Podcasts about outpatient

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Best podcasts about outpatient

Latest podcast episodes about outpatient

FOAMcast -  Emergency Medicine Core Content
Primary Care Management of Pulmonary Embolism

FOAMcast - Emergency Medicine Core Content

Play Episode Listen Later Jan 15, 2022 14:02


Outpatient management of pulmonary embolism for low-risk patients has been encouraged for several years. However, little is known about pulmonary embolism diagnosed and managed exclusively in the outpatient setting. In this study, Vinson et al describe the course of patients diagnosed with PE and managed in the outpatient setting in an integrated healthcare delivery system. Shownotes/References: FOAMcast.org Thanks for listening! Lauren Westafer

ER-Rx: An ER + ICU Podcast
Episode 67- What options exist for outpatient COVID treatment?

ER-Rx: An ER + ICU Podcast

Play Episode Listen Later Jan 13, 2022 10:52


What are these new oral antiviral agents for COVID and how well do they work? We answer these questions and a few more this week. Click HERE to leave a review of the podcast!Subscribe HERE!References:All references for Episode 67 are found on my Read by QxMD collectionDisclaimer: The information contained within the  ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution,  seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of,  any medical institutions, educational facilities, or other healthcare programs.Support the show (https://www.buymeacoffee.com/errxpodcast)

Ron Paul Liberty Report
Dr. McCullough Bombshell: Covid Outpatient Treatments Being Suppressed!

Ron Paul Liberty Report

Play Episode Listen Later Jan 4, 2022 29:39


In a recent interview with the Epoch Times, Dr. Peter McCullough claimed that the US government is actively working to suppress any investigation of outpatient Covid treatments. As the Omicron variant appears to be infecting the vaccinated as well as the unvaccinated, the question increasingly being asked is why after two years are there no treatments? Also today, an insurance company CEO blows the whistle on a shocking increase in working-age deaths last year. Finally - a victory for Navy Seals suing for medical freedom.

The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
674: Why 3 days of outpatient remdesivir is probably not going to catch on

The Elective Rotation: A Critical Care Hospital Pharmacy Podcast

Play Episode Listen Later Dec 30, 2021 3:21


Show notes at pharmacyjoe.com/episode674. In this episode, I ll discuss why I think a recent study about 3 days of outpatient remdesivir is probably not going to catch on. The post 674: Why 3 days of outpatient remdesivir is probably not going to catch on appeared first on Pharmacy Joe.

UBC News World
Find The Best Behavioral And Psychological Care Outpatient Facility In Eatontown

UBC News World

Play Episode Listen Later Dec 29, 2021 2:24


The new state-of-the-art https://positivereseteatontown.com/ (Positive Reset) facility is now accepting new patients in Eatontown, providing a full range of care services to those in need. Get in touch today at (732) 724-1234.

Novant Health Healthy Headlines
From inpatient to outpatient: How leaders can navigate big changes in orthopedics

Novant Health Healthy Headlines

Play Episode Listen Later Dec 27, 2021 19:57


Regulatory changes have made it increasingly easier to perform orthopedic procedures in an outpatient setting. This shift was driven by the Centers for Medicare and Medicaid Services, or CMS, with a goal of reducing the national spend on health care and creating access at lower cost sites. Here to explain how health systems are navigating this change is Dr. Bryan Edwards, system physician executive at Novant Health Orthopedics and Sports Medicine Institute, and Zack Landry, system administrative executive at the Orthopedics and Sports Medicine Institute.

SHEA
Outpatient COVID-19 Oral Treatments & Other Therapeutics

SHEA

Play Episode Listen Later Dec 17, 2021 51:17


Overview: In this podcast, Dr. Christopher Crnich has an insightful conversation with Dr. Monica Mahoney and Dr. Jason Pogue around outpatient COVID-19 oral treatments and other therapeutics. They discuss monoclonal antibodies, including the current treatments and what is to potentially come, recently released Molnupiravir and Nirmatrelvir, and the impacts, challenges, and best practices around administering these to patients. Speakers: Christopher Crnich, MD, PhD (moderator) Monica Mahoney, PharmD, BCPS, BCIDP, FCCP Jason Pogue, PharmD, BCPS, BCIDP What do you think of our podcasts? Do you have topic or speaker suggestions? Let us know at https://learningce.shea-online.org/content/shea-podcast-feedback

The Hospital Finance Podcast
2022 Inpatient and Outpatient coding updates

The Hospital Finance Podcast

Play Episode Listen Later Dec 15, 2021 11:31


In this episode, we are joined by Sandy Brewton, Senior Healthcare Consultant at Panacea Healthcare Solutions, to talk about both inpatient and outpatient coding changes that will affect you in 2022. Learn how to listen to The Hospital Finance Podcast® on your mobile device. Highlights of this episode include: How many new codes have been Read More

The Westerly Sun
Westerly Sun - 2021-12-14: Donald Panciera, Westerly Hospital's turnaround, and Ralph Parise

The Westerly Sun

Play Episode Listen Later Dec 14, 2021 3:24


You're listening to the Westerly Sun's podcast, where we talk about the best local events, new job postings, obituaries, and more. First, a bit of Rhode Island trivia. Today's trivia is brought to you by Perennial. Perennial's new plant-based drink “Daily Gut & Brain” is a blend of easily digestible nutrients crafted for gut and brain health. A convenient mini-meal, Daily Gut & Brain” is available now at the CVS Pharmacy in Wakefield. Now for some trivia. Did you know that Rhode Island native, Donald Panciera, was an American football quarterback, halfback, and defensive back in the All-America Football Conference and the National Football League? He played professionally for the New York Yankees, the Detroit Lions, and the Chicago Cardinals. In college, he played for the Boston College Eagles and the San Francisco Dons. Now for our feature story: The numbers tell the story of Westerly Hospital's turnaround and resurgence during the five years it has been part of the Yale New Haven Health system. Patrick Green, the hospital's president and CEO, discussed strides the facility has made during a recent interview. At the start of Yale's ownership in September 2016, Westerly Hospital posted 2,500 patient contacts per year. The number has grown to 4,580 this year. Outpatient patient contacts have grown from 102,000 in 2016 to 128,000 year. Surgeries performed at the hospital on Wells Street have increased from 280 to 700 per year, and the average daily patient census has grown from 29 to 62. Green attributes the growth to the Yale system's commitment to the Westerly region through expansion of programs and services, physician recruitment, investments in new medical equipment, as well as in renovations and other physical plant improvements. Green said: "Everything that we've done has really been following through on our commitment to this growth in Westerly Hospital and making it a viable hospital for the people of Westerly,"  In addition to new facilities, the hospital has added a state-of-the-art hospital pharmacy that meets the needs of both the cancer center and the hospital at large, acquisition of a da Vinci Xi Surgical System robot, and a complete upgrade of the cardiac catheter laboratory. In all, the Yale system injected more than $78 million into the facility during its first five years of ownership. For more about the coronavirus pandemic, the recovery, and the latest on all things in and around Westerly, head over to westerlysun.com. Today we're remembering the life of Ralph Parise. He was the devoted husband of Natalie for 59 years. Born in Westerly, Ralph worked locally as a union mason for many years until his retirement. He was a communicant of Our Lady of Victory Church and a US Army Veteran. Ralph was a life member of the Westerly Yacht Club, the Calabrese Society and the Westerly Lodge of Elks BPOE #678. He was also a member of the North End Social Club. His days were filled spending time with his family especially his granddaughter Grace. He always said "she was his angel from heaven". He will be dearly missed by his wife, his two children, his granddaughter as well as many nieces and nephews. Thank you for taking a moment with us today to remember and celebrate Ralph's life. That's it for today, we'll be back next time with more! Also, remember to check out our sponsor Perennial, Daily Gut & Brain, available at the CVS on Main St. in Wakefield! See omnystudio.com/listener for privacy information.

The Addiction Files
”To Admit or Not to Admit” Part 2 Outpatient Management of Alcohol Withdrawal

The Addiction Files

Play Episode Listen Later Dec 14, 2021 48:34


This episode discusses managing alcohol withdrawal syndrome in the outpatient setting. We review  appropriate patient selection with a  targeted history and stratification tools like the PAWSS scale. We discuss when patients should be admitted for medically managed withdrawal vs treatment options and evidence-based guidelines for  outpatient management. Hosted by Darlene Petersen, MD and Paula Cook, MD. Check us out on facebook @Theaddictionfiles or twitter @THEADDICTIONFI1 or Instagram  Theaddictionfiles No explicit language but this podcast discusses the abuse and treatment of legal and illegal drugs and may not be appropriate for all listeners.

Talk Ten Tuesdays
Reduce Revenue Leakage: An Important Role for Outpatient CDI

Talk Ten Tuesdays

Play Episode Listen Later Dec 7, 2021 58:31


Clinical documentation integrity (CDI) programs can have a broad impact in outpatient settings. One key area for outpatient CDI to consider is denials reduction, which begins with understanding what's contributing to denial risk.Denial reduction is really about denial prevention. It's about analyzing denials by category, by payer, and by reason to uncover trends for high-volume or high-dollar denials, then using that discovery to provide education about clinical documentation issues or gaps.In the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with the final segment of her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener's survey during the weekly Internet radio broadcast.The live broadcast will also feature these other segments:Tuesday Focus: Susan Gatehouse will report on the potential impacts of the new Edit 20 (Unspecified Code Edit) for inpatient claims opens up an opportunity for enhanced CDI with targeted education. The list of unspecified diagnosis codes, subject to the new edit, will require targeted training for your billing staff to avoid reimbursement issues, and provides a platform for improving CDI.News Update: Mary H. Stanfill, a new ICD10monitor correspondent focusing on ICD-11, will provide the latest update on the new code set looming on the horizon.The Coding Report: Laurie Johnson will report on the latest coding news that has appeared on her radar screen.  News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Mark Leeds DO On Addiction Treatment And Addiction Recovery
Inpatient Vs Outpatient Rehab: Do Inpatient and Outpatient Rehab Programs Work?

Mark Leeds DO On Addiction Treatment And Addiction Recovery

Play Episode Listen Later Dec 5, 2021 17:04


Questioning Medicine
Episode 186: 186. ACE vs ARB, Blood Clots, and Mifepristone

Questioning Medicine

Play Episode Listen Later Nov 30, 2021 17:38


Contraception 2021 Sep 20;[EPub Ahead of Print], D Grossman, S Raifman, N Morris, A Arena, L Bachrach, J Beaman, MA Biggs, C Hannum, S Ho, EB Schwarz, M GoldSTUDY DESIGNThis is an interim analysis of an ongoing prospective cohort study conducted at five sites. Clinicians assessed patients in clinic and, if they were eligible for medication abortion and ≤63 days' gestation, electronically sent prescriptions for mifepristone 200 mg orally and misoprostol 800 mcg buccally to a mail-order pharmacy, which shipped medications for next-day delivery. Participants completed surveys three and 14 days after enrollment, and we abstracted medical chart data for this interim analysis.  In this prospective cohort study, researchers estimated the effectiveness, feasibility, and acceptability of medication abortion with mifepristone dispensed by a mail-order pharmacy with next-day delivery after in-person clinical assessment. The researchers found that complete medication abortion occurred for 96.9% of participants; 88.4% reported being very satisfied receiving medications by mail, and 89.6% said they would use the mail-order service again if needed. Of the 4.9% who experienced adverse events, none were related to mail-order dispensing. This research suggests that mail-order pharmacy dispensing of mifepristone is effective and acceptable to patients, providing further evidence that the in-person dispensing requirement for this medication should be removed.  IMPLICATIONSThe in-person dispensing requirement for mifepristone, codified in the drug's Risk Evaluation and Mitigation Strategy, should be removed.      Stevens SM et al. Antithrombotic therapy for VTE disease: Second update of the CHEST Guideline and Expert Panel Report. Chest 2021 Aug 2; [e-pub]. (https://doi.org/10.1016/j.chest.2021.07.055)  The ninth edition of the CHEST Clinical Practice Guidelines for managing venous thromboembolism (VTE) — published in 2012 and updated in 2016 — now has a second update, which addresses 14 clinical questions and offers 32 guidance statements for clinicians who manage patients with VTE. The 2012 guideline (Chest 2012; 141:Suppl:e419S and the 2016 update (NEJM JW Emerg Med Feb 2016 and Chest 2016; 149:315) both are publicly available.Key Recommendations Patients with isolated subsegmental pulmonary embolism (PE): Rule out proximal deep venous thrombosis (e.g., with ultrasonography). If risk for recurrent VTE is low, surveillance is recommended over anticoagulation. If risk for recurrent VTE is high, anticoagulation is recommended. (Weak recommendation, low-certainty evidence) Patients with incidentally discovered asymptomatic PE (other than isolated subsegmental PE): Same initial and long-term anticoagulation that patients with symptomatic PE receive should be used. (Weak recommendation, moderate-certainty evidence) Patients with cancer-associated VTE: Direct-acting oral anticoagulants (DOACs; i.e., apixaban, edoxaban, or rivaroxaban) should be used for the treatment phase of therapy (strong recommendation, moderate-certainty evidence). Caveat: for patients with luminal gastrointestinal malignancies, apixaban or low-molecular-weight heparin is preferred to reduce bleeding risk. Patients with antiphospholipid syndrome: Warfarin (target international normalized ratio, 2.5) is recommended over DOAC therapy during the treatment phase for VTE. (Weak recommendation, low-certainty evidence) Catheter-assisted mechanical thrombectomy: Recommended for patients with PE and hypotension who also have high bleeding risk, failed systemic thrombolysis, or shock that is likely to lead to death before systemic thrombolysis can take effect. (Weak recommendation, low-certainty evidence) Initial anticoagulation setting: Outpatient treatment is recommended over hospitalization in patients with low-risk PE, if access to medications and outpatient care is available. (Strong recommendation, low-certainty evidence) Treatment-phase anticoagulants: DOACs are recommended over warfarin. (Strong recommendation, moderate-certainty evidence) Extended-phase therapy (beyond 3 months) for VTE: Extended anticoagulation should be offered to patients with unprovoked VTE — i.e., with no major or minor transient risk factors. Risk for recurrent VTE, risk for bleeding, and patients' values and preferences should be considered in decisions about extended anticoagulation therapy. (Strong recommendation, moderate-certainty evidence) Low-dose apixaban or rivaroxaban is recommended over full doses of these agents. (Weak recommendation, very low-certainty evidence) Aspirin is recommended for patients who are stopping anticoagulation. (Weak recommendation, low-certainty evidence) Ingason AB et al. Rivaroxaban is associated with higher rates of gastrointestinal bleeding than other direct oral anticoagulants: A nationwide propensity score–weighted study. Ann Intern Med 2021 Oct 12; [e-pub]. (https://doi.org/10.7326/M21-1474) The study used icelands National databank to compare GI bleeding among almost 6000 patients receiving  apixaban, dabigatran, and rivaroxaban for the first time.  Patients were followed for 1-1/2 years and GI bleeding was verified by review of the medical records.  Once there was a propensity score analysis it was deemed that rivaroxaban had significantly high rates of minor and major gastrointestinal bleeding compared to apixaban with a number needed to treat of around 40 or 50.  However there was no difference between rivaroxaban and dabigatran.  I think this goes to what we have all seen and that the bleeding risk among most anticoagulate medications is not equal but unfortunately which medication the insurance companies will pay for it is also not equal.  However if your patient is at large risk for GI bleed likely should consider not using rivaroxaban                     Chen R et al. Comparative first-line effectiveness and safety of ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers: A multinational cohort study. Hypertension 2021 Sep; 78:591. (https://doi.org/10.1161/HYPERTENSIONAHA.120.16667) In this retrospective study of patients who initiated monotherapy for hypertension, researchers used eight large observational databases to compare outcomes for 2.3 million new users of ACE inhibitors and nearly 700,000 new users of ARBs.  Myocardial infarction, stroke, and heart failure occurred with similar frequency in the two groups, after extensive adjustment for demographic and clinical variables. However, cough, angioedema, pancreatitis, and gastrointestinal bleeding occurred significantly more often in ACE-inhibitor users than in ARB users.            Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism: A Systematic Review and Meta-analysis: Annals of Internal Medicine: Vol 174, No 10 (acpjournals.org) What happens if you extend anticoagulation past the 3 to 6 months for an individual who has a first unprovoked venous thromboembolism.  Often this is a debate in the clinical practice of while you seem low risk so maybe we should discontinue this anticoagulation or well you had his lab value is off to me we should continue anticoagulation.  The scary thing is you do not want to discontinue the anticoagulation and the may have a massive saddle embolism and die!  It is easy to start a medication but it is always so hard to stop the medication.  this study looked at that exact question --it looked at 14 randomized control trials and 13 cohort studies with just over 17,000 patients taking either vitamin K antagonist or DOACs.  The patient had to have received a minimum of at least 9 months of anticoagulation in order to be enrolled in the final analysis and they looked at patients who had had extended anticoagulation up to 5 years.In the end the incidence of major bleeding with warfarin was 1.7 events per year per 100 patients and much lower with the DOACs at 1.12 events per year per 100 people.  While that does not sound like a lot with the newer agents he has remember that is only after 1 year if he looked at the 5-year cumulative incidence of major bleeding for those individuals on either warfarin or a DOAC it was 6.3% which is certainly at significant risk of bleeding especially when you consider that the case fatality rate was 8.3% expirationThat was a whole bunch of numbers but basically I guess with this meta-analysis is really saying is that the current recommendations for anticoagulation after a unprovoked venous thromboembolism are 3 to 6 months and if you are going to extend that out to 9 months or a year or even up to 5 years he better have a darn good reason given that the eventual rates of bleeding are so high and the mortality rate from those bleeds are also so high.  

DMH UCLA Public Mental Health Partnership
Assisted Outpatient Training (AOT) 101 Training, Part 3

DMH UCLA Public Mental Health Partnership

Play Episode Listen Later Nov 29, 2021 116:16


This series of trainings begin by outlining the AOT statute, criteria, referral process, and components for outreach and engagement for FSP providers. During Part 2, there will be an emphasis on processes for enrolled clients, from AOT specific measures to navigation of levels of care. The final training will detail how to draft declarations, progress reports, and testimony for court proceedings that interact with AOT clientele. This three part training will utilize skill building activities, comprehensive quizzes, and dynamic discussion to ensure that these key learning objectives are met. Part 3.

The ACDIS Podcast: Talking CDI
Outpatient CDI: Prospective chart reviews

The ACDIS Podcast: Talking CDI

Play Episode Listen Later Nov 23, 2021 30:33


Today's guest is Leyna Belcher, MSN, RN, CCDS, CCDS-O, enterprise system CDI educator for WVU Medicine in West Virginia. Today's show is co-hosted to Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, the CDI education director at HCPro/ACDIS in Middleton, Massachusetts. Today's show is supported by 3M Health Information Systems. 3M Health Information Systems, now with M*Modal, delivers innovative software and consulting services designed for a wide range of healthcare environments. From closing the loop between clinical care and revenue integrity, to computer-assisted coding, clinical documentation integrity and performance monitoring, 3M can help you reduce cost and provide more informed care. Featured solution: Today's featured ACDIS solution is ACDIS Pro. Just like the printed ACDIS Pocket Guide, this online portal provides all of the detail, explanation, and content you have come to trust and expect from the ACDIS team but is updated in real-time to keep you at the forefront of the CDI industry! Easily access all the query, coding, and documentation resources you love and need every day – anywhere, any time! This new, fully customizable, easy to navigate online portal can be accessed on any device – pull it up on your phone in a meeting to make sure you have the right code, access it on the go while talking to a physician, or from your office! With the ability to add your own personal notes directly into conditions for easy reference, ACDIS PRO will become your favorite reference. Click here to learn more or purchase access.  (http://ow.ly/Q5m830s1BMn)   In the News: “Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS” from the Office of the Inspector General (http://ow.ly/MJQ530s1BO8) ACDIS update: CDI Week 2021 Q&A: Ordering takeout | Outpatient CDI with Leyna Belcher (http://ow.ly/Uv9q30s1BN0)   Send us a picture of your ACDIS Pocket Guide in the wild! (http://ow.ly/jMCH30s1BOj)

Core IM | Internal Medicine Podcast
#93 Hyperkalemia in CKD: Mind the Gap Segment

Core IM | Internal Medicine Podcast

Play Episode Listen Later Nov 17, 2021 30:18


What degree of hyperkalemia makes you worried enough to send your patient to the ED? Are ECG changes sensitive in detecting hyperkalemia? Do you know how to advise your patient on dietary changes? What medications can you effectively use in the outpatient setting?Show notes, Transcript and References: https://www.coreimpodcast.com/2021/11/17/hyperkalemia-mind-the-gap-segment/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps01:01 Introductions07:58 Nutrition17:13 Medications20:48 Outpatient medications26:16 RecapTags: IM Core, CoreIM, outpatient, blood work, diet, electrolytes, ECG, nephrology, chronic kidney disease, nutrition

REBEL Cast
REBEL Cast Ep103: Outpatient COVID-19 Therapy

REBEL Cast

Play Episode Listen Later Nov 15, 2021 32:04


I was fortunate enough to record a podcast on Rob Orman's, Stimulus podcast on Oct 14th, 2021.  We both felt it was an important enough topic that we should post it on both his and my site.  The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing.  In this podcast ... Read more The post REBEL Cast Ep103: Outpatient COVID-19 Therapy appeared first on REBEL EM - Emergency Medicine Blog.

Talk Ten Tuesdays
Exclusive: Outpatient CDI in the Emergency Department

Talk Ten Tuesdays

Play Episode Listen Later Nov 9, 2021 29:25


Is the emergency department (ED) an outpatient CDI priority for your organization? The emergency department is the main source of admissions to a hospital – and the first location patients typically receive care. What should you consider when determining how an outpatient CDI program could support quality patient care, proper payment, and complete and accurate data?   During the next live edition of Talk Ten Tuesdays, outpatient CDI expert Colleen Deighan will return with another installment in her popular series on a subject that continues to generate listener interest and questions. Deighan will also conduct a listener's survey during the weekly Internet radio broadcast.The live broadcast will also feature these other segments:Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, wraps up her four-part series on the impact of coding on severe maternal morbidity with a discussion about the intersection of coding and clinical indicators. Conditions specifically in the crossfire are sepsis, acute kidney injury, and coagulation disorders. Pollard will address which data the maternal collaboratives want to track and how you can incorporate these initiatives into existing CDI programs. The Coding Report: Laurie Johnson will report on the outcome of the recent ICD-10 Coordination and Maintenance Committee meeting.  RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional-turned-well-known healthcare IT authority, will report on the most recent final payment rules released by CMS on Tuesday.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Voices of UMassMed
Celebrating the new VA community-based outpatient clinic at UMass Chan

Voices of UMassMed

Play Episode Listen Later Nov 9, 2021 67:55


The VA Central Western Massachusetts Healthcare System and UMass Chan Medical School hosted a ribbon-cutting ceremony Monday, Nov. 8, to celebrate the opening of a new 48,000-square-foot community-based outpatient clinic for veterans located on the Medical School's campus in Worcester. You can listen to the entire press conference in the podcast. Learn more at: https://www.umassmed.edu/news/

Becker’s Healthcare -- Ambulatory Surgery Centers Podcast
Dr. Ravi Bashyal, Director of Outpatient Hip and Knee Replacement Surgery at NorthShore University HealthSystem

Becker’s Healthcare -- Ambulatory Surgery Centers Podcast

Play Episode Listen Later Nov 9, 2021 21:12


This episode features Dr. Ravi Bashyal, Director of Outpatient Hip and Knee Replacement Surgery at NorthShore University HealthSystem. Here, he discusses using robotics, what he's seeing internationally compared to the US with joint replacement, and more.

The Curbsiders Internal Medicine Podcast
#304 COVID Updates: The Outpatient Edition

The Curbsiders Internal Medicine Podcast

Play Episode Listen Later Nov 8, 2021 49:28


Who gets a COVID booster? Can we mix and match COVID vaccines?  What are monoclonal antibodies and when should we use them? What is molnupiravir and does it work? Shots for kids? Ready yourself to answer these questions and more with our guest, Dr. Monica Gandhi @MonicaGandhi9.  Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer and Writer: Isabel Valdez PA, Molly Heublein MD Infographic: Edison Jyang Cover Art:  Edison Jyang,  Isabel Valdez, PA Hosts: Molly Heublein MD, Chris Chui MD, Isabel Valdez PA Reviewer: Emi Okamoto MD Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com Guest: Monica Gandhi MD Sponsor: The American College of Physicians Join the American College of Physicians today! U.S. based post-training physicians can take advantage of a limited-time 20% membership discount. Visit acponline.org/ACPdiscount and use the code ACP20. Membership discount is available only through December 31, 2021.  Sponsor: Provider Solutions & Development Start the conversation or reach out to one of their career navigators today at info.PSDConnect.org/curbsiders  CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner, Picks of the Week* Case from Kashlak Covid Boosters Pfizer data Moderna Data DNA vaccines Pediatric Vaccines Monoclonal Antibodies Molnupiravir Dr Gandhi's crystal ball Outro

Saving Lives: Critical Care w/eddyjoemd
Paxlovid: An Outpatient Therapy to Potentially Reduce Hospitalizations (Saving Lives Video Podcast)

Saving Lives: Critical Care w/eddyjoemd

Play Episode Listen Later Nov 6, 2021 16:45


Pfizer has a new therapeutic Paxlovid (PF-07321332/ritonavir) to help patients stay out of the hospital. Is the cost worth the potential benefit? Show Notes: https://eddyjoemd.com/paxlovid Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom. Website: www.eddyjoemd.com Instagram: www.instagram.com/eddyjoemd Twitter: www.twitter.com/eddyjoemd Facebook: www.facebook.com/eddyjoemd Podcast: https://anchor.fm/eddyjoemd My Amazon store for resources you may find helpful: www.amazon.com/shop/eddyjoemd --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/eddyjoemd/support

High Intensity Health Radio with Mike Mutzel, MS
Longevity Drugs You Should Consider for Immune Health

High Intensity Health Radio with Mike Mutzel, MS

Play Episode Listen Later Nov 3, 2021 21:45


Metformin and Rapamycin, two popular longevity drugs, have been shown to support immune health in elderly and high-risk subjects as well as decrease mortality in persons infected with COVID-19. We discuss the science and rationale for prophylactic blood sugar health support in non-diabetics for longevity and immune health.  Support your fasting lifestyle with Berberine HCl & Alpha Lipoic Acid by by MYOXCIENCE Nutrition: https://bit.ly/berberine-biotin-ala-stack Use code Podcast to save Related Podcast: Latest Breakthroughs In the Biology of Aging with Matt Kaeberlein, PhD   Time Stamps: 0:00 intro 0:38 mTOR inhibitors 1:15 Low Side effect profile 2:19 Metformin and influenza 2:50 Metabolic and immune health are one in the same 3:15 Aging and Immune Competence 3:52 Microdosing mTOR inhibitors 4:31 Dog Aging Project 5:07 Aging and Immunity 6:10 T Cells are Essential 6:55 Metformin was initially helpful for Influenza 8:11 Why chronic inflammation is bad 9:39 Pulsing mTOR inhibitors 13:38 Electrolytes and Creatine 14:19 Drugs are not always bad 15:28 Poor blood sugar control is a problem 18:20 Metformin and B Vitamins 19:15 Metformin and C*19   Articles Mentioned: Bischof, E., C Siow, R., Zhavoronkov, A., & Kaeberlein, M. (2021). The potential of rapalogs to enhance resilience against SARS-CoV-2 infection and reduce the severity of COVID-19. The Lancet Healthy Longevity, 2(2), e105–e111. http://doi.org/10.1016/S2666-7568(20)30068-4   Bramante, C. T., Buse, J., Tamaritz, L., Palacio, A., Cohen, K., Vojta, D., et al. (2021). Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity. Journal of Medical Virology, 93(7), 4273–4279. Kruglikov, I. L., Shah, M., Elife, P. S.,. (2020). Obesity and diabetes as comorbidities for COVID-19: Underlying mechanisms and the role of viral–bacterial interactions. Elifesciences.org. metabolism, A. S. D.,. (2020). Metformin and COVID-19: from cellular mechanisms to reduced mortality. Nutrition, Metabolism and Cardiovascular Diseases. http://doi.org/10.1016/j.diabet.2020.07.006  

CRTonline Podcast
The King and I: Season2, Episode 16 | Colin Powell and Outpatient PCI

CRTonline Podcast

Play Episode Listen Later Nov 2, 2021 13:25


Ron Waksman, Spencer B. King, III

Feeding Fatty
Is The U.S. Healthcare System Failing Due to Greed, Ignorance, or Arrogance?

Feeding Fatty

Play Episode Listen Later Nov 2, 2021 69:02


Is The U.S. Healthcare System Failing Due to Greed, Ignorance, or Arrogance? Featuring Dr. Robert Yoho What's wrong with America's healthcare system? We are the richest most developed country in the world and we refuse to take care of our own. Even if you have decent insurance you have to fight for everything you get. Forget about those uninsured for whatever reason. We can and should be committed to doing much better. Let's start demanding more. Now!!! About Dr. Robert I was born in l953 in Richmond, Virginia, and grew up in Kent, Ohio, (known for the Kent State riots during the Vietnam war), was an Eagle Scout, and a Judo wrestler. I spent four years at Oberlin College and went to Small College National Championships in Varsity Wrestling my senior year. Then, was accepted at one of the finest medical schools in the United States, Case Western Reserve University in Cleveland, Ohio. At 22 years old, one year into my medical education, I decided that I needed to “find myself” and took a two-year sabbatical. After starting and managing a tree surgery business, I went to Wyoming to work on oil drilling rigs, and then spent the next year traveling to rock climbing areas. I became a master climber and traveled to cliffs in twelve states. Additionally, I published articles in climbing magazines and made “first ascents” at Devil's Tower, Wyoming, and Joshua Tree, California. I made an early ascent of “The Naked Edge,” a classic climb near Denver, and climbed the Long's Peak Diamond. As recently as the mid-1980s, I climbed such difficult classics as Astroman, the west face of El Capitan, and the Crucifix in Yosemite, free climbing up to a mid-“5.12” difficulty level. I climbed the Regular Northwest Face of Half Dome in 18 hours in 2004 and the Nose route on El Capitan in less than 24 hours in 2005. After returning to medical school in l978, I found that bodybuilding complemented my studies. With the added responsibility of specialty training and professional pressures, I had less opportunity for athletics in the past decade. However, I ran 14 triathlons in the late '80s and early '90s and made time for some Kempo Karate (though injuries sidelined me). I have practiced Astanga (flow) Yoga and trained with the legendary 70-year-old master Yogi, Frank White, at the “Center For Yoga” in Hollywood. More recently, I practiced Bikram Yoga and concluded, “it's way hot in there.” (105 to 115 degrees F). I currently practices Baptiste Yoga every day. I married a wonderful woman from Trinidad and had three kids. My son Alan became an All American cross country star in high school, and he and his twin Sarah graduated from Brown University. He now works at Google and Sarah at Nasdaq. Hannah, their older sister, managed a group at the Four Seasons Resorts by the time she was 24. Curriculum Vitae: cosmetic surgery career (now retired) DATE OF BIRTH October 3, 1953 INTERESTS Children, weight lifting, rock climbing, psychology, writing, kayak, Ashtanga and Bikram yoga. Bookworm: Reading averages 3 new books a week. Climbed El Capitan 4 x, Half Dome, Sentinel, Astroman (5.11c), Crucifix (5.12b) in Yosemite. New routes: a grade 5 in Zion and El Matador (5.11) at Devil's Tower, others at Joshua Tree. Climbed regular route on Half Dome in 17 hours 2004. EDUCATION 1971-1975 : Oberlin College Oberlin, Ohio 1975-1981: Case Western Reserve Univ. Medical School 10900 Euclid Ave, Cleveland, Ohio. 44106-4920 POSTGRADUATE TRAINING 1981 – 1982: Internal Medicine Internship R 1 year University of Cincinnati, Cincinnati, OH 1982 – 1983: Dermatology Residency R 2 years Hanover, New Hampshire at Dartmouth-Hitchcock Medical Center One Medical Center Drive, Lebanon, New Hampshire 1983 – 1985: Emergency Medicine Residency Training Los Angeles County Hospital LAC/USC Medical Center 1200 N. State St. Room 1011, Los Angeles, CA Huntington Memorial Hospital, Pasadena, CA WORK HISTORY 2020-2021 full-time writer. 2019: retired from my medical and surgical practice and resigned my medical license. I had a fantastic career, and I was initially sad to end it. But I was soon relieved that I was no longer responsible for patient care and was able to write full time without conflicts of interest. See also the first chapter of Butchered by Healthcare for the circumstances, included on this website under “Writing.” 1992-2019: Cosmetic surgery practice, Pasadena, Visalia, and Oxnard, California. Liposuction, breast implantation specializing in through the umbilicus (belly button), laser blepharoplasty, face-lifts, facial implants, laser resurfacing, vein treatments, hair transplantation. Operated medical hyperbaric chamber between 1996 and 2000. 1987-1994: General practice in Pasadena, California. 1984-1987: Employed by the Huntington Memorial Hospital Emergency Medicine Group, SPECIAL EXPERTISE One of the most extensive experiences in the United States with tumescent liposuction and Brazilian butt lift with fat. Some of our liposuction supply vendors say we are their largest account internationally for several years. Trans-umbilical breast augmentation is a surgery that many try, but few become proficient. Thousands performed. One of only two surgeons in the United States who passed the specialty boards in both cosmetic surgery and emergency medicine. PAST MEMBERSHIPS IN PROFESSIONAL SOCIETIES Los Angeles County Medical Society California Medical Association American Society of Cosmetic Breast Surgery Fellow, American Academy of Cosmetic Surgery ACADEMIC STAFF APPOINTMENTS (INACTIVE) Drew-King Medical Center, assistant clinical professor, Department of Dermatology. Training residents in cosmetic surgery techniques. BOARD CERTIFICATION EXAMINATIONS TAKEN AND PASSED (NOW INACTIVE): American Board of Emergency Medicine (ABEM), 1987. Re-certification examination passed l999 and 2009. 3000 Coolidge Rd., East Lansing, Michigan 48823-6319 American Board of Dermatologic Cosmetic Surgery passed in 1999. Recertification passed ten years later. 18525 Torrence Ave., Lansing Illinois 60438. (708) 474-7200. American Board Laser Surgery passed in 2000. 417 Palmtree Dr. Bradenton, Florida 34210-3009. ACLS re-certification 1999, 2002, 2005. ATLS in past. Member, Fellow, and Past President, American Society of Cosmetic Breast Surgery: testing included written and oral examination as well as peer observation of surgical technique. PEER REVIEW WORK Produced with Robert Goldweber, M.D., Socrates Emergency Medicine Oral Boards Review Course, 1987. This was distributed nationwide for over 5 years. Emergency Medicine Residency Director Huntington Memorial Hospital (coordinated and trained Los Angeles County Hospital emergency medicine residents) 1985-1987. Board of Directors of California Academy of Cosmetic Surgery, 1998-2000. Outpatient surgical facilities reviewer training for IMQ surgical centers and AAAHC surgical centers. (Inactive) Testified before California Medical Board 6/01 regarding liposuction standards and 11/02 regarding expert witness problems. Robert Yoho Website – Hormone Secrets and Butchered by Healthcare www.robertyohoauthor.com www.feedingfatty.com Full Transcript Below Is The U.S. Healthcare System Failing Due to Greed, Ignorance? Featuring Dr. Robert Yoho Wed, 7/21 1:13PM • 1:08:42 SUMMARY KEYWORDS drug, people, doctors, studies, book, good, called, money, influence, fda, problem, patient, alzheimer, industry, patent, hormone, healthcare, crazy, years, standards SPEAKERS Dr. Robert, Terry, Roy Barker   Roy Barker  00:00 One. Hello and welcome to another episode of Feeding Fatty. I'm your host Roy.   Terry  00:08 I'm Terry   Roy Barker  00:08 Of course we are the podcast journaling chronicling our journey through this wellness process. You know, in the beginning, we talked a lot about diet, not a necessarily a diet, but you know what we eat, what, what we're trying to cut down on and be more healthy eating. We also talk a lot about exercise getting out and moving.   And we talk about mindset as well. That has kind of been the point it's led us to a lot of people know what they should be doing, trying to get in the right mindset to make the change, and then also to make it sustainable. That seems to be the difficulty and the challenge for us. But anyway, we also bring guests on from time to time experts in the field today is no different. We are very lucky to have Robert Yoho with us and I'm gonna let Terry introduce him.   Terry  00:55 Now. Robert Yoho is 67 years old. He has spent three decades as a cosmetic surgeon after a career as an emergency physician. His generalist training gives him perspective and allows him to avoid favoring any medical specialty. He's had little deal dealings with hospitals, Big Pharma or insurance companies before he wrote his his book Butchered by Healthcare. No one has ever considered him a whale prescriber or device device implanter he retired from the medical practice in 19. Excuse me, 2019 1999. Dr. Yoho, thank you so much for being on the show. We're so happy to have you as a guest.   Dr. Robert  01:38 Thanks, Terry. Well, let me just go over my sequence which led to my interest in this field. Yeah, I have all things. I did a career in cosmetic surgery, doing breast dog breast implants, liposuction, you know, facial, beautification, all that stuff. And I had two people in six months die in my offices. Oh, wow. And so that was quite a timeframe, introspection, and one of them I wasn't even operating on but it still was a heck of a shock.   And, you know, cosmetic surgeons or plastic surgeons usually have one fatality in surgery during their careers. And I'd had to in a very short sequence, so I started thinking and reading and I started uncovering what I later became started to think of as medical corruption. And so the basic, you know, I'm listening to your guys podcasts. And I see, it's an interesting process, because you have not had chronic diseases, you haven't had to worry about your health, you're, you're pulling your way through this material and thinking you're smelling a rat somewhere, that there's some. And I can tell you, after four years of studying this material, there's a lot wrong. And the bottom line is that we spend twice what the other developed countries spend per person, twice what Japan, Great Britain, France, and so on, and Canada spends per person.   In other words, we spent nearly 20% of our gross domestic product on health care, right? And twice as much per person. And the worst part is we get a bad product, okay? In other words, aren't we have earlier infant mortality. And it's not an academic controversy 50%, fully 50% of what we do, either doesn't work or actually is harmful. And there's many references for that you can look at my book butchered by healthcare to get more detail. But, but it doesn't work. Now, the simple bottom line for how this all developed is we raise money out of the sky, on our health care providers and the healthcare industry.   We gave them our insurance money, we gave them our federal Medicare money. And it was when free money happens, there's a lot of people come around to scoop it up. And these are entrepreneurs, you know, or possibly criminals, you know, that that got into this thing. Now, I'm not saying it's all bad, I don't want to make that message. You know, half of it works, you know, and a half as important and we have new therapies for certain things that are profoundly effective. But and the way these people have influenced our prescribing and the medical devices, and the insurance industry, is essentially through bribery.   Now bribery is a technical term, that term means something in legal jargon, so I really shouldn't use that term, but it's anytime money changes hands, the well is poisoned. And as we You see, you'll see when we go through these various medic medical specialty, there's a lot of money changing hands between industry and the rest of of the medical service providers. I mean, it's a phenomenal thing.   And so the important point, which you can read, if you start looking at influence theory in psychology, is that any amount of money changing hands profoundly affects the person's behavior, even taking a woman out to dinner and serving her a nice meal, you can get benefits that are far beyond the the cost of that meal. You know, that's a simple thing that drug reps come into their offices feed us food. And we think it doesn't influence our behavior, but it does. And it's a terrible thing. So that's the basic setup of medical care worldwide, but particularly in America.   And I'm, before I let you guys start the questions, I'm just going to tell you the three central insights I had during my study of this, and I didn't learn this right away. But the first one I've already mentioned, and that's the updated Golden Rule. And that is, those are the gold make the rules, right? That's, and the second is, science is being used to obscure the truth. Okay. So if you don't understand it ROI, that doesn't mean you're a dummy. What that means is somebody is BSE, you know, because you're just as smart.   As a storyteller, you're smart as the average physician. And sometimes, if you learn too much detail, that actually obscures the truth, because you don't need to be an academic to judge ethics. The last thing is, and this is the important one, if there's controversy about something, that doesn't mean that there's controversy, that means that it doesn't freaking work. Right? If if there's controversy, confusion, or contradictory evidence, don't fall into the trap of believing reasonable people disagree? Because you know, and I know, they've studied hundreds, if not 1000s of patients to produce the controversy. So forget about it, it doesn't work.   So you read a study that says, we don't know for sure they got these barely statistically significant figures or something like that, it means it doesn't work. So that's a good rule of thumb. I mean, I can't state that absolutely. Blanket fashion. But it, it is a good place to start. So ask me anything you want, I can develop the medical specialties or the insurance industry or, you know, a lot of other areas where we've essentially   Roy Barker  07:31 gone off the rails and say, Man, I got a I got a flat. But let's start out with your first concept. The, you know, the golden rule the people with the money, Mike the rule, because there's not only a lot of influence between the the pharmaceuticals and the doctors, that I would suspect with lobbyists and everything else, there's a lot with our lawmakers as well.   Dr. Robert  07:54 Yeah, the lobby for healthcare is far bigger than oil and gas and banking combined is, is monstrous. pharma has a $1.3 trillion gross worldwide, and it's something is well over half the profits occur in the United States and 40% of the sales, it might be 70 or 80% of the profits. So these guys have money to burn.   Roy Barker  08:19 One of the things that just just now thought of this when we were when you were doing your intro is is there a way to track the if I'm a drug maker cannot track the the doctors that are prescribing as though   Dr. Robert  08:33 they track a track exactly who it is. And I here's how they do it. They go to the pharmacy and they get the prescriber number, and then they go to the AMA, and the AMA sells them. The doctors name that associates with a prescriber number the AMA is a very economic organization. They shouldn't be doing this in my opinion. Yeah.   Roy Barker  08:55 Yeah. Because it's good to   Terry  08:56 know I was gonna say it's backlinks, it's like SEO, you know, computerized everything. It's all I don't even know where I was going with that, because I have so many things running through my head, I can't even form a good one.   Dr. Robert  09:12 Let me give you a stunning example of how money pollutes I mean this, this one is going to be hard for you guys to believe. But oncology is one of the most heavily influenced or, you know, cancer therapy. The cancer doctors is one of the most heavily influenced specialties and the reason is, well over half of their incomes come from retailing cancer drugs, they get about 25% and the average cancer drug costs $100,000 a year.   So these guys have these chairs, right the cancer chemotherapy chairs, the more chairs they have and the more patients they have, the more they can bill and they clip 25% off the top of the drugs price. Now you think this is terrible, but it's gets worse. It gets worse. This would be If a doctor sold them the drug, so another doctor, the drug, it would be called camping. It's a federal crime, they put both of them in jail. But the drug companies are allowed to do this because of some sort of exception. Now it gets even worse, they are rewarded, they are rewarded by the milligram. In other words, larger doses make more money for them. So they are incentivized to prescribe very high doses of whatever the most expensive thing is.   Now, I mean, doctors have integrity, we're trained to have ethics in a way that no other industry is. And you know, we're pretty good bunch. But I just want to say that there's no way anyone can get around a financial incentive, even a small one. And these guys well over half of their income, on average comes from far from sales of these drugs that they deliver in the office. Some of the other specialties, like the guys doing the testosterone blockers like Lupron to the best of my knowledge, they get, you know, the shot costs $10,000 or whatever the heck it is, takes two minutes. The doctor gets 25% It's crazy. I mean, it's absolutely crazy.   And that one that was a whole nother story. And that's it's a very damaging drug of questionable utility. According to Otis Brawley, who is the head of the American Cancer Society. Until recently, he thinks that it does more harm than good on average, because the drug actually, you know, the, the prostate cancer is cut by the fatalities are cut by a third, by using that drug. It sounds great, right? But the drug causes so many problems, the overall fatalities probably go up. I mean, it's just crazy. And you know, it's kind of not joke jokingly, but not jokingly, we listen to, especially during the evening news when we listen to these commercials, and they come out with the drug that helps you with this.   And then they've got 10 minutes worth of countries in the world ROI that allow that, yeah, that's direct to consumer advertising. It's an outrage, it got slowly slanted into our system over a period of five to 10 years, when they finally figured out there were no direct laws against it. And it's a complicated political battle, but they these pharmaceutical companies, is very effective is very effective, even though you're not sure what the hell it is, when they're talking about it on the TV. Ask your doctor, and then they go in and ask the doctors and the doctors are so busy. What are they going to do a lot of times they just write for the drug? Yeah,   Roy Barker  12:30 yeah. Well, nothing I was gonna say is they have like 10 minutes worth of but the side effects that this may cause, I mean, in some of the side effects that they list, it's like, wow, I would rather have whatever they're trying to treat is not near as harmful as all these potential side effects that they have. It's crazy. The studies are frequently   Dr. Robert  12:51 obscure the side effects and they measure, they, they measure, they're looking under the money tree, and not the tree of truth. You know what I mean? So, Ben Goldacre wrote a book about the frauds involved in pharmaceutical and device studies. And there are there are, I mean, you cannot imagine what these guys do.   They they mess with the statistics, they conceal studies that don't. Right, and they cherry pick their results in various ways. They change people and put them in the wrong group. So it looks like there are fewer fatalities. I mean, the HPV vaccine, you've heard of that it's a vaccine for venereal warts that supposedly affects cervical cancer. Well, they conceal 50% of the studies. And in my view, the best commentators at Cochrane you know, the Cochrane Institute in Europe, which does meta analyses, they don't think it works, you know, and at least the most sophisticated ones don't think it works. I mean, it's there.   They're influenced by pharma money also. So Japan abandoned the use of HPV, or at least they said it didn't work to their populace, and their inoculation rate dropped to 1% in one year. So that's the truth. They've got a public health system at least as robust as ours. And they they don't use HPV vaccine in any consequential fashion. The rest of the world still on it, pretty much. Yeah.   Terry  14:26 I was gonna ask, so what's the role? No, this is open up a can I was asked, What's the role of the FDA and all of this?   Dr. Robert  14:34 Okay. So the, the FDA, I have a chapter in butchered by healthcare about the FDA and the FDA is the most effective regulatory agent see in the world, but unfortunately, they are since 2003. A law was signed into effect that we could no longer negotiate prices with these. These pharma companies and Since then they've they've just bought everything and the prices have gone way up. But the the the FDA is fed or their revenues come from what's called user fees that the pharmaceutical companies pay them and well over half of their some some sources say 75% or more of their total budget of $5 billion is it comes from directly from pharma.   