Episodes
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Date: 7/30/24
Name of podcast: Dr. Patient
Episode title and number: 26 Advocate Toolkit, Hospital Edition
Episode summary:
It's so incredibly complicated to be a patient today, as I recently observed when I hung out at the bedside of a sick relative. If you don't have a "doctor friend", you might need to help your friend or family member get the best possible experience in the hospital by becoming their advocate. Hear about my own observations on where and when help is needed, and also hear some tips on how you can get started.Guest(s): none
Key Terms: none
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 7/22/24
Name of podcast: Dr. Patient
Episode title and number: 25 The Disadvantage of Medicare Advantage, Part 2
Episode summary: Part 2 discussing why Medicare Advantage plans are an actual DISadvantage for you and for our country's fiscal system. When you sign up for Medicare, you have a choice of Traditional/Original, Medicare or "Medicare Advantage", which is technically not Medicare and is instead a private health insurance company caring for you on their behalf, like a surrogate. The plans are Uber-restrictive and filled with hidden costs that many people don't recognize until it's too late. They often offer "zero dollar premiums" to lure folks in, then you might have trouble getting back into regular Medicare. Join Alexandra "Al" Eidenberg from The Insurance People, and me to hear all of the details.Guest(s): Alexandra (Al) Eidenberg, President and Founder of The Insurance People
Key Terms: none
References:
The Insurance People homepage: www.theinsurancepeople.com
How to sign up for Medicare: https://www.medicare.gov/basics/get-started-with-medicare/sign-up/how-do-i-sign-up-for-medicare
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Episodes manquant?
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Date: 6/16/24
Name of podcast: Dr. Patient
Episode title and number: 24 The Disadvantage of Medicare Advantage, Part 1
Episode summary:
Wow, I knew Medicare was complicated but didn't realize just how complicated. I've spent the last few weeks diving deep and was most curious about Medicare Advantage, Part C of Medicare, where beneficiaries can sign up for private health insurance. This week I'll be talking about how bad this is for our federal budget, and how the model simply doesn't work fiscally. Next week, in Part 2, I'll be talking with Al (Alexandra) Eidenberg about why it's also bad for the beneficiaries themselves.
Guest(s): noneKey Terms:
CMS - Center for Medicare and Medicaid Services
HMO - Healthcare Maintenance Organization
Beneficiary or Enrollee - the person signing up for a health plan
Fee-for-service - a model of healthcare where a doctor or hospital gives a service and is then paid for it
Capitation - a monthly payment Advantage plans get per patient that are signed up on their planReferences:
Video by Congresspeople Mark Pocan, Jan Schakowsky and Ro Khanna
Center for Medicare and Medicaid Services
How the Government Updates Payment Rates for Medicare Advantage Plans
Understanding Medicare Advantage Payment
Medicare Advantage Risk Adjustment
US Sues Cigna for fraudulent diagnostic codes
Advantage plans overpaid by about $140 billion over last 12 years
Video: How to Sign up for Medicare
MedicareFAQ: Why Advantage Plans are Bad
Understanding Medicare Advantage Payment
Other podcasts on this topic:
Arm and A Leg
The Real Investment Show
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 6/18/24
Name of podcast: Dr. Patient
Episode title and number: 23 In Doctors We Trust
Episode summary: What is trust as it relates to the doctor-patient relationship? How is it fostered when the very healthcare system itself works against it? Why is it important, and what can you do to foster it with your doctor?Guest(s): none
Key Terms: none
References:
Trust, Race and Risk in American Medicine: https://onlinelibrary.wiley.com/doi/full/10.1002/hast.1080Patient Trust in Physicians:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495476/
The importance of building trust in the physician-patient relationship:
