The External Medicine Podcast (The External Medicine Podcast)
Explore every episode of The External Medicine Podcast
| Pub. Date | Title | Duration | |
|---|---|---|---|
| 24 Feb 2022 | Michael Levin, PhD: Limb Regeneration, Bioelectricity, and Why Neurons Aren’t Special | 01:18:26 | |
In this exciting episode, Mitch Belkin and Daniel Belkin speak with Professor Michael Levin about bioelectricity, the electrical potentials that cells use to communicate with one another. Professor Levin argues that bioelectricity is the software of cellular communication and is the medium through which we can control top-down modular programs for cancer prevention, limb regeneration, and birth defect repair. This interview covers how he co-created Xenobots; how somatic cells function like neurons; how his work incorporates insights from Karl Friston on collective intelligence and the free energy principle; and his dream of building an anatomic compiler, a theoretical biological-design program that would allow users to produce any anatomic configuration of any organism using bioelectricity. Who is Michael Levin? Professor Michael Levin is a biologist at Tufts University, where he investigates informational storage and processing in biological systems. He received a dual Bachelor’s in computer science and biology at Tufts. He then received his PhD in Genetics from Harvard where he characterized the molecular-genetic mechanisms of embryologic left-right asymmetry. Nature lists this discovery on its 100 milestones of developmental biology of the century. Currently, he is the director of the Tufts Center for Regenerative and Developmental Biology and the Allen Discovery Center at Tufts University. He is the co-editor in chief of the journal Bioelectricity, the founding associate editor of Collective Intelligence, and he sits on the editorial advisory board of Laterality. He has published more than 350 papers.
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| 23 Apr 2022 | Ben White, MD: Radiology, Medical Education, and Blogging | 01:02:33 | |
In this episode, Mitch Belkin and Daniel Belkin speak with Ben White about his background and reasons for selecting radiology. They discuss ways to improve radiology residency training and medical school education. They briefly touch on physician shortages, Dr. White’s blogging at BenWhite.com, and his nano-fiction project (Nanoism). Who is Ben White? Dr. Ben White is a practicing neuroradiologist and an Associate Program Director at Baylor University Medical Center. Dr. White obtained his Medical Degree from University of Texas Medical School at San Antonio before completing a radiology residency and neuroradiology fellowship at UT Southwestern Medical Center. He’s a prominent blogger at BenWhite.com, the editor of a nano-fiction website, and the author of three books, including a free book on student loans. References:
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| 28 Apr 2022 | Robert Montgomery, MD: Immunology, Pig Organs, and the Future of Transplantation | 00:52:44 | |
In this episode, Mitch Belkin and Daniel Belkin speak with Robert Montgomery, MD, DPhil, about his background, family history of cardiomyopathy, as well as his work in immunology and transplantation. They discuss the 3 types of organ rejection, how to manage and prevent rejection, porcine endogenous viruses, as well as Dr. Montgomery's work on xenotransplantation. This podcast was recorded on February 4th, 2022. Who is Robert Montgomery? Dr. Robert Montgomery is a Professor of Surgery and the chair of the Department of Surgery at NYU Langone as well as the director of the NYU Langone Transplant Institute. He received his MD from the University of Rochester School of Medicine and completed his surgical residency, multi-organ transplant fellowship, and post-doctoral fellowship in Human Genetics at Johns Hopkins. He also received a Doctorate of Philosophy in molecular immunology from the University of Oxford. He’s been the recipient of many awards including the Johns Hopkins Clinician Scientist Award, the Champion of Hope Award from the National Kidney Foundation of Maryland, and the Terasaki Medical Innovation Award from the National Kidney Registry. Dr. Montgomery developed the first laparoscopic kidney procurement technique for transplants as well as the first “domino paired donation” -- which is when two or more donors and recipients are paired in a kidney swap. He helped develop a protocol combining kidney and bone marrow transplants to prevent rejection of donor organs in immune-incompatible patients which has eliminated the need for immunosuppressive therapy in some patients. In September 2021, Dr. Montgomery performed the first xenotransplantation of a nonhuman kidney to a deceased human donor. References:
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| 05 May 2022 | Nikhil Krishnan: Healthtech Startups, Dank Memes, and Zero to One in Healthcare | 01:02:55 | |
In this conversation, Mitch Belkin and Daniel Belkin speak with Nikhil Krishnan about his healthcare newsletter (OutofPocket), why he’s optimistic about healthcare startups, and what he’s learned from investing in health tech companies. He talks about his preferred business models and gives advice to healthcare entrepreneurs on the zero-to-one phase of startups. They also discuss direct-to-physician and direct-to-consumer advertising of pharmaceuticals, digital therapeutics, unbundling of the hospital, and touch on medical education. Nikhil Krishnan is a prolific blogger and masterful meme-maker who writes about healthcare. He’s the author of a free newsletter (outofpocket.health) on which he tries to make healthcare and changes in the industry accessible. Previously, he worked at TrialSpark, building a new way to run clinical trials faster and cheaper, and CB Insights creating data driven research trends in healthcare. He is the author of a children’s book and a Medical Bankruptcy Game. References: ______________________ Follow us at @ExMedPod | |||
| 16 May 2022 | Rick Johnson, MD: Fructose, Metabolic Syndrome, and Bipolar Disorder | 00:57:05 | |
In this conversation, Mitch Belkin and Daniel Belkin speak with Rick Johnson, MD, about how his views on fructose metabolism have evolved over the past decade. If you haven’t checked out Episode 9 with Dr. Johnson, check that out for more background. In this episode, Dr. Rick Johnson talks about endogenous fructose metabolism, the thrifty gene hypothesis, fat as a source of metabolic water, dehydration and how it stimulates fat production, as well as the relationship between uric acid and bipolar disorder. He also talks about how alcohol-induced liver disease is actually mediated by fructose. Finally, he argues that fructose metabolism is a significant contributor to Alzheimer’s disease. Who is Rick Johnson? Dr. Johnson is a Professor of Nephrology at the University of Colorado School of Medicine. He is one of the world’s leading experts on fructose. His research focuses on the role of fructose and uric acid in obesity, diabetes, hypertension, and kidney disease. He is the author of over 700 academic papers as well as three books for a general audience: The Fat Switch, The Sugar Fix, and most recently Nature Wants Us To Be Fat. References:
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| 07 Jun 2022 | Jason Ryan, MD: Physician Entrepreneurship, Boards and Beyond, and How to Improve Medical Education | 00:49:33 | |
In this conversation, Mitch Belkin and Daniel Belkin speak with Dr. Jason Ryan, the creator of Boards and Beyond. We discuss how he started Boards and Beyond, what aspects of medical education are in need of reform, and why he is bullish on med ed entrepreneurship. In this episode, we cover Dr. Ryan's background, his roots in chemical engineering, and how he decided on internal medicine and cardiology. We delve into how Dr. Ryan started Boards and Beyond, as his first entrepreneurial venture in 2014. He discusses why and how he began the medical education company, how he incorporates feedback into the product, as well as the difficulties he has encountered running the business. We touch on problems with standardized testing, how residency programs evaluate applicants, and why attendings struggle to evaluate medical students. Finally, we discuss how to reduce costs in medical school and the difficulties medical schools have in finding medical preceptors. Who is Jason Ryan? Dr. Jason Ryan is a general cardiologist and an Associate Professor of Medicine at the University of Connecticut. He received his MD and MPH from University of Connecticut before completing his postdoctoral training at Harvard’s Beth Israel Deaconess Medical Center in Boston. Dr. Ryan is a gifted medical educator and the creator of Boards and Beyond, a video subscription service that provides a comprehensive review of USMLE Board topics. References:
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| 08 Jul 2022 | Christy Chapin, PhD: Bad Incentives, the AMA, and How US Healthcare Became Dysfunctional | 01:20:56 | |
In this conversation, Daniel Belkin and Mitch Belkin speak with Professor Christy Chapin, who is an Associate Professor of History at University of Maryland Baltimore County. We discuss how the American insurance company-based model of healthcare developed in the first half of the 20th century. Specifically, we explore the role of some of the major actors who created the fragmentary and expensive US healthcare landscape: the American Medical Association (AMA), Blue Cross and Blue Shield, as well as private insurance companies. In this episode, Professor Chapin defines what she terms the “insurance company model” of healthcare. We explore various competing models at the turn of the 20th century, including prepaid physician groups, which were an early multi-specialty group practice. (This model of healthcare delivery, which Professor Chapin argues, could have become the dominant model of US healthcare, was effectively banned by the American Medical Association in 1938). We discuss the organizational history of the AMA, its rise to prominence, and how it influenced the development of American healthcare. While the AMA attempted to maintain physician autonomy in the 1920s, concerns of government involvement prompted a 1938 deal with insurance companies that produced our current model of 3rd party financed healthcare. By insisting on a fee-for-service payment structure, this led to vast increases in the cost of care. Overtime, increasing insurance company regulation and government involvement (Medicare, the ACA, etc.) have attempted to reduce costs with limited success. Professor Chapin argues that the US healthcare system is not a free market. Rather, it is a product of warped incentives brought about by historical negotiations between insurance companies, hospitals, government agencies, and special interest groups. Cost containment measures instituted by insurance companies to reduce costs have led insurers to effectively control the practice of medicine. Who is Christy Chapin? In addition to being an Associate Professor of History at UMBC, Professor Chapin is a visiting scholar at Johns Hopkins. Her professional interests include 20th century U.S. political, business, and economic history. She’s also the author of Ensuring America’s Health: The Public Creation of the Corporate Health Care System, which was published in 2015. Follow us at @ExMedPod | |||
| 19 Jul 2022 | John Cochrane, PhD: The Economics of Affordable Healthcare | 01:01:48 | |
In this conversation, Daniel Belkin and Mitch Belkin speak with Professor John Cochrane about the economics of the American healthcare system. We discuss the lack of clarity around US healthcare pricing, as well as how employer-sponsored health insurance and the persistence of massive cross subsidies contribute to dysfunction in the US healthcare market. Professor Cochrane argues that the best way to solve these problems is to simplify regulation and remove regulatory hurdles which prevent innovative entrants from improving healthcare and making it more affordable. Who is John Cochrane? Professor John Cochrane is an economist specializing in finance and macroeconomics. Formerly a professor at the University of Chicago, Cochrane is now the Rose-Marie and Jack Anderson Senior Fellow at the Hoover Institution at Stanford University. He blogs regularly as The Grumpy Economist at https://johnhcochrane.blogspot.com/. References:
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| 07 Aug 2022 | Joel Topf, MD: Acute Kidney Injury, Contrast-Associated Nephropathy, and Precious Bodily Fluids | 01:07:06 | |
In this conversation, Daniel Belkin and Mitch Belkin speak with Joel Topf, MD, about contrast-associated nephropathy. We discuss Acute Kidney Injury (AKI), the value of creatinine as a marker for AKI, how to evaluate volume status, the evidence around contrast-induced/contrast-associated nephropathy, recommendations on fluids to prevent AKI in patients with Chronic Kidney Disease, and comparing venous and arterial contrast with respect to the risk of AKI. Who is Joel Topf? Dr. Topf is a clinical nephrologist in Detroit, who is a partner and medical director at St Clair Nephrology and an assistant professor at Oakland University William Beaumont School of Medicine. He is the co-creator of NephMadness and NephJC. He hosts multiple podcasts, blogs at pbfluids.com, and tweets @Kidney_boy. References:
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| 06 Sep 2022 | Sekar Kathiresan, MD: Pioneering Single Dose Medications to Cure Cardiovascular Disease | 01:09:40 | |
In this conversation, Daniel Belkin and Mitch Belkin speak with Sekar Kathiresan, MD, about using gene editing medications to treat cardiovascular disease. We discuss Dr. Kathiresan’s company Verve Therapeutics, which has pioneered a lipid nanoparticle delivery system of a CRISPR-based gene editing technology. We delve into the pathophysiology of cardiovascular disease, the role played by LDL and the LDL receptor in atherosclerosis, the genetics underlying monogenic and polygenic risk for myocardial infarction, CRISPR and the future of gene editing technologies, and Verve’s ongoing phase I trial of a PCSK9 gene editing medication (VERVE-101) in humans. Dr. Sekar Kathiresan, a cardiologist, geneticist, and the CEO and co-founder of Verve Therapeutics. Verve Therapeutics is a company pioneering a new approach to the treatment of cardiovascular disease with single-dose gene editing medications. Prior to co-founding Verve, he served as the director of the Massachusetts General Hospital Center for Genomic Medicine and was a Professor of Medicine at Harvard Medical School.
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| 24 Sep 2022 | Adam Cifu, MD: On Ending Medical Reversals and Reimagining Medical Education | 01:02:32 | |
In this conversation, Daniel Belkin and Mitch Belkin speak with Adam Cifu, MD, about how to improve medical education, the importance of evidence-based medicine, and medical reversals. We discuss his collaboration with Vinay Prasad, MD, why we should swap the order of medical school curricula, and landmark trials that changed his clinical practice . Who is Adam Cifu? Adam Cifu a general internist and professor of medicine at the University of Chicago. He is a clinical educator, a podcast host, and the author of over 100-peer reviewed articles as well as two books: Ending Medical Reversal: Improving Outcomes, Saving Lives (2015) and Symptom to Diagnosis: An Evidence Based Guide (4th Edition, 2019)
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| 16 Oct 2022 | Carl Schneider, JD: Patient Decision-Making, Questioning Informed Consent, and Why IRBs Should Be Abolished | 02:07:26 | |
In this colorful conversation, Daniel Belkin and Mitch Belkin speak with Carl Schneider, JD about informed consent and the problematic nature of IRBs. We discuss the difficulties of patient education and whether patients actually want medical knowledge in order to guide their decision-making. We discuss the onerousness of IRB regulation, event licensing, the costs of inhibiting knowledge generation, as well as the paternalism of IRBs. We cover how "protections" for vulnerable groups counterintuitively harms these groups by preventing both the generation of knowledge and the development of treatments. Professor Schneider argues that IRBs should be abolished and the system of informed consent ought to be reconsidered. Professor Carl Schneider is a lawyer and bioethicist. He is a Professor of Ethics, Morality, and the Practice of Law at University of Michigan. After attending University of Michigan Law School, he served as law clerk to Justice Potter Stewart of the United States Supreme Court. Schneider has authored several books, including The Censor's Hand: The Misregulation of Human-Subject Research and The Practice of Autonomy: Patients, Doctors, and Medical Decisions. What is the External Medicine Podcast? Follow us at @ExMedPod | |||
| 29 Oct 2022 | Paul Offit, MD: The Cost of Medical Innovation, DDT and Malaria, and Bivalent Covid-19 Boosters | 00:58:28 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Paul Offit, MD about his book You Bet Your Life, how banning DDT caused increased deaths from malaria, and the data regarding the bivalent booster as of October 2022. They discuss the human price paid for medical advances, sins of commission versus sins of omission, which populations should get bivalent boosters, short versus long incubation period viruses, and vaccine-related myocarditis. Who is Paul Offit? Dr. Offit is the Director of the Vaccine Education Center and an attending in the Division of Infectious Diseases at the Children's Hospital of Philadelphia. He is on the FDA's Vaccines and Related Biological Products Advisory Committee. In addition, he was the co-inventor of the RotaTeq vaccine for rotavirus, has published over 130 papers in medical and scientific journals, and is the author of many books on vaccines, antibiotics, medical overuse, and medical history. including You Bet Your Life. If you didn’t see our initial episode with Dr. Paul Offit, check it out. What is the External Medicine Podcast? Follow us at @ExMedPod | |||
| 19 Nov 2022 | Jean Hébert, PhD: Aging, Brain Plasticity, and Replacing the Neocortex | 00:45:38 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Jean Hébert, PhD about aging, brain plasticity, and progressive neocortical replacement. They discuss one hallmark of aging—extracellular matrix damage—as well as how tissue replacement is a possible solution to aging. In addition, they explore the practicalities of progressive neocortex replacement, dopaminergic neuron transplants in Parkinson's patients, and Professor Hébert's work on stroke. Who is Jean Hébert? Jean Hebert, PhD, is a Professor of Neuroscience and Genetics at the Albert Einstein College of Medicine where he focuses on age-related brain degeneration in the adult neocortex. He is one of the world’s leading researchers on brain cell and tissue replacement. He is the author of the book Replacing Aging. Follow us at @ExMedPod | |||
| 04 Dec 2022 | Derek Lowe, PhD: A Medicinal Chemist's Thoughts on Drug Discovery and the Future of Pharma | 01:05:25 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Derek Lowe, PhD, about drug discovery, clinical trials, drug patents, Alzheimer’s disease, the FDA, and his blog “In The Pipeline”. They discuss the potential role for machine learning in pharmaceutical development, whether Big Pharma spends excessively on marketing, and much much more. Who is Derek Lowe? Derek Lowe, PhD, is a medicinal chemist who works in preclinical drug discovery. He received a PhD in organic chemistry from Duke University and completed a Humboldt Fellowship in Germany for his post-doc. His blog about the pharmaceutical industry “In The Pipeline” has been continuously operating since 2002. Follow us at @ExMedPod | |||
| 03 Jan 2023 | Polly Matzinger, PhD: Dangerous Ideas in Immunology | 01:34:46 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Polly Matzinger, PhD, about her model of immunology, which she calls 'The Danger Model'. They discuss how The Danger Model helps explain aspects of immunology ignored by the self/non-self model, including why mothers don't reject their fetuses, autoimmune diseases, organ transplant rejection, cancer surveillance, allergy and more. Who is Polly Matzinger? Polly Matzinger received her PhD in Biology from UCSD before completing a postdoc at Cambridge. She then worked at the Basel Institute for Immunology before moving to the NIH, where she was a section head at the National Institute of Allergy and Infectious Diseases of the so-called “Ghost Lab”. She is the creator of the Danger Model (1994), which argues the immune system discriminates between dangerous and safe by recognition of pathogens or alarm signals from injured or stressed cells and tissues. Follow us at @ExMedPod | |||
| 29 Jan 2023 | Saloni Dattani: Peer Review, Division of Labor in Science, and the Genetics of Psychiatric Disorders | 01:11:34 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Saloni Dattani about the genetics of psychiatric disorders and how to improve science. They discuss the lack of division of labor in academia, the history of peer review, ways to improve peer review, human challenge trials, and much more. Who is Saloni Dattani? Saloni Dattani is a PhD student at King’s College London. She is the founding editor of the online magazine Works in Progress. She is also an editor at Stripe Press and a researcher at Our World in Data. References:
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| 27 Feb 2023 | Adam J Brown, MD: History of Rheumatology, The Black Death, and Why You Shouldn't Inject Uric Acid Crystals into Your Knee | 01:00:52 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Adam J Brown, MD about the field of Rheumatology, autoimmune diseases, and his podcast Rheuminations. They discuss the history of gout, plaquenil, the relationship between infectious diseases and rheumatologic conditions, the inflammasome, autoinflammatory disorders, vasculitis, fibromyalgia, Covid, and much more. Who is Adam J Brown? Dr. Adam J. Brown is a Rheumatologist at the Cleveland Clinic. Dr. Brown is the author of the book Rheumatology Made Ridiculously Simple. He is also the host of the Healio podcast Rheuminations, which focuses on autoimmunity, rare diseases, and the history of medicine. References:
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| 13 Mar 2023 | Ross Levine, MD, PhD: Deep Dive on Acute Myeloid Leukemia | 00:45:39 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Ross Levine, MD, PhD about Acute Myeloid Leukemia and its treatment. They discuss the different types of leukemias, the history of AML treatment, including chemotherapy and stem cell transplantation. They touch on Graft vs Host Disease, treatment after relapse, and open questions in leukemia, including future trials, and further investigation of ven/aza (Azacitidine/venetoclax). Who is Ross Levine? Dr. Ross Levine of the Memorial Sloan Kettering Cancer Center. Dr. Levine studies hematologic malignancies and is a world-renowned expert on myeloproliferative neoplasms and acute myeloid leukemia. Follow us at @ExMedPod | |||
| 20 Mar 2023 | Parker Rogers: How FDA Deregulation Promotes Medical Device Innovation & Safety | 01:06:32 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Parker Rogers about his recent job-market paper "Regulating the Innovators: Approval Costs and Innovation in Medical Technologies" which examines the impact of FDA regulation on innovation, market structure, and product safety. They discuss the FDA's medical device risk classification and his analysis of down-classification events (from higher to lower risk categories), which shows deregulation has a positive impact on innovation, firms producing devices, as well as product safety. They also touch on the value of regulation versus litigation, legal liability exposure of small versus large firms, and the European Medicine Agency. Who is Parker Rogers? Parker Rogers is a Ph.D. Candidate in Economics at the University of California, San Diego. In the fall of 2023, he will be a Postdoctoral Fellow in Aging and Health Research at the National Bureau of Economic Research. In the fall of 2024, he will be joining the School of Business at Indiana University as an Assistant Professor. Follow us at @ExMedPod | |||
| 23 Apr 2023 | Andrew Foy, MD: Critical Appraisal, Austrian Economics, and Medical Conservatism vs Medical Liberalism | 01:07:22 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Andrew Foy, MD, about evidence-based medicine, applying Guideline-Directed Medical Therapy (GDMT) to hospitalized patients, and evaluating aggressive versus conservative blood pressure goals in patients with comorbitidies. They discuss Dr. Foy's article on Hayek, critical appraisal of the medical literature, medical conservatism, and his skepticism around Coronary Computed Tomography Angiography as compared to Functional Stress Testing in patients with coronary artery disease. Finally, they touch on alternative visions of medical practice, content expertise in COVID, as well as statins as a potential cause of diabetes. Who is Parker Rogers? Andrew Foy, MD is a cardiologist and Associate Professor of Medicine and Public Health Sciences at Penn State College of Medicine. His research interests include management of emergency department patients with low-risk chest pain, management of patients with benign and renovascular hypertension, as well as unnecessary and overly-aggressive medical care. Follow us at @ExMedPod | |||
| 12 May 2023 | John Ayers, PhD: ChatGPT and the Future of Medicine | 01:19:59 | |
In this conversation, Daniel Belkin and Mitch Belkin interview John Ayers, PhD about ChatGPT and its potential to revolutionize the practice of medicine. We delve into his recent JAMA internal medicine study, which evaluated ChatGPT answers to questions posed on the subreddit r/AskDocs. We also touch on responses to his article discussed on a recent Sensible Medicine Podcast. Finally, we discuss Dr. Ayer's previous work on e-cigarettes, cannabis, and the sociology of suicide. Who is John Ayers? John Ayers, PhD is a computational epidemiologist who uses big data to study public health. He is the Vice Chief of Innovation in the Division of Infectious Diseases and Global Public Health at UCSD. References: Follow us at @ExMedPod | |||
| 24 May 2023 | Simon Whitney, MD, JD: Unethical Research, Unintended Consequences, and the Critical Need for IRB Reform | 01:18:43 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Simon Whitney, MD, JD, about his book From Oversight to Overkill. They discuss the history of Institutional Review Boards (IRBs), including ethically questionable experiments such as Chester Southam's cancer cell injections, the Willowbrook experiment, as well as the US Public Health Service Syphilis Study (AKA Tuskegee experiment). They then discuss Peter Buxton, Henry Beecher, James Shannon, and the congressional oversight of federally funded research. Finally, they touch on the ISIS-2 study, Pronovost's checklist, OHRP's crackdown in the late 1990s, and discuss whether research is too safe, IRB infallibility, autonomy in the Belmont Report, and the risks and benefits of restricting research in the name of safety. Who is Simon Whitney? Simon Whitney, MD, JD, is a family medicine physician and ethicist. He previously taught at Baylor College of Medicine for 22 years. He is currently retired from the practice of medicine but continues to publish and teach medical ethics. He is the author of the book "From Oversight to Overkill: Inside the Broken System That Blocks Medical Breakthroughs—And How We Can Fix It." Follow us at @ExMedPod | |||
| 12 Jun 2023 | Robin Hanson, PhD: Healthcare Signaling, the Conspicuous Caring Hypothesis, and Prediction Markets in Medicine | 01:24:12 | |
