The External Medicine Podcast

In this episode, Daniel Belkin and Mitch Belkin interview Ben Strong, MD about teleradiology and medical malpractice. They discuss RadNet’s database on major misses and lawsuits as well as how tort law varies state-by-state.Who is Ben Strong?Dr. Strong is the Chief Medical Officer at vRad and head clinical content creator and curator of vRad Radiology Education. Dr. Strong  is an AIRP Lecturer and a contributor to vRad’s popular free radiology educational content.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Steven Hollon, PhD about the evolutionary roots of unipolar depression, its prevalence, as well as current treatment options.  They discuss Aaron Beck, the father of cognitive therapy (CBT), before diving into the potential adaptive origins of depression, rumination, and how cognitive behavior therapy works. Finally, they touch on whether combining CBT and medication actually decreases relapse rates more than CBT or medication alone.Who is Steven Hollon?Steven Hollon, PhD, is a psychologist and researcher at Vanderbilt University. Dr. Hollon’s research focuses on the treatment and prevention of depression.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Eliot Siegel, MD about developing the first filmless healthcare enterprise at the Baltimore, VA in 1993 which revolutionized the practice of medicine. They discuss the challenges of this innovation, including the costs of computing, the difficulties of imaging compression and data management. They touch on theragnostics, a novel subspecialty in nuclear medicine, which utilizes molecular treatments to target cancer.Who is Eliot Siegel?Dr. Eliot Siegel is a Professor of Radiology at the University of Maryland School of Medicine. He is a prolific author and speaker, has written over 300 articles on medical imaging and PACS, has edited several books, and given more than 1,000 presentations worldwide. In addition to his interest in digital imaging and PACS, he’s interested in telemedicine, the electronic medical record, informatics and artificial intelligence/machine learning. Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Marc Gosselin, MD about his journey to radiology, being a radiology program director, dealing with burnout, transitioning from academics to private practice, and overdiagnosis in radiology. They discuss in situ thrombosis versus pulmonary emboli, whether medical evidence should have an expiration date, and why physicians should admit fault when they are wrong.Who is Marc Gosselin?Dr. Marc Gosselin is the head of cardiopulmonary imaging at Vision radiology, a retired full professor at Oregon Health and Science University. Previously, Dr. Gosselin was a program director of the University of Utah’s radiology program.References:Clinical Features of Pulmonary Embolism (1961)Sensible Medicine: Why statins do not cause diabetesSupport the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Hussam Alkaissi, MD about his journey in medicine, experience with populations with high consanguinity, and uncovering of rare diseases. They touch on several unusual cases Hussam has solved including one of CHILD syndrome, homocystinuria, and acute hypercalcemia.Who is Hussam Alkaissi?Dr. Hussam Alkaissi is an Endocrinology Clinical Fellow at the NIH/NIDDK. He has an interest in diabetes, glucose metabolism, insulin signaling, and insulin resistance.References:Hussam's TwitterHussam's Academic WorksNature paper on link between EBV and Multiple Sclerosis Gadolinium, NALCN channel, and metastasis in Mice Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Bryan Carmody, MD, about physician shortages, resident unionization, and the OB/GYN ERAS divorce. They discuss the recent changes to legislation in Tennessee which allows international medical graduates to bypass the US residency system. They also touch on the Weisman versus Barnes Jewish Hospital court case.If you missed the initial episode with Bryan Carmody Episode #6, be sure to check that out.Who is Bryan Carmody?Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Daniel Belkin and Mitch Belkin interview Joann Elmore, MD, about screening mammography. Dr. Elmore shares insights on the USPSTF's new draft mammography recommendations, which lowers the breast cancer screening age from 50 to 40. They discuss the difference in American and European call back rates for biopsy and whether mammography screening programs have substantially improved breast cancer mortality rates or if improvements are primarily due to enhanced treatment methods. They also touch on the potential for AI to transform radiology and pathology.Who is Joann Elmore?Joann G. Elmore is as a professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. Her research interests include diagnostic accuracy, physician variability, cancer screening, patient engagement, and AI/machine learning in diagnostics. She has over 200 publications.References:Joann Elmore's UCLA pageUSPSTF May 2023 - proposed changes to Mammography ScreeningNEJM: Variability in Radiologists' Interpretations of MammogramsSupport the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this conversation, Daniel Belkin and Mitch Belkin interview infectious diseases physician and epidemiologist Dan Morgan, MD, about infection prevention, diagnostic stewardship, diagnostic reasoning, and medical overuse. They discuss regional differences in medical use and delve into a cluster-randomized controlled trial of contact precautions in ICU patients to evaluate whether this prevents C. Diff, MRSA, and VRE. They also touch on AI's potential role in clinical decision support, and the question of how to improve clinician statistical reasoning.Who is Dan Morgan?Dan Morgan, MD, MS is a physician and epidemiologist at University of Maryland School of Medicine. He directs the Center for Innovation in Diagnosis and is Chief of Epidemiology at the VA Maryland Healthcare System. His research interests include probability in medicine, medical overuse, diagnostic stewardship, and infection prevention.If you enjoyed this episode, be sure to check out our episodes with Paul Offit and Deborah Korenstein on medical overuse.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this conversation, Daniel Belkin and Mitch Belkin interview Robin Hanson, PhD, about healthcare and medicine. They discuss three randomized controlled trials on the population-wide benefits of medicine (RAND health insurance experiment, Oregon Health Insurance Experiment, and the Karnataka Hospital Insurance Experiment), which do not demonstrate benefit for more medical care. They talk about the conspicuous caring hypothesis put forward in Robin's book The Elephant in the Brain. Other topics discussed include end-of-life care, medicine as something Sacred, and prediction markets in medicine.Who is Robin Hanson?Robin Hanson, PhD, is an associate professor of economics at George Mason University and a research associate at Oxford University. He is known for his wide-ranging interests, including artificial intelligence, prediction markets, and signaling. He is the author of several books, including The Age of Em and The Elephant in the Brain.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this conversation, Daniel Belkin and Mitch Belkin interview Simon Whitney, MD, JD, about his book From Oversight to Overkill. They discuss the history of Institutional Review Boards (IRBs), including ethically questionable experiments such as Chester Southam's cancer cell injections, the Willowbrook experiment, as well as the US Public Health Service Syphilis Study (AKA Tuskegee experiment). They then discuss Peter Buxton, Henry Beecher, James Shannon, and the congressional oversight of federally funded research. Finally, they touch on the ISIS-2 study, Pronovost's checklist, OHRP's crackdown in the late 1990s, and discuss whether research is too safe, IRB infallibility, autonomy in the Belmont Report, and the risks and benefits of restricting research in the name of safety.Who is Simon Whitney?Simon Whitney, MD, JD, is a family medicine physician and ethicist. He previously taught at Baylor College of Medicine for 22 years. He is currently retired from the practice of medicine but continues to publish and teach medical ethics. He is the author of the book "From Oversight to Overkill: Inside the Broken System That Blocks Medical Breakthroughs—And How We Can Fix It."Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon