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February 21st, 2020

Podcast 253: Is a single-dose HPV vaccination effