient, and encourages more shops to get involved in this unique, community driven fundraising effort that's helping fuel groundbreaking research. Show Notes: Watch Full Video Episode The First Breast Cancer Vaccine Trial Recipient: Jennifer Davis [CC 111]: https://remarkableresults.biz/remarkable-results-radio-podcast/cc111/ Introduction (00:00:00) Celebrating the $2 Million Milestone (00:03:08) Origin Story of Breaks for Breasts (00:03:46) Connection to Cleveland Clinic and Dr. Tuohy (00:06:01) Personal Motivations for Founding (00:06:55) Industry Call to Action and Broader Impact (00:07:31) Expanding Research Beyond Breast Cancer (00:10:09) Clinical Trials Overview: Phase One (00:12:14) Clinical Trials: Phase Two and Three Plans (00:14:08) How Research Funding Works at Cleveland Clinic (00:19:42) 2024 Check Presentation and Fundraising Impact (00:21:03) Jennifer Davis: The First Clinical Trial Patient (00:23:38) Hope and Realistic Expectations...
Multiple sclerosis (MS) is a disease in which the body’s immune system attacks the protective layer around the nerves. It affects more than 2.8 million people worldwide, most often younger adults between ages 20 and 40 – with women significantly more affected. What are the symptoms? What should newly diagnosed individuals know? In this episode, Robert Bermel, MD, Director of the Mellen Center for Multiple Sclerosis at the Cleveland Clinic, explains what happens after an MS diagnosis, from early signs and the importance of timely treatment to lifestyle strategies and long-term planning. We also hear from Hanna Jones, a 31-year-old MS advocate and blogger, who shares her personal journey of being diagnosed and how education helped her face her diagnosis. Whether you’re newly diagnosed, a caregiver, or simply curious, this episode offers insight, guidance, and hope.See omnystudio.com/listener for privacy information.
In the first episode of our Rare Lung Diseases podcast series, host Saranya Ravindran speaks with James Stoller, Chief of Education and Pulmonary Physician at Cleveland Clinic, about Alpha-1 antitrypsin deficiency, a rare genetic condition that is frequently underdiagnosed. The discussion explores the complexities of Alpha 1, including current challenges in detection, advances in diagnosis and management, and what the future may hold for improving care. Timestamps: 1:20 - Current barriers to timely diagnosis 4:35 - How close are we to identifying all patients with Alpha 1? 5:20 - Role of consumer genomics in alpha detection 6:20 – Targeted testing amongst COPD patients
In the first episode of our Rare Lung Diseases podcast series, host Saranya Ravindran speaks with James Stoller, Chief of Education and Pulmonary Physician at Cleveland Clinic, about Alpha-1 antitrypsin deficiency, a rare genetic condition that is frequently underdiagnosed. The discussion explores the complexities of Alpha 1, including current challenges in detection, advances in diagnosis and management, and what the future may hold for improving care. Timestamps: 01:00 - Management of Alpha 1 03:30 - Augmentation therapy 05:50 - The discussion of neonatal screening for Alpha 1 08:00 - Evolving landscape 09:40 - Patients' challenges with Alpha 1 11:20 - Closing comments on Alpha 1
There are serious ramifications for the continued payment reductions in the Medicare home health regulations, Steven Landers, MD, MPH, CEO of the National Alliance for Care at Home, said. Beyond the lack of access to home health services, the whole payment structure has been decimated, he said. This year, the home health payment program will total just over $15 billion, down from $17.8 billion in 2019. The cuts are making it harder for agencies to have the purchasing power to staff agencies. Another negative development for home care is the passage of the “Big Beautiful” bill, which will place pressure on states to reduce home- and community-based services. The Medicaid work requirements in the law may hurt personal care workers who use Medicaid as their health insurance, he noted. While home care is not the most powerful lobbying contingent in Washington, “sometimes right beats might,” Landers said. Landers' past positions, which included his role as director of home care at the Cleveland Clinic, helped him see the value of home care and how policy making in Washington affected the care regular people receive. As part of his tenure, he would like to see home care providers be able to deploy new care models such as the Medicare Care Choices Model. Landers sees the Alliance being a partner with the Centers for Medicare & Medicaid Services to combat rampant hospice fraud.Follow us on social media:X: @McKHomeCareFacebook: McKnight's Home CareLinkedIn: McKnight's Home CareInstagram: mcknights_homecareFollow the National Alliance for Care at Home on social media:X: @TheAllianceHomeFacebook: National Alliance for Care at HomeLinkedIn: National Alliance for Care at HomeInstagram: thealliancehomeShow contributors:McKnight's Home Care Editor Liza Berger; Steven Landers, MD, MPH, CEO, National Alliance for Care at Home
The College Essay Guy Podcast: A Practical Guide to College Admissions
In Episode 5 of our series on Admission Nutrients, Tom Campbell is joined by Nathan Faust, Admission Counselor at Loyola Marymount University, to talk about Service to Others / Community Impact. In their conversation, they get into: Why service to others and community impact is a valuable nutrient to fold into your high school experience—and life Tips on communicating your service and community-impact initiatives to admissions officers Examples of how this nutrient may overlap with the others Advice for counselors on how to explain the value of this nutrient to students and families And more! Nathan Faust is a graduate of Loyola Marymount University where he earned both his B.A. (2019) and M.A. (2023) in English. After brief stints in finance and sports management, he joined the admission team in 2021 as a regional recruiter in the Pacific Northwest, where he works with students from Oregon and Washington. Nathan is passionate about educational opportunity, enjoys connecting with students, and values demystifying the admission process. In his free time, Nathan enjoys creative writing, the highs and lows of cheering for the Portland Trail Blazers, camping in mosquito-less places, and spending time with friends also in mosquito-less places. We hope you enjoy. Play-by-Play: 4:40 – Why is service to others important at Loyola Marymount University (LMU)? 6:36 – How does LMU view service hours differently and why? 16:55 – How does service to others impact wellbeing? 23:56 – How can students best communicate their service work on their application? 29:40 – How can students weave in service to others in the personal statement? 33:45 – Where else does service to others show up in the application? 41:03 – FAQs about service to others 41:43 – What if I want to talk about my mission trip? 43:30 – What if I quit my service endeavor? 43:47 – What if my service program was discontinued? 44:42 – How do I know what really counts as service? 45:34 – What if I didn't really take anything away from this service opportunity? 47:10 – Closing thoughts and advice for students Resources: Why Giving Is Good for Your Health (Resident Psychologist Susan Albers, Cleveland Clinic, 2022, ) Why I changed my mind about volunteering (Rachel Cohen, Vox, 2024, ) Workplace Wellness Programs Why Meaningful, Long-Term Volunteer Opportunities Are The Key To Engaging Your Top Talent (William Aruda, Forbes, 2022) How to Use the Common App Additional Information section and Challenges and Circumstances section: Guide + Examples College Essay Guy's Personal Statement Resources College Essay Guy's College Application Hub
Adrienne is sharing her recent episodes from the Modern Wellness Podcast. Follow or Subscribe wherever you get your podcasts!First up, Oli, Sammi and Adrienne look at the ever expanding world of vitamins and supplements. Noting that it's important to understand which vitamins and minerals you can get too much of, like vitamin C and calcium. Read the Cleveland Clinic article here: Yes, You Can Take Too Many VitaminsThen the team discuss ChatGPT and the impact it's having on our ability to think critically, but will the team agree on the damage versus benefit scale? Read Time's article: ChatGPT May Be Eroding Critical Thinking Skills, According to a New MIT StudyAnd in trending Adrienne looks at Clean Beauty - will it go the way of animal testing? Don't forget to rate/review and subscribe or follow!You can follow the show and send in your questions to @modernwellnesspodcast or email questions@modernwellnesspodcast.comAnd follow the hosts Adrienne @adrienne_ldn, Sammi @sammiadhami, and Oli @_olipatrick. Hosted on Acast. See acast.com/privacy for more information.