So they regard pharmaceutical companies as clients, rather than or entities to be regulated because if they refuse a drug, sometimes they can't make their own payroll. Now, you got to realize the the size of these entities they have to regulate, they have $5 billion, which sounds like a lot of money. But pharma is 1.3 trillion worldwide, 40% in the US, and the FDA doesn't have a prayer of watching all these factories in India and China. Inside the US, they inspect them once a year. And they you know, they do a little better job.   But in China, they all these there are the all these stories about these FDA inspectors getting fed fake facilities and fake paperwork and room. It Catherine even wrote a book called bottle of lies, if you're interested in the FDA and, and all that stuff. It's very illuminating. And it really gives you the feeling that the generics, we were I think were 90% generics because we've been so we've been so overpriced by the patent drugs, the patent drugs are good quality, they're actually what they are. They're manufactured under strict controls, but they're so expensive.   And they these guys have decided the price point of making them outrageous is the best strategy. And I guess it is they don't have to do as much and they sell all these things like, like bottled gold. And so we are buying 90% of our medications from India and China's about half and half. And these the generics often are adulterated with some in bad ingredient or they don't work as well. The long lasting generics physicians have often discovered that the long lasting generics are only they only last 12 hours instead of 36 hours.   Cleveland Clinic It was so bad at Cleveland Clinic that they developed their own mini FDA and they started testing their own medications. And they they found out what worked and what didn't. In Africa and other third world less advantaged countries that don't even have an FDA. The physicians keep a small stock of the good drug, the actual patent drug to use on people who are dying, that were the other drug doesn't seem to be working. And so they have to experiment with their patients. But the FDA is a mess. I have insiders quotes from whistleblowers and so on and so forth. But, I mean, it's the best any country has it's better than the one in Europe, you know, or who are who are respected.   Roy Barker  18:02 You know, also anyway. Yeah, unless it's a, you know, on the other show that we have, we've talked a little bit about the new release of the   Terry  18:12 Doom, Doom, that new Alzheimer's drug.   Dr. Robert  18:15 Oh, yeah, that's an outrage. Okay, so the there are about 10 of these patent Alzheimers drugs, and they cost probably a couple $1,000 a month. At a minimum, you know, they're very expensive. It might might only be $1,000 a month, what a bargain. But even the people who work with those drugs and you read their papers, they can't claim they freakin work. I mean, they, they have some small effects. But like the rest of these drug studies, they're basically half fake and half concealed.   And they use contract research groups, and out of the country, and if these guys don't produce the results that they want, they never use them again, you know, so. So anyway, so Alzheimers is a special case. This is very interesting subject because it's Alzheimer's is arguably the most expensive if long term care costs are included is the most expensive disease of all, but we've got excellent, we have an excellent thing to prevent Alzheimer's, right. So in my second book, on hormones, I showed how Astra dial prevents 50 to 80% of all Alzheimers, I mean this could save billions of dollars if it was used and not concealed right and not not derided basically.   Roy Barker  19:42 Yeah, well, this. I'll let Terry's speak a little more to it because she she's done the research but this new adullam it's $56,000 a year. But what they thought mine can't be what what they need, though, They found out two years from now. They found out that the committee that was assigned to assign it what our scientists study it, when they went ahead and said, okay, it's okay for sale. I think 10 of the 11 doctors that were on the panel all resigned because they had already it's it's not   Terry  20:22 it was a it was a an 11 member panels, three of them resigned. And their their vote, the voting on it was there. 10 of them said no, don't release it. And then one was uncertain. And then the FDA went ahead and said, Okay, well, they manipulate it seems like to me, they manipulated the study process, or, you know, the results that they got, and and made it   Roy Barker  20:48 and Okay, and then now I think there's an investigation. Yes, a lot. This   Dr. Robert  20:52 is a, this is a story you'll see over and over and over. And I've got stories like that all through my book, The tragedy of this whole thing, as you guys are finding out, you if you have a chronic disease, and Roy has a problem here. I mean, I think your problems simple compared to someone with cancer, but and you know, the the, the variety of you anyway, so but the tragedy is that you almost need physician level expertise to decipher what the heck to do next, and ever you need and you've got you got your woman by your side there who can help? Yeah,   Roy Barker  21:28 yeah. Well, and that's the thing to, you know, kind of get back to more general terms is, I guess what I see are concerned about is, instead of doctors taking the time to find out what is this underlying issue, they would rather prescribe to treat a symptom instead of actually having a conversation.   Terry  21:46 That's where they get their money is if they like give them the pharmacy, you know, give them the meds,   Dr. Robert  21:53 you know, they are trapped in a in a system that where they're their actions are dictated and even these guys who work for Health Maintenance Organizations, they if they don't have prescribing habits that mimic the, quote, standard of care, which is largely dictated by Big Pharma, influenced by the standards panels, who are paid each one of the persons on the panel has huge conflict of interest paid by two or three pharma companies, for example, antidepressants and statin drugs, right?   Both of those are should be thinly used, and they're the damn no depressants must be 10% of the whole country is on antidepressants, like drugs is 15% or more. But the influence is so the industry influence is so heavy, that your primary care doctor is not an independent actor anymore. He's got an individual license, he's responsible, but he operates under protocols. So they're not they're there.   They're not innocent, but they're not the they're not the real problem. The problem is they're in a matrix, you know, they're a matrix of control. And the money is so huge, that these companies are getting more overt or obvious about their influence. Now, in the last year, they all sort of came out of the closet and said, do as we tell you, or else you know, that's my opinion about what happened.   Roy Barker  23:20 Wow, yeah, it's unbelievable. Yeah, I was just gonna go down I was looking at the second one is the science is obscured, to hide the truth. And so I just was going to ask, you know, in your opinion, are, are these clinical trials large enough? Are they lengthy enough to actually you know, and the problem with anything is that something may be something may be doesn't come to light in the short term, but after you do it for 10 1520 years, all of a sudden, now, there's a big problem. But, again, in your opinion, are we even taking enough time to evaluate these drugs before we release them?   Dr. Robert  24:04 Okay, so Roy, you're asking the right questions, and you're trying, you guys are trying to Paul your way through this mess of data, and try to figure out what the heck is going on. But if you want to read about these clinical trials and the frauds I think the easiest and most approachable book is been gold acres, bad pharma, and that's 10 years old. But the answer is that the answer is that you can hardly trust anything.   Now the doctors are. We are conditioned to think that double blind placebo controlled trials are the beyond handle, but it's a garbage in garbage out situation and Geico situation. And it depends on the intentions of the people who are doing the trial. And so the answer is now, anecdotal medicine is almost better than the clinical trials and I it's almost a waste of time to look at them. Because if you go to the back of the paper and they're sponsored by the the company selling the drug, he was a gold makes the rules right. So they I mean, it's a it's a tragedy but everyone thinks they mean something. One of my friends says the whole thing has been almost garbage since 2000 is not crazy.   I because the the industry is just taking control of freakin everything now. So I don't say this stuff casually. I studied it for four years, I've got 500 References In this book, nothing I say. Everything I say is derivative of authors that have come before me. I didn't do original research. I I read the stuff that was available. And I looked at the references, you know?   Terry  25:52 Oh, my gosh. Shocking, isn't it dairy. It's shocking. And you don't take anything.   Dr. Robert  25:59 You don't want to take anything you want to you basically. And I think you guys are on the right track with your, your keto and your your controlled fasting and your prolonged fasting. I think all that stuff, there is better evidence than anything else we have. I think that the you know, all the fat stuffs turned around want to eat animal fat and all that all those narratives about about the animal fat is being bad for you.   That's all wrong. I mean, it's and it's all that's all food industry driven. And as you may recall the Food and Drug it the FDA is food and drug, right? So they spend half their money half that billion $5 billion, regulating the food industry, and they don't do a very good job there. And I've got references if you're interested in that, if you're interested in the vegan stuff. I have references for that, too.   Roy Barker  26:45 Okay, yeah, I mean, that that is because we are you know, we haven't gone total vegan, we are more what we call plant based. And, you know, we we do not, we eat protein, but not it's not the focal point of the meal. Like it used to be used to you had the, you know, the big meat and a side thing of potatoes or whatever. So, you know, we've tried to flip that. But, you know, it gets back to this this thing about I have read some research, this is not my my research, but I've read a number of studies that say, you know, kind of staying with Alzheimer's is that that can be traced back to the low fat diet of the 70s and 80s. Because we need this fat for our brain to keep those receptors lubricated. And, yeah,   Dr. Robert  27:31 I thought that was interesting. I listened to you. interview someone who'd given cook it on the world for three months to someone and they freakin improved, you know, so who knows? That's that's another anecdote. I have no expertise about this.   Roy Barker  27:46 Yeah, that was a very, it was a very, it was a one person, but it sparked some huge longitudinal studies on that just to, you know, see if this fat intake. But yeah, there's been a lot of saying that that's what has caused this huge spike right now is what we did. And I guess that's kind of our mission to it's changed a lot on this show. But you know, part of it is, you know, I'll speak for me, I'm going into an older phone into the older age brackets sooner than I would like to. And so I need to be sharing carry good health good habits into this. I mean, you can't wait to you're 18 years old and say, Wow, I need to change some things. I mean, yeah.   Dr. Robert  28:30 Well, another clue about my other book, which is the hormone book is after reviewing all the data for hormones, it's my opinion, and brace yourself. It's my opinion, that hormone supplementation over 40 or 50 years old is more important than exercise. Possibly as important as diet, you get it. So there's a lot of there's a lot of data on that a lot of a lot of studies and the standards that are promulgated are a pack of lies, you know, it's crazy. I mean, then we've got, we've got black box warnings on testosterone, estrogen and progesterone. Those three are vital, and they they can save your life and likely make you live longer. They save your alertness decrease Alzheimer's, I mean it has they have multiple good effects. Anyway,   Terry  29:23 is that why is that? I mean, do you do you think that is one of the reasons that all timers and dementia has increased, so   Dr. Robert  29:32 no doubt about it. There's no doubt about it. And the hormone levels are dropping, sperm counts are dropping, and we have good measurements in men about these trends over the last 20 years. We don't know why. It may be stress, it might be chemicals, it might be who knows it might be nutritional, and it might be something else but they it for any given age. Those are dropping and it's if we supplement we can prevent many, many problems.   Roy Barker  30:00 So I'm sure that this is difficult to prove collusion. But do you think that there's a link in not releasing certain products because we would rather sell the drugs on? Instead of being proactive? We'd rather wait and sell the drugs on the back end.   Dr. Robert  30:18 Yeah, you, you have to realize that these companies, they're not evil, and they're not good. They're only interested in money. And so they're willing, they're willing to, there are speculations that they, they would or do sell things that absolutely don't work in order to make the money and they can, they can fake the studies. In other words, you do 20 studies, and one of them is statistically significant, you know, when you that's the only one you publish. So, you know, I mean, they can sell wheat grass and a pill for God knows what.   But it's, it's it's truly a sad story, because some of the things are injurious. There's a class of antidepressants or anti psychotics, because it called atypical antipsychotics. These things are well documented to shorten your life by 10 to 20 years, through diabetes and all this other stuff. However, they're getting passed out like jelly beans to people who have simple depressions. The SSRI drugs like Prozac, they cause consequential violence and suicide in a small number. And those guys are passed out very casually, they're exceedingly addictive.   And, you know, it's it's basically an outrage. And the whole, the whole thing has been covered up since the start, the initial studies for Prozac showed the suicide rate, and that they paid off plaintiff after plaintiff for these things, rather than have it brought out. So, I mean, there's a lot of drugs that are just that are no good. And in fact, the whole psychiatric formulary. And I'm not, I'm not one of those, what do they call it the anti psychiatry is religion. What is that called? The Scientologists are not a Scientologist right?   The but the Scientologists got this one, right. The psychiatry is drugs are the way they're used. Currently, that means indiscriminately on almost everyone, with these standards that were essentially fabricated with hand in glove with the pharmaceutical companies. It's it's an outrage, and that's the most, that's the most expensive medical specialty. And that that whole thing is a mess. I mean, it's truly a mess. And there are a lot of psychiatry is the only specially that has a massive number of people who are essentially psychiatry deniers, they don't think they should be operating at all.   Every other specialty, they're doing something, you know, they're, they're making some mistakes, but psychiatry, the drugs have never been subjected to proper double blind placebo controlled trials. I mean, essentially, if you can't find any, you can't find anybody to put on a sugar pill these days, because we've got 15% of the country taking these darn drugs. Yeah,   Terry  33:08 it's crazy. Yeah. Which leads to which probably has led up to a lot of the violence that's happening, you know, all these I like to see it.   Dr. Robert  33:18 Yeah. The mass violence. Yeah. Everyone knows seems to be associated with with a psychiatric drug use. But of course, everybody's on the damn drugs. So   Terry  33:27 who knows? How do you know? Yeah, yeah.   Roy Barker  33:30 Well, you mentioned something, too, about settlements. And I, I just have mixed emotions about that. Because I feel like if, if I'm able, if I'm a $1.3 trillion industry, I'm able to offer some pretty big dollars for you to not take this to court. You know, it's like, okay,   Dr. Robert  33:50 it's this important point, right. The pharma industry, in terms of their settlements to federal prosecutors, is the most criminal industry in history. They have billions of dollars in settlements every year. It's an unbelievable scene. And essentially, they are paying everyone off to leave them alone and let them continue doing what they're doing. So I mean, it's, it's   Terry  34:16 about it, what and to shut up about it not saying well, you know,   Dr. Robert  34:20 they, when when they make a settlement, they don't admit wrongdoing. But when you give someone $2 billion to to to stop the prosecution, I mean, it's a rich pay off, and the prosecutors can stand on the pile of loot and say they've been, they've saved the world from, you know, one of these companies, and, I mean, it's crazy. Pfizer has profit margins of 40% for the last five years.   So if you know anything about industry, a 10% profit margin is a very good profit margin. It's in a competitive industry, but this is in an industry where the money falls out of the sky on healthcare, and and Pfizer Pfizer for what Have a reason, you know, which we won't speculate about. But you can speculate privately about their profit margins are very high. It's crazy.   Terry  35:08 And so what? How does that? So you mentioned Pfizer, so how does that tie into the COVID? vaccination? Maybe? Okay,   Dr. Robert  35:18 so, here now, I just want to make a comment about doctors and politics, right? So if you go to a doctor, and he talks politics to you, that's called a boundary violation. It's not considered cool in medical ethics, ethics term, just like, just like in polite company, we don't talk about religion, politics or net worth, right? It's not it's not considered reasonable. So this vaccine has been kicked around so much. It's being censored by YouTube and all these crazy media people. So I think we can consider the vaccine a political issue.   So I'm going to make a comment which will tip you off to what I think about these modern vaccines without specifically commenting on the COVID varieties. Right. So we have we have the the two vaccines that were have been promulgated in the last 20 years now, you know, measles vaccine, and all that was before that, and they all have robust effectiveness, right. But the two are the flu vaccine. And HPV, I already told you what I thought of HPV vaccine, Japan rejected it.   And they've got a very good public health service that seems less influenced by pharma. But for the flu vaccine, this costs billions and billions of dollars every year, Britain and France stockpile this thing. And their governments are influenced by the manufacturers, obviously, because that stuff doesn't work very well at all, it doesn't do much of anything. It may decrease the length of the the severity of the disease by eight hours or some crazy thing.   And this is not a controversial thing. You can go to Cochrane Reviews, you just Google Cochrane Reviews flu vaccine, you can read the summaries of the last few meta analyses and they, you know, read between the lines, but it does it doesn't say the freakin stuff works, you know, it doesn't work very well, it's very expensive. So we can, we can certainly extrapolate pharmas products, which we know a lot about the other products, I mean, these these site drugs, they've tracked the rise in disability very closely.   So that is a suggestion that the drugs cause the rise and disability, right? These there's a lot of other drugs like the stat that basically, I mean, there is arguable small use cases for it, but they've, they've gone so crazy, we've got 8060 or 80 million people in the US on status. And they are toxic, they can cause an occasional fatality and muscle wasting a lot of stuff like that. So the only two use cases for that one is hereditary hypercholesterolemia, which means you have a super high cholesterol and post heart attack. If you're not in those two groups, you're better off doing Roy's method of fasting or being careful with your ketone, you know, or intermittent fast.   Roy Barker  38:18 So what about Black Label or black? I can't remember, I think that's it, like off off label uses. Like, we designed this medicine for this because I hear that both ways. I hear there are some medicines out there that help other things they won't let them do. But then I also hear that there are some medicines for one thing that they're using for others that cause harm as well.   Dr. Robert  38:42 Something between a third and two thirds of drugs are prescribed off label. So it's completely conventional to do that. The thing that's not conventional is for Big Pharma to advertise there. patented medication for every freakin use under the sun. And there's many, many examples of this in my book, and that's what they get the fines for. That's all this left on the books to get these guys. I mean, research fraud, they sometimes identify some of that, but it's largely done outside of the country. Those studies are accepted, analyzed inside the country.   And I mean, that doesn't seem to do much. You know, they put an occasional doctor in jail for a couple of years for that, but they're, they're obvious their champion, their champion fraudsters, you know, but it's done universally. I mean, again, that Goldacre book is a good source. And I'll mention Whitaker's book about the psychiatrists in the psychiatry he uses. He's a seminal author about that, where he dislikes the data and shows that there. I mean, arguably, those drugs are if they work is for a very narrow group.   Roy Barker  39:52 Is there any studies on on that at all? Do they have to do any research on the off label? Or do they go on go through a whole new clinical trial for those?   Dr. Robert  40:01 Well, that's the thing they're on, you know, I mean, I suppose you see a clinical trials are done to create a patent, which is a monopoly for whatever it is 20 years, you know, from the very start of it. And that's the profitable stuff. When a drug passes off patent, other companies apply to produce it, right. And then in theory, it becomes a matter of supply and demand and whether this stuff really works.   Right. But it's not that clear, because there are all kinds of lawsuits that fall that go back and forth between these these big groups, the patent drug manufacturers, and the generic drug manufacturers, and, and sometimes they're just paid. The generic drug manufacturers are just paid not to produce the drug. I mean, it goes on and on.   I described that in butchered by healthcare. But Did that answer your question? Yeah, yeah, yeah. And so. So there are many good uses, there are many good uses for off label prescribing. And in fact, ineligible for physician does that. And I think that there are many, many treatments that are not recognized because they can't be patented. And among these are bioidentical hormones, because pieces of the human body cannot be patented.   In theory, they've got some loopholes, like they patent certain doses of these darn things, which doesn't make any sense to me so. So you go through what's called a compounding pharmacy, which is 5% or less of the total pharmacists, and they are allowed to make a drug only for one person, they can't mass produce the drug. So, and there, there are other constraints on those guys, too, that I   Roy Barker  41:46 yeah. So let's talk for a minute about, there's so many drugs prescribed about polypharmacy. And I know that some in theory are, if we use the same pharmacy, they should catch that, but I'm going to tell you that we use a national brand and have had some that slipped through like nobody's even taken a look at that.   Dr. Robert  42:11 So drug interactions are not studied when the drug is patented. In other words, only one drug at a time is, is studying, right? So we know, we know something about drug interactions from after market effects, and maybe studies that have been done on it. But in the modern nursing home, it's not uncommon to see patients on 20 drugs. And these include that a typical anti psychotic that shortens their lifestyle life lifespan, because it shuts them up.   I mean, they've got to control them somehow, I guess. But 20 medications is a medication farm and not a patient, they are just farming the revenues. And you can imagine these things, the expense of them and the insurance reimbursement and the insanity of the whole thing is just a, it's just a travesty. There are people who are studying this that I cited in butchered by healthcare, and they there are specialties that revolve around trying to take people off of as many of their medications as possible.   So if you're a patient and you're not sick, I would advise you just to be very careful about what you take. Because the indications for conditions that you can't feel like blood pressure have been trumped up. In other words, the standard for when you Medicaid for blood pressure, there was very little scientific evidence that medicating past the upper limit 160 or the systolic blood pressure that trying to get it lower than that there's very little evidence that it makes any difference.   And there's certainly almost no evidence that medicating past 140 systolic makes any difference. And so, especially if you're a senior, that they that, you know, there's there's it's ridiculous, but but the standards have been changed progressively for cholesterol for blood pressure for other medical conditions that are medicated prophylactically. And it prophylactically means before you get sick. So I mean, it's crazy.   The whole thing about the bone density drugs. I mean, that's a that's a crazy story. And these things are very toxic. And they create problems have their own, like fractures and certain long bones like the femur, they create rotty jaw bones, right. And in theory, they densify the bones as well. They are a net loss in my opinion, after reading all about it. I mean, it's it's a crazy crazy thing, and you get those things and they last years inside your body, and they're a shot administered in the office. So the doctor gets 25% of the gross revenue. I mean, it's just it's it's a conflict of interest. Nobody You can get around.   Roy Barker  45:01 Well, some of what led to that, too was, you know, in, in the nursing home expecially was, you know, when physical restraints, you know, people started taking a hard look at that, and they outlawed them. It's unfortunate, but, you know, we call it chemical restraints, all they did was just moved from having them, you know, tied down in the chair with the belt to chemical chemical restraint of the medication that they give them.   Dr. Robert  45:29 So I don't know what there's a good solution for that. But let me just draw a similar point in the insanity field in this psychotic field, right? Well, almost all psychiatric conditions. And these are defined as things for which there is no laboratory test. So the psychiatrists are going almost purely by their gut instinct and talking right, unlike any other medical field, but oh, let's see, I lost my thread. What was I talking about?   Right now we're talking about the chemic, chemical restraints, right? Okay. So, in psychiatry, every single psychiatric entity, like schizophrenia, like anxiety, like depression, waxes and wanes, it goes up, it goes down, goes up and goes down, right? But when we start people on psychiatric medications, it habituates them to the medication, and produces chronicity. So this has increased, or it's thought to have increased the number of people on social security disability, all this crazy stuff. So anyway, that's an that's, I don't have an answer for people who are completely out of it, you know, and letting them go through their thing in a walk facility, and then letting them out when they're when they're doing okay, that might be the way to go.   It's not inexpensive, but the drugs are not inexpensive either. Well, and the bad thing about the some of the, you know, worst cases in the nursing home, especially was it really wasn't about the patient acting out, it was just if you could medicate enough of them, you didn't have to spend time, you know, devote time and resources to them. Unfortunately, it takes a lot of expertise to carefully medicate these people. And you have to have someone who cares about often about people who are demented, you know, and it's, it's hard, hardly anybody. It takes kind of a safe saintly person to be interested in keeping these people clean and in the best possible condition.   And there are private places that do a good job, but the usual nursing home, Medicaid is heavily. I mean, it's crazy. The pharmacies who supply these nursing homes, make millions and millions of dollars per nursing home. I mean, it's crazy. It's like, they turn out blister packs for every patient in the nursing home, often 20 medications, I mean, in the hundreds of dollars a month at a minimum for the for the moderately priced ones, and just break it in, you know, and the nurses pass them out. And go ahead.   Terry  48:07 I was I was just gonna say I mean, that's. So what do we do back in the olden days, When, when, when Big Pharma wasn't in control? I mean, we they did, they did send people with senility and, and psychiatric issues, they did put them away for a while or a lifetime. But there weren't many of them, because they weren't taking the drugs to be able to cause whatever it is, they're   Dr. Robert  48:31 right, we've got a control group for psychiatry, and that's called the third world, right. And they don't have the money to spend on these drugs. So Whittaker and other Robert Whittaker, and other people have looked at that. And they get better results than we do. Our drugs encouraged chronicity and dependency in the third world, they'd lock them up for a while, maybe give them a few drugs, but they don't give them the drugs and definitely the way the way our standards have developed to, to do this, you know, depression, that you know, this chemical, chemical fault in the brain that's supposed to be depression that the SSRI antidepressants are supposed to fix. You've heard about that.   Right? It's a chemical deficiency in the brain. Well, that was made up, that idea was made up by a marketer. That was not there's no science behind that at all. We don't know what the hell's happening in the brain is made up by a marketer. So that thing took hold. And once a bell is wrong, it cannot be unrung. So everybody in the country thinks that the depressed people have a chemical deficiency in the brain. And that means that you have to take the drug forever and pay the pharma company forever. And, you know, I mean, it all falls right, made up by a marketer at Smith Kline and French.   Roy Barker  49:48 So what about allergies have has this overmedication or maybe it's the food source or whatever that it's, you know, we had a casual conversation about this the other day That, you know, as I was growing up, and I'm not, you know, mostly back in the 60s and 70s It's been a while, but it didn't seem to be kids with the chronic asthma, the chronic allergies, peanut butter, you know, things like that. And it seemed like nowadays there are so much   Terry  50:19 more. All right, yeah, they're all they can't have dairy, they can't they're an app have everything gluten free, no peanuts, all of that.   Dr. Robert  50:28 I don't have any specific knowledge about that, except for it sounds to me, like it's part of the diagnosis creep, that has been fostered by industry and abetted by the doctors, you know, just like for the blood pressure, the cholesterol, you know, the the bone density, the bone density story is a is a six story that started in some, you know, medical meeting where they got together and they all decided that bone density below a certain amount was going to be called osteopenia, which is not true osteoporosis.   But then they decided that osteo Pina peenya, had to be medicated with these toxic drugs to prophylactic or prevent osteoporosis, which that's the link was never proven. But now we've got, we got all these people on these drugs, they're getting less popular because their toxicities are more widely known. And who wants to have a patient who has a necrosis or a rotten jaw, you know, I mean, that's, but I guess if you're getting paid 20 $500 for a shot, you know, maybe you're risking, you know, you get a you get a herd of about 40 of men, they're coming in once a month, or whatever it is, you got a lot of money on your hands.   Terry  51:41 So what's a patient to do? That's the hard part. Okay, what do you do?   Dr. Robert  51:47 Right? Well, my wife has a chronic problem. And I be I become her advocate. And it's taken my background to keep her out of trouble. And she's doing very well. But I think that you guys, you guys don't have serious problems yourself. I think you can research what you're doing. You stay away from those drugs, Metformin is okay, but the rest of them are not good. And they'll keep you from losing weight. But if you have a complicated problem, you can go to the best doctors in the country virtually now. And Trump put out this executive order. And I don't think Biden is countermanded. That said that virtual consultations, even on the first visit, are cool, you get it. Whereas before, they would always insist that you come to the office to see them to see you. Because it was considered beneath the standard of care to see a patient virtually or on the phone, especially for the first visit, there's something to that an experienced physician can just look at somebody and they can see physical signs, they can see, they can see stuff they can't see as well over zoom.   Although these are very clear images, it's not as good. You know, they get you get your clothes off and look even without even listen to your lungs or looking, you know, just kind of look them over. And and they get hints to what's going on. And they can lead to good ideas about therapy and diagnosis. But you can go to Stanford, and you can do a virtual consultation with these people. And if they won't allow a first time virtual consultation, fly out there, pay for the whole thing, and then do the subsequent visits, and then get your local doctor to do whatever the other guy tells him to do. So you can get the best care in the country, anywhere you live.   You know, if you've got a few dollars to rub together, I mean, it's not free. But it's not so outrageously expensive that that you can't get it done. The Second. Second thing is, you know, the problem with healthcare is twofold. Right? Have I want to do too much those are the people on fee for service and fever services, enormous conflict of interest, right? It's impossible to get away from I mean, I was a cosmetic surgeon, I got paid for doing breast dogs. I wanted to do them, you know, and I would like to think I never oversold it on someone that had breasts that were big already or something but you know, you got to make the customers happy, right?   But the problem is for fee for service, they want to do too much but the other guys the HMO guys, they're on salary, and they're often incentivized in various subtle ways to do less. So you got to watch those guys and make sure that you're getting the best care from them. They have all the modern stuff. They can do whatever they want, but it often takes a supervising physician outside the system. If you have a complicated problem. If you're have cancer, cancer is there is many different diseases. It's complicated.   Many different specialties are required to manage it frequently. You get a cardiologist involved and you know the cancer doctor and he you know, I mean it just goes on and on and on. And there's many possible And the thing is an art, which doesn't work very well, if it's applied the way the standards go, two months of improved survival is what 95% plus of the cancers get from our chemotherapy. And that's not that's not controversial. Two months survival improvement, right? We can cure about five to seven of these cancers. If we catch them at the right stage. It really I mean, you know, what, testicular cancer, some lymphomas, leukemias, you know, some other some other entities get cured, which is, you know, that's a blessing.   But the rest of it is, it's definitely an art. And if you establish good relationships with the people, if you don't, if you don't think that they're relating to you, personally, you need to go elsewhere. I mean, doctors are human beings too. And if they seem like they're pushing patients through the clinic, and that's what they're up to. You can sense it your your judgment is better than you think. And you go on and study everything you can, if you have friends that are nurses, or doctors who can help advocate for you and learn everything they can, they'll they possibly will be more sophisticated, although sometimes they are just part of the freakin machine.   Roy Barker  56:11 So we're running way long. But I did want to ask you, you wrote another book about hormones. And so we just wanted to touch on that briefly. I know you talked a little bit about testosterone and estrogen earlier, but now kind of what's going on over in that realm? Well,   Dr. Robert  56:28 the interesting thing is, the amazing thing is that every single hormone has been run down by standards groups, right? The FDA has, there's a thing called a blackbox warning the FDA puts on drugs, that it deems it's a postmarket thing, right? They put on rather than send the drug back to the manufacturer, which would, you know, it's very expensive. And in theory, the drug works, they put a warning on the drug.   So theoretically, patients and physicians can be careful about it and not, not, you know, be aware that there there are risks, and they put black box warnings, unwarranted blackbox warnings on testosterone, estrogen and progesterone based on obsoletes drug studies. In other words, the drugs studies were done is called the Women's Health Initiative, which you probably heard of that thing evaluated drugs that shouldn't be used any longer for chronic care.   Okay, like Premarin, Premarin is horse urine, estrogen. Now that stuff has its place. But for chronic care, it has some low level risks, that true estrogen that's Astra dial, which is the compound that should be used is bioidentical doesn't have, right. And, you know, there's a whole series of caveats. But But basically, in testosterone, it's practically unbelievable what's happened with testosterone, they put a blackbox warning on testosterone based on two studies, or they look through the wrong end of the telescope. In other words, they took people on testosterone and look for problems.   So that's the wrong way to evaluate a drug. What you need to do is take 1000 people or whatever half up on the drug half, I'm off the drug and see what happens to them in the future. Right. So testosterone, they've stuck this blackbox warning on testosterone for stroke and heart disease, when this stuff has enormously beneficial effects on weight loss. It's the best weight loss drug we've ever had. It's much better than phentermine.   It has many positive effects. And you guys, you know, are of the age group where you should consider this stuff and you read my book and see what you think I've got referral sources in there. And even a drug as harmless as progesterone, which is the other female hormone. There's a story they started about that was you don't need anyway.   Terry  58:56 So it's it's a crazy I was put, I was given a cream.   Dr. Robert  59:00 I mean, the cream is the cream for progesterone is ineffective. It doesn't give you enough to drop like,   Terry  59:07 I quit. I mean, I didn't take it very well.   Dr. Robert  59:09 You should take oral micronized progesterone, and the doses and everything are in my hormone secrets book. Okay. So that's something that the women should study any woman over 50 should be intimately familiar with all that material. Because you're not going to get it your it's going to be hard to get from anywhere anywhere else. I mean, you can if you go to the right doctor, they can help but there's there's a lot of quote, controversy and the the subjects been just completely covered up. Sorry, Roy.   Roy Barker  59:40 Oh, no, no, no, I just I was thinking you might actually thought of something back kind of on the drug issue is that you know, we talked about how things kind of go around with the FDA looking down over this but I'm able to walk into any drugstore, any grocery store And by any form of some kind of a supplement, and they don't have a my understanding with them is they have little to no oversight except for the company. So most of them come from China to do like, okay, yeah. Oh, yeah, I guess the for briefly on that, you know the benefits versus the pitfalls of you know, walking in and, and one for me that I know as that I was told about was iron like, for most men, too much iron can be dangerous more dangerous than than low iron.   Dr. Robert  1:00:36 Don't take iron, don't take iron, right? But yeah, Terry if you don't have menstrual periods you shouldn't need iron to see. But the reason why you have low iron in the blood blood is you have blood loss, either through mineral or if you have a GI bleed a slow gut bleed, you can get a lower iron. And if you have that you want to check it out. You don't want to just take iron.   Roy Barker  1:00:57 Yeah, yeah, no, no, I wasn't taking it, I have a colon cancer. That was just an example of, you know, one that I know for certain that I've heard is detrimental to men. But then, you know, like some of the others I've heard that they can have interactions with, you know, certain medications that we're taking. So just you know, it kind of the more I've learned about the supplements, kind of the scarier that whole thing is, and the   Terry  1:01:21 fish and fish oil Didn't we just learned about fish? Well, we cut out the fish oil supplements, because we spoke to a neural neurologist, who told us that how it was processed, processes that out of what you need. So to go and get, you know, they have to, they have to cook it at such high heat that it actually makes it detrimental. But you can take there's a liquid three, six and nine, that's a lot more.   Roy Barker  1:01:48 It's more efficient. But it's also like it has all the nutrients that you really need. So little things like that, you know, like the Who would think you know, nobody ever talked to me about this whole thing with fish oil, everybody's like official is good, but it's the process that kills it.   Dr. Robert  1:02:04 I'm not an expert on fish oil I but I understand it's out. The thing I do know about is vitamin D, which actually is not a vitamin, it's a hormone. And you can get your levels drawn of D, your primary care can do that. Or you can go straight through life ext

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UF Health MedEd Cast
COVID-19 from Intensive Care Unit to Outpatient Clinic

UF Health MedEd Cast

Play Episode Listen Later Oct 27, 2021


Bashar Alzghoul MD and Hiren Mehta, MD discuss COVID-19 from intensive care unit to outpatient clinic. They help us to understand the best practices and standard of care for COVID-19 patients in the ICU. They examine available literature about long-term care/outpatient care for COVID-19 patients, the care provided at UF and available resources for long term management of post COVID-19 fibrosis including lung transplantation

Talk Ten Tuesdays
Continuing Series on Outpatient CDI: How to Begin an HCC Program

Talk Ten Tuesdays

Play Episode Listen Later Oct 26, 2021 32:44


Outpatient CDI expert Colleen Deighan will return to the next edition of Talk Ten Tuesdays to continue her popular series on a subject that continues to generate listener interest and questions.Deighan will also conduct a listener's survey during the weekly Internet radio broadcast. When healthcare organizations are considering, planning, or beginning efforts directed toward documentation integrity in the outpatient setting, Hierarchical Condition Categories (HCCs) are a key focus. Deighan will also discuss what to consider when determining the timing of your HCC review, top HCC category specifics, and best practices for compliant HCC reporting.The live broadcast will also feature these other segments:Special Series: Maternal Morbidity and Mortality: Senior healthcare consultant Kristi Pollard, Director of Coding Quality and Education for the Haugen Consulting Group, will continue her four-part series, reporting how coded data is being used by the Alliance for Innovation on Maternal Health (AIM) to improve maternal outcomes.The Coding Report: Laurie Johnson will report on the latest coding news.The Dunn Report: Rose T. Dunn, a past president and former CEO of the American Health Information Management Association (AHIMA), will report that ED-level denials are mounting everywhere, and payers are using AI and applying their own criteria.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.Point of View: Susan Gatehouse, founder and CEO of Axea Solutions, will be substituting for Erica Remer, MD. Gatehouse will provide context and commentary on a subject that has caught her attention during a recent edition of the segment.

