The Paradocs Podcast with Eric Larson

Entrepreneurs are funny creatures. Some seem to be born to innovate and create businesses. Others, like today's guest, create new businesses out of necessity because they can't find a system that works for them. Dr. Rick Rosenfield is an OB/GYN who enjoys gynecological surgery. He didn't feel that he could do that in his first job with a large health system so he struck out on his own and started...

One thing you can be certain of with COVID-19 is that there is no shortage of controversy. Whether it is lockdowns, treatment, vaccines, or testing there have been volumes written about what should or should not happen. So today, we're going to learn about the most common test in the middle of the controversy - the PCR. That's why I reached out to expert, Kevin McKernan of Medicinal Genomics to un...

Dr. Diana Bitner describes herself as a survivor. As an OB/GYN, she had what one would describe as a typical practice. She was employed in a large multi-specialty physician group that later got acquired by a large health system. But within this traditional insurance based practice, Dr. Bitner looked to deliver care to her OB/GYN patients in a different way. She thought of herself as an 'introprene...

In his excellent book, From Killer to Common Cold: Herd Protection and the Transitional Phase of COVID-19, Dr. David Graham lays out the upcoming evolution from pandemic to endemic for SARS-CoV-2 virus. Although published months ago, the book has proven to be right on with how the virus is progressing and we now find ourselves in the transitional phase of the pandemic. The virus is transitioning f...

Pain. We all experience it. It is as much a part of life as breathing itself. But what is pain? Is it physical? Is it mental? Is it emotional? Is it mechanical? Also, how does pain become chronic? One of the few things experts on pain can agree on is that our ability to treat pain - especially chronic - is not very good. My guest, Dr. Melissa Cady did a pain fellowship and realized that it wasn't...

As COVID-19 continues to rage across the globe, everyone has been trying to figure out how to protect themselves from getting infected. Although we know a lot about what puts people at risk (age, diabetes, heart disease), not much is talked about as far as preventative care goes. That might be where we should begin our discussion about vitamin D. Perhaps this common vitamin is a linchpin to preven...

The most obvious statement we can make about the US health care system is that it's a mess. It's complicated, expensive, and rarely delivers what patients expect. The unserious answer to how you fix the health care system is to blow it up and start over. As the largest sector of the economy that hires the most people, there are far too many interests in keeping the system just as it is. The soluti...

Direct primary care (DPC) is a style of practicing medicine we have discussed many times. The way DPC works is that instead of using insurance to cover the cost of doctor visits with copays, patients contract directly with the doctor – usually on a monthly basis. What happens when care has to be episodic like with a pregnancy? And if you're that doctor covering all the patients in your panel for 2...

Well, it finally happened, the COVID-19 vaccines have started to arrive and get administered to health care workers in the United States. Both vaccines use a revolutionary new technology for inducing an immune response, messenger RNA (mRNA). As millions of doses start rolling out throughout our hospitals and nursing home care workers we need to reflect on whether the vaccine is effective, safe, an...

What does it mean to feel grief? Is it sadness? Anger? Resignation? Unfortunately, life will almost certainly present you with grief at some point. Where there is love there will also be grief when the love is lost. But always, grief is a human emotional state that we will all have to struggle with before our life is over. As a physician, one treats not only physical illness but also mental anguis...

Cancer. It is a word that evokes feelings of fear, pain, hopelessness, and loss. It also brings to mind images of chemotherapy, nausea, weight loss, hair loss, and loved ones suffering in pain. Cancer is all of these things and so much more. What is more interesting is why do people get cancer? Why do all cancers end up looking the same despite originating from different parts of the body? And why...

It's been a while since we have discussed medical liability on the show but malpractice is a large and expensive part of what doctors have to face in today's medical landscape. Physicians are often under attack not just from frivolous lawsuits but also attacks from disgruntled patients online or office disputes. It is important for doctors to understand the risks they face both to their careers an...