In the first episode of our Rare Lung Diseases podcast series, host Saranya Ravindran speaks with James Stoller, Chief of Education and Pulmonary Physician at Cleveland Clinic, about Alpha-1 antitrypsin deficiency, a rare genetic condition that is frequently underdiagnosed. The discussion explores the complexities of Alpha 1, including current challenges in detection, advances in diagnosis and management, and what the future may hold for improving care.
In the first episode of our Rare Lung Diseases podcast series, host Saranya Ravindran speaks with James Stoller, Chief of Education and Pulmonary Physician at Cleveland Clinic, about Alpha-1 antitrypsin deficiency, a rare genetic condition that is frequently underdiagnosed. The discussion explores the complexities of Alpha 1, including current challenges in detection, advances in diagnosis and management, and what the future may hold for improving care. Timestamps 00:56 – What is Alpha-1 antitrypsin deficiency? 01:45 – Mechanism of this genetic disorder 03:12 – What makes Alpha 1 so hard to spot? 04:30 – Genetic complexities of Alpha 1 06:00 – Risk factors
Show Notes: Kendalle Cobb, a family physician, has been practicing in Cleveland since 2004. She graduated from George Washington University School of Medicine in Washington, DC and completed her family medicine residency at Kaiser Foundation Hospital in Fontana, California. After a year in Boston, she returned to serve on the faculty at her former residency program. She met her husband, who taught at a boarding school in Claremont, California, and after they got married, they moved to Cleveland to be closer to his family. Family Physician and Physician Advisor Kendalle shares that family medicine, as a primary care specialty, takes a more holistic approach with the inclusion of counseling and a “cradle to grave” mentality that follows the patient through different stages of life. She sees patients 50% of the time in a family health center in the community. The rest of her time is spent as one of the associate chiefs of staff and as a physician advisor at Cleveland Clinic Lerner College of Medicine, a five-year program that trains students to be physician investigators, focusing on research, scholarship, personal and professional development, and reflective practice. The physician advisor attests to the students' competency report is representative of the feedback that the students receive. Supporting Medical Students Kendalle talks about working as a physician advisor. She shares what she has learned in this role. One aspect she has realized is that people are often used to being self-sufficient, making it challenging to ask for help or to work in collaborative environments. She explains what some students struggled with in terms of peer-to-peer interaction, challenges of the assessment system, and accepting that there will always be areas of improvement. Kendalle helps normalize expectations for students. She also talks about the connections between her work as a physician advisor and as a family physician. The Partnership Aspect of Medicine When Kendalle first thought about becoming a doctor, she initially had an idea of being able to fix things, but now she appreciates the partnership aspect of medicine where she accompanies people along their path. She mentions that there is often a difference between the textbook ideal treatment and what's best for the patient in front of her. She explains that medicine is a team sport, and group work requires trust and collaboration, and while she didn't like group work in school, she realizes that, in medicine, no individual can do everything, and doctors rely on others to answer phones, send messages, and process refill requests. By understanding and addressing these challenges, doctors can help their students navigate the challenges they face and become better doctors. Counseling and Family Medicine Kendalle talks about how family medicine and her approach to counseling has evolved over time. During her residency, one afternoon a week was dedicated to mental health, in addition to didactic sessions, she had two hour-long patients, supervised by a family physician and psychiatrist. Over the course of her residency, she had an increasing number of clinic sessions to see an increasing number of patients with various physical and mental health concerns. She learned that some people just want to share their feelings without wanting to change anything. She shares a story of a patient who was upset about a situation, and although their conversation was not health related, it helped Kendalle support the patient in figuring out next steps. In addition to counseling, she also learned to use tactical phrases and questions to help patients make decisions that align with their goals. This approach allows for more effective communication and understanding of patients' needs and concerns. Creating a Safe Space for All Patients Kendalle discusses the importance of understanding and addressing various health issues in healthcare settings. She shares her experiences with the stub toe theory, which is really "broken arm theory," which is when a doctor attributes any concern with which a patient presents, to some other risk factor (smoking, obesity, gender identity). She also discusses the importance of considering factors that can affect health in interacting with patients. She shares a case of a woman with previously well-controlled blood pressure whose blood pressure was high. Kendalle uncovered a social stressor. Kendalle emphasizes the need to consider different priorities and the reasons behind people's decisions regarding their health. She avoids asking the question "why" and instead asks "what factors contributed" to the patient's decision or thoughts about their health issues. This approach helps patients feel less defensive and allows Kendalle to better partner with patients to manage their health. Confidentiality in the Doctor's Office Kendalle explains that she is often the doctor for more than one generation in a family, and she shares a story that stresses the importance of confidentiality in the doctor's office. She also talks about how difficult it can be when extended family members want to become her patients, but the fact that the family entrusts the doctor with their loved ones is special. She also talks about the trust, gratitude, and grace shown by the patients, and how these are the moments that stay with her. Influential Harvard Professors and Courses Kendalle mentions history professor Michael McCormick, who helped her develop confidence in analyzing primary sources from medieval and early modern Europe. She also mentions fundraising for CityStep by organizing a formal event in Memorial Hall. Timestamps: 01:26: Kendall Cobb's Career Journey 02:28: Understanding Family Medicine 04:12: Teaching and Advising at Cleveland Clinic 05:40: Learning and Adapting in Medical Education 12:02: Counseling and Patient Interactions 13:57: Handling Patient Health Issues 25:21: Patient Relationships and Trust 29:10: Personal Life and Interests 31:33: Harvard Memories and Influences Links: LinkedIn: https://www.linkedin.com/in/kcobbmd/ Featured Non-profit: The featured non-profit of this week's episode is the Houston Learning Network recommended by Huang Quan Vu who reports: “Hi. I'm Huang Quan Vu, class of 1992. The featured non-profit of this episode of The 92 Report is the Houston Learning Network. HLN helps Houston area educators grow their practice and transform their classrooms by providing funding and support so they could attend in person professional development at Harvard, participate in virtual Harvard educational programming from Houston and learn from Harvard educators who passed through Houston. I was a founding member of HLN, and I'm currently the Vice Chair of the Board of Directors. You can learn more about their work at Houston learning network.org, and now here's Will Bachman with this week's episode.” To learn more about their work, visit: HoustonLearningNetwork.org.
What separates scalable healthcare AI from hype? Dr. Bernardo Perez-Villa, Cleveland Clinic's Senior Innovations Engagement Partner, breaks down how to validate AI ideas, assess product-market fit, and build business models that survive reimbursement hurdles. Hosted by Dr. Sanjay Juneja.
Segment 1: President Trump's One Big Beautiful Bill Defunds Planned Parenthood President Trump signs sweeping legislation that defunds Planned Parenthood for one year. Dr. Chaps breaks down what's in the bill and how it passed. Segment 2: Planned Parenthood Shuts Down in Cleveland As a result of the funding cuts, Planned Parenthood permanently closes its doors in Cleveland. What does this mean for the pro-life movement and the region? Segment 3: Dr. Anthony Harper Reports from the White House on Israel White House correspondent Dr. Anthony Harper joins us with a special update on U.S.-Israel relations, direct from the White House briefing room. Get free alerts at http://PrayInJesusName.org © 2025, Chaplain Gordon James Klingenschmitt, PhD. Airs on NRB TV, Direct TV Ch.378, Roku, AppleTV, Amazon FireTV, AndroidTV, GoogleTV, Smart TV, iTunes and www.PrayInJesusName.org
What if the very thought of pregnancy or giving birth filled you with terror — not just discomfort or anxiety, but real, paralyzing fear?In this episode, Erika and Kristen explore tokophobia, an often-overlooked condition defined by the Cleveland Clinic as an extreme fear of childbirth. Tokophobia can affect people so severely that they may go to great lengths to avoid pregnancy altogether. For those who do become pregnant, the fear can overshadow what many new parents expect to be a joyful time. We unpack the psychological and cultural roots of this condition, share firsthand accounts from those living with it, and discuss how tokophobia intersects the choice to remain childfree. Whether you've experienced this fear yourself, or are just hearing about it for the first time, this episode offers validation, insight, and a fresh perspective on reproductive autonomy.In This Episode, We Cover:
Get ready for a tail-wagging adventure! Oliver Super Beardie, our fearless furry hero and member of the Woof Chat Kids, is back on the case—this time to solve a mysterious throat trouble affecting his buddy Sam. Why is swallowing so hard? What's causing the pain? Oliver's on the trail… and he's sniffing out answers!. Joining Oliver is brilliant expert guest Dr. Sophia Patel, a leading Pediatric Gastroenterologist from Cleveland Clinic. Together with host Jacqueline Gaulin, they'll follow the clues to uncover what's really going on inside Sam's esophagus—and introduce kids (and grown-ups!) to a condition called Eosinophilic Esophagitis (EoE). You'll learn what symptoms to watch for, how EoE is diagnosed, and what steps can help kids like Sam feel better—all in a fun, kid-friendly way that mixes science and heart. A huge shout-out to the incredible John Kennedy, the puppeteer and voice behind Oliver Super Beardie, whose creativity and heart make every episode unforgettable. This special episode is brought to you by Dupixent.
Eric Topol (00:06):Hello, this is Eric Topol from Ground Truths, and I'm delighted to welcome Owen Tripp, who is a CEO of Included Health. And Owen, I'd like to start off if you would, with the story from 2016, because really what I'm interested in is patients and how to get the right doctor. So can you tell us about when you lost your hearing in your right ear back, what, nine years ago or so?Owen Tripp (00:38):Yeah, it's amazing to say nine years, Eric, but obviously as your listeners will soon understand a pretty vivid memory in my past. So I had been working as I do and noticed a loss of hearing in my right ear. I had never experienced any hearing loss before, and I went twice actually to a sort of national primary care chain that now owned by Amazon actually. And they described it as eustachian tube dysfunction, which is a pretty benign common thing that basically meant that my tubes were blocked and that I needed to have some drainage. They recommended Sudafed to no effect. And it was only a couple weeks later where I was walking some of the senior medical team at my company down to the San Francisco Giants game. And I was describing this experience of hearing loss and I said I was also losing a little bit of sensation in the right side of my face. And they said, that is not eustachian tube dysfunction. And well, I can let the story unfold from there. But basically my colleagues helped me quickly put together a plan to get this properly diagnosed and treated. The underlying condition is called vestibular schwannoma, even more commonly known as an acoustic neuroma. So a pretty rare benign brain tumor that exists on the vestibular nerve, and it would've cost my life had it not been treated.Eric Topol (02:28):So from what I gather, you saw an ENT physician, but that ENT physician was not really well versed in this condition, which is I guess a bit surprising. And then eventually you got to the right ENT physician in San Francisco. Is that right?Owen Tripp (02:49):Well, the first doctor was probably an internal medicine doctor, and I think it's fair to say that he had probably not seen many, if any cases. By the time I reached an ENT, they were interested in working me up for what's known as sudden sensorineural hearing loss (SSHL), which is basically a fancy term for you lose hearing for a variety of possible pathologies and reasons, but you go through a process of differential diagnosis to understand what's actually going on. By the time that I reached that ENT, the audio tests had showed that I had significant hearing loss in my right ear. And what an MRI would confirm was this mass that I just described to you, which was quite large. It was already about a centimeter large and growing into the inner ear canal.Eric Topol (03:49):Yeah, so I read that your Stanford brain scan suggested it was about size of a plum and that you then got the call that you had this mass in your brainstem tumor. So obviously that's a delicate operation to undergo. So the first thing was getting a diagnosis and then the next thing was getting the right surgeon to work on your brain to resect this. So how did you figure out who was the right person? Because there's only a few thousand of these operations done every year, as I understand.Owen Tripp (04:27):That's exactly right. Yeah, very few. And without putting your listeners to sleep too early in our discussion, what I'll say is that there are a lot of ways that you can actually do this. There are very few cases, any approach really requires either shrinking or removing that tumor entirely. My size of tumor meant it was really only going to be a surgical approach, and there I had to decide amongst multiple potential approaches. And this is what's interesting, Eric, you started saying you wanted to talk about the patient experience. You have to understand that I'm somebody, while not a doctor, I lead a very large healthcare company. We provide millions of visits and services per year on very complex medical diagnoses down to more standard day-to-day fare. And so, being in the world of medical complexity was not daunting on the basics, but then I'm the patient and now I have to make a surgical treatment decision amongst many possible choices, and I was able to get multiple opinions.Owen Tripp (05:42):I got an opinion from the House clinic, which is closer to you in LA. This is really the place where they invented the surgical approach to treating these things. I also got an approach shared with me from the Mayo Clinic and one from UCSF and one from Stanford, and ultimately, I picked the Stanford team. And these are fascinating and delicate structures as you know that you're dealing with in the brain, but the surgery is a long surgery performed by multiple surgeons. It's such an exhausting surgery that as you're sort of peeling away that tumor that you need relief. And so, after a 13 hour surgery, multiple nights in the hospital and some significant training to learn how to walk and move and not lose my balance, I am as you see me today, but it was possible under one of the surgical approaches that I would've lost the use of the right side of my face, which obviously was not an option given what I given what I do.Eric Topol (06:51):Yeah, well, I know there had to be a tough rehab and so glad that you recovered well, and I guess you still don't have hearing in that one ear, right?Owen Tripp:That's right.Eric Topol:But otherwise, you're walking well, and you've completely recovered from what could have been a very disastrous type of, not just the tumor itself, but also the way it would be operated on. 13 hours is a long time to be in the operating room as a patient.Owen Tripp (07:22):You've got a whole team in there. You've got people testing nerve function, you've got people obviously managing the anesthesiology, which is sufficiently complex given what's involved. You've got a specialized ENT called a neurotologist. You've got the neurosurgeon who creates access. So it's quite a team that does these things.Eric Topol (07:40):Yeah, wow. Now, the reason I wanted to delve into this from your past is because I get a call or email or whatever contact every week at least one, is can you help me find the right doctor for such and such? And this has been going on throughout my career. I mean, when I was back in 20 years ago at Cleveland Clinic, the people on the board, I said, well, I wrote about it in one of my books. Why did you become a trustee on the board? And he said, so I could get access to the right doctor. And so, this is amazing. We live in an information era supposedly where people can get information about this being the most precious part, which is they want to get the right diagnosis, they want to get the right treatment or prevention, whatever, and they can't get it. And I'm finding this just extraordinary given that we can do deep research through several different AI models and get reports generated on whatever you want, but you can't get the right doctor. So now let's go over to what you're working on. This company Included Health. When did you start that?Owen Tripp (08:59):Well, I started the company that was known as Grand Rounds in 2011. And Grand Rounds still to this day, we've rebranded as Included Health had a very simple but powerful idea, one you just obliquely referred to, which is if we get people to higher quality medicine by helping them find the right level and quality of care, that two good things would happen. One, the sort of obvious one, patients would get better, they'd move on with their lives, they'd return to health. But two and critically that we would actually help the system overall with the cost burden of unnecessary, inappropriate and low quality care because the coda to the example you gave of people calling you looking for a physician referral, and you and I both know this, my guess is you've probably had to clean plenty of it up in your career is if you go to the wrong doctor, you don't get out of the problem. The problem just persists. And that patient is likely to bounce around like a ping pong ball until they find what they actually need. And that costs the payers of healthcare in this country a lot of money. So I started the company in 2011 to try to solve that problem.Eric Topol (10:14):Yeah, one example, a patient of mine who I've looked after for some 35 years contacted me and said, a very close friend of mine lives in the Palm Springs region and he has this horrible skin condition and he's tortured and he's been to six centers, UCSF, Stanford, Oregon Health Science, Eisenhower, UCLA, and he had a full workup and he can't sleep because he's itching all the time. His whole skin is exfoliating and cellulitis and he had biopsies everywhere. He's put on all kinds of drugs, monoclonal antibodies. And I said to this patient of mine I said, I don't know, this is way out of my area. I checked at Scripps and turns out there was this kind of the Columbo of dermatology, he can solve any mystery. And the patient went to see him, and he was diagnosed within about a minute that he had scabies, and he was treated and completely recovered after having thousands and thousands of dollars of all these workups at these leading medical centers that you would expect could make a diagnosis of scabies.Owen Tripp (11:38):That's a pretty common diagnosis.Eric Topol (11:40):Yeah. I mean you might expect it more in somebody who was homeless perhaps, but that doesn't mean it can't happen in anyone. And within the first few minutes he did a scrape and showed the patient under the microscope and made a definitive diagnosis and the patient to this day is still trying to pay all his bills for all these biopsies and drugs and whatnot, and very upset that he went through all this for over a year and he thought he wanted to die, it was so bad. Now, I had never heard of Included Health and you have now links with a third of the Fortune 100 companies. So what do you do with these companies?Owen Tripp (12:22):Yeah, it's pretty cool. These companies, so very large organizations like Walmart and JPMorgan Chase and the rest of the big pioneers of American industry and business put us in as a benefit to help their employees have the same experience that I described to provide almost Eric Topol like guidance service to help people find access to high quality care, which might be referring them into the community or to an academic medical center, but often is also us providing care delivery ourselves through on-demand primary care, urgent care, behavioral health. And now just last year we introduced a couple of our first specialty lines. And the idea, Eric, is that these companies buy this because they know their employees will love it and they do. It is often one of, if not the most highly rated benefits available. But also because in getting their employees better care faster, the employees come back to work, they feel more connected to the company, they're able to do better and safer and higher quality work. And they get more mileage out of their health benefits. And you have to remember that the costs of health benefits in this country are inflating even in this time of hyperinflation. They're inflating faster than anything else, and this is one of most companies, number one pain points for how they are going to control their overall budget. So this is a solution that both give them visibility to controlling cost and can deliver them an excellent patient experience that is not an offer that they've been able to get from the traditional managed care operators.Eric Topol (14:11):So I guess there's a kind of multidimensional approach that you're describing. For one, you can help find a doctor that's the right doctor for the right patient. And you're also actually providing medical services too, right?Owen Tripp (14:27):That's right.Eric Topol (14:30):Are these physicians who are employed by Included Health?Owen Tripp (14:34):They are, and we feel very strongly about that. We think that in our model, we want to train people, hire people in a specific way, prepare them for the kind of work that we do. And there's a lot we could spend time talking about there, but one of the key features of that is teamwork. We want people to work in a collaborative model where they understand that while they may be expert in one specific thing that is connected to a service line, they're working in a much broader team in support of the member, in support of that patient. And we talk about the patients being very first here, and you and I had a laugh on this in the past, so many hospitals will say we're patient first. So many managed care companies will say they're patient first, but it is actually hard the way that the system is designed to truly be patient first. At Included Health, we measure whether patients will come back to us, whether they tell their friends about us, whether they have high quality member satisfaction and are they living more healthy days. So everybody gets surveyed for patient reported outcomes, which is highly unusual as you know, to have both the clinical outcomes and the patient reported outcomes as well.Eric Topol (15:41):Is that all through virtual visits or are there physical visits as well?Owen Tripp (15:47):Today that is all through virtual visits. So we provide 24/7/365 access to urgent care, primary care, behavioral health, the start of the specialty clinic, which we launched last year. And then we provide support for patients who have questions about how these things are going to be billed, what other benefits they have access to. And where appropriate, we send them out to care. So obviously we can't provide all the exams virtually. We can't provide everything that a comprehensive physical would today, but as you and I know that is also changing rapidly. And so, we can do things to put sensors and other observational devices in people's homes to collect that data positively.Eric Topol (16:32):Now, how is that different than Teladoc and all these other telehealth based companies? I mean because trying to understand on the one hand you have a service that you can provide that can be extremely helpful and seems to be relatively unique. Whereas the other seems to be shared with other companies that started in this telehealth space.Owen Tripp (16:57):I think the easiest way to think about the difference here is how a traditional telemedicine company is paid and how we're paid because I think it'll give you some clue as to why we've designed it the way we've designed it. So the traditional telehealth model is you put a quarter in the jukebox, you listen to a song when the song's over, you got to get out and move on with the rest of your life. And quite literally what I mean is that you're going to see one doctor, one time, you will never see that same doctor again. You are not going to have a connected experience across your visits. I mean, you might have an underlying chart, but there's not going to be a continuity of care and follow up there as you would in an integrated setting. Now by comparison, and that's all derived from the fact that those telehealth companies are paid by the drink, they're paid by the visit.Owen Tripp (17:49):In our model, we are committing to a set of experience goals and a set of outcomes to the companies that you refer to that pay our bill. And so, the visits that our members enjoy are all connected. So if you have a primary care visit, that is connected to your behavioral health visit, which is great and is as it should be. If you have a primary care appointment where you identify the need for follow-up cardiology for example. That patient can be followed through that cardiology visit that we circle back, that we make sure that the patient is educated, that he or she has all their questions answered. That's because we know that if the patient actually isn't confident in what they heard and they don't follow through on the plan, then it's all for naught. It's not going to work. And it's a simple sort of observation, but it's how we get paid and why we think it's a really important way to think about medicine.Eric Topol (18:44):So these companies, and they're pretty big companies like Google and AT&T and as you said, JPMorgan and the list goes on and on. Any one of the employees can get this. Is that how it works?Owen Tripp (18:56):That's right, that's right. And even better, most of what I've described to you today is at a low or zero cost to them. So this is a very affordable, easy way to access care. Thinking about one of our very large airline clients the other day, we're often dealing with their flight crews and ramp agents at very strange hours in very strange places away from home, so that they don't have to wait to get access to care. And you can understand that at a basic humanitarian level why that's great, but you can also understand it from a safety perspective that if there is something that is impeding that person's ability to be functioning at work, that becomes an issue for the corporation itself.Eric Topol (19:39):Yeah, so it's interesting you call it included because most of us in the country are excluded. That is, they don't have any way to turn through to get help for a really good referral. Everything's out of network if they are covered and they're not one of the fortunate to be in these companies that you're providing the service for. So do you have any peers or are there any others that are going to come into this space to help a lot of these people that are in a tough situation where they don't really have anyone to turn to?Owen Tripp (20:21):Well, I hope so. Because like you, I've dedicated my career to trying to use information and use science and use in my own right to bring along the model. At Included Health, we talk about raising the standard of care for everybody, and what we mean by that is, we actually hope that this becomes a model that others can follow. The same way the Cleveland Clinic did, the same way the Mayo Clinic did. They brought a model into the world that others soon try to replicate, and that was a good thing. So we'd like to see more attempt to do this. The reality is we have not seen that because unfortunately the old system has a lot of incentives in place to function exactly the way that it is designed. The health system is going to maximize the number of patients that correspond to the highest paying procedures and tests, et cetera. The managed care company is going to try to process the highest number of claims, work the most efficient utilization management and prior authorization, but left out in the middle of all of that is the patient. And so, we really wanted to build that model with the patient at the center, and when I started this company now over a decade ago, that was just a dream that we could do that. Now serving over 10 million members, this feels like it's possible and it feels like a model others could follow.Eric Topol (21:50):Yeah, well that was what struck me is here you're reaching 10 million people. I'd never heard of it. I was like, wow. I thought I try to keep up with things. But now the other thing I wanted to get into you with is AI. Obviously, that has a lot of promise in many different ways. As you know, there are some 12 million diagnostic serious errors a year in the US. I mean you were one, I've been part of them. Most people have been roughed up one way or another. Then there's 800,000 Americans who have disability or die from these errors a year, according to Johns Hopkins relatively recent study. So one of the ways that AI could help is accuracy. But of course, there's many other ways it can help make the lives of both patients helping to integrate their data and physicians to go through a patient's records and set points of their labs and all sorts of other things. Where do you see AI fitting into the model that you've built?Owen Tripp (22:58):Well, I'll give you two that I'm really excited about, that I don't think I hear other people talking about. And again, I'm going to start with that patient, with that member and what he or she wants and needs. One and Eric, bear with me, this is going to sound very banal, but one is just making sense of these very complicated plan documents and explanations of benefits. I'm aware of how well-trained you are and how much you've written. I believe you are the most published in your field. I believe that is a fact. And yet if I showed you a plan description document and an explanation of benefit and I asked you, Eric, could you tell me how much it's going to cost to have an MRI at this facility? I don't think you would've any way of figuring that out. And that is something that people confront every single day in this country. And a lot of people are not like you and me, in that we could probably tolerate a big cost range for that MRI. For some people that might actually be the difference between whether they eat or not, or get their kids prescription or not.Owen Tripp (24:05):And so, we want to make the questions about what your benefits cover and how you understand what's available to you in your plan. We want to make that really easy and we want to make it so that you don't have to have a PhD in insurance language to be able to ask the properly formatted question. As you know, the foundation models are terrific at that problem. So that's one.Eric Topol (24:27):And that's a good one, that's very practical and very much needed. Yeah.Owen Tripp (24:32):The second one I'm really excited about, and I think this will also be near and dear to your heart, is AI has this ability to be sort of nonjudgmental in the best possible way. And so, if we have a patient on a plan to manage hypertension or to manage weight or to manage other elements of a healthy lifestyle. And here we're not talking about deep science, we're just talking about what we've known to work for a long period of time. AI as a coach to help follow through on those goals and passively take data on how you're progressing, but have behind it the world's greatest medical team to be able to jump in when things become more acute or more complex. That's an awesome tool that I think every person needs to be carrying around, so that if my care plan or if my goal is about sleeping better, if my goal is about getting pregnant, if my goal is about reducing my blood pressure, that I can do that in a way that I can have a conversation where I don't feel as a patient that I'm screwing up or letting somebody down, and I can be honest with that AI.Owen Tripp (25:39):So I'm really excited about the potential for the AI as an adjunct coach and care team manager to continue to proceed along with that member with medical support behind that when necessary.Eric Topol (25:55):Yeah, I mean there's a couple of things I'd say about that. Firstly, the fact that you're thinking it from the patient perspective where most working in AI is thinking it from the clinician perspective, so that's really important. The next is that we get notifications, and you need to not sit every hour or something like that from a ring or from a smartwatch or whatever. That isn't particularly intelligent, although it may be needed. The point is we don't get notifications like, what was your blood pressure? Or can you send a PDF of your heart rhythm or this sort of thing. Now the problem too is that people are generating lots of data just by wearing a smartwatch or a fitness band. You've got your activity, your sleep, your heart rate, and all sorts of things that are derivatives of that. No less, you could have other sensors like a glucose monitoring and on and on. No less your electronic health record, and there's no integration of any of this.Eric Topol (27:00):So this idea that we could have a really intelligent AI virtual coach for the patient, which as you said could have connects with a physician as needed, bringing in the data or bringing in some type of issue that the doctor needs to attend to, but it doesn't seem like anything is getting done. We have the AI capabilities, but nothing's getting done. It's frustrating because I wrote about this in 2019 in the Deep Medicine book, and it's just like some of the most sophisticated companies you would think Apple, for the ring Oura and so many others. They have the data, but they don't integrate anything, and they don't really set up notifications for patients. How are we going to get out of this rut?Owen Tripp (27:51):We are producing oil tankers of data around personal experience and not actually turning that into positive energy for what patients can do. But I do want to be optimistic on this point because I actually think, and I shared this with you when we last saw each other. Your thinking was ahead of the time, but foundational for people like me to say, we need to go actually make that real. And let me explain to you what I mean by making it real. We need to bring together the insight that you have an elevated heart rate or that your step count is down, or that your sleep schedule is off. We need to bring that together with the possibility of connecting with a medical professional, which these devices do not have the ability to do that today, and nor do those companies really want to get in that business. And also make that context of what you can afford as a patient.Owen Tripp (28:51):So we have data that's suggestive of an underlying issue. We have a medical team that's prepared to actually help you on that issue. And then we have financial security to know that whatever is identified actually will be paid for. Now, that's not a hard triangle conceptually, but no one of those companies is actually interested in all the points of the triangle, and you have to be because otherwise it's not going to work for the patient. If your business is in selling devices. Really all I'm thinking about is how do I sell devices and subscriptions. If my business is exclusively in providing care, that's really all I'm thinking about. If my business is in managing risk and writing insurance policies, that's really all I'm thinking about. You have to do all those three things in concert.Eric Topol (29:34):Yeah, I mean in many ways it goes back to what we were talking about earlier, which is we're in this phenomenal era of information to the fifth power. But here we are, we have a lot of data from multiple sources, and it doesn't get integrated. So for example, a person has a problem and they don't know what is the root cause of it. Let's say it's poor sleep, or it could be that they're having stress, which would be manifest through their heart rate or heart rate variability or all sorts of other metrics. And there's no intelligence provided for them to interpret their data because it's all siloed and we're just not really doing that for patients. I hope that'll happen. Hopefully, Included Health could be a lead in that. Maybe you can show the way. Anyway, this has been a fun conversation, Owen. It's rare that I've talked in Ground Truths with any person running a company, but I thought yours.Eric Topol (30:36):Firstly, I didn't know anything about it and it's big. And secondly, that it's a kind of a unique model that really I'm hoping that others will get involved in and that someday we'll all be included. Maybe not with Included Health, but with better healthcare in this country, which is certainly not the norm, not the routine. And also, as you aptly pointed out at terrible costs with all sorts of waste, unnecessary tests and that sort of thing. So thanks for what you're doing and I'll be following your future efforts and hopefully we can keep making some strides.Owen Tripp (31:15):We will. And I wanted to say thanks for the conversation too and for your thinking on these topics. And look, I want to leave you just with a quick dose of optimism, and you and I both know this. The American system at its best is an extraordinary system, unrivaled in the world, in my opinion. But we do have to have more people included. All the services need to be included in one place. When we get there, we're going to really see what's possible here.Eric Topol (31:40):I do want to agree with you that if you can get to the right doctor and if you can afford it, that is ideally covered by your insurance. It is a phenomenal system, but getting there, that's the hard part. And every day people are confronted. I'm sure, thousands and thousands with serious condition either to get the diagnosis or the treatment, and they have a really rough time. So anyway, so thank you and I really appreciate your taking the time to meet with me today.****************************************************************Thanks for listening, watching, reading and subscribing to Ground Truths.An update on Super Agers:It is ranked #5 on the New York Times bestseller list (on the list for 4th time)https://www.nytimes.com/books/best-sellers/advice-how-to-and-miscellaneous/New podcastsPBS Walter Isaacson, Amanpour&Co Factually, With Adam ConoverPeter Lee, Microsoft Researchhttps://x.com/MSFTResearch/status/1943460270824714414If you found this interesting PLEASE share it!That makes the work involved in putting these together especially worthwhile.Thanks to Scripps Research, and my producer, Jessica Nguyen, and Sinjun Balabanoff for video/audio support.All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don't hesitate to post comments and give me feedback. Let me know topics that you would like to see covered.Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. Get full access to Ground Truths at erictopol.substack.com/subscribe
What does it truly mean to grow as a doctor, not just in skill, but in humanity? In this powerful episode, Dr. Tarek Souaid joins us to discuss his book How Doctors Grow and reflect on the emotional journey of becoming a physician. From the high-stakes environment of the Cleveland Clinic to the quiet moments that shaped his empathy, Dr. Souaid opens up about what medical training often overlooks: the importance of emotional intelligence, patient connection, and self-care. We dive into the common communication pitfalls young doctors face, how to foster meaningful doctor-patient relationships, and why burnout continues to plague the profession. Dr. Souaid also shares insights on navigating stress during residency and how institutions can better support physician wellbeing. Whether you're in medicine or simply curious about its human side, this episode is a thoughtful exploration of growth, resilience, and purpose. #HowDoctorsGrow #MedicalHumanism #PhysicianWellbeing #EmpathyInMedicine #DoctorBurnout #EmotionalIntelligence #ResidencyLife #MedicalTraining #DoctorPatientRelationship #HealthcareLeadership #NarrativeMedicine #ClevelandClinic #MedicalEducation #HumanSideOfMedicine #PhysicianGrowth
Artificial Intelligence, or AI in healthcare, is experiencing a rise in new technologies and applications. Generative AI, more specifically, is a form of artificial intelligence that's trained to find patterns in data and then generate new content. AI can enhance patient care, optimize clinical workflows, and drive innovation-while maintaining transparency and ethical integrity. But no matter how innovative and revolutionary the application, the future of AI in healthcare - and its successful adoption - is driven by patient trust.rnrnNow, leadership from MetroHealth, the Cleveland Clinic, AI Center of Excellence, WellLink, and Ohio Health Literacy Partners are coming together on the City Club stage to discuss real-world applications, challenges, and strategies for fostering trust in AI-driven healthcare transformation.
Brendan Fortuner from Ambience Healthcare and Ben Shahshahani from Cleveland Clinic discuss how AI is transforming medical documentation and coding in a healthcare system that spends $1 trillion annually on administrative tasks. They explore Ambience's technical breakthrough using OpenAI's Reinforcement Fine-Tuning to achieve medical coding accuracy that exceeds human doctors by 12 percentage points, including their specialty-by-specialty approach and solutions to reward hacking behavior. The conversation reveals key insights about AI deployment strategy, including how Cleveland Clinic achieved 75% voluntary adoption across 4,000 physicians after requiring just a single use of the AI scribe. This case study demonstrates what it takes to successfully implement AI tools in complex, high-stakes healthcare environments where user skepticism and regulatory requirements create significant deployment challenges. Sponsors: Oracle Cloud Infrastructure: Oracle Cloud Infrastructure (OCI) is the next-generation cloud that delivers better performance, faster speeds, and significantly lower costs, including up to 50% less for compute, 70% for storage, and 80% for networking. Run any workload, from infrastructure to AI, in a high-availability environment and try OCI for free with zero commitment at https://oracle.com/cognitive The AGNTCY: The AGNTCY is an open-source collective dedicated to building the Internet of Agents, enabling AI agents to communicate and collaborate seamlessly across frameworks. Join a community of engineers focused on high-quality multi-agent software and support the initiative at https://agntcy.org NetSuite by Oracle: NetSuite by Oracle is the AI-powered business management suite trusted by over 42,000 businesses, offering a unified platform for accounting, financial management, inventory, and HR. Gain total visibility and control to make quick decisions and automate everyday tasks—download the free ebook, Navigating Global Trade: Three Insights for Leaders, at https://netsuite.com/cognitive PRODUCED BY: https://aipodcast.ing CHAPTERS: (00:00) About the Episode (04:05) Introduction and Backstory (05:20) Ambiance Healthcare Overview (07:53) AI Adoption in Healthcare (11:11) Documentation Pain Points (Part 1) (16:11) Sponsors: Oracle Cloud Infrastructure | The AGNTCY (18:11) Documentation Pain Points (Part 2) (19:00) Product Architecture Deep Dive (26:23) Technical Evolution and Specialization (Part 1) (32:05) Sponsor: NetSuite by Oracle (33:28) Technical Evolution and Specialization (Part 2) (33:50) Healthcare Coding Challenges (48:37) Reinforcement Fine-Tuning Implementation (58:13) Task Prioritization Framework (01:08:40) Adoption Strategies Culture (01:12:12) Cost Lessons Grader Selection (01:18:33) Future Directions Patient Products (01:24:53) Closing Thoughts Opportunities (01:27:58) Outro
The Cleveland Clinic is in the third year of a first-of-its-kind brain study that was launched in 2022. The aim of the study is to identify biomarkers for neurological disorders earlier and either slow the progression or stop the progression all together. It's estimated that 1 in 6 people worldwide live with a neurological disorder—a broad term that can include Alzheimer's, epilepsy, multiple sclerosis, Parkinson's, and stroke among others. The study is expected to last for 20 years. Currently, more than 3,500 people from 46 states including Northeast Ohio are taking part in the study. But more participants are needed. Later, we talk to historian and author Brandy Schillace, Ph.D., about her new book, “The Intermediaries: A Weimar Story.” The book traces the story of the founding of the Institute for Sexual Science, the world's first center for homosexual and transgender rights. We conclude the show with the latest episode of our podcast, “Shuffle.”
Are you struggling with symptoms of hyperthyroidism like anxiety, insomnia, or heart palpitations? In this video, Dr. Anshul Gupta, a functional medicine expert and former Cleveland Clinic physician, shares a science-backed herbal tea recipe that may help support your thyroid health naturally.This herbal tea uses lemon balm, bugleweed, and motherwort—three powerful herbs shown in research to help calm the thyroid, reduce anxiety, and support better sleep without harsh side effects.Don't forget to Like, Subscribe & Share with someone who needs this!Buy Advanced Thyroid Wellness Bundle -https://functionalwellbeingshop.com/collections/thyroid-bundle/products/advanced-thyroid-wellness-bundle?variant=50481711055129Consult Dr. Anshul Gupta from anywhere in the world for personalized, root-cause solutions to your thyroid and health concerns." link below for booking consultation.Work With Me -https://www.anshulguptamd.com/work-with-me/Don't forget to like, subscribe, and hit the notification bell for more health tips and treatments from Dr. Anshul Gupta.Take The Thyroid Quiz & Evaluate Your Thyroid Health -https://www.anshulguptamd.com/thyroid-quiz/To Buy Good Quality Supplements Goto -https://functionalwellbeingshop.com/To Buy Good Quality Supplements Goto (For India) -https://www.drguptafunctionalcenter.com/shop/Free Gift 3-day Mito-Thyroid Diet Meal Plan) -https://reversinghashimotobook.com/3-day-meal-planCheck Out More Useful Videos -1 Cup of This Alkaline Water STOPS Inflammation (Backed by Science)https://youtu.be/R-4C2j9wQk8?si=f69QRm19p09r4AOd#1 Natural Supplement For Inflammation & Thyroid (Stronger Than Turmeric)https://youtu.be/jtB_Qryb5fw?si=9gF2LRPRRprOI9VY#1 Habit To Get Rid Of Gut Inflammation (Don't Ignore) -https://youtu.be/0CoXDrgAFFk#1 Natural Remedy To Clear Mucus And Beat Allergies -https://youtu.be/dteX2hOjpBcConnect With Me -Instagram - https://www.instagram.com/anshulguptamd/WhatsApp - https://whatsapp.com/channel/0029VbAWez9HAdNSEf2Wse2rTwitter - https://www.twitter.com/anshulguptamdFacebook - https://www.facebook.com/drguptafunct0:00 – Introduction & Caution 1:07 – What is Hyperthyroidism? 2:00 – 3 Powerful Herbs That Help 4:04 – Herbal Tea Recipe & How to Make It 4:42 – When to Drink & Final Tips 5:05 – ConclusionFor personalized thyroid treatment plans and expert guidance, reach out to Dr. Anshul Gupta.Our approach focuses on holistic and sustainable methods to manage thyroid health and enhance energy levels.Connect With Me -Instagram - https://www.instagram.com/anshulguptamd/Twitter - https://www.twitter.com/anshulguptamdFacebook - https://www.facebook.com/drguptafunctPinterest - https://www.pinterest.com/anshulguptamdTo Buy Good Quality Supplements Goto -https://functionalwellbeingshop.com/Work With Me -https://www.anshulguptamd.com/work-with-me/Take The Thyroid Quiz & Evaluate Your Thyroid Health -https://www.anshulguptamd.com/thyroid-quiz/About Dr.Anshul Gupta MD -Dr. Anshul Gupta Md Is a Board-certified Family Medicine Physician, With Advanced Certification In Functional Medicine, Peptide Therapy, And Also Fellowship training in Integrative Medicine. He Has Worked At The Prestigious Cleveland Clinic Department Of Functional Medicine As Staff Physician Alongside Dr. Mark Hyman. He Believes In Empowering His Patients To Take Control Of Their Health And Partners With Them In Their Healing Journey.He Now Specializes As A Thyroid Functional Medicine Doctor, And Help People Reverse Their Unresolved Symptoms Of Thyroid Dysfunction.