What Women Want Today
Hormone Secrets with Robert Yoho, MD

What Women Want Today

Play Episode Listen Later Oct 26, 2021 39:09


Part One of the podcast we have a lively discussion about menopause and the benefits of hormone supplemenation. We dive into the differences between the types of HRT and the benefits. We also begin our discussion on thyroid. Amazon Affiliate Link Highly recommended Liquid Thyroid Supplement  Amazon Affiliate Link Robert Yoho - Hormone Secrets Book  Website Stop the thyroid madness  Learn more about Robert Yoho at his website Roberty Yoho retired MD, Author  2020-2021 full-time writer. ​2019: retired from my medical and surgical practice and resigned my medical license. I had a fantastic career, and I was initially sad to end it. But I was soon relieved that I was no longer responsible for patient care and was able to write full time without conflicts of interest. See also the first chapter of Butchered by Healthcare for the circumstances, included on this website under "Writing." 1992-2019: Cosmetic surgery practice, Pasadena, Visalia, and Oxnard, California. Liposuction, breast implantation specializing in through the umbilicus (belly button), laser blepharoplasty, face-lifts, facial implants, laser resurfacing, vein treatments, hair transplantation. Operated medical hyperbaric chamber between 1996 and 2000. 1987-1994: General practice in Pasadena, California. 1984-1987: Employed by the Huntington Memorial Hospital Emergency Medicine Group, SPECIAL EXPERTISE One of the most extensive experiences in the United States with tumescent liposuction and Brazilian butt lift with fat. Some of our liposuction supply vendors say we are their largest account internationally for several years. Trans-umbilical breast augmentation is a surgery that many try, but few become proficient. Thousands performed. One of only two surgeons in the United States who passed the specialty boards in both cosmetic surgery and emergency medicine. PAST MEMBERSHIPS IN PROFESSIONAL SOCIETIES Los Angeles County Medical SocietyCalifornia Medical AssociationAmerican Society of Cosmetic Breast SurgeryFellow, American Academy of Cosmetic Surgery ACADEMIC STAFF APPOINTMENTS (INACTIVE) ​Drew-King Medical Center, assistant clinical professor, Department of Dermatology. Training residents in cosmetic surgery techniques. BOARD CERTIFICATION EXAMINATIONS TAKEN AND PASSED (NOW INACTIVE): American Board of Emergency Medicine (ABEM), 1987. Re-certification examination passed l999 and 2009. 3000 CoolidgeRd., East Lansing, Michigan 48823-6319 American Board of Dermatologic Cosmetic Surgery passed in 1999. Recertification passed ten years later. 18525 Torrence Ave., Lansing Illinois 60438. (708) 474-7200. American Board Laser Surgery passed in 2000.417 Palmtree Dr. Bradenton, Florida 34210-3009. ACLS re-certification 1999, 2002, 2005. ATLS in past. Member, Fellow, and Past President, American Society of Cosmetic Breast Surgery: testing included written and oral examination as well as peer observation of surgical technique. PEER REVIEW WORK Produced with Robert Goldweber, M.D., Socrates Emergency Medicine Oral Boards Review Course, 1987. This was distributed nationwide for over 5 years. Emergency Medicine Residency Director Huntington Memorial Hospital (coordinated and trained Los Angeles County Hospital emergency medicine residents) 1985-1987. Board of Directors of California Academy of Cosmetic Surgery, 1998-2000. Outpatient surgical facilities reviewer training for IMQ surgical centers and AAAHC surgical centers. (Inactive) Testified before California Medical Board 6/01 regarding liposuction standards and 11/02 regarding expert witness problems.

Empowered Patient Podcast
Facilitating On-Demand Outpatient Physical Therapy at Home with Palak Shah Luna TRANSCRIPT

Empowered Patient Podcast

Play Episode Listen Later Oct 26, 2021


Palak Shah is a physical therapist and Co-Founder of Luna who is attacking the problem of providing physical therapy to the growing population of patients with the need to receive in-person care by a physical therapist. Palak explains, "What is super different about Luna is that we're not a home health agency. We're bringing out physical therapy to patient homes for all our patients in 19 states and 32 metro markets today. Having about 1,200 therapists on the platform now throughout the country, bringing technology and high-quality care from the therapists, is Luna's superpower. The vision here is what we're trying to bring with technology and these amazing quality therapists is to reimagine the physical therapy experience." "All of Luna's therapists are moonlighting with Luna, more than 95% and hence the name Luna. So they are working at outpatient clinics today that are in our community, but also have this amazing opportunity to participate with an organization like Luna that allows them supplemental income." @GetLunaCare #COVID19 #HomePhysicalTherapy #HospitalatHome #PhysicalTherapist #PT #PhysicalTherapy #Recovery #Rehab #RehabatHome #Rehabilitation #RehabTherapy #Treatment GetLuna.com Listen to the podcast here

Empowered Patient Podcast
Facilitating On-Demand Outpatient Physical Therapy at Home with Palak Shah Luna

Empowered Patient Podcast

Play Episode Listen Later Oct 26, 2021 17:08


Palak Shah is a physical therapist and Co-Founder of Luna who is attacking the problem of providing physical therapy to the growing population of patients with the need to receive in-person care by a physical therapist. Palak explains, "What is super different about Luna is that we're not a home health agency. We're bringing out physical therapy to patient homes for all our patients in 19 states and 32 metro markets today. Having about 1,200 therapists on the platform now throughout the country, bringing technology and high-quality care from the therapists, is Luna's superpower. The vision here is what we're trying to bring with technology and these amazing quality therapists is to reimagine the physical therapy experience." "All of Luna's therapists are moonlighting with Luna, more than 95% and hence the name Luna. So they are working at outpatient clinics today that are in our community, but also have this amazing opportunity to participate with an organization like Luna that allows them supplemental income." @GetLunaCare #COVID19 #HomePhysicalTherapy #HospitalatHome #PhysicalTherapist #PT #PhysicalTherapy #Recovery #Rehab #RehabatHome #Rehabilitation #RehabTherapy #Treatment GetLuna.com Download the transcript here

Becker’s Healthcare -- Spine and Orthopedic Podcast
Dr. Ravi Bashyal, Director of Outpatient Hip & Knee Replacement Surgery at NorthShore Orthopaedic and Spine Institute

Becker’s Healthcare -- Spine and Orthopedic Podcast

Play Episode Listen Later Oct 20, 2021 16:59


Dr. Ravi Bashyal, Director of Outpatient Hip & Knee Replacement Surgery at NorthShore Orthopaedic and Spine Institute, joined the podcast to talk about value in orthopedic care and how surgeons are getting back to the basics in quality.

Podcasts360
Chandler Howell, PharmD, on Disparities in Outpatient Management of Type 2 Diabetes

Podcasts360

Play Episode Listen Later Oct 19, 2021 10:45


In this podcast, Chandler Howell, PharmD, speaks about the guideline-recommended first and second-line treatment options for type 2 diabetes, the pharmacist involvement in the care of people with diabetes, and gaps that exist in access to medication for people with fewer financial resources. He presented on this topic at ADCES21.

Pharmacy Preceptor Podcast
Episode 54: New Ways to Justify Outpatient Clinical Services

Pharmacy Preceptor Podcast

Play Episode Listen Later Oct 18, 2021 16:42


Sara and Ryan talk with Dr. Ed Battjes from St. Joseph Regional Medical Center Family Medicine Center about ways to establish and expand outpatient clinical services rendered by pharmacists.  The discussion includes financial as well as provider acceptance aspects.

ERCAST
61. Outpatient COVID-19 Therapy with Salim Rezaie, MD

ERCAST

Play Episode Listen Later Oct 14, 2021 30:54


The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing. Today we have a conversation with Salim Rezaie, MD whose dive into this literature couldn't be much deeper. We discuss which subgroup of patients might benefit from monoclonal antibodies, why the jury is still out on the benefit of ivermectin, the role of inhaled budesonide, and outpatient anticoagulation which hasn't been studied, but hopefully will be someday. Listen on: iTunes Spotify Stitcher   Guest Bio:  Salim Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University.  He currently works as a community emergency physician at Greater San Antonio Emergency Physicians (GSEP) where he is the director of clinical education.  Salim is the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that tries to cut down knowledge translation gaps of research to bedside clinical practice. Hear more from Salim on Stimulus #16 Accumulation of Marginal Gains.    We Discuss: The fact that the best treatment of COVID-19 is prevention through vaccination [2:30];   The value and purported benefit of monoclonal antibodies [03:21];     Whether a rapid antibody test would help predict seronegativity [06:30];   Specifically which monoclonal antibodies are being used in Salim's shop [07:40]; The irony of people demanding monoclonal antibodies, but refusing vaccination because they don't know what's in it [08:50];     Why you can't trust everything you read about COVID-19 therapy in a news headline [12:40];   One of the largest ivermectin studies which was based on falsified data, yet continues to influence the results of meta-analyses  [15:30];   Inhaled budesonide for COVID-19 symptom control [22:00];   The slippery slope of outpatient anticoagulation [23:39];   The things Salim might do if he had symptomatic COVID-19 and was well enough to be managed as an outpatient [27:25];   And more.   Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/   If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx

Stimulus.
61. Outpatient COVID-19 Therapy with Salim Rezaie, MD

Stimulus.

Play Episode Listen Later Oct 14, 2021 30:54


The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing. Today we have a conversation with Salim Rezaie, MD whose dive into this literature couldn't be much deeper. We discuss which subgroup of patients might benefit from monoclonal antibodies, why the jury is still out on the benefit of ivermectin, the role of inhaled budesonide, and outpatient anticoagulation which hasn't been studied, but hopefully will be someday. Listen on: iTunes Spotify Stitcher     Guest Bio:  Salim Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University.  He currently works as a community emergency physician at Greater San Antonio Emergency Physicians (GSEP) where he is the director of clinical education.  Salim is the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that tries to cut down knowledge translation gaps of research to bedside clinical practice. Hear more from Salim on Stimulus #16 Accumulation of Marginal Gains.    We Discuss: The fact that the best treatment of COVID-19 is prevention through vaccination [2:30];   The value and purported benefit of monoclonal antibodies [03:21];     Whether a rapid antibody test would help predict seronegativity [06:30];   Specifically which monoclonal antibodies are being used in Salim's shop [07:40]; The irony of people demanding monoclonal antibodies, but refusing vaccination because they don't know what's in it [08:50];     Why you can't trust everything you read about COVID-19 therapy in a news headline [12:40];   One of the largest ivermectin studies which was based on falsified data, yet continues to influence the results of meta-analyses  [15:30];   Inhaled budesonide for COVID-19 symptom control [22:00];   The slippery slope of outpatient anticoagulation [23:39];   The things Salim might do if he had symptomatic COVID-19 and was well enough to be managed as an outpatient [27:25];     And more.   Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/   If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx

Ask Doctor Dawn
Lots of Brain-related topics and many other interesting health stories

Ask Doctor Dawn

Play Episode Listen Later Oct 13, 2021 38:17


KSQD 10-06-2021: Benefits and side effects of implanted spinal stimulators for pain control; A case of using brain stimulation to address treatment-resistant depression; COVID News: Merck announces an oral antiviral pill for COVID-19; Vaccine is good during pregnancy; Outpatient intravenous COVID-19 treatment; Recent Australian forest fires dumped iron into the ocean, feeding algae blooms that absorbed much of the CO2 released from the fires! Editorial about Resilience at many levels; Repurposing an existing asthma drug helps treat sinusitis with nasal polyps; Using mRNA vaccine technology to fight cancer; Evolution designed us to utilize plants to try to protect us from pollution, radiation etc.; A drug derived from turmeric may have significant anti-cancer, anti-Parkinson's and other anti-neurodegenerative properties; Ahiflower Oil is a good vegan source for adequate healthy Omega fatty acids; Irisin, which helps convert white fat into brown, improves cognitive function

Ask Doctor Dawn
Lots of Brain-related topics and many other interesting health stories

Ask Doctor Dawn

Play Episode Listen Later Oct 13, 2021 38:17


KSQD 10-06-2021: Benefits and side effects of implanted spinal stimulators for pain control; A case of using brain stimulation to address treatment-resistant depression; COVID News: Merck announces an oral antiviral pill for COVID-19; Vaccine is good during pregnancy; Outpatient intravenous COVID-19 treatment; Recent Australian forest fires dumped iron into the ocean, feeding algae blooms that absorbed much of the CO2 released from the fires! Editorial about Resilience at many levels; Repurposing an existing asthma drug helps treat sinusitis with nasal polyps; Using mRNA vaccine technology to fight cancer; Evolution designed us to utilize plants to try to protect us from pollution, radiation etc.; A drug derived from turmeric may have significant anti-cancer, anti-Parkinson's and other anti-neurodegenerative properties; Ahiflower Oil is a good vegan source for adequate healthy Omega fatty acids; Irisin, which helps convert white fat into brown, improves cognitive function

Becker’s Healthcare Podcast
Total Joints and the Outpatient Setting

Becker’s Healthcare Podcast

Play Episode Listen Later Oct 13, 2021 20:52


In this episode we are joined by orthopedic surgeons, Dr. Aric Christal and Dr. Ronald Singer to discuss total joints and what they are seeing in the outpatient setting. They dive into the trends they are seeing with moving from hospital outpatient settings, the role of technology, the movement of being more patient driven, patient selection and much more.This episode is sponsored by Smith+Nephew.

Talk Ten Tuesdays
Outpatient CDI Risk Adjustment and HCC Capture

Talk Ten Tuesdays

Play Episode Listen Later Oct 12, 2021 56:18


Outpatient CDI programs can have real impact with risk adjustment and Hierarchical Condition Categories (HCCs). An important component of the HCC risk adjustment model is accurate and appropriate HCC capture, representing a patient's disease burden year over year.HCCs reflect hierarchies within related disease categories. A patient can have multiple HCC categories assigned, and each category, along with patient demographics, is factored into the patient's overall risk adjustment factor (RAF) score.The higher the RAF score, the sicker the patient. On the upcoming edition of Talk Ten Tuesdays, we'll will cover the basics of HCCs and what steps to take in order to begin your outpatient CDI program with a focus on these factors. Broadcast Special Guest Colleen Deighan will also conduct a Talk Ten Tuesdays Listener Survey on this topic.The live broadcast will also feature these other segments:The Coding Report: In keeping with the broadcast's theme, Laurie Johnson will report on the new psychiatric codes for fiscal year 2022.Tuesday Focus: CMS Resumes Targeted Probe-and-Educate Program: Nationally recognized professional, coder, auditor, and educator Terry A. Fletcher will return to the broadcast to report on the resumption of the Centers for Medicare & Medicaid Services (CMS) Targeted Probe-and-Educate (TPE) program, which was delayed in response to the COVID-19 public health emergency (PHE) in March 2020. CMS has given the Medicare Administrative Contractors (MACs) the go-ahead to resume paused TPE reviews and initiate new reviews.Special Report: CMS One-Year Extension: Susan Gatehouse, founder and president of Axea Solutions, will report on the CMS one-year extension of New Technology Add-on Payments (NTAPs) for 13 technologies for which the payments otherwise would have discontinued beginning in 2022.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

CEimpact Podcast
Report Cards for Outpatient Antimicrobial Prescribing

CEimpact Podcast

Play Episode Listen Later Oct 5, 2021 27:11


Can a ‘report card' tame excessive prescriptions of antibiotics in outpatient settings? In this episode Dr. Wall with guest Josh Yost, MD, FACP will evaluate a paper that looked at using 'report cards' on antibiotic use and its impact on outpatient prescribing.Earn CME or CPE credit here!References and resources: Schwartz KL, Ivers N, Langford BJ, et al. Effect of Antibiotic-Prescribing Feedback to High-Volume Primary Care Physicians on Number of Antibiotic Prescriptions: A Randomized Clinical Trial. JAMA Intern Med. Published online July 06, 2021. doi:10.1001/jamainternmed.2021.2790Continuing Education Information:Learning Objectives:1. Discuss the implementation of a report card to educate primary care providers on overuse of antibiotics2. Discuss issues related to implementation of the study methods to other health systems and the potential costs that could be saved in doing so0.05 CEU | 0.5 HrsACPE UAN: 0107-0000-21-306-H01-PInitial release date: 9/7/21Expiration date: 9/7/22Complete CPE & CME details can be found here.What's new?GameChangers Pharmacotherapy Podcast will release new episodes on Mondays starting 10/18/2021We are making it easier to claim CE Credit for listening each week! This October - we'll launch a simple, one membership option so you can get one-click CE redemption for GameChangers episodes.  Name changes! You'll notice the podcast show will change to CEimpact - you'll still get new GameChangers episodes released each week on Mondays. Keep listening here and your feed will automatically switch over to CEimpact on 10/18.

Talk Ten Tuesdays
Outpatient CDI and Getting Back to the Basics

Talk Ten Tuesdays

Play Episode Listen Later Sep 28, 2021 57:14


Physician engagement, query productivity, and revenue integrity are some but not all of the activities that encompass today's outpatient clinical documentation integrity (OP CDI) arena, which continues to gain traction among America's hospitals and health systems.During an exclusive broadcast report, CDI expert Colleen Deighan will unveil a Talk Ten Tuesdays listener's survey on this topic, in which listeners are encouraged to participate. Delving into the survey responses, Colleen will join us on a biweekly basis through the end of the year, and share her knowledge and experience on how hospitals and health systems can determine where and how to focus their efforts to have the biggest impact.The live broadcast will also feature these other segments:The Coding Report: Laurie Johnson will report on the latest coding news.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.Tuesday Focus: Root operation control guidelines have changed during the last five years, and a new update will take place on Oct. 1, 2021. Senior healthcare consultant Kristi Pollard, director of coding quality and education with Haugen Consulting Group, will report on this topic while providing examples for reporting the control of bleeding.Special Report: The No Surprises Act, or the "balance billing rule" for emergent out-of-network services, saw a provider reprieve as it pertains to the Jan. 1, 2022 effective date,  as the Centers for Medicare & Medicaid Services (CMS) will delay certain provisions of the Act to allow for better infrastructure, interoperability, and communication between payors, facilities, and providers. Nationally recognized professional coder, auditor, and consultant Terry Fletcher will report the good news.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Family Addiction Recovery Podcast
The Hedin brothers share their experience of addiction and triumph. Now working in the addiction recovery field; their story is amazing.

Family Addiction Recovery Podcast

Play Episode Listen Later Sep 21, 2021 81:44


Episode six features the Hedin brothers whose journey began when they were each using substances in their mother's basement. They both were able to go through treatment and today have years of long-term sobriety. Bryan is the Executive Director of our Residential center and Jameson the Clinical Director of the Outpatient program.

BS Free MD with Drs. May and Tim Hindmarsh

You asked for it! More updates on Covid. We are giving a Sparks notes version on Vaccines, Boosters, and early treatment. We take a look around the world, to see what is going on and to bring you a sense of where we THINK we are headed. -Boosters- yay or nay? -Outpatient treatment- what's in vogue and why aren't we using it? -What we know about Chicken health and how that impacts Covid vaccines And yes…...someone who's vaccinated got COVID! Was it Sturgis?? Today's show is brought to you by Deputy- an award-winning mission- driven time management scheduling and communication software for physician practices. Disclaimer All opinions expressed by the guest in this episode are solely our opinion and are not to be used as specific medical advice. The hosts, May and Tim HIndmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Links: Ivermectin, ‘Wonder drug' from Japan: the human use perspective: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740/ Vaccine Failure and the Way Out: https://eugyppius.substack.com/p/vaccine-failure-and-the-way-out Leaky Vaccines Enhance Spread of Deadlier Chicken Viruses: https://www.nationalgeographic.com/science/article/leaky-vaccines-enhance-spread-of-deadlier-chicken-viruses Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1 Learning From the Past: https://www.nature.com/articles/s41579-020-00462- Sponsor: Doctorpodcastnetwork.com/deputy Stay in the loop with us: Thanks for joining us! You are the reason we are here.  If you have questions, reach out to us at doc@bsfreemd.com or find Tim and I on Facebook and IG. Please check out our every growing website as well at : bsfreemd.com (no www)  GET SOCIAL WITH US! Instagram:: https://www.instagram.com/bsfreemd/ Facebook: https://www.facebook.com/bsfree  

I Love Neuro
73: 3 Easy Ways to Stay Up To Date with Research (Even If You Have No Time)

I Love Neuro

Play Episode Listen Later Sep 6, 2021 32:45


Okay so we didn't actually count how many we give, but there are at least 3 and they are definitely easy! Why should we care about the research? Because we care about evidence-based care! So how to stay up to date on the latest research?? Today we talk about how to stay current and apply it in your practice.  Claire and Erin share their favorite EASY methods for staying up to date on current evidence. Want to access free full text articles that aren't available to you?  Try this site: https://sci-hub.se Join us for our next webinar series to get the latest research and evidence-based ideas!  A 2-part series entitled Building the Functional Foundation Across the Rehab Spectrum: Trunk Activation and Control Part 1 will be Supine and Sitting for Clinicians Working in Acute, Inpatient Rehab, and Skilled Nursing Facilities and Part 2 will be Standing and Walking for Clinicians Working in Home Care and Outpatient  https://www.neurocollaborative.com/trunk Anti-racist action: Reviewing articles inside JAMA August 17, 2021, Vol 326, No. 7, Pages 587-680 | Racial and Ethnic Disparities and Inequities in Medicine and Health Care https://jamanetwork.com/journals/jama/issue/326/7

Conservative Review with Daniel Horowitz
Ep 943 | An ICU Doctor Warns of the Emergency Need for Early Outpatient Treatment | Guest: Dr. Mollie James

Conservative Review with Daniel Horowitz

Play Episode Listen Later Aug 28, 2021 59:15


Today, I'm joined by Dr. Mollie James, a board-certified general surgeon and critical care doctor, who has been treating COVID since the first days of the New York City outbreak last March. She gives a vivid description of what she is seeing in the ICU and how, if the medical establishment allowed her to innovate, she'd be able to turn more people around. But more importantly, her experience has taught her that early treatment is the best way to avoid critical illness to begin with. To that end, she volunteers for MyFreedoctor.com and has her own personal telemedicine business at IvermectinCan.com. Those dumping on ivermectin might want to speak to her patients who are now alive thanks to her willingness to buck the system and prescribe the drug.  Learn more about your ad choices. Visit megaphone.fm/adchoices

The Covexit.com Podcast
Dr. Richard Urso Comments on the Delta Variant and the Need to Constantly Adapt Outpatient Treatment Protocols

The Covexit.com Podcast

Play Episode Listen Later Aug 27, 2021 22:01


Dr. Richard Urso is one of the most prominent frontline doctors in the US, having been at the forefront of the battle for the early treatment of COVID-19 since early 2020. His remarks are those not only of a frontline doctor but also of an expert in the repurposing of drugs.

Bob & Brad
Could This Outpatient Procedure Finally Relieve Your Chronic Low Back Pain? Interview With Dr. Ekstrom

Bob & Brad

Play Episode Listen Later Aug 23, 2021 53:41


Bob interviews Erik Ekstrom M.D. & Cynthia Konrath PA-C on Back Pain Surgery known as Intracept Procedure. The Intracept Procedure is a new, minimally invasive option to treat chronic low back pain. The procedure has been proven to be safe and effective in clinical trials, and is much less invasive than typical surgical options to treat low back pain. Dr. Ekstrom Website- https://www.summitortho.com/provider/erik-j-ekstrom-md/ Karen's Success Story- https://www.summitortho.com/2021/04/29/karens-summit-story/ Intracept article summit- https://www.summitortho.com/2020/02/12/intracept-offers-new-hope-for-low-back-pain/ Intracept /Relievant site- https://www.relievant.com/intracept-procedure/

America's Town Hall with Heidi St. John
HOPE in the midst of fear! You Don't Need to Fear Covid: Dr. Richard Bartlett on Early Outpatient Treatments

America's Town Hall with Heidi St. John

Play Episode Listen Later Aug 18, 2021 57:13


Dr. Richard Bartlett, an emergency room doctor, joins me today to talk about Covid and how it has been grossly mishandled by the medical establishment and our government. There are successful treatments that are extremely effective and available to you right now. Stop listening to the fear-mongering, mask mandates, and endless stream of frightening information in the mainstream news outlets—there is HOPE. Grab a pencil and listen to this powerful interview with Dr. Richard Bartlett. ***Budesonide Works | Synergy Health DPC | MyFreeDoctor.com***

The ACDIS Podcast: Talking CDI
Getting started in outpatient CDI

The ACDIS Podcast: Talking CDI

Play Episode Listen Later Aug 4, 2021 32:51


Today's guest is Yvonne Whitley, RN, BSN, CPC, CRC, CDEO, CCDS-O, manager of ambulatory CDI at Novant Health in Charlotte, North Carolina. Today's co-host is Sharme Brodie, RN, CCDS, CCDS-O, CDI education specialist with HCPro/ACDIS in Middleton, Massachusetts. Today's show is sponsored by Curation Health. Curation Health helps providers and health plans navigate and scale from fee-for-service to value-based care. Our advanced clinical decision support platform for value-based care drives more accurate risk adjustment and quality program performance by curating and delivering relevant, real-time insights to the clinician and care team. For more information, visit www.curationhealth.com. Featured solution: Today's featured ACDIS solution is the 2021 ACDIS national conference. After a year in which we had to cancel our 2020 event, ACDIS is stepping forward to make ourselves and the CDI profession stronger than ever. Join us October 24-28 in Dallas, Texas, for the return of the ACDIS national conference. We're offering cutting-edge education across more than 60 CDI-focused presentations in our first-ever hybrid event. Our in-person event at the Sheraton Dallas Hotel features four concurrent tracks focused on coding and clinical concerns, management and professional development, regulatory changes and challenges, outpatient CDI, and much more. In a new value-added supplement this year, we're offering online-only bonus presentations that participants can enjoy when they return home. Click here to learn more and register today! (http://ow.ly/7l3b30rLACx) In the News: “Note from the ACDIS Director: Signs of a strong CDI comeback,” by Brian Murphy in CDI Strategies (http://ow.ly/uJNw30rOzBd)      ACDIS update: “ACDIS update: Download the Leadership Council report on CDI and technology today,” from CDI Strategies (http://ow.ly/KrII30rPYAx)

Radio Advisory
85: Two big surprises in CMS' 2022 outpatient proposed rule

Radio Advisory

Play Episode Listen Later Jul 29, 2021 12:41


Last week, CMS released its proposed payment rule for hospital outpatient departments and ambulatory surgery centers for 2022. In this episode, Rae sits down with Advisory Board's Heather Bell and Rob Lazerow to dive into the proposed rule and discuss what it means for hospitals, specifically in the realm of price transparency and site of care shifts. Links: The IPO list is here to stay—and 3 other surprises in CMS' 2022 outpatient proposed rule [Webinar | Aug. 19] Stay Up to Date: What the new outpatient and physician payment rules mean for health care How will CMS' removal of the IPO list affect your hospital? Here's how to find out. Ep. 76: Transparency and surprise billing: The biggest policies coming your way