The Paradocs Podcast with Eric Larson

The COVID Drawdown Today we are going to discuss the COVID drawdown. Essentially, this is what must inevitably happen for us to return to lives of normalcy where we have typical interactions with others at family gatherings, sporting events, concerts, and business meetings. Unless we are prepared to radically change the way we live our lives and choose isolation (which probably has far greater phy...

When you run a business, one person you usually meet and hire is a health insurance broker. In theory, these brokers work with the employers to secure the best deals for health insurance to meet the company's health care objectives. However, in practice, the brokers serve as a sales force for the insurance companies who lavish them with bonuses, trips, and gifts. The seedy underbelly of the health...

Not only has the COVID pandemic politicized our country - it has led to a lot of misinformation and a shutdown of communication. For instance, is there really asymptomatic spread of COVID? Or just pre-symptomatic and symptomatic spread? That might seem like splitting hairs but it can have a profound effect on policy for quarantining and testing. We've talked about this before on the show as well a...

  There are a lot of urgent care clinics all over the country. But few of them, to my knowledge, also operate as regular primary care clinics. But that is exactly what is happening today in the Houston, Texas area with the emergence of Next Level Medical. If you think about it, it makes perfect sense to leverage all the facilities needed for a primary care clinic - exam rooms, physicians, etc. and...

  A lot has happened since we last met with Dr. Keith Smith from the Surgery Center of Oklahoma back in 2018. Back then, we talked about how he brought the radical notion of full price transparency to the surgery space in 2009 all without taking any government payers. We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So...

  A big struggle for doctors is when they watch what goes on in the state and national legislatures and realize that there is very little knowledge of what they do, how they practice, and what they did to get where they are. There are no better examples of this failure to understand the nature of what physicians do than the debate over the Affordable Care Act (Obamacare) in 2013.That episode was w...

  Ask any primary care physician and they will tell you the toughest thing about helping their patients change lifestyle is that they don't have enough time or contact with the patient. Especially when it comes to weight loss control, primary care docs are stretched so thin on time that they struggle to have the impact they'd like on their patient's healthy habits or lack thereof.  Weight Loss Beg...

  Being an expert has a lot to do with muffins. Or rather, when I was eating a fresh muffin the other day for breakfast it certainly got me thinking about experts. You see, I eat my muffins differently than the rest of my family. They break off the top of the muffin and butter the top and then the bottom. I felt like it would be better to cut my muffin down the middle so I could eat a muffin top w...

There has been no shortage of casualties in the last year and half with the COVID pandemic. Schools have been closed, businesses shuttered, and families torn apart with different levels of concern for the virus. But one surprising victim has been science itself. The practice of scientific inquiry, discussion, and debate disappeared. Instead of science - which we can loosely define hypotheses that...

If you want to get a doctor's blood pressure up or make her sweat, just tell her that you have a great electronic health record (EHR) to use. EHRs are the bane of a physician's life because they don't work well with your work flow, create extra work and inefficiencies, and cost a ton of money. That's why I spoke to Dr. Richard Sztramko of Hamilton, ON who is co-founder of Arya health technology co...

"Beware the variants!" scream the headlines all over the news. Now that the vaccine is available for SARS-CoV-2, we are pounded with endless daily fear-filled stories about how the variants of COVID are coming and will continue to put people in the hospitals and funeral homes. Are the variants that dangerous? Are there really wholesale mutations occurring in this virus that will make our natural i...

This year, the Colorado legislature introduced a bill to radically change the way health care would be delivered in the state. HB 21-2132 was introduced this year with the hope of creating a public option health insurance for everyone in Colorado. Of course, their expectation is that they will lower health care expenses by over 10% with this plan. If this doesn't happen, the hammer comes down on e...

In many ways, Dr. Fauci's failure to properly handle the pandemic response with COVID was inevitable. Men like him - according to my guest Peter Suderman of Reason.com - believe in the general infallibility of the bureaucratic process. They think that by following a mechanical paperwork process that they will come to the best, safest, and correct conclusions. These public health bureaucrats also h...

