The Dose

Eighty-five percent of all U.S. health care spending goes toward managing chronic diseases connected to poor diet and nutrition. Yet most doctors receive little to no meaningful training in nutrition. As a result, food and nutrition remain absent from doctor–patient conversations, with medications the default option for most ailments.
On the new episode of The Dose podcast, Dr. Joel Bervell talks with Dr. Dariush Mozaffarian, director of the Food Is Medicine Institute at Tufts University, about why that gap exists, what it will take to close it, and what's presently working.
Increasingly, doctors are beginning to prescribe produce or meals medically tailored to a patient's condition, with the cost covered by the patient's health plan. And a growing number of states are currently testing or planning to test food-as-medicine programs through Medicaid. Meanwhile, a third of U.S. medical schools have committed to meaningful nutrition education for doctors, something that would have been unthinkable a decade ago.
"Food is the single biggest challenge and opportunity, not just in health care, but also in our economy and the environment," says Dr. Mozaffarian. "And it's all fixable."

The prospect of 900,000 New York City residents losing Medicaid coverage under H.R. 1, the tax and spending law passed by Republicans last year, amounts to "bureaucratic violence," says Dr. Alister Martin. In response, he's devised a plan that starts on the streets of Queens and builds out from there with strategically placed community health workers and people assisting with insurance enrollment.
On the new episode of The Dose podcast, Dr. Joel Bervell talks with Dr. Martin, an emergency physician, former White House Fellow, and now health commissioner for 8.5 million New Yorkers. They discuss what a city can do when the federal safety net is pulled out from under its residents.
"Having people be at the center of our response is critically important, because that's what's going to make a difference. You can only move at the speed of trust in public health."

Much of the AI used in health care today is tied up in helping the industry manage its revenue streams — think billing and coding assistance. But Dr. Toyin Ajayi knows there's more AI can do to help manage the health of patients.
On the new episode of The Dose, Dr. Joel Bervell talks with Dr. Ajayi, a board-certified family physician and CEO of the primary care provider Cityblock Health, about the ways she is using AI to make meaningful differences in the health of the most underserved patients. Dr. Ajayi's data-driven, outcomes-based care model has already demonstrated reductions in emergency room visits and higher patient engagement — as well as lower overall costs. Now, she's using AI to scale it.
"Technology, if done right, is one of the very few deflationary forces we can apply to health care costs right now."
Cityblock Health

When people receive a medical diagnosis or experience a new symptom, the first thing many of us do is reach for our phone. If a doctor isn't available to provide an answer, someone else is.
On The Dose podcast, host Dr. Joel Bervell talks with Dr. Mike Varshavski, a primary care physician with more than 30 million social media followers, about what it takes to fight health misinformation at scale, what health institutions still get wrong about social media, and why entertainment and education aren't opposites.
Doctor Mike, as he's known, didn't set out to become a popular online figure. He says he was driven to act as he watched misinformation fill a space that medicine was too cautious to engage with.
"We trust you to cut people open, to prescribe all these medicines that have potential side effects — but we don't trust you to make a video on the subject you're an expert on," he says, describing the double standard physicians face online.
Show Notes:
The Checkup with Doctor Mike

Dr. Kaytura Felix didn't set out to document the Black maternal health crisis. She set out to find the people who are already doing something about it.
On this episode of The Dose podcast, Dr. Joel Bervell talks with Felix, founder of the Black Birthing Futures project, about what she discovered: a constellation of Black community midwives providing "deep care" — clinical, emotional, social, and spiritual support centered on care of the birthing family.
"The family is the sun and all the providers are orbiting them," says Felix.
But keeping the family at the center isn't easy. Felix shares what stands between deep care and the families who need it most.