Direct primary care (DPC) is a movement that is growing quickly in the United States. Patients and physicians are looking to bypass the traditional box store medical practice and deal directly with one another. The shift to this sort of practice can be scary for a doctor. In order to answer some of these questions I asked nine DPC practices from around the country what is the one question you wish...

What's it like living a year without health insurance if you are a family with two doctors? Well, we found out sort of by choice and sort of by chance. It was one where we learned a lot about expenses, prices, and the utter insanity of medical system pricing. We become better shoppers of medical services. We hired a doctor to help navigate buying drugs, getting labs, and imaging tests. Best of all...

Since 2010, the number of NPs in the United States has grown from 109,000 to 290,000. It is transforming the health care landscape in the United States. But is it improving overall health? Is it providing more care for patients? Is it allowing for improved access? Is the quality improved or at least the same with physician-led care? Does that solve the problem of rural care? These questions are th...

The last few years have seen a resurgence in the use of fasting. Fasting is an ancient practice tied to religions and culture. In many ways, how and when we eat developed based on the availability of food. My guest is Dr. Jason Fung, a nephrologist and expert in intermittent fasting for the treatment of diabetes and weight control. His first argument, however, is a simple one - fasting is old, saf...

Dr. David Graham returns again this week to discuss his newly published book, From Killer to Common Cold. The book touches upon the topics we have discussed on this show for a few months now. The central theme of the book is how SARS-CoV-2 will transition from the pandemic killer COVID-19 to a common cold coronavirus. Dr. Graham expertly lays out his case in a short book that is easy to digest. He...

Episode 100 is a momentous achievement for a podcast about medicine where I had only about 3 show ideas in mind when I launched. My guest host today is my wife, Marcy, who has been by my side throughout the show and obviously, the loss of our son Andy in a car accident. His death has served as a dedication to the show, a way to honor him with his audio track closing every show, and a reminder to m...

Okay, so today's title to the show is a little provocative. But it's meant to convey the most important takeaway from the discussion. Our problem is the recent news that asymptomatic people and athletes showed signs of myocarditis (heart inflammation) on cardiac MRI and there was concern that this put them at immediate risk of heart diease. To explain the controversy, I brought Dr. Rohin Francis o...

Today's discussion begins way back in the early 1990s when Congress was trying to figure out a way to reduce its health care expenses. Sound familiar? Some things never change. And this story is as old as Congress itself as legislators try to solve one problem and end up creating a bigger mess that actually ends up creating far more harm than was occurring with the original. It goes by the rather...

We're breaking from our discussion of COVID-19 and discussing life after pandemic with finding means of passive income. Specifically, how one can earn passive income through real estate. My guest is Dr. Jeff Anzalone, a periodontist in Monroe, LA who has created a website to help other high income earners find ways to earn passive income through real estate. He is an advocate for investing in real...

Following our discussion last week where we discussed the probable lower herd immunity rate threshold for COVID-19, today we are going to discuss the transition from a global pandemic to endemic state for the virus. This makes one fundamental assumption - that COVID-19 isn't going to go away, ie, it won't get eradicated. The reasons to suspect this are all around us in that almost no viruses have...

One commonly used expression regarding the current COVID pandemic is herd immunity. People are obsessed with reaching herd immunity as soon as possible so that we can put this pandemic to bed. It is hoped that the development of a vaccine will get us the herd immunity of 60-80% far quicker than waiting to reach it through natural infections. But my guest today is convinced her modeling puts the ac...

Pharmacy benefit managers (PBMs) are one of the 'middle men' in health care that have recently come under fire for the added expense they bring in the prescription drug market. What was once a relatively unknown player in the health care delivery process, PBMs are now finding themselves with a target on their back for the first time. Learn more about your ad choices. Visit megaphone.fm/adchoices

One driver of health care inflation in the United States are pharmaceuticals. Although we usually associate rising drug prices with prescription medicines, that is not always the case. In fact, the purchase of generics through insurance plans can be surprisingly expensive. This is because the 'discount' provided by your insurance carrier may not really be much of a discount and your copay could be...