The External Medicine Podcast

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...

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 c...

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 subspecialt...

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...

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 Fell...

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 episo...

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 improv...

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....

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 th...

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 experimen...

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...

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,...

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-classific...

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 invest...

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?...

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 foundi...

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...

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 medicin...

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...

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 inc...

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 generatio...

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...

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...

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 ve...

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...