Claudio Milstein, PhD joins the podcast to discuss the concept of unified care in managing voice, swallowing, and upper airway disorders. Dr. Milstein explains the importance of interdisciplinary collaboration in optimizing patient outcomes and shares details about an exciting upcoming CME on unified care.
In this episode of Better Buildings for Humans, host Joe Menchefski sits down with Stephen Parker, architect and mental health planner at Stantec, to explore the power—and responsibility—of trauma-informed design. Stephen shares how his personal and professional experiences have fueled his mission to create spaces that foster safety, dignity, and belonging for people in crisis. From veterans living with PTSD to individuals overcoming addiction, Stephen explains why the built environment is never neutral—and how even simple details like door placement, daylight, and acoustic privacy can make or break a healing experience. They also discuss cultural competency, the hidden triggers in institutional settings, and the crucial role of co-design with communities. This conversation is a masterclass in designing buildings that heal not just bodies, but hearts and minds.More About Stephen ParkerStephen Parker is a dedicated Mental + Behavioral Health Planner with significant healthcare projects across the US, Canada, China, Kenya, Australia and India. A Royal Institute of British Architects (RIBA) Rising Star, Parker is a proponent of “architect as advocate” for colleague, client, and community alike, he believes strongly in leadership through service. Stephen has served a diverse client base, including the Cleveland Clinic, Kaiser Permanente, and the U.S. Department of Veterans Affairs, helping develop the VA's new Inpatient Mental Health Design Guide. An accomplished design researcher and pro bono community designer, Stephen is a Behavioral Health Business Future Leader, AIA AAH Best Healthcare Designer Under 40, ENR Top 20 Under 40 Young Professional, HCD Rising Star, HFSE George Pressler Under 40 Award recipient, and ULI Health Leader. Stephen championed the AIA Strategic Council's Mental Health + Architecture during the pandemic and is a US representative to the International Union of Architects' Public Health Group. He currently serves as Associate Director for the Design in Mental Health Network headquartered in England, Founding Member of the Center of Health Design's Behavioral & Mental Health Environment Network, among other service leadership roles at organizations advocating for mental health environments from the Arctic to Australasia.CONTACT:https://www.stantec.com/en/people/p/parker-stephen https://healthcaredesignmagazine.com/trends/2024-hcd-conference-preview-evolving-crisis-care-models-in-behavioral-health/67229/ https://www.stantec.com/en/projects/united-states-projects/s/southeast-psychiatric-treatment-center-norristown-state-hospitalhttps://www.mentalhealthdesignandbuild.com/story/44645/drawn-together-through-lived-experiencehttps://www.stantec.com/en/projects/united-states-projects/w/womens-hospital-perinatal-mental-health-unithttps://urbanland.uli.org/planning-design/returning-home-advancements-in-mental-health-design-for-u-s-veteran-facilitieshttps://www.ribaj.com/intelligence/rising-stars-2024-stephen-parkerWhere To Find Us:https://bbfhpod.advancedglazings.com/www.advancedglazings.comhttps://www.linkedin.com/company/better-buildings-for-humans-podcastwww.linkedin.com/in/advanced-glazings-ltd-848b4625https://twitter.com/bbfhpodhttps://twitter.com/Solera_Daylighthttps://www.instagram.com/bbfhpod/https://www.instagram.com/advancedglazingsltdhttps://www.facebook.com/AdvancedGlazingsltd
In this episode of Tales From the Heart host Lisa Salberg speaks with Dr. Jeff Bennett with the Cleveland Clinic discusses HCM in people who are young. This conversation was recorded June 27, 2025.
In this episode, guest host Rachel Alexandria talks with Katy Rose, a functional medicine diagnostic nutritionist and health educator. Katy talks about what her soul has shared with her on her journey: “trauma becomes wisdom, wisdom becomes joy.” From a near-death experience to multiple debilitating illnesses, Katy's remarkable journey has shown her how taking care of her health has little to do with vanity, and is actually the path to fulfilling her sacred purpose and her soul's agenda. Rachel and Katy discuss how going through suffering and sitting in wisdom allows us to get out of our heads, into our bodies, and into our full being-ness. Bios: Rachel Alexandria, MFA, MA, helps high performers out of their secret messes like overwhelm, anxiety, perfectionism, and people pleasing, so they can finally feel peace in the midst of their big work. A former Psychotherapist turned Soul Medic, she offers concierge care for the soul and psyche so her clients can build healthier relationships where they can care without carrying other people's energy. Rachel has written three books on difficult conversations, inner critics, and stress relief. Her clients range from CEOs to General Counsels to multi-million-dollar business owners who say, "I wish I had a pocket Rachel with me all the time!” Find more about Rachel at www.rachelalexandria.com Katy Rose is a Functional Medicine Diagnostic Nutritionist & Health Educator with formal certification through The Functional Medicine Coaching Academy, in partnership with The Cleveland Clinic's acclaimed Institute of Functional Medicine. My work is based in the body's natural ability to heal chronic disease and slow the aging process through nutrition and lifestyle support. My clients learn how they can begin to engage simple lifestyle adjustments (just “a smidge a day”) to lay the groundwork for a lifetime of change and wellness. Find more about Katy at www.katyrose-coaching.com The Asked and Answered by Soul podcast is dedicated to helping you understand that your Soul is the answer. To learn more about your soul's answers and purpose, access your free guide at www.themythsofpurpose.com. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this week's episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? Spoiler: It's more complicated than it seems. We've invited two palliative care doctors to talk about survivorship with us: Laura Petrillo, a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker, an outpatient palliative care doctor at the Cleveland Clinic. This episode is a must-listen for those navigating the evolving landscape of cancer care, and asking not just how we treat cancer, but how we support people who are living with it. If you want some further reading on survivorship, check out some of these articles: A NEJM article titled “Time to Study Metastatic-Cancer Survivorship” A ASCO publication that includes a section on survivorship - Patient-Centered Palliative Care for Patients With Advanced Lung Cancer A webinar on survivorship - Blending Survivorship and Palliative Care (NCI)
Frank McGillin, CEO of The Clinic by Cleveland Clinic, shares how they are using the increasing speed of technology to help doctors around the country gain access to top experts when dealing with a tough diagnosis.Statistics show 72% of doctors initiate conversations about second opinions, and 95% of doctors support them when patients ask for a second opinion. The Clinic by Cleveland Clinic has a streamlined process to get the patient's information to a leading expert in the needed area and back to the local doctor in a matter of days. This allows for quicker movement on a treatment plan and saves patient travel time. To learn more go to ClinicByClevelandClinic.comTo learn more go to ClinicByClevelandClinic.com Visit ConfidenceThroughHealth.com to find discounts to some of our favorite products.Follow me via All In Health and Wellness on Facebook or Instagram.Find my books on Amazon: No More Sugar Coating: Finding Your Happiness in a Crowded World and Confidence Through Health: Live the Healthy Lifestyle God DesignedProduction credit: Social Media Cowboys
I am delighted to connect with Dr. Anshul Gupta today! Dr. Gupta is a best-selling author, speaker, researcher, and world expert on Hashimoto's. He educates people worldwide on reversing Hashimoto's disease. He is a Board-Certified Family Medicine Physician who worked at the prestigious Cleveland Clinic alongside Dr. Mark Hyman. In this episode, Dr. Gupta shares his personal story, and we discuss the root of autoimmunity, how Hashimoto's disease causes the slow destruction of the thyroid gland, and the impact of chronic stress, diet, and an imbalanced gut microbiome. We also discuss toxins and infections, labs to watch out for, fasting and thyroid disease, as well as medication options, peptides, and the issues surrounding iodine supplementation. I sincerely hope you enjoy listening to today's conversation with Dr. Gupta as much as I did recording it! IN THIS EPISODE YOU WILL LEARN: How Dr. Gupta's personal health journey sparked his passion for thyroid issues. What is autoimmunity, and what is Hashimoto's? How increasing doses of thyroid medication indicates a deterioration of the thyroid gland Dr. Gupta shares five major root causes of Hashimoto's. Gluten and dairy, and how they impact the thyroid gland Why are heavy metals such a big issue? Impact of exposure to mold and mycotoxins. Epstein-Barr virus and how it interacts with the thyroid to make people more susceptible to Hashimoto's. How does exposure to stress impact thyroid function? Natural ways to detoxify the body Dr. Gupta talks about lab testing for the thyroid and Hashimoto's. Benefits of fasting for mitochondrial health, particularly for people with thyroid issues Different medication options for people with Hashimoto's, including peptides and LDN (low-dose naltrexone) Dr. Gupta shares his thoughts on iodine. Connect with Cynthia Thurlow Follow on X Instagram LinkedIn Check out Cynthia's website Connect with Dr. Anshul Gupta On his website YouTube and other social media (@AnshulGuptaMD)
Amber Spradlin, Aliza Sherman, & Amy Hooper ////// UpdatesPart 1 of 1 www.TrueCrimeGarage.comThis week from the Garage, we are very happy to be bringing to you major updates in three cases that we have covered. 38 year old Amber Spradlin was killed at an after work party sometime in the night of June 18, 2023. True Crime Garage covered this case in July of 2023 with episode #687. Since, arrests have been made and trial dates have been set. In 2013 Cleveland Clinic nurse Aliza Sherman was killed in downtown Cleveland in broad daylight. Back in December of 2017 we covered his “stranger than fiction” true crime story in a four part series. These were episodes #167 to #170. As we predicted Aliza Sherman's divorce attorney Gregory Moore was arrested and charged with her murder. In March of 1992, Amy Hooper was murdered in her Lincoln Village apartment on the westside of Columbus, Ohio. In December of 2025 Bruce Daniels was arrested for this homicide in Washington state. We are keeping a close eye on this one as it inches closer to the murder trial. Original True Crime Garage coverage: Aliza Sherman - December 2017 - Episodes 167 to 170Amy Hooper - April 2019 - Episodes 294 & 295 Amber Spradlin - July 2023 - Episode 687All are available on this feed - listen for FREE Beer of the Week - Mothman Double Imperial New England Style IPA from Ogopogo BrewingGarage Grade - 4 out of 5 bottle caps More True Crime Garage can be found on Patreon and Apple subscriptions with our show - Off The Record. Catch dozens of episodes of Off The Record plus a couple of Bonus episodes and our first 50 when you sign up today. True Crime Garage merchandise is available on our website's store page. Plus get True Crime Garage Pod art that you can post on your socials on our Media page. Follow the show on X and Insta @TrueCrimeGarage / Follow Nic on X @TCGNIC / Follow The Captain on X @TCGCaptain Thanks for listening and thanks for telling a friend. Be good, be kind, and don't litter!
The evidence for climate change is irrefutable. But how does surgical care contribute to global emissions, and is there anything we can do to make surgery more sustainable? Join Jon Williams and our ASGBI partners for the next installment of our BTK/ASGBI collaborative series, where we discuss how to make surgical care greener. Mrs. Cleo Kennington from the UK and Dr. Benjamin Miller from the US are our guest experts, and provide valuable insights into local sustainability efforts you can take home to your hospital, broader concepts of how high-quality care is sustainable, innovations in sustainability, and what the future of sustainable surgery may look like. After listening, you get to decide–Who has more sustainable surgical practices? The UK or US? Mrs. Cleo Kenington is a Consultant Emergency General and Trauma Surgeon at St George's Hospital, London and was the recent ASGBI Sustainability Lead. She is a big advocate for practicing what she preaches, focusing on how we can reduce the environmental impact at all stages, from cycling to work, preventing complications and unnecessary surgeries, to reducing the use of disposable surgical components. Dr. Benjamin Miller is a general and minimally invasive surgeon at the Cleveland Clinic, with a clinical focus on complex abdominal wall reconstruction. After earning his MD from University of Minnesota School of Medicine in 2011, Dr. Miller went to Nashville to complete his general surgery residency at Vanderbilt University Medical Center. Following this, he became a MIS/complex ab wall fellow at Cleveland Clinic, after which he joined as faculty in 2023. In addition to his clinical interests, Dr. Miller has a deep passion for sustainability efforts within surgical practice, carrying on the legacy of established sustainability efforts within surgical care at Cleveland Clinic and training the next generation of sustainable surgeons. If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative content. If you have any questions or comments, please feel free to reach out to us at hello@behindtheknife.org. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan Ellis as they review mesh materials used in hernia repair and the general properties surgeons who perform hernia repairs should know. Hosts: - Sara Maskal, MD, Cleveland Clinic - Ryan Ellis, MD, Cleveland Clinic - Benjamin T. Miller, MD, Cleveland Clinic - Michael Rosen, MD, Cleveland Clinic Learning Objectives: - Understand common mesh materials - Review properties of the different mesh materials - Understand how to apply knowledge of the different mesh properties to different patient scenarios References: - Ellis R, Miller BT. Mesh selection in abdominal wall reconstruction: an update on biomaterials. Surgical Clinics. 2023 Oct 1;103(5):1019-28. https://pubmed.ncbi.nlm.nih.gov/37709387/ - Krpata DM, Petro CC, Prabhu AS, Tastaldi L, Zolin S, Fafaj A, Rosenblatt S, Poulose BK, Pierce RA, Warren JA, Carbonell AM. Effect of hernia mesh weights on postoperative patient-related and clinical outcomes after open ventral hernia repair: a randomized clinical trial. JAMA surgery. 2021 Dec 1;156(12):1085-92. https://pubmed.ncbi.nlm.nih.gov/34524395/ - Rosen MJ, Krpata DM, Petro CC, Carbonell A, Warren J, Poulose BK, Costanzo A, Tu C, Blatnik J, Prabhu AS. Biologic vs synthetic mesh for single-stage repair of contaminated ventral hernias: a randomized clinical trial. JAMA surgery. 2022 Apr 1;157(4):293-301. https://pubmed.ncbi.nlm.nih.gov/35044431/ - Maskal S, Miller B, Ellis R, Phillips S, Prabhu A, Beffa L, Krpata D, Rosenblatt S, Rosen M, Petro C. Mediumweight polypropylene mesh fractures after open retromuscular ventral hernia repair: incidence and associated risk factors. Surgical Endoscopy. 2023 Jul;37(7):5438-43. https://pubmed.ncbi.nlm.nih.gov/37038022/ - Harris HW, Primus F, Young C, Carter JT, Lin M, Mukhtar RA, Yeh B, Allen IE, Freise C, Kim E, Sbitany H. Preventing recurrence in clean and contaminated hernias using biologic versus synthetic mesh in ventral hernia repair: the PRICE randomized clinical trial. https://pubmed.ncbi.nlm.nih.gov/33443907/ - Olavarria OA, Bernardi K, Dhanani NH, Lyons NB, Harvin JA, Millas SG, Ko TC, Kao LS, Liang MK. Synthetic versus biologic mesh for complex open ventral hernia repair: a pilot randomized controlled trial. Surgical Infections. 2021 Jun 1;22(5):496-503. https://pubmed.ncbi.nlm.nih.gov/33259771/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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