Perfection. We all strive for it. Some more than others, but we all look to be better versions of who we are. In medicine, we tend to be high achievers so we want to 'conquer' parenthood. Being perfect isn't any more possible in parenting than it is in medicine. Human relationships are messy and raising children up to be the best versions of themselves has no handbook. The push and pull of you try...

The most important question we have to ask ourselves is who should get the vaccine? The question comes down to who should get the vaccine, or rather, who shouldn't get vaccinated? This is where Dr. Noorchashm argues that anyone who has had COVID-19 and cleared the disease should not get vaccinated. A near immunological certainty is that once you have cleared a viral infection, you have immunity th...

We're talking about COVID and our American Independence Day from SARS-CoV-2 on June 1, 2021. The first thing I need you to do is look down and if you're wearing a red shirt, take it off. Not just one sleeve, take it all the way off. Likewise, if you're wearing a blue shirt, I need you to do the same thing. There are no red teams or blue teams here. We're just Americans. It's time to open up. Learn...

Today's episode strikes right to the heart of the reason I started this podcast - the injustice of maintenance of certification. If you're a doctor, you know all about the unfairness of this system which requires more money, paperwork, money, testing, money, time away from patients and families, and money. It contributes to physician burnout. For patients, it is why your doctor might retire early,...

Health care, according to today's guest Dr. Eric Bricker, is filled with euphemisms. One you hear a lot is value based care. The claim is that we need to restructure insurance plans to reward health systems that provide care focused on outcomes instead of activity. Conceptually, it makes a lot of sense that you would reward the people providing superior outcomes with better pay. Unfortunately, thi...

Today, we depart from our pandemic of SARS-CoV-2 to discuss what was easily the number one killer of colonial Americans in the Revolutionary War - infectious disease. It is estimated that battle casualties totaled 5-6,000 while disease (infections like small pox and the like) killed between 40-50,000. The toll paid by the civilian population was even worse as loose estimates put the death toll at...

Advocates for vaccine passports are multiplying by the day. But rest assured, this a bad idea. Not only will they be impractical, they will be useless in a few short months before the passports could really be developed and adopted. In the show, I will lay out the case for passports and then explain why they are bad idea from a practical and civil liberty perspective. Learn more about your ad choi...

My guest today is Dr. Vatsal Thakkar who developed an app to take away the pain for patients and health care professionals trying to file out of network insurance claims. Lots of care is provided outside of insurance contracts which requires people unfamiliar filling out insurance paperwork to do so. Thakkar created Reimbursify which does all the filing automatically and eliminating a huge pain po...

There is so much evidence right now that shows that the virus spreads and bursts into regional epidemics independent of local measures to contain it. This doesn't mean that masks do not work for individuals to prevent infection or protect others. However, it is pretty clear that laws don't affect much in the spread of the virus. Comparing states to one another shows that there is little difference...

Trust is essential in medicine. Not only between a doctor and patient but between a community and the health care system. A unique difference between the United States and Africa is the relative recency of colonial powers controlling the country. Our colonial past is distant dating back to the 1700s. For Africa, it's as recent as the late 20th century. But how does history of recent colonialism af...

Today is a departure from a direct discussion of the medicine or the US medical system. We delve into food. Food, is medicine in a way since it has physiological effects on how our bodies function. Finally, what's the deal with eggplants? If the food is locally sourced it has many inherent advantages like improved 'ripeness' at harvesting, decreased transit time and chance to spoil, and it support...

One thing few outside of medicine realize are the unique challenges doctors face in their personal relationships. Marriage can especially difficult due to the unique responsibilities and expectations placed on doctors with work. Unusual hours, call, and administrative work that can find its way into the home is stress that can strain any relationship if the couple isn't careful. Learn more about y...