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2 Docs Talk: Medicine | Health | Healthcare Policy | Evidence Based Medicine

Welcome to 2 Docs Talk, the podcast about healthcare, the science of medicine and everything in between. Join cohosts Kendall Britt, MD and Amy Rogers, MD for a 15 minute check-up on current issues in medicine and health policy. The doctor is always in.
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2 Docs Talk: Medicine | Health | Healthcare Policy | Evidence Based Medicine
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Apr 3, 2017

Kendall and Amy are in agreement that hospice care is an important, compassionate aspect of healthcare that humanizes what can be a very clinical, impersonal process. We've both experience with hospice - personally and professionally. 

Sadly, like most aspects of healthcare, the potential for profit has introduced some ugly practices into what should be focused solely on the needs of dying patients and their families.

Today, Kendall and Amy talk about the good and the bad of hospice as it exists in 2017.

Resources:

 

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Mar 27, 2017

Ever since Sarah Palin famously accused Obamacare of promoting death panels, the idea remains a fixture for some politicians to fall back on to impugn the healhcare law. 

But were death panels ever a part of the original healthcare law? And more importantly, how should patients and their physicians be approaching the topic of death, if at all?

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Mar 20, 2017

In this follow up episode to last week, we dig in to how the American Healthcare Act, aka Trumpcare, will affect Medicaid, and who will benefit from all the tax breaks. 

We recorded this episode before the Congressional Budget Office came out with their evaluation of the plan. We weren't too far off, if anything we may have been generous with Trumpcare. We've linked the CBO report in the resources below in case you want to check it out for yourself.

Also, I mistakenly credited the Vox article to Ezra Klein, but it was Sarah Kliff who wrote the excellent summary of the AHCA. It's also linked below.

Resources:

Health Affairs Blog on AHCA

Kaiser’s side-by-side comparison of Obamacare and AHCA

Obamacare Essential Healht Benefits

Vox Article by Sarah Kliff

Summary of Congressional Budget Office Report

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Mar 13, 2017

UPDATE: Since the episode aired (like the very next day) the Congressional Budget Office came out with their assessment of the American Healthcare Act. It was not positive. Stay tuned to the second part of this episode coming out on Monday, March 20, where we will discuss what they had to say.

_________________

Over the past week, we've finally gotten to take a look at the elusive Republican healthcare plan, the proposed replacement for Obamacare.

In this episode we talk about the faults opponent found with Obamacare, and how the proposed plan, which we call Trumpcare, attempts to address those issues.

This is the first installment of a two-part episode on Trumpcare, so be sure to listen this week and next week to get our full analysis.

Resources:

Health Affairs Blog on AHCA

Kaiser's side-by-side comparison of Obamacare and AHCA

Obamacare Essential Healht Benefits

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Mar 6, 2017

Hepatitis C infection is on the rise in recent years. The growing opioid epidemic has multiplied the problem, as the primary means of spread is IV drug use. 

Surprisingly only 35 percent of those infected received treatment even though excellent treatment available is for this devastating disease. Not surprisingly, drug costs are a major factor in this issue.

Join us as we discuss the issue of Hep C and what can be done about it.

Resources:

American Journal of Managed Care Special Issue on Hepatitis C Virus

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Feb 27, 2017

 

Lice are an issue that many parents of elementary students have to deal with, often more than once.

In this episode we discuss the three different types of lice - body lice, pubic lice, and head lice - how to get them, the health threats associated with them, and what works to get rid of them. 

Resources:

The CDC on head lice treatment

An Interesting Paper if You Want to Get Totally Geeky on Lice

Dr. Pearlman's Site on the Cetaphil Treatment and Lice

 

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Feb 20, 2017

Physician burnout is a big issue in the medical community. According the the Medscape Lifestyle Report 2017, over half of physicians report burnout. But physician burnout isn't just a problem for physicians. It is a problem for patients, for other medical staff, and for the health care economy. 

Today we dig into the causes of physician burnout and how it can be addressed. Here's a hint: It doesn't involve meditation or counseling.

