The Paradocs Podcast with Eric Larson

Maintenance of Certification (or MOC) is a requirement by all the specialty boards in the United States that is above and beyond what the original certification is to become board certified. In the 90's specialty boards put time limits on the original certification and began to require MOC and its outrageous fees and busywork. Dr. Torie Sepah is a board certified psychiatrist in Pasadena, CA and f...

Now that we're approaching the half way point of summer it's time to start thinking about what we're going to do with school for K-12 (and college) kids. States and communities are starting to finalize their plans with how they expect to conduct elementary and secondary education in the face of the COVID pandemic. The only certainty is that there is a lot of uncertainty in what will happen. Learn...

Hydroxychloroquine is an old medicine and treatment for conditions causing cyclical fevers like malaria. But hydroxychloroquine has been used in the treatment of infections like SARS, influenza and others. Why did this happen? Where did it start? And what is its place today in the treatment regimen for COVID-19? My guest today is Dr. Adam Rodman of Bedside Rounds Podcast. He is an internist and am...

What does it mean to have a virtual telehealth doctor's visit? Can artificial intelligence (AI) and telehealth actually work in a medical setting in a way that doesn't frustrate doctors or patients? Well, my guest today is the chief medical officer of 98Point6 which is a text based primary care service for patients. That's right, patients use their phone or tablet with texts to receive their prima...

Today I'm joined by my friend and colleague Dr. Randy Lovell who has opened his own innovative practice in Grand Rapids where he looks to become fully transparent. Dr. Lovell has implemented and perfected the technique of WALANT or Wide Awake Local Anesthesia No Tourniquet. He describes in great detail the advantages of this practice technique not just for the patient and physician experience - bu...

We're back at it again discussing the Coronavirus pandemic. The shutdowns/lockdowns continue in the United States and the tenor of the debate or discussion had changed within the media and culture. At the beginning of the pandemic the focus was on flattening the curve. Today, it is about stopping people from 'catching' the coronavirus. This is a mistake. Learn more about your ad choices. Visit meg...

Now that we are over a month into the variable stay at home orders in the United States for the coronavirus it is probably a good time to reflect and guess as to how this all unfolds. Today I interviewed infectious disease specialist Dr. David Graham. Dr. Graham lives in Billings, Montana and provides a perspective on the pandemic that I had not yet heard. He suggests that at the forefront of this...

The response from state governments in the United States have varied in how they are responding to the Coronavirus pandemic (COVID-19). Michigan has been in a state of emergency for weeks with it now extending through the end of the month. Our government deems "allowed" instituted more draconian rules in the face of no evidence of benefit. This is not to say that there is no risk to resources or p...

Once again I discuss the coronavirus outbreak in the US. Today, I speak with Dr. Michel Accad about the ways the US has bungled the response. We specifically look at how the mistakes from ossified bureaucracies have prevented decision makers from having necessary data and the ability to make informed decisions. Also, what is the financial impact to doctors and their practices and what about the lo...

Five months ago, my family dropped our health insurance and switched to a health sharing ministry (Samaritans). So far, so good. We've gotten better medical care by hiring a DPC doctor and have saved over $2000 in five months. What will it be like dealing with coronavirus without insurance? I'm pretty sure fine. However, the second half of the show I talk about the reasons the US response has been...

Dominating the news today is the pandemic coronavirus or COVID 19. It is unique in that its hosts are often asymptomatic but infectious for days making its spread so effective. There is some reason for concern that the response in the US may have been too swift. Perhaps we should have waited another week or so to allow some more community infections to improve herd immunity since there is no vacci...

Child abuse is a something we can all agree is a terrible crime. It is something that we must work to stop. But what is the best way? And how can we be sure that those accused of abuse actually did? Because we can agree that child abuse is bad - so it removing children from their family if people are wrongly accused. My guest is Dr. Niran Al-Agba who details the story of her patient who was taken...

