Episode 135: Apple Failed at Health Care, Doctors Didn't with Dr. Doug Farrago
The Paradocs Podcast with Eric Larson
Release Date: 07/01/2021
Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi
The Paradocs Podcast with Eric Larson
Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...
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Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover
The Paradocs Podcast with Eric Larson
What happens when you take Go Fund Me and put it into an ecosystem of likeminded folks who want to build a community to care for each other's health care expenses? You get which draws upon some of the concepts of crowd funding for one time health care expenses within its community. By taking people from all over the country and putting them into a community where there are expectations of caring for others, Crowd Health offers a solution to paying for health care expenses without breaking the bank. Is Crowd Health Insurance? If you've been paying attention to the US health care...
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Episode 152: The COVID Drawdown
The Paradocs Podcast with Eric Larson
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 physical and mental health detriments) then we have to consider how the drawdown occurs and what conditions ned to be present for it to happen. What HaS TO HAPPEN FOR THE DRAWDOWN TO OCCUR? We've talked to...
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Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg
The Paradocs Podcast with Eric Larson
One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...
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Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.
The Paradocs Podcast with Eric Larson
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 insurance broker industry is that they are really not working to save money or get deals for their clients - the checks are written by the insurance carriers and that's who they answer to. Who do...
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Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD
The Paradocs Podcast with Eric Larson
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 as general discussions on COVID policy which can be found , , and . 12 Myths and 12 Facts About COVID-19 If there is one certainty during this confusing pandemic it is that there are plenty of...
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Episode 148: Urgent Care as Primary Care with Dr. Juliet Breeze of Next Level Medical
The Paradocs Podcast with Eric Larson
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 use it to deliver regular and sometimes non-urgent care. We've discussed before that lower the cost of care with transparency so this seems like the next logical step with urgent care. We...
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Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD
The Paradocs Podcast with Eric Larson
The COVID pandemic has brought on all sorts of changes to the way we live our lives. From wearing masks, working from home, stay at home orders, and restrictions on social interactions, the virus has caused untold disruption to the way our society functions. Although the changes COVID has brought to our schools and the lives of our school age children, it is perhaps less appreciated what changes have occurred for our infants. It is a well known fact that our environment and meaningful stimulation is necessary for normal intelligence and brain development. Infants are completely...
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Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson
The Paradocs Podcast with Eric Larson
Imagine yourself in California at a clearing in a large forest. And it’s on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They’re yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn’t anything wrong at all. Of course, the largest group of people are...
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Episode 145: Surgery without Insurance with Dr. Keith Smith
The Paradocs Podcast with Eric Larson
A lot has happened since we last met with Dr. Keith Smith from the back in 2018. . We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So what's happened since then and how has the center done with the pandemic? Is the Surgery Center of Oklahoma Thriving or Just Surviving? Not surprisingly, Dr. Smith says that the center is doing just fine and has increased its market share from other states. Additionally, the international community from Canada is now being allowed to come back into the US for their...
info_outlineThere has been no shortage of people or schemes to fix the US health care industry. US medicine consistently fails to deliver quality care at affordable prices and manages to irritate both doctors and patients alike. Politicians and think tanks come up with grandiose plans every day to treat what plagues the system. Likewise, big tech companies like Apple are now entering the fray and bringing their technology as solutions.
Unfortunately for Apple (and its tech cousins like Amazon), the health space is extremely complicated and can't be solved simply using technology. Its attempt to "make it" flopped just as other ventures by tech companies have in the past. The common thread in all of those is the belief that they could replace doctors.
Doctors Make it Work, Not Expensive
A common misconception found at tech companies like Apple is that people are easy to replace with algorithms and gadgets. But humans aren't machines so you can't always predict how they will behave. Even with sophisticated devices monitoring heart rate, blood pressure, etc. that information is not useful in isolation. You must have someone who can figure out if any of the data is important based on examination, intuition, and experience that can't be found in any algorithm.
Also, the companies believe that by removing the physician, they will find the cost savings they need to cut costs and deliver an equivalent service. But anyone who has been paying attention (or looked at expenses in medicine) will find that doctors are one of the smallest parts of the cost equation. They are easily surpassed by imaging, laboratories, pharmaceuticals and the biggest and baddest of them all - administrative. Middle men and the third party payor system in general are what are driving the majority of price inflation in health care.
How to Really Solve the Shortage on Care - Hint: It's not getting rid of doctors
My guest today is Dr. Doug Farrago, founding member of the DPC Alliance, newly retired direct primary care doctor, author of books on how to start your own DPC practice, and inventor of the knee saver for catchers and the cryo helmet for sufferers of migraines and concussions. Dr. Farrago points out the most obvious flaw in the plan from these tech companies - data is only as useful as the one applying it. Just as it wouldn't be recommended to get random batteries of tests to arrive at diagnoses, accumulating massive amounts of vital signs or rhythm data is just as useless without the context provided.
A good example is familiar to any doctor who has ever ordered a chest x-ray. When you get the reading from the radiologist, their diagnosis of the problem is dependent on the history of the patient. Maybe that fluffy infiltrate is extra fluid, or pneumonia, or blood. You need to correlate what is going on to get the most out of that film. Without a correlation, it is just a random test that may or may not be significant.
The Solution? Direct Primary Care
So what is the solution to the cost and quality problem facing primary care in medicine? Dr. Farrago (and many others whom I've spoken with here, here, here, and here) is direct primary care. The personal membership based relationship between a doctor and patient without insurance or any of the middle men allows for the best care. It is affordable and allows the doctor to use his or her intuition and clinical judgment based on their prior relationship with that patient and their previous health history. That's why Dr. Farrago thinks DPC is the clearest solution to what is plaguing us - not some new piece of tech. Tech are just tools that the clinician can use - they can't replace a human touch, physical exam, and experience.
Dr. Doug Farrago is a recently retired DPC physician previously of Forest Direct Primary Care. He is the writer at Authentic Medicine and DPC News. He is the author of many books on DPC and the inventor of the Cryo Helmet and knee saver for baseball catchers.
show notes
Episode 135: Today's show
Apple Can't Even Get Primary Care Right This is the article we discussed focusing on Apple's failure getting into the primary care space.
DPC News: This is a great resource for those interested in what is going on in direct primary care. A news accumulator with some original content.
Authentic Medicine: Dr. Farrago's blog of 20 years where he has commented on medicine.
DPC Alliance: This is an organization founded by Dr. Farrago that is committed to helping DPC doctors organize and learn from each other to become successful clinicians and business men and women.
Episode 002: Dr. Amat describes why she went into DPC.
Episode 045: Dr. Neuhofel explains what it was like starting one of the first DPC practices in the country.
Episode 049: Dr. Gross describes how DPC is a cornerstone for rebuilding our health care system.
Episode 067: Dr. Umbehr speaks about the resources he has created to help DPC docs be successful in their new practice model.
Locum Story: Today's sponsor for the show is Locum Story and how they help doctors find locum tenens positions.s
Doctor Podcast Network: The home for the Paradocs and a number of other physician based podcasts.
Made Simply Web Site Creations: This is the great, affordable website service that built my wife's podcast site. I cannot recommend this company more to someone looking for creating a website.
Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them.
YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.
Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.