In this conversation, Daniel Belkin and Mitch Belkin interview Robin Hanson, PhD, about healthcare and medicine. They discuss three randomized controlled trials on the population-wide benefits of medicine (RAND health insurance experiment, Oregon Health Insurance Experiment, and the Karnataka Hospital Insurance Experiment), which do not demonstrate benefit for more medical care. They talk about the conspicuous caring hypothesis put forward in Robin's book The Elephant in the Brain. Other topics discussed include end-of-life care, medicine as something Sacred, and prediction markets in medicine. Who is Robin Hanson? Robin Hanson, PhD, is an associate professor of economics at George Mason University and a research associate at Oxford University. He is known for his wide-ranging interests, including artificial intelligence, prediction markets, and signaling. He is the author of several books, including The Age of Em and The Elephant in the Brain. Follow us at @ExMedPod | |||
| 27 Jun 2023 | Dan Morgan, MD: Diagnostic Stewardship, Medical Overuse, and Contact Precautions | 01:03:14 | |
In this conversation, Daniel Belkin and Mitch Belkin interview infectious diseases physician and epidemiologist Dan Morgan, MD, about infection prevention, diagnostic stewardship, diagnostic reasoning, and medical overuse. They discuss regional differences in medical use and delve into a cluster-randomized controlled trial of contact precautions in ICU patients to evaluate whether this prevents C. Diff, MRSA, and VRE. They also touch on AI's potential role in clinical decision support, and the question of how to improve clinician statistical reasoning. Who is Dan Morgan? Dan Morgan, MD, MS is a physician and epidemiologist at University of Maryland School of Medicine. He directs the Center for Innovation in Diagnosis and is Chief of Epidemiology at the VA Maryland Healthcare System. His research interests include probability in medicine, medical overuse, diagnostic stewardship, and infection prevention. If you enjoyed this episode, be sure to check out our episodes with Paul Offit and Deborah Korenstein on medical overuse. Follow us at @ExMedPod | |||
| 02 Oct 2023 | Joann Elmore, MD: Mammography Guidelines and Other Controversies | 00:39:41 | |
In this episode, Daniel Belkin and Mitch Belkin interview Joann Elmore, MD, about screening mammography. Dr. Elmore shares insights on the USPSTF's new draft mammography recommendations, which lowers the breast cancer screening age from 50 to 40. They discuss the difference in American and European call back rates for biopsy and whether mammography screening programs have substantially improved breast cancer mortality rates or if improvements are primarily due to enhanced treatment methods. They also touch on the potential for AI to transform radiology and pathology. Who is Joann Elmore? Joann G. Elmore is as a professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. Her research interests include diagnostic accuracy, physician variability, cancer screening, patient engagement, and AI/machine learning in diagnostics. She has over 200 publications. References:
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| 31 Oct 2023 | Bryan Carmody, MD: Physician Shortages, Resident Unionization, and the OB/GYN ERAS Divorce | 01:01:41 | |
In this episode, Daniel Belkin and Mitch Belkin interview Bryan Carmody, MD, about physician shortages, resident unionization, and the OB/GYN ERAS divorce. They discuss the recent changes to legislation in Tennessee which allows international medical graduates to bypass the US residency system. They also touch on the Weisman versus Barnes Jewish Hospital court case. If you missed the initial episode with Bryan Carmody Episode #6, be sure to check that out. Who is Bryan Carmody? Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process. Follow us at @ExMedPod | |||
| 19 Jan 2024 | Hussam Alkaissi, MD: Solving Difficult Medical Cases | 01:19:56 | |
In this episode, Daniel Belkin and Mitch Belkin interview Hussam Alkaissi, MD about his journey in medicine, experience with populations with high consanguinity, and uncovering of rare diseases. They touch on several unusual cases Hussam has solved including one of CHILD syndrome, homocystinuria, and acute hypercalcemia. Who is Hussam Alkaissi? Dr. Hussam Alkaissi is an Endocrinology Clinical Fellow at the NIH/NIDDK. He has an interest in diabetes, glucose metabolism, insulin signaling, and insulin resistance. References:
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| 05 Mar 2024 | Marc Gosselin, MD: Overdiagnosis, Critical Thinking, Burnout, and Other Topics in Radiology | 01:20:22 | |
In this episode, Daniel Belkin and Mitch Belkin interview Marc Gosselin, MD about his journey to radiology, being a radiology program director, dealing with burnout, transitioning from academics to private practice, and overdiagnosis in radiology. They discuss in situ thrombosis versus pulmonary emboli, whether medical evidence should have an expiration date, and why physicians should admit fault when they are wrong. Who is Marc Gosselin? Dr. Marc Gosselin is the head of cardiopulmonary imaging at Vision radiology, a retired full professor at Oregon Health and Science University. Previously, Dr. Gosselin was a program director of the University of Utah’s radiology program. References: Follow us at @ExMedPod | |||
| 24 Jul 2024 | Eliot Siegel, MD: Pioneer in Radiology and Theragnostics | 01:20:30 | |
In this episode, Daniel Belkin and Mitch Belkin interview Eliot Siegel, MD about developing the first filmless healthcare enterprise at the Baltimore, VA in 1993 which revolutionized the practice of medicine. They discuss the challenges of this innovation, including the costs of computing, the difficulties of imaging compression and data management. They touch on theragnostics, a novel subspecialty in nuclear medicine, which utilizes molecular treatments to target cancer. Who is Eliot Siegel? Dr. Eliot Siegel is a Professor of Radiology at the University of Maryland School of Medicine. He is a prolific author and speaker, has written over 300 articles on medical imaging and PACS, has edited several books, and given more than 1,000 presentations worldwide. In addition to his interest in digital imaging and PACS, he’s interested in telemedicine, the electronic medical record, informatics and artificial intelligence/machine learning. Follow us at @ExMedPod | |||
| 28 Jan 2025 | Steven Hollon, PhD: An Evolutionary Perspective on Depression | 01:04:11 | |
In this episode, Daniel Belkin and Mitch Belkin interview Steven Hollon, PhD about the evolutionary roots of unipolar depression, its prevalence, as well as current treatment options. They discuss Aaron Beck, the father of cognitive therapy (CBT), before diving into the potential adaptive origins of depression, rumination, and how cognitive behavior therapy works. Finally, they touch on whether combining CBT and medication actually decreases relapse rates more than CBT or medication alone. Who is Steven Hollon? Steven Hollon, PhD, is a psychologist and researcher at Vanderbilt University. Dr. Hollon’s research focuses on the treatment and prevention of depression. Follow us at @ExMedPod | |||
| 17 Feb 2025 | Ben Strong, MD: Teleradiology and Medical Malpractice | 01:23:08 | |
In this episode, Daniel Belkin and Mitch Belkin interview Ben Strong, MD about teleradiology and medical malpractice. They discuss RadNet’s database on major misses and lawsuits as well as how tort law varies state-by-state. Who is Ben Strong? Dr. Strong is the Chief Medical Officer at vRad and head clinical content creator and curator of vRad Radiology Education. Dr. Strong is an AIRP Lecturer and a contributor to vRad’s popular free radiology educational content. Follow us at @ExMedPod | |||
| 17 Feb 2021 | Fluvoxamine as a potential treatment for COVID-19 | 00:48:54 | |
*Since recording this podcast in January 2021, Steve Kirsch has publicly made misleading allegations regarding vaccine effectiveness and safety (e.g., Kirsch has claimed that mRNA vaccines are ineffective and are responsible for large numbers of deaths). While ExMedPod believes diverse viewpoints ought to be publicly discussed, we do not endorse Kirsch's beliefs regarding vaccine safety and efficacy.* What is Fluvoxamine? Fluvoxamine (Luvox) is a Selective Serotonin Receptor Inhibitor (SSRI) that is clinically indicated for OCD in children, and can be used off label for depression. It was approved by the FDA in 1994 and has been used in millions of patients worldwide. Side effects include nausea, upset stomach (up to 25%), and other sexual side effects typical of SSRIs. Clinical Data: Eric Lenze’s Phase 2 RCT on Fluvoxamine vs Placebo (Nov 2020) Results: “Of 152 patients who were randomized (mean [SD] age, 46 [13] years; 109 [72%] women), 115 (76%) completed the trial. Clinical deterioration occurred in 0 of 80 patients in the fluvoxamine group and in 6 of 72 patients in the placebo group (absolute difference, 8.7% [95% CI, 1.8%-16.4%] from survival analysis; log-rank P = .009). The fluvoxamine group had 1 serious adverse event and 11 other adverse events, whereas the placebo group had 6 serious adverse events and 12 other adverse events.” David Seftel's Open Label Clinical Trial of Fluvoxamine (Jan 2021) Abstract: “We report a real-world experience using fluvoxamine for coronavirus disease 19 (COVID-19) in a prospective cohort in the setting of a mass outbreak. Overall, 65 persons opted to receive fluvoxamine 50mg twice daily and 48 declined. Incidence of hospitalization was 0% (0/65) with fluvoxamine and 12.5% (6/48) with observation alone. At 14 days, residual symptoms persisted in 0% (0/65) with fluvoxamine and 60% (29/48) with observation.” Follow us at @ExMedPod | |||
| 11 Apr 2021 | Metformin and the Biology of Aging with Nir Barzilai, MD | 00:58:03 | |
In this episode, Daniel Belkin and Mitch Belkin interview Nir Barzilai, MD, the founding director of the Institute for Aging Research and an expert in the genetics of longevity. Dr. Barzilai is a professor in the departments of Medicine and Genetics at the Albert Einstein College of Medicine. He is the recipient of numerous awards and grants. He has published over 230 peer-reviewed papers, reviews, and textbook chapters, as well as the book Age Later. Centenarian studies: What is Metformin? What is the TAME Trial? Follow us at @ExMedPod | |||
| 26 Apr 2021 | When Modern Medicine Goes Too Far: A Discussion with Paul Offit, MD | 00:55:43 | |
This conversation was recorded on April 5, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Paul Offit about mRNA vaccine technology as well as a number of topics from his book, Overkill: When Modern Medicine Goes Too Far. They discuss the use of antipyretics to treat a fever, the overuse of antibiotics, vitamin D and C, as well as cancer screening. Who is Paul Offit? Dr. Paul Offit is a pediatrician at the University of Pennsylvania specializing in infectious diseases, vaccines, immunology, and virology. He is the co-inventor of the RotaTeq vaccine for rotavirus, has published more than 130 papers in medical and scientific journals, and he is the author or co-author of books on vaccines, vaccination, and antibiotics. To learn more about Dr. Offit, visit his website. Follow us at @ExMedPod | |||
| 14 May 2021 | The Invisible Graveyard: A Conversation with Economist Alex Tabarrok | 01:01:40 | |
In this interview, Mitch Belkin and Daniel Belkin speak with Professor Alex Tabarrok about what economists can bring to discussions of the pandemic, the US government’s response to COVID-19, the performance of the FDA and the CDC, regulatory nationalism, the first doses first campaign, and why America should vaccinate the world. This conversation was recorded on May 2nd, 2021. Who is Alex Tabarrok? Professor Alex Tabarrok is the Bartley J. Madden Chair in Economics at the Mercatus Center and a professor of economics at George Mason University. He is the co-author of the popular economics blog Marginal Revolution and co-founder of Marginal Revolution University. He is the author of numerous academic papers in the fields of law and economics, criminology, regulatory policy, voting theory and other areas in political economy. His articles have appeared in the New York Times, the Washington Post, the Wall Street Journal, and many other publications. Follow us at @ExMedPod | |||
| 18 Jun 2021 | Diagnostic Reasoning and Medical Overuse with Deborah Korenstein, MD | 01:04:12 | |
This conversation was recorded on June 7th, 2021. In this interview, we talk with Deborah Korenstein, MD, about medical overuse and overdiagnosis. We discuss her April 2021 publication in JAMA Internal Medicine, the Accuracy of Practitioner Estimates of Probability of Diagnosis Before and After Testing as well as the diagnostic process, the teachability of diagnostic reasoning, cognitive biases, and other topics. Dr. Deborah Korenstein is Chief of the General Internal Medicine Service at Memorial Sloan Kettering Cancer Center in New York. Her clinical work focuses on care to adult survivors of childhood and other high-risk cancers. As a researcher and an educator of physicians in training, she is interested in improving the value of care while minimizing unnecessary and potentially harmful tests and treatments. To learn more about mitigating medical overuse, check out the ABIM Foundation's Choosing Wisely campaign and Dr. Korenstein's project Testing Wisely. 1. 2019 Update on Medical Overuse: A Review in JAMA Internal Medicine Highlights:
2. Overdiagnosis in primary care: framing the problem and finding solutions in BMJ (2018) Highlights:
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| 02 Jul 2021 | The Case for Medical Education Reform with Bryan Carmody, MD | 01:08:24 | |
