Raise the Line

As we've noted on Raise the Line from Elsevier before, the system Americans rely on to keep vaccine recommendations grounded in science has changed in ways that many in the medical community find alarming. Our guest today, Dr. Jason Goldman, has watched this shift unfold from a closer vantage point than most in his role as liaison from the American College of Physicians (ACP) to the CDC's Advisory Committee on Immunization Practices.
“The vaccine guidelines must be based on science and evidence and that doesn't change because of someone's political beliefs. We have to keep politics out of healthcare,” says Dr. Goldman, who has been a prominent voice responding to the risks resulting from these changes as well as other public health issues.
This candid conversation with host Lindsey Smith also explores:
Why Dr. Goldman calls himself a "dinosaur";
The Medicare quirk that pits doctors against each other;
His advice to students when choosing a specialty.
Mentioned in this episode:
American College of Physicians

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As many of our listeners know from news reports, emergency departments have been under enormous strain in recent years trying to manage overcrowding, the opioid addiction crisis, the consequences of an under-resourced mental health system, and rising rates of violence against staff, among many other challenges. But our guest today guest thinks there’s something else that should top that list. "I think hands down the most important issue is the reimbursement model," says Dr. Ryan Stanton, president-elect of the American College of Emergency Physicians.
Dr. Stanton’s uniquely-informed view is built on his work leading a physician-owned group staffing two Kentucky emergency departments, serving as EMS medical director for Lexington-Fayette County, and overseeing on-track medical response crews for auto racing series such as NASCAR.
In this candid conversation with Raise the Line from Elsevier host Lindsey Smith, Dr. Stanton traces how underpayment from insurers is squeezing physicians and warping the incentives of emergency care, and why he believes the profession's ability to advocate collectively, not individually, is what will move the needle.
This informative episode also explores:
Why he thinks physician autonomy is the antidote to burnout;
His approach to communicating medical information as a TV commentator;
What it’s like providing care at a NASCAR race when the “car is still smoking.”

Mentioned in this episode:
American College of Emergency Physicians

If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Limiting the side effects of cancer treatments has been an animating force in the field of oncology for many years, and there’s been progress to report on that front, but what if you could target cancer tumors without using radiation or chemotherapy and instead generate heat from inside the tumor to kill cells?
That’s the quest of our guest today, Dr. Hadiyah-Nicole Green, whose promising research using lasers and nanoparticles to eliminate tumors received Breakthrough Device Designation from the FDA earlier this year. “The laser beam that we're using is low power like a laser pointer, and without activation by the laser, the nanoparticles are harmless. Both are targeted just at the site of the tumor so because we don’t use systemic delivery, we avoid all of the systemic side effects,” she explains.
Dr. Green is also the founder and president of the Ora Lee Smith Cancer Research Foundation, named for an aunt who raised her and who died of cancer without pursuing curative treatment because of her fear of the side effects. Shortly after, her aunt’s husband also died of cancer, opting for treatments that took a heavy toll on his body. “At 22 years old, I saw the horrors of cancer and the horrors of cancer treatment and just felt in my heart that there has to be something better than this,” she tells host Michael Carrese.
On this fascinating episode of Raise the Line from Elsevier, we'll explore the science behind Dr. Green's approach, the challenges of raising the millions of dollars needed for human clinical trials, and rethinking the current funding landscape for cancer treatments.
Mentioned in this episode:
Ora Lee Smith Cancer Research Foundation

If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

"It's really hard to justify a test that has any complications if there isn't any reasonable expectation of benefit," says Dr. Rita Redberg, who has spent her career trying to help fellow clinicians consider the actual value of routine screenings and diagnostic testing in asymptomatic patients. Dr. Redberg -- a cardiologist and professor of medicine at the University of California, San Francisco for more than three decades -- is one of the leading voices advocating for a “high-value care” approach, an uphill fight in a healthcare system that tends to reward action over restraint. Her highest profile effort was launching the instructive “Less is More” series in JAMA Internal Medicine when she served as its editor-in-chief for 14 years.
On a related track, her research on the assessment of the safety and effectiveness of medical technology, specifically high-risk cardiovascular devices, has yielded a troubling picture. "We found only 1% of devices enter the market through the FDA's most rigorous approval process. The high-quality evidence to support benefit for these devices that I had assumed was present, wasn't actually there.”
Join Raise the Line host Lindsey Smith for an eye-opening exploration of what Dr. Redberg considers to be the overlooked risks and false reassurance of common tests and procedures, and her efforts to put the “do no harm” principle of medicine at the forefront of everyday practice.
Mentioned in this episode:
UCSF School of Medicine
JAMA Internal Medicine's Less is More Series

If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

For millions of young women and girls, often the first place they turn with questions about their bodies isn't a doctor's office, it's social media which can lead to encountering many misconceptions and outright misinformation. Or, if the right voices show up, it can mean something else entirely.

Our guest today, Dr. Charis Chambers, is one of those voices. She’s a board-certified OB/GYN with specialty certification in Pediatric & Adolescent Gynecology, and Chief Medical Officer at Clue, a leading period and cycle-tracking app. She's also the founder of The Period Doctor, a platform she launched in 2019 to provide medically accurate reproductive health information and to place more minority physicians in the spaces where patients are already looking for answers.

As she tells Raise the Line from Elsevier host Lindsey Smith, Dr. Chambers embraces the role of being a bridge between generations: "I can serve as a medical mediator where I advocate for the child and then educate the parent so that the child’s concerns are met."

Stay tuned to this important conversation to also learn about:

Her new book, The Period and Puberty Parenting Revolution, which tackles many of the same myths she encounters every day in her clinic;

Why stubborn myths around periods rarely hold up once you ask where they come from;

How she thinks about the responsibility, and limits, of being a trusted medical voice on social media.

Mentioned in this episode:

Clue

The Period Doctor

The Period and Puberty Parenting Revolution

If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast