Ep. 105 Innovations in Interventional Radiology Training Practices with Dr. Sunny Murthy

“Direct contract with yourself.” That is Mark Cuban's challenge to hospital CEOs and CFOs whose own self-insured health plans, he says, can pay a carrier-owned administrator more for an employee's care than the hospital itself was paid to provide it. On this episode of the BackTable Podcast, Dr. Ruchika Talwar, value-based care leader, talks with Mark Cuban, entrepreneur and founder of Mark Cuban Cost Plus Drug Company, about who actually sets the price of care in the United States. They trace how a cold email about drug shortages led to Cost Plus Drugs, a robotic factory that can switch manufacturing lines every four hours, and then Cost Plus Wellness, an open source library of direct contracts between self-insured employers and providers, and why he believes the contract, not the published price, is where the real problems hide. The discussion also covers who really pays: by his estimate, 67% of people with job-based coverage get it through a self-insured employer, and 72% of the big carriers' revenue comes from taxpayers. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction01:53 - From Drug Shortages to Cost Plus Drugs06:08 - Cost Plus Wellness and Direct Contracts11:04 - Publishing Provider Contracts16:39 - Using AI to Review Contracts and RFPs20:16 - Direct Contracting Advice for Hospitals and Physicians26:33 - Value-Based Care, Brokers, and Self-Insured Hospitals32:09 - Direct Contracting for Independent Practices34:20 - AI as a Business Adviser for Physicians38:39 - National Policy and Who Pays for Healthcare46:59 - Misaligned Incentives and Corporate Culture51:00 - Key Takeaways54:04 - Closing Remarks --- More about this episodeThe conversation then turns practical for physicians and hospital administrators. Mark Cuban lays out how hospitals, clinics, and independent practices can find the self-insured employers among their own patients and offer direct contracts or carve-outs, why a promise to trust the doctor can earn employers a better rate, and how he runs contracts that stretch past a thousand pages through several AI models in turn. He and Dr. Talwar also cover what employers can learn from Form 5500 filings, the national changes he would make, from ending gag clauses to standardized public contracts, and why both see misaligned incentives as the root of the problem. --- ResourcesMark Cuban Cost Plus Drug Companyhttps://costplusdrugs.com Cost Plus Wellness: an open source initiative by Mark Cubanhttps://costpluswellness.com Mark Cuban dives into direct contracting. Becker's Hospital Review. 2026https://www.beckershospitalreview.com/finance/mark-cuban-dives-into-direct-hospital-contracting/ Form 5500 filings search (EFAST2), U.S. Department of Laborhttps://www.efast.dol.gov/welcome.htmlKFF. 2025 Employer Health Benefits Survey https://www.kff.org/health-costs/2025-employer-health-benefits-survey/ Gag Clause Prohibition Compliance Attestation. Centers for Medicare & Medicaid Services https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/gag-clause-prohibition-compliance-attestation New generic drug company named after Mark Cuban first founded by a part-time radiologist. Health Imaging https://healthimaging.com/topics/healthcare-management/medical-practice-management/mark-cuban-generic-drug-company --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app

Where is the line between what a surgeon needs to know and what technology can look up for them? On this episode of BackTable Industry, host Anish Parikh interviews Dr. Satyan Sreenath, rhinologist and skull base surgeon at Indiana University, about building operative comfort, lifelong learning, and the new role of artificial intelligence in clinical education. They discuss how surgical autonomy develops during residency, the resources that fill the gap after training, and the practical realities of staying current as technology and patient expectations evolve. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:48 - Graduating During the COVID-19 Pandemic08:18 - Building Operative Comfort in Residency12:14 - Competency Benchmarks and Board Readiness15:27 - Educational Resources and Surgical Autonomy19:21 - Continuing Education Routine22:41 - Society Curricula and Hands-On Courses27:52 - Artificial Intelligence in Practice33:20 - Staying Current with New Technology 36:08 - Balloon Sinuplasty and Patient Expectations38:22 - Societies, Meetings, and Closing Remarks --- More about this episode Dr. Sreenath shares how he sets up a routine for continuing education, what he looks for in society curricula, podcasts, and hands-on courses, and why repetition and autonomy matter more than simply gathering information. The conversation covers the rise of AI in the exam room, the credibility gap when patients bring in their own research, and the value of in-person meetings and peer networks. The episode closes with practical advice on navigating new technologies, building confidence, and why surgical comfort is earned, not downloaded. --- Resources FLEX, the Focused Lifelong Education Xperience, American Academy of Otolaryngology-Head and Neck Surgeryhttps://www.entnet.org/education/flex/ American Academy of Otolaryngology-Head and Neck Surgeryhttps://www.entnet.org/ American Rhinologic Societyhttps://www.american-rhinologic.org/ Rhinology Roundtable, the American Rhinologic Society podcast serieshttps://www.american-rhinologic.org/rhinology-roundtable-podcast BackTable Industry Episode 96, Navigating Revenue Cycle Management Challenges in Healthcare, named on air by the guesthttps://www.backtable.com/shows/industry/podcasts/96/navigating-revenue-cycle-management-challenges-in-healthcare Outlive: The Science and Art of Longevity, Peter Attia, referenced on air by title-less mentionhttps://peterattiamd.com/outlive/ --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare.Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app

What does a personal learning system look like when you have to build it yourself, in your first year out of training? On this episode of the BackTable Industry Podcast, host Anish Parikh sits down with Dr. Gregg Khodorov, a newly graduated interventional radiologist joining IR Centers in South Jersey after his integrated IR/DR residency at Thomas Jefferson University Hospital, to discuss the realities of keeping up with the field in early practice. They explore the transition from the structure of residency to the challenge of self-directed learning, including board preparation, endovascular simulation, tumor boards, podcasts, and the AI-powered study tools Dr. Khodorov created for himself. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:57 - Learning IR Beyond Textbooks06:37 - The BackTable App as a Learning Tool08:48 - Lectures and Tumor Boards11:45 - AI for Learning and Literature Review14:45 - Building a AI Question Bank from a Textbook19:08 - Learning Modes and Resources24:26 - Transition to Practice and Board Preparation27:06 - Modernizing Residency Curriculum and BackTable Mondays33:22 - Closing Remarks --- More about this episodeDr. Khodorov describes how he organizes his learning into three domains: preparing for exams, real-time recall for clinical practice, and expanding his knowledge beyond personal experience. He shares how he uses an AI agent to summarize the latest IR literature, built a custom question bank from a textbook in under half an hour, and developed a GPT tool restricted to trusted sources. The conversation also highlights the value of group learning, such as BackTable Mondays and live case symposia, and emphasizes the importance of humility, peer networks, and ongoing innovation to stay sharp in a fast-evolving specialty. --- Resources TREAT Symposium live cases (Mount Sinai)https://treatsymposium.com/live-cases/ IR oral boards simulator named on air by the guesthttps://oralboardssimulator.com Thomas Jefferson University integrated interventional radiology residencyhttps://www.jefferson.edu/academics/colleges-schools-institutes/skmc/departments/radiology/educational-programs/residency/interventional-radiology-integrated/current-residents.html Dr. Gregg Khodorov, guest profilehttps://www.doximity.com/pub/gregg-khodorov-md --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app

How do private practice ENTs keep up with a rapidly evolving field and decide when a new technique or device is worth the investment? On this episode of BackTable Industry, host Anish Parikh interviews Dr. Christopher Gentile, a general ENT in private practice outside Atlanta, about the realities of continuing education, device adoption, and the economics of running a community practice. They talk through Dr. Gentile's broad case mix in general ENT, his approach to allergy and sleep, and how he stays current through conferences, proctored labs, podcasts, and peer-to-peer learning. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction00:46 - From Neuroscience to ENT02:22 - The Scope of a General ENT Practice04:50 - Running Allergy In-House06:03 - Keeping Technique Current After Training08:40 - Podcasts, Conferences, and State Society Meetings10:43 - Inspire and Sleep Apnea Referral Pipeline13:45 - Biologics and the Polyp Patient15:14 - Realities of Device Adoption and Reimbursement16:34 - Posterior Nasal Nerve Ablation and Payer Coverage17:33 - Where ENT Is Headed: Sleep, GLP-1s, and Neurostimulators19:15 - Underserved Sleep Apnea and Geographic Access20:46 - Education Sources and Learning Intracapsular Tonsillectomy22:22 - Adopting a New Technique23:36 - Closing Remarks --- More about this episode The conversation explores the friction of learning new techniques after residency, the risks of device adoption in a small practice, and what ENT really needs from industry partners. Dr. Gentile discusses how payer approval can make or break the use of new technology, why GLP-1s are changing the sleep apnea landscape, and the slow but steady process of adopting procedures like intracapsular tonsillectomy. The episode also highlights the importance of surgical training, mentorship, and building a network to support lifelong learning and better patient care. --- Resources Dr. Christopher Gentile on LinkedInhttps://www.linkedin.com/in/christopher-gentile-bb73a951/ Otolaryngology–Head and Neck Surgery ("the White Journal")https://aao-hnsfjournals.onlinelibrary.wiley.com/journal/10976817 --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app

How is AI reshaping the way radiology residents study, dictate reports, and summarize clinical courses? BackTable co-founder Anish Parikh catches up with Dr. Sunny Murthy, a PGY-2/R1 integrated interventional radiology (IR) resident at the University of Virginia (UVA). --- Get the BackTable apphttps://www.backtable.com/app --- More about this episode Dr. Murthy outlines the lecture structure (morning didactics, noon case-based sessions) and a curriculum shift toward on-demand video learning via Modality, alongside books, Radiopaedia, and targeted journal use. They discuss conference learning at SIR, the role of podcasts like BackTable, and balancing information overload. AI comes up in both clinical workflows (Epic-generated hospital-course summaries that can be wrong) and education (Claude/Notion for organizing study), with debate about limiting AI for trainees versus preparing for future practice. The resident explains learning procedures across multiple devices, relying on techs, industry training and exhibit halls, and notes receiving a resident teaching award while emphasizing the need for better IR exposure and simulation-based training content. --- Resources Fundamentals of Body CThttps://www.us.elsevierhealth.com/fundamentals-of-body-ct-9780323608329.html Journal of Vascular and Interventional Radiologyhttps://www.jvir.org/ CardioVascular and Interventional Radiologyhttps://www.cvironline.org/ --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app

Is print medical literature officially dead, or are we just drowning in a digital sea of unread journal articles? On this episode of the BackTable Industry Podcast, host Anish Parikh sits down with Dr. George Koch, an attending reconstructive urologist at The Ohio State University and early career editor for the Journal of Urology, to discuss the realities of staying clinically current in a rapidly evolving field. They explore how digital platforms, subspecialty meetings, and peer mentorship are shaping the future of education, collaboration, and device adoption in reconstructive urology. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:55 - Embracing Multiple Learning Platforms 04:13 - Staying on Top of New Literature 08:26 - Behind the Scenes: Editorial Insights11:44 - Rise and Fall of “UroTwitter”15:50 - GURS Meeting Value21:49 - Pathways to Device Adoption25:53 - Decoding Industry Signal and Noise29:16 - Closing Remarks --- More about this episode Dr. Koch emphasizes that while podcasts serve as an excellent supplement, staying clinically current requires a multi-medium approach. He highlights the immense clinical value of Genitourinary Reconstructive Surgeons (GURS) meetings for practical surgical techniques and video reviews, contrasting them with the broader American Urological Association (AUA) sessions that tend to spark academic research questions. He reflects on the shift from print to digital journal alerts, the decline of the once-vibrant "UroTwitter" community, and how peer trust, rather than marketing noise, dictates the clinical adoption of new medical devices and biologics. --- Resources Kerecis Fish Skin Graft Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11015860/ Optilume Clinical Trialshttps://www.laborie.com/news/laborie-announces-first-procedures-in-endure-1-study-with-the-optilume-ureteric-drug-coated-balloon/ --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app

How do you protect your time, stay current, and thrive after leaving academic medicine for private practice in a fast-evolving allergy and immunology specialty? In this episode of BackTable Industry, host Anish Parikh talks with Dr. Basil Kahwash, an allergist-immunologist, about his journey from internal medicine training through academic medicine at Vanderbilt and back to community practice in Columbus. They discuss the challenges of protecting time, adapting to higher patient volumes, and staying up to date as allergy and immunology rapidly evolve. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:57 - Academics vs. Private Practice08:30 - From Evidence to Practice10:53 - Staying Current Online13:23 - Group Chats and Timing16:40 - Posting and Info Quality25:05 - AI Decision Support27:00 - Patients Using ChatGPT and Closing Remarks --- More about this episode Dr. Kahwash contrasts academia’s structured time for teaching and research with the demands of private practice, where non-clinical work requires deliberate effort. He highlights the field’s recent shifts, including the rise of oral immunotherapy and biologics, and explains how he keeps pace with new developments through CME, journals, online platforms, and group chats. The conversation explores the pros and cons of information democratization, the impact of AI decision support, and the growing trend of patients arriving with ChatGPT-informed questions. Dr. Kahwash also discusses the integration of allergy and ENT practices and shares practical advice for clinicians navigating a fast-changing specialty. --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app

The transition between residency or fellowship to clinical practice can be a big jump, especially when it comes to keeping up with new data and independently making decisions with patients. In this episode of BackTable Industry, Anish Parikh hosts medical oncologist Dr. Kate Baker shares her experience managing a broad range of patients, from solid tumors to benign and malignant hematology. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction01:29 - From Fellowship To Practice05:01 - Nuances of Oncology Practice & Keeping Up-To-Date with New Data07:47 - What Counts As Practice Changing13:51 - Information Flow Between Pharmaceuticals & Physicians17:10 - Early Career Admin Advice --- More about this episodeDr. Baker describes oncology’s clinical nuances, the need to tailor discussions with patients on survival data during decision-making, and the challenge of staying current with real-time information. To maintain agility in the field, she attends disease-state specialist meetings, focusing on practice-changing evidence before considering adopting new treatments. She also emphasizes consulting colleagues via tumor boards and reaching out to experts for complicated cases when patients don’t fully fit the guidelines. --- ResourcesDESTINY-Breast05https://www.nejm.org/doi/full/10.1056/NEJMoa2514661 --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app

Are academic medical conferences falling short when it comes to preparing clinicians for the unpredictable realities of modern surgery and patient care? In this episode of BackTable Industry, co-founder Anish Parikh interviews Dr. Ruchika Talwar about the real-world challenges traditional conferences often overlook and how informal, peer-to-peer exchanges like those at Creator Weekend™ in Nashville bridge the gap. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:37 - Why Conferences Miss It06:35 - From Training to Practice08:10 - On Call Reality Check10:39 - Learning With Videos14:44 - Keeping Up With New Info16:37 - Rise and Fall of Urology Twitter19:27 - Lifelong Learning and Patients25:44 - CME and Med Ed Revolution28:30 - Closing Thoughts --- More about this episode Together, they unpack what it really takes to bring new NMIBC therapies into clinical practice, from navigating approval barriers and staffing challenges to managing workflow and operational details. Dr. Talwar shares insights on moving from training to independent practice, navigating on-call emergencies with quick learning tools like surgical videos and residency notes, and building patient-centered approaches beyond rigid guidelines. The conversation also explores how surgeons use their own "game tape" to improve, the rise and fall of online medical communities like MedTwitter, and the evolving landscape of CME and lifelong learning for today’s physicians. --- Resources Hinman’s Atlas of Urologic Surgeryhttps://www.clinicalkey.com/#!/browse/book/3-s2.0-C20210026651 American Urologic Association Guidelines & Video Bankhttps://www.auanet.org/guidelines-and-quality/guidelines --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes. ► https://www.backtable.com/app

Discover how modern physicians are secretly swapping out old medical textbooks for Google and AI tools like Gemini to prep for your next surgery. On this episode of BackTable Industry, Anish Parikh talks with Dr. Chris Beck about being eleven years out of training, and how his learning focus has shifted from seeking the single “right” cutting-edge answer to optimizing patient care with available tools and resources. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 Introduction03:54 Finding Your Way as an Attending06:26 Internet Prep Habits12:28 Keeping Up in the Field21:13 IR Culture MacGyver26:44 Wrap Up Thanks --- More about this episode He describes realizing he had become a mid-career physician when younger partners began calling him for advice, despite his own imposter syndrome. They discuss how he prepares for infrequently performed or new procedures—using “phone a friend,” targeted Google searches, specific journals like Techniques in Vascular and Interventional Radiology, SIR’s Digital Video Library, and AI tools such as Open Evidence —while being discerning about sources. Baxter explains overlap between specialties (e.g., double-J ureteral stents), variability between devices and when reps or formal training like cadaver labs are needed, and how IR’s broad, evolving scope fosters a MacGyver-like, information-sharing culture. --- Resources Open Evidencehttps://www.openevidence.com/ Techniques in Vascular nad Interventional Radiologyhttps://www.sciencedirect.com/journal/techniques-in-vascular-and-interventional-radiology Digital Video Library of the Society of Interventional Radiology (SIR)https://www.youtube.com/c/SocietyofInterventionalRadiology --- Backtable Industry is the go-to podcast for healthcare leaders, business-minded providers, and innovators that are shaping the future of healthcare. Download the free BackTable app to get early access to new episodes.► https://www.backtable.com/app