This conversation with Dr. Bryan Carmody was recorded on June 21st, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Carmody about the history of the USMLEs, the value of standardized test scores, and the arms race in the residency admissions process. They touch on conflict of interest in medical education and the rising cost of medical schools among other topics. Who is Bryan Carmody? Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process. For years, he has argued that USMLE Step 1 should go pass-fail and that Step 2 CS should be eliminated — both of these events happened in the last year and a half. Campbell’s law: Campbell’s law comes from Donald Campbell, a psychologist and social scientist from the mid-20th century. In 1976, Campbell wrote: “Achievement tests may well be valuable indicators of general school achievement under conditions of normal teaching aimed at general competence. But when test scores become the goal of the teaching process, they both lose their value as indicators of educational status and distort the educational process in undesirable ways.” For instance, there are now entire school curricula devoted to improving test scores. This obviously wasn’t the original intention. References: Radiology Journal Article: “Do residency selection factors predict radiology resident performance?” This article finds a fairly modest association between USMLE score and discordance rates between preliminary resident reads of radiologic findings and the final attending interpretation. This was for residents at UPMC. https://pubmed.ncbi.nlm.nih.gov/29239834/ Paul Graham: The podcast references his essay, The Lesson to Unlearn. More on Dr. Carmody: Youtube video on capping residency applications: Sheriff of Sodium blog Follow us at @ExMedPod | |||
| 18 Jul 2021 | The Epigenetics of Aging & Dispelling mRNA Vaccine Myths with Yuri Deigin | 00:55:39 | |
This conversation with Yuri Deigin was recorded on June 25th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Yuri about aging, which he argues is fundamentally an epigenetic phenomenon. We discuss partial reprogramming using Yamanaka factors, evolutionary explanations of aging, and recent in vivo experiments which suggest that aging is partially reversible. We also touch on mRNA vaccines, specifically to address allegations about the cytotoxicity of the spike protein and concerns about infertility discussed on Bret Weinstein’s Dark Horse Podcast with Steve Kirsch and Robert Malone, MD, recorded on June 11th 2021. Who is Yuri Deigin? Yuri Deigin is a biotech entrepreneur with a background in pharmaceutical development. He received degrees in computer science and mathematics from the University of Toronto and an MBA from Columbia University. He is the CEO of Youthereum Genetics, a company which aims to translate epigenetic rejuvenation therapies to humans. Yuri was an early proponent of the SARS-CoV-2 lab leak hypothesis, the idea that the virus may have inadvertently escaped from a lab. In April 2020, he published a detailed genomic analysis of SARS-CoV-2. In that article, Yuri discusses the virus’s furin cleavage site, genetic similarities and differences with its closest relative (RaTG13), and the similarities between the virus’s receptor binding motif and that of a pangolin respiratory virus. He also explores the gain-of-function research program at the Wuhan Institute of Virology. Unfortunately, we did not have time in this conversation to delve into this hotly debated topic. References: Universal methylation age across mammalian species Partial reprogramming of Progeria mice David Sinclair paper on restoring vision in mice Uri Manor Lab spike protein paper Large doses of Spike Protein Induce Acute Lung Injury in Mice Pfizer ADME study (translated from Japanese) How frequently are side effects reported to VAERS? More on Yuri: Medium article on SARS-CoV-2 Origins Yuri’s twitter: @ydeigin Follow us at @ExMedPod | |||
| 25 Jul 2021 | Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD | 00:53:14 | |
This conversation with Dr. John Mandrola was recorded on July 11th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Mandrola about a 2019 article he co-authored entitled The Case for Being a Medical Conservative. They discuss concerns about vaccine-induced myocarditis in children, vaccine mandates, and whether the AMA and other physician organizations should take sides on controversial political issues. Who is John Mandrola? Dr. John Mandrola is a practicing cardiac electrophysiologist and a regular columnist for theheart.org on Medscape. He hosts the fantastic “This Week in Cardiology” podcast and is a blogger at drjohnm.org. He completed his medical training in Internal Medicine, Cardiology and Electrophysiology at Indiana University. References: This Week In Cardiology Podcast Twitter: @drjohnm Follow us at @ExMedPod | |||
| 13 Aug 2021 | Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD | 01:06:17 | |
This conversation was recorded on June 24th, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Johnson about fructose and its relationship to fat storage. They discuss uric acid as a cause of kidney inflammation and essential hypertension, how glucose intake can trigger endogenous fructose production, and the relationship between salt and obesity. Finally, they touch on the evolutionary history of uric acid metabolism and the potential role for fructokinase inhibitors in treating metabolic disease. Dr. Johnson is a Professor of Nephrology at the University of Colorado School of Medicine. He is one of the world’s leading experts on fructose. His research focuses on the role of fructose and uric acid in obesity, diabetes, hypertension, and kidney disease. He has over 700 publications, in journals including JAMA and the NEJM. He is also the author of two books for a general audience, The Fat Switch and The Sugar Fix. Uric Acid levels predicts future hypertension Uric acid and its relationship with pediatric hypertension Randomized Trial - Allopurinol on hypertensive adolescents Endogenous fructose production and kidney inflammation High salt diet and endogenous fructose production in mice How osmolality of soup increases blood pressure Fructose, Uricase, and the Back-to-Africa Hypothesis Books: ______________________
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| 20 Oct 2021 | Karl Friston on Understanding Schizophrenia using the Free Energy Principle | 01:15:43 | |
In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Karl Fristonabout his proposed free energy principle and how it applies to various psychiatric and neurological disorders including schizophrenia, depression, autism, and Parkinson’s. They also touch on the disconnection hypothesis of schizophrenia, how theories of schizophrenia have evolved over the last two centuries, and the relationship between schizophrenia and autism.
