The Dose

Dr. Elisabeth Potter was in the middle of operating on a patient with breast cancer when a nurse delivered an urgent message: UnitedHealthcare was on the line. She stepped outside the OR and took the call. It was the insurer asking why the patient, who was on the operating table, needed to stay overnight.
"It felt like they had invaded a very sacred space where the priorities should be really clear, patient first always, and they were bringing these administrative questions into the moment."
On The Dose podcast, Dr. Joel Bervell talks with Dr. Potter, a surgeon in Austin, Texas, about what years of fighting insurance companies, building her own surgery center, and walking the halls of Congress have taught her about how our health system actually works, and how we can change it.
"Doctors should be able to spend more time being doctors," Potter says. "And patients should be able to spend less time fighting the system just to get well."

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