Resources:

Medscape Lifestyle Report 2017

2 Docs Talk About Pricing Transparency

2 Docs Talk About Medicare for All

2 Docs Talk About Drug Pricing

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Feb 13, 2017

Diabetes is an old disease that hasn't had a many new solutions in a long time. In this episode we look at what Type 1 and Type 2 diabetes are, how they are treated, and some potential game changers for their treatment on the horizon.

Resources:

Diabetes Stats

The exorbitant cost of diabetes

ACP Guidelines for Treatment of Type 2 Diabetes

Digital Start-up Trying to Help Low Income Diabetes Patients

Research into the Utility of the BCG Vaccine for the Treatment of Diabetes

 

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Feb 6, 2017

Historically, cervical cancer has been one of the major killers of young women. But since the advent of the pap smear, death from the disease has dropped dramatically. However, treatment of lesions identified on pap smear can lead to significant issues including infertility. And in other parts of the world where screenign is not easily accessed, cervical cancer remains a significant cause of death for women in the prime of life.

As with any disease, prevention is better than treatment, and this is where the HPV vaccine comes into play. Known mainly by its trade name, Gardasil, the vaccine has been on the market for over a decade. That's long enough to provide data to draw reasonable conclusions about its safety and efficacy.

Resources:

Prevalence of HPV after introduction of vaccine

Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era

 

Safety Resources:

https://www.ncbi.nlm.nih.gov/pubmed/21907257

https://www.ncbi.nlm.nih.gov/pubmed/23027469

https://www.ncbi.nlm.nih.gov/pubmed/24108159

http://jamanetwork.com/journals/jama/fullarticle/1886177

https://www.cdc.gov/vaccinesafety/pdf/data-summary-hpv-gardasil-vaccine-is-safe.pdf

 

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Jan 23, 2017

The 21st Century Cures Act was passed by both bodies of Congress and signed into law by President Obama on December 7, 2016. The bill received overwhelming bipartisan support, with only a small number (of notable) exceptions.

On the surface, the law sounds like a triumph for healthcare and medical research. But a closer look at funding for the act brings its staying power into question. The only provisions of the law that don't require further action to maintain funding benefit one lucky group. 

Here's a hint: it's not patients. 

So today, 2 Docs Talk about what the 21st Century Cures Act accomplishes and what it doesn't accomplish. Buckle up. 

Resources:

Legislative history and text of 21st Century Cures Act

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Jan 16, 2017

We’ve got a lot of questions marks ahead of us this year when it comes to healthcare. What will happen with the Affordable Care Act, Medicare, Medicaid, Planned Parenthood, etc. etc.

The future of healthcare under the new administration is a big unknown. But one thing we do know - healthcare costs far too much.

One of the key contributors to these costs is the over $200 billion per year in unnecessary medical care. 

In today's episode, we dig in to the reasons for these costs, and more importantly, we talk about the things we can do as healthcare consumers to reduce unnecessary medical care in our own lives. 

Resources:

Unnecessary Medical Costs

Low Value Care in Medicine

Unnecessary Tests and Treatments

Freakonomics Radio: Bad Medicine

Choosing Wisely

 

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Jan 9, 2017

In a country (the U.S.) where people drink, on average, 44.7 gallons of soda per person, it's smart to think about what we are putting into our bodies. 

Most of us have figured out that all that sugar is a bad idea, but what about sugar substitutes? Diet sodas make up a big portion of that 44.7 gallons. But is it really any better than plain old sugar?

Resources:

Generally Recognized as Safe

San Antonio Heart Study

Fueling the obesity epidemic: Artificially sweetened beverage use and long term weight gain

Artificial Sweeteners and Gut Microbiota in Rats

 

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Jan 2, 2017

America has a weight problem. A full one third of us are classified as obese, and other third are obese. This has implications for individuals, families and society that cut across social and economic factors.

We take a look at a handful of studies that take a look at the weight problem from a variety of angles.