Dr. Karl Friston is a professor of neuroscience at University College London and an authority on brain imaging. He is the 20th most-cited living scientist with over 260,000 citations for his works. After studying natural sciences at Cambridge, he completed his medical studies at King’s College Hospital in London and worked for 2 years in an inpatient psychiatric facility on the outskirts of Oxford, where treated patients suffering from schizophrenia. Dr. Friston has developed a number of statistical tools for analyzing data from the brain, including statistical parametric mapping (SPM), voxel-based morphometry (VBM) or dynamic causal modeling (DCM). His mathematical contributions include variational Laplacian procedures and generalized filtering for hierarchical Bayesian model inversion. Follow us at @ExMedPod | |||
| 09 Nov 2021 | Katherine Flegal, PhD: The Obesity Wars and the Politicization of Science | 00:57:39 | |
In this interview, Mitch Belkin and Daniel Belkin speak with Katherine Flegal about the relationship between BMI and excess mortality. Dr. Flegal's publication of two papers in JAMA led to substantial controversy among obesity researchers. They discuss the data regarding the U-shaped mortality curve, the history of BMI, as well as the politicization of science. Who is Katherine Flegal? Katherine Flegal is an epidemiologist and former senior scientist at the CDC's National Center for Health Statistics. She is one of the most cited scientists in the field of obesity epidemiology. After receiving a bachelor's from UC Berkley, a PhD from Cornell, and an MPH from Pittsburgh, she worked in the biostatistics department of University of Michigan prior to working at the CDC in the National Center for Health Statistics. Dr. Flegal worked on the National Health and Nutrition Examination Survey (NHANES), which is a comprehensive data set of nationally representative cross-sectional data from the US that combines interviews, physical exams, and laboratory tests along with demographic, socioeconomic, and dietary data. Her 2005 analysis of the NHANES data set and her 2013 meta-analysis demonstrated that people who are “overweight” (defined as a BMI between 25 and 30) have significantly lower all cause mortality compared to people who are “normal weight” (BMI 18.5 - 24.9). In addition, her publications showed no significant difference in mortality between people who have a BMI of 30-35 and people who are normal weight. References Excess deaths associated with underweight, overweight, and obesity (JAMA, 2005) Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysis (JAMA, 2013) Follow us at @ExMedPod | |||
| 12 Dec 2021 | Emily Oster, PhD: Breastfeeding Recommendations, Rising C-section Rates, and Other Controversies | 01:03:54 | |
In this interview, Mitch Belkin and Daniel Belkin speak with Brown Economics Professor Emily Oster about the studies behind breastfeeding recommendations, the dramatic increase in the U.S. C-section delivery rate over the last half century, and how she approaches analyzing studies. Who is Emily Oster? Emily Oster is the Royce Family Professor of Teaching Excellence and Professor of Economics at Brown University where she studies health, behavioral, and development economics. She received her PhD from Harvard University and taught at the University of Chicago Booth School of Business. She is the author of three popular books on pregnancy and parenting: Expecting Better, Cribsheet, and The Family Firm. References: In our podcast, we reference the following papers, ideas, and talks:
Errata:
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| 03 Jan 2022 | Stephan Guyenet, PhD: GLP-1, Semaglutide, and the Big Future of Weight Loss Therapies | 01:04:39 | |
In this interview, Mitch Belkin and Daniel Belkin speak with Stephan Guyenet, PhD, about Glucagon-like peptide-1 (GLP-1) and Semaglutide. They discuss GLP-1’s mechanisms of action, Anthony Sclafoni’s experiments on food reinforcement and nutrient receptors in the small intestines. Finally, they touch on some exciting new weight loss drugs that may replace semaglutide and potentially even bariatric surgery. Dr. Stephan Guyenet received his PhD in Neurobiology and Behavior from the University of Washington. Afterward, he completed a postdoctoral fellowship in the neuroscience of obesity. He is the author of the book The Hungry Brain. Dr. Guyenet is the founder & director of Red Pen Reviews, which publishes expert reviews of popular nutrition books with structured semi-quantitative evaluations. In addition, he is a senior researcher at GiveWell where he conducts cost effectiveness analyses on water quality interventions and malnutrition treatments in low income countries. What is GLP-1 ? Glucagon-like peptide-1 is a hormone produced by the intestines. It is an incretin, meaning it signals the pancreas to increase insulin secretion in a glucose-dependent manner. Initially, GLP-1 agonists were developed for the treatment of diabetes. In both animal and human models, it was discovered that GLP-1 agonists suppress food intake, which led to weight loss. This discovery spurred its use in obesity trials, including STEP 1. Citations for Stephan Guyenet:
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| 26 Jan 2022 | Daniel Burka: How to Design Successful and User-friendly Healthcare Applications | 01:12:29 | |
In this episode, Mitch Belkin and Daniel Belkin speak with Daniel Burka about his work at Resolve to Save Lives and the project Simple.org, a hypertension reduction application. They discuss the importance of iterative building processes that trial various ideas and then quantifiably measure success. Daniel Burka stresses the importance of understanding the goals of all users--physicians, patients, public healthcare experts--when designing successful healthcare applications. Daniel Burka is the director of product and design at Resolve To Save Lives, where he works on the web-based, open-source hypertension reduction application Simple.org. Previously, he was a Design Partner at Google Ventures, the Creative Director for Digg.com, and the Director of Design for Tiny Speck which later became Slack. Among many notable projects, he designed the Firefox logo and Mozilla’s website. What is Resolve to Save Lives? Resolve to Save Lives is an initiative to prevent 100 million cardiovascular deaths over the next 30 years. The initiative is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, Gates Philanthropy Partners, and the Chan Zuckerberg Foundation. Methods to reduce deaths include hypertension reduction, trans fat elimination, and sodium reduction initiatives. In addition, Resolve to Save Lives aims to increase epidemic preparedness. What is Simple.org? Simple.org is a project of Resolve to Save Lives. It is an ultralight weight electronic health record system designed to manage patients with hypertension and diabetes. As of January 2022, 1.4 million patients in India, Bangladesh, and Ethiopia use the application. References:
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