A discussion on where the lines are on making vaccinations mandatory. Are you compelled to get vaccinated to help the overall population's herd immunity? Or do you have a right to control what is injected into your body no matter the consequences to others. We tackle those questions and try to get to the bottom of the question of where your rights end and mine begin. Learn more about your ad choic...

Today I discuss how Dr. Bill Hennessey of Pratter, Inc. is already forcing price transparency in the market for health care products. He helps self insured businesses and unions save money by showing them lower cost alternatives for their members. By showing the price for every imaging exam, lab, etc. in town it is then easy for people to decide where to go to get the best price. Without any laws...

A new phenomenon of the 21st century is the online attack. This is where people launch a coordinated attack on a business with the intent on destroying its reputation. The attackers hit you on Facebook, Yelp, Google Reviews and aren't interested in a discussion - just destruction. This can be very damaging to a business but also it causes many doctors and professionals to withdraw from the public...

In today's special Patreon release we enter the world of politics and discuss independent Rep. Justin Amash from Michigan. I speak with Nathan Leamer, a former state house and federal staffer in Amash's office. This unique exposure to who Amash is as a person and boss leads to a better understanding of what his goals are in politics. We discuss Amash's run for Congress as an independent and whethe...

Pharmacy Benefit Managers (PBM) have been villains in earlier episodes. Basically, PBM are the largest health care corporations in the US and exert tremendous lobbying pressure. Although their role in health care is to settle claims they make their billions through a complicated series of kickbacks and rebates from drug companies. My guest today is Vinay Patel, a pharmacist who was frustrated by t...

It isn't often that people walk into hospitals and ask themselves how does this thing work? In fact, the same can be said for those who work in hospitals too. Whether you're a doctor, nurse, phlebotomist, orderly, or patient - how the whole enterprise works is usually a mystery. Also, what protections are there for patients so that they don't have people who are grossly negligent or dangerous cari...

The beginning of a new year is always a good time to reflect on the medical trends on where we've been and where we are going. What are the positive and negative medical trends we're seeing right now. Despite all the negativism about health care I believe that there is much to be hopeful about whether you are a patient or physician. Of course, there is no shortage of potential policy misadventures...

As sure as life exists, death will follow. As such, people will continue to try to control not only their life but the circumstances of their death. Life is also full of instances of suffering, pain, and despair. Those who are in significant pain, the throes of depression or despair may not see any solution to suffering except taking their own life. The questions then come down to whether we need...

Many physicians and those supportive of markets in medicine are making a big deal on Trump's proposed executive order to increase price transparency in hospitals. The thinking is that by exposing how much each hospital charges for their services, hospitals will begin to compete on price and the cost of care will go down. Although I believe this to be an admirable goal, I think it is very shortsigh...

One of the most common questions I get asked about the health care system is why are medical bills so enormous? It seems strange that the explanation of benefits you receive after getting care or services are so obviously inflated. Yet those charges which the hospitals, health care professionals, and pharmacies post are there to see which they clearly have no expectation of getting paid. Why does...

If you own your own business, which physicians who are independent or run concierge or DPC practices do - you need to focus part of your time on branding and marketing. What words you use to describe yourself is critical to success and an important part of marketing and branding. I speak with Dr. Nitin Gupta about what he did with marketing to turn things around at his clinic. Learn more about you...

One of the most expensive ways to receive care in the US health care system is thru an emergency room. The use of urgent care centers is a less expensive alternative. Unfortunately, one of the problems with urgent care centers is that the care is often not very good. It is especially poor when it comes to treating children where the average urgent care refers 40% of its patients to the ER even tho...

Moving from academic medicine to private practice is a scary thing to do for any doctor. But what is it like for a specialist is the city with the highest concentration of her specialty to find patients?   My guest today is Dr. Rudrani Banik, who treats patients with vision disturbances, headaches, and other neurological conditions related to the eye. By leaving academics (partly since she still d...