Metabolic rate, BMI, whole grain intake,physical inactivity, and more.

 

Resources:

CDC Info on Obesity

“The Biggest Loser” Study

BMI study

Whole Grain Study

Exercise to Offset Sitting

Cost of Physical Inactivity

 

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Dec 26, 2016

These days you can buy e-Books  for your e-Reader and participate in e-Commerce. You can send your friends Evites, e-file your taxes, and meet the love of your life on eHarmony.

So it’s really no surpise that e-Cigarettes have become as popular as they are. Hats off to whoever named them, since they are actually physical items that you can hold in your hands, unlike most e-products.

The question, of course, is if there are any health advantages to e-Cigarettes. Do they really help you stop smoking?

And, do they create their own set of health problems?

That’s what we’re talking about this week.

 

Resources:

E-Cigs and Poison Control

Southern California Children’s Health Study

USPSTF on Smoking Cessation

Aphthous Ulcers and Nicotine

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Dec 19, 2016

Over the last couple of decades, the conversation surrounding hormone replacement therapy and menopause has been confusing. Does it work? Is it safe? What about alternative therapies? it’s hard to sort out conflicting information coming from various sources. In this episode we discuss:

  • The recent history of hormone replacement therapy (HRT)
  • HRT for symptom relief
  • HRT, endometrial hyperplasia, and uterine cancer
  • HRT and cardiovascular disease
  • HRT and breast cancer
  • Bioidentical hormones
  • And more.

Resources

The Bitch is Back

Study of Women’s Health Across the Naiton (SWAN)

The Women’s Health Initiative

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Dec 12, 2016

 

In this episode we take a look back at our first year of podcasting and some of the more interesting topics we've discussed. Remember medical marijuana? What about vaccines or telemedicine? There are new developments in these areas and more and we discuss these new developments and more. Also, if you hang on to the end, you'll hear one of the few times we disagree. We disagreed, we discussed, we still like eachother. Kendall didn't even tweet about what yuuuge loser Amy is.

Podcasts we discuss in this episode:

Vaccines

Pricing Transparency

Medical Marijuana

Planned Parenthood

Birth Control

Back Pain

Telemedicine

 

Resources

MMR and SSPE

California Drug Price Relief Act (It didn't pass)

Voting Habits by Medical Specialty

Reclassification of Marijuana

CMS on Post-partum Reimbursements for LARCs

Yoga for Back Pain

FDA Approves Manufacture of Digital Stethescopes for Telemedicine by Tytocare

 

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Dec 5, 2016

The media serves us a lot of news about some very flashy diseases. Sometimes is skews our perception of what the most serious threats to our health really are. But no matter what new danger the latest headlines proclaim, heart disease remains the number one cause of death in the United States. Often, those deaths are caused by heart attacks. 

In today's episode, 2 Docs Talk about heart attacks, what they are, how they are treated, and how you should respond if you think you or someone near you is having one. 

Resources:

Prognosis after out of hospital cardiac arrest with and without automatic external defibrillation.

A stem cell treatment for heart disease currently being pursued.

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Nov 28, 2016

With the very stressful election we've all just been through, we thought it might be a good idea to lighten things up and have a little fun this week. So we are taking a look at the medical news this week to find teh fun and lightness we are all needing right about now. If you want to learn more about the items we talked about today, the links are listed below.

Why are we ticklish

http://www.latimes.com/science/sciencenow/la-sci-sn-tickling-rats-20161110-story.htm

Flu risk and birth year

http://www.cnn.com/2016/11/10/health/flu-risk-birth-year/

Cannabis gym

http://hoodline.com/2016/11/world-s-first-cannabis-gym-to-debut-in-the-mission-this-spring

Sugar-sweetened beverage tax passed in four cities

http://theincidentaleconomist.com/wordpress/misapplication-of-the-berkeley-soda-tax-to-diet-drinks/

FIT for colorectal screening

http://annals.org/aim/article/2571716/colorectal-cancer-screening-united-states-what-best-fit

Roller coaster kidney stones

http://jaoa.org/article.aspx?articleid=2557373

 

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Nov 21, 2016

If you live anywhere but under a rock, you know that Planned Parenthood has been the center of controversy in recent months. In this episode, we discuss the history of the organization and its founder Margaret Sanger. Then we dig into Planned Parenthood as it exists today and the controversy surrounding it.

The coverage of the controversy in the media is filled with innuendo and half-truths from both sides of the political spectrum. We wanted to know the facts, so we did a little searching. Since we recorded this episode, the courts in Houston did too, and found no evidence that they were profiting from the sale of fetal tissue or organs.

But, what role does Planned Parenthood play in healthcare today?

Do they provide needed services? What are those services? Is abortion their primary business? Should Medicaid funds cover their services? And finally, is there anything that can be done to curb the number of abortions performed today? (Hint: yes there is, and it has nothing to do with Roe v. Wade.)

Resources:

Where are Planned Parenthood Clinics Located?

Texas Tribune Articles on Planned Parenthood

Planned Parenthood Services by the Numbers

CDC Abortion Surveillance Report - 2012

New England Journal of Medicine on Planned Parenthood

Long Acting Reversible Contraception in Colorado

The Choice Project - LARCs in Colorado

 

Nov 14, 2016

November 8, 2016 has come and gone and no matter what box you checked you are probably a little surprised by the outcome. Donald Trump will be the 45th POTUS. 

This has the potential to shake things up in a lot of areas of American life, but we want to focus today on the healcare ramifications of a  Donald Trump presidency. What did he say he would do? Will he do it? And what will it look like if he does.

We refer to a couple of our previous podcasts in this show and they are worth a listen as you evaluate the plans Donald Trump is offering up:

Episode 10: What Does Planned Parenthood Actually Do?

Episode 6: Pricing Transparents in Medicine and Healthcare

Nov 7, 2016

The process of drug approval is long and expensive. To complicate matters, pharmaceutical companies, patients, an the FDA are all invested in the process, for different reasons - and they aren't always the same.

Today we discuss the story of how a new drug came to market and the unusual circumstances around its approval. 

Resources:

FDA grants accelerated approval to first drug for Duchenne muscular dystrophy

CDC on Duchenne Muscular Dystrophy

Right to Try

Compassionate Use

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Oct 31, 2016

It's one of those things that doesn't feel so big and important compared to other medical problems, but in reality, acne can be a difficult problem to deal with.

For teens it can be a huge blow to already fragile self-confidence. It isn't a walk in the park for adults who find themselves with a break-out, either.

So today, we are talking about what causes acne, what the science says about dietary approaches to reducing it, and what the most current treatments are. 

Resources:

Acne: A Disease of Western Civilization

Prevalence, severity, and severity risk factors of acne in high school pupils: a community-based study.

Our podcast on supplements

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Oct 24, 2016

If you've paid any attention to the news over the past year or so, you've likely seen stories of greedy capitalists gouging the vulnerable by hiking up the prices of their life-saving drugs.

But are the prices hikes all that bad?

Yes. Yes, they are. And we talk about that to day on 2 Docs Talk.

Resources:

JAMA on Drug Pricing

Our episode on Hep C

Our episode on Alzheimers

Our episode on Pricing Transparency

Oct 17, 2016

You'd think that something like screening for prostate cancer would be free of controversy, but that just isn't the case. The benefits and risks of screening have been hotly debated by different medical organizations over the years.

Today, 2 Docs Talk about how prostate screening and the various issues surrounding it. This is a topic every man should discuss with his physicians, and we hope this hepls you know what questions to ask when you do.

Resources:

Weiner AB, Matulewicz RS, Eggener SE, Schaeffer EM. Increasing incidence of metastatic prostate cancer in the United States (2004-2013). Prostate Cancer Prostatic Dis. 2016 Jul 19.]

AU Tacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ. TI Serenoa repens for benign prostatic hyperplasia. SO Cochrane Database Syst Rev. 2012;12:CD001423.

https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq

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