https://www.wolterskluwer.com/en/expert-insights/the-importance-of-building-trust-in-the-physician-patient-relationship
Physician perspectives on building trust with patients:
https://onlinelibrary.wiley.com/doi/10.1002/hast.1528?af=R
Summary table of survey questions of patients about trust:
https://www.drpatientpodcast.com/blog/eps-22-and-23-doctor-satisfaction-and-trust-in-doctors/
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 6/11/24
Name of podcast: Dr. Patient
Episode title and number: 22 Doctors in Distress
Episode summary: The majority of doctors today are dissatisfied with the healthcare system. That's not to say that they don't want to be doctors anymore. It's just that they're fed up with the same system that patients are stuck in and fed up with. It's important that doctors and patients see and understand each other more clearly to strengthen their relationships against the onslaught of external forces that are slowly degrading our health system in the US.Guest(s): Dr. Karen Leitner
Key Terms: none
References:
Dr. Leitner's site: https://www.karenleitnermd.com/
NYTimes article (might require a sign-in, sorry): https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html
Physicians Foundation report: http://physiciansfoundation.org/wp-content/uploads/PF23_Brochure-Report_Americas-Physicians_V2b-1-2.pdf
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 6/4/24
Name of podcast: Dr. Patient
Episode title and number: 21 How We Learn to Be a Patient, Part 2
Episode summary: Continuing from the end of last season, Ep 12, where I talked with my own daughter about her experience going to an urgent care center alone for the first time, here's the follow up with a group of young women going through similar challenges of trying to understand health insurance, how to make an appointment, how to make healthcare decisions for themselves, and more.Guest(s): Berit, JeeSoo, Maya, Gabby, Lena and Ashley
Key Terms: none
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 5/28/24
Name of podcast: Dr. Patient
Episode title and number: 20 Short Stories on Being a Patient
Episode summary:
I have this never-ending quest to help doctors and patients understand each other better. This collection of short stories on what it's like to be a patient are meant to do just that. These are a few years old - I wrote them when I had breast cancer in 2020-2021 and went through surgery, chemotherapy and radiation. Hope they paint a realistic picture for you.
Guest(s): noneKey Terms: none
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 5/21/24
Name of podcast: Dr. Patient
Episode title and number: 19 US Drug Costs Are Insane, Part 2
Episode summary: Part 2 follows the last episode, where I reviewed how we got to where we are with insane drug costs in the US and a bit on how the Pharma system works. This week I did a deep dive on how someone can save on their medication costs. I review some cost comparing websites, online pharmacies, direct discounts from manufacturers and more.Guest(s): none
Key Terms: none
References:
Convoluted drug cost diagram from last episode: https://www.wbur.org/onpoint/2023/12/14/pharmacy-benefit-managers-the-middleman-that-decides-what-you-pay-for-medications
How to shop around: https://www.webmd.com/health-insurance/features/medication-shop-around
How does a place like GoodRx work: https://support.goodrx.com/hc/en-us/articles/115004944026-What-is-GoodRx-How-does-it-work
Ozempic.com with discounts and coupon info: https://www.ozempic.com/savings-and-resources/save-on-ozempic.html?utm_medium=banner&utm_source=goodrx&utm_campaign=trizone&utm_content=wstpay25&utm_id=nmtDC00004081
General ideas on how to save: https://www.forbes.com/advisor/personal-finance/save-money-on-prescription-drugs/
How Medicare drug costs work: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage
Getting help with Medicare drug costs: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap/5-ways-to-get-help-with-prescription-costs
Overview of Medicare Part D Prescription Drug Benefits: https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/Cost comparing websites:
GoodRx
RxSaver
WebMDRx
RxPriceQuotes
SingleCare
NeedyMedsOnline pharmacies:
HoneybeeHealth
DiRX
Mark Cuban’s CostPlus Drugs
Marley Drug
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 5/07/24
Name of podcast: Dr. Patient
Episode title and number: 18 US Drug Costs Are Insane, Part 1
Episode summary: Wow, drug costs in the US have skyrocket in recent years. The popularity of Ozempic and other weight loss drugs have really brought this issue into the light lately. Why do our drugs cost so much more than the same medications sold in other countries? How is the system set up? Who sets the list price? Hear answers to all these questions and more in this episode, part 1 of a 2 part series.Guest(s): none
Key Terms: none
References:
CONVOLUTED DIAGRAM OF US DRUG COSTS: https://www.wbur.org/onpoint/2023/12/14/pharmacy-benefit-managers-the-middleman-that-decides-what-you-pay-for-medications
Flow of Money Through the Pharmaceutical Distribution System: https://healthpolicy.usc.edu/research/flow-of-money-through-the-pharmaceutical-distribution-system/
Why do your prescription drugs cost so much: https://www.health.harvard.edu/blog/why-do-your-prescription-drugs-cost-so-much-202401183007
Prescription Drug Payment Policy: Past, Present and Future: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193453/
Here's How Much More Ozempic Costs in the U.S. Compared to Other Countries: https://www.healthline.com/health-news/heres-how-much-more-ozempic-costs-in-the-u-s-compared-to-other-countries
Bernie Sanders's letter to Novo Nordisk CEO: https://www.sanders.senate.gov/wp-content/uploads/Letter-from-Sen.-Bernard-Sanders-to-Novo-Nordisk.pdf
Pharmacy Benefit Management (PBM) Industry: Definition: https://www.investopedia.com/articles/markets/070215/what-pharmacy-benefit-management-industry.asp
Acquired podcast episode that I mentioned on Novo Nordisk: https://www.acquired.fm/episodes/novo-nordisk-ozempic
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 4/30/24
Name of podcast: Dr. Patient
Episode title and number: 17 Big Hospital Break Up
Episode summary: I’m breaking up with my hospital. I live in Chicago, with its plethora of academic medical centers. I’ve long believed that these are generally good places to receive healthcare, but I’ve become exhausted at how hard I have to work to receive the actual care. As a retired physician, and a daughter and sister of physicians, I cannot help but to speak out about the troubling way that today’s healthcare is being practiced. I did not name the hospital out of respect, but I’ll be sending them a copy of this break up letter, and also releasing it as a mini-episode on my podcast, Dr. Patient.Guest(s): none
Key Terms: none
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 4/23/24
Name of podcast: Dr. Patient
Episode title and number: 16 Race and Healthcare: Teaching Med Students
Episode summary: Episode 3 of 3 of a miniseries on racial disparities in healthcare. We've heard from Linda Villarosa on how we got to where we are today and what some of the harsh realities of health disparities are, from Michael Tyler on a real life story of how his race actually impacted his care. Today we're pivoting towards solutions as I speak with Dr. Patricia Poitevien, Associate Dean at Brown University's medical school on how to teach this stuff to the next generation of physicians.Guest(s): Dr. Patricia Poitevien, Senior Associate Dean of Diversity, Inclusion & Equity at Brown University's medical school. https://diversity.biomed.brown.edu/people/patricia-poitevien-md-msc-faap
Key Terms:
[22:57] MCAT - Medical College Admission Test; the test that college students take to be able to apply for medical school
[22:58] STEP - the examination that medical students take close to the end of school to be able to apply for residency training
[32:48] FTE - full time equivalent - 1.0 means a full time jobReferences: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 4/16/24
Name of podcast: Dr. Patient
Episode title and number: 15 Race and Healthcare: One Man's Story
Episode summary: Last week we heard from Linda Villarosa on the impact slavery still has on our modern healthcare system and how it leads to racial health disparities in the US. Today we’ll hear from Michael Tyler, children’s author, about his specific experience with race impacting his care.
Guest(s): Michael Tyler, children's author: www.michaeltylerwrites.com
Key Terms:
[07:02] PSA – prostate specific antigen, a blood-based screening tool for prostate cancer
[08:30] BPH – Benign Prostate Hypertrophy, a condition where the prostate enlarges and causes urinary symptoms. Annoying, but generally not dangerous
[08:38] Biomarkers - https://www.health.harvard.edu/mens-health/biomarkers-for-better-prostate-cancer-screening#:~:text=Biomarkers%20are%20%22chemicals%22%20that%20can,and%20potentially%20catch%20it%20early
[10:35] “Broke the seal” and Prostatectomy – a tumor has “broken the seal” of the prostate when it grows outside of the actual prostate wall. A prostatectomy is the partial or complete removal of the prostate
[19:35] “Prostate cancer gene” – some cases of prostate cancer are caused by genetics. There are some genes that can be inherited (sort of like the BRCA breast cancer genes for women. Men with variants in these genes have a high risk of developing prostate cancer and, in some cases, other cancers during their lifetimesReferences:
2014 Study about the difference in location of prostate biopsies depending on race: “Pathological examination of Radical Prostatectomy Specimens in Men with Very Low Risk Disease at Biopsy Reveals Distinct Zonal Distribution of Cancer in Black American Men”: https://www.auajournals.org/doi/abs/10.1016/j.juro.2013.06.021
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 4/9/24
Name of podcast: Dr. Patient
Episode title and number: 14 Race and Healthcare: Historical Roots
Episode summary: Many of the health inequities that we see in healthcare today stem from beliefs held in the time of slavery that have led to "myths" about black bodies and black health. Compounded by historical policy making related to socioeconomics, red lining, civil rights and more, people of color in the US are still facing inequity in healthcare today, from access to treatment to outcomes. Linda Villarosa is an author on race and health in America, professor and journalist in residence at The City College of New York, contributing writer to the NY Times and a contributor to the 1619 project.Guest(s): Linda Villarosa
Key Terms:
11:12 – Drapetomania
11:32 – Spirometer
23:04 – Momnibus billReferences:
03:29 – Black women in the US have a higher death rate in pregnancy than white women with the same socioeconomic status
03:39 – Big review article showing how black patients receive pain meds less often
03:45 – Study from University of Virginia 2016 medical students beliefs about black body myths
04:04 – Race correction on PFTs (pulmonary function tests)
05:51 – A black woman with a PhD is more likely to die in childbirth than a white woman with a high school degree
07:51 – The history of Dr. J Marion Sims
09:23 – Statue of Dr. J Marion Sims taken down in NYC
09:39 – Anarcha, Lucy, and Betsey (The Mothers of Gynecology) art installation in Montgomery, AL
09:47 – Say Anarcha book
10:20 – Dr. Cartwright
12:32 – (Lack of) science behind the spirometer race correction
15:07 – Weathering book
21:23 – CA maternal death rates
23:41 – Dr. Mary Bassett, NY Health Commissioner, requires anti-bias training
26:03 – “Lightly Black and Green” movement at HBCUs
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 4/2/24
Name of podcast: Dr. Patient
Episode title and number: 13 Claim Craziness Pt 1Episode summary: Have you ever spent hours, days or weeks trying to get money back from a health insurance claim? If you have, this episode will let you know that you're not alone. If you haven't, this will give you some insight into the process. This week's episode is just me, letting you in on an insane claim fiasco that I'm going through with my health insurance company. The claim is for about $108, and at another time in my life I might just give up on trying to get that money back because of all of the roadblocks my insurance company is putting up. But for your sake (and mine), I'm not giving up. Join me for some Claim Craziness part 1.
Guest(s): none
Key Terms: none
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 3/25/24
Name of podcast: Dr. Patient
Episode title and number: 12 Bosom Buddies
Episode summary:
Today's episode is a fly-on-the-wall perspective for you of how friends talk about cancer. A couple of my friends and I all had cancer within a couple of years of each other, and this is a full-length, unedited conversation that we had about it last year. Warning there's some foul language and tough discussions.
Guest(s): Laura and Melissa
Key Terms:
portacath [15:04] - a device that is placed under the skin, usually on the right side of the chest, with a tube that goes deeper into a blood vessel. Medications and IV fluids can be given through it
medical oncologist [multiple times] - a doctor that specializes in the chemical treatment of cancers, primary chemotherapy
surgical oncologist [multiple times] - a doctor that specializes in performing surgical removals of cancers
ecchymosis [29:36] - this is the medical term for a bruise
References: none
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Season 2 is coming soon!
During this break I’ve been spending more and more time on the healthcare of my friends and family lately. I continue to act as a doctor friend to whomever needs it, helping guide people through the healthcare landscape to get done what they need, whether it’s finding a doctor, figuring out how to actually have a phone conversation with your doctor, getting an urgent appointment, or getting a second opinion on a diagnosis. Hopefully by telling some of these stories this season, you too will get something helpful out of them. Or, you’ll just enjoy hearing them.This season, I’m changing format of the podcast a bit. I’ll be doing more frequent, shorter episodes without guests, and then sprinkling in longer episodes and miniseries with guests like the upcoming one on racial disparities in healthcare.
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 7/19/22
Name of podcast: Dr. Patient
Episode title and number: 11 How We Learn to Be a Patient
Episode summary:
My daughter had an encounter at a doctor's office recently, which was her first time going for a health visit by herself. What ensued was confusion and hilarity. It got me thinking that I haven't really prepared my kids to be the kind of patient that I think people need to be today: self advocating, informed, comfortable asking questions. -
A rundown of who's who in hospital, ER and clinic settings. It can be really confusing to be a patient and not know what each person's role is when you're receiving health care.
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 6/13/22
Name of podcast: Dr. Patient
Episode title and number: 10 Pushback, Part 2Episode summary:
How did we get to where we are today, where health insurance companies dictate how medicine should be practiced between a doctor and their patient? This episode reviews the origins of Medicare, and reviews Medicare For All as an alternative to the over-privatization of current Medicare plans. This is yet another way that physicians (and patients) can pushback on a dysfunctional system.
Guest(s):
Dr. Susan Rogers, President of Physicians for National Health Program
Key Terms:
Medicare – federal insurance for people 65 and older, some younger people with disabilities
Medicare Parts A, B, C, D – A provides inpatient/hospital care, B is for outpatient coverage, C offers an alternative way to get your benefits, D provides prescription drug coverage
Medicare For All – a single payer, national health insurance program concept; would provide everyone in the US with comprehensive health care coverage
Medicare Advantage – Part C plans; private companies provide the care
Fee For Service, FFS – system of health insurance payment where a doctor or other health care provider is paid a fee for each service rendered
Single Payor System – health care system where one entity (a single payer) collects all health care fees and pays for all health care costs
Affordable Care Act, ACA – legislation from 2010 that provided more affordable health insurance to more people, expanded the Medicaid program and supports innovative medical care delivery methods to reduce costs. Also called “Obamacare”
Direct Contracting Entity, DCE – Private 3rd parties that provide an alternative payment model for healthcare. They act as the intermediatry between the government and the beneficiary
Capitation – the payment of a fee to a doctor per patient; often is about $10k per year per patient whether the doctor sees that patient 1 time or 20 times during the year
References:Physicians for National Health Program
How do Medicare Advantage Plans work?
Social Determinants of Health
US Health Insurance System (overview)
A Brief history of Medicare in America
History of Health Insurance in the United States
Medicare and the Affordable Care Act
There goes your Medicare: The trouble with DCEs
Single-Payer Healthcare vs. Universal Coverage
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] -
Date: 6/7/22
Name of podcast: Dr. Patient
Episode title and number: 9 Pushback Part 1
Episode summary:
Part 1 of stories about doctors and patients who are pushing back on a broken healthcare system. Learn about concierge care and direct primary care, from two doctors that left traditional fee for service practice models for these alternatives.Guest(s):
Dr. Charles Dillon, University Associates in Chicago
Dr. Cindy Rubin, In Touch Pediatrics & Lactation in ChicagoKey Terms:
[11:42] - physical extender - someone certified in basic medical training - Physician Assistant, Nurse Practitioner, Nurse Midwife
[14:47] - Guillan-Barre Syndrome - immune disorder where your body's immune system attacks itself
References:Dr. Dillon site: https://www.doximity.com/pub/charles-dillon-md
Dr. Rubin site: https://intouchpediatrics.com
Direct Primary Care Coalition: https://www.dpcare.orgDCP Nation: https://dpcnation.orghttps://www.medicaleconomics.com/view/difference-between-concierge-and-direct-care
Podcast website: www.drpatientpodcast.com
Podcast email, become a guest: [email protected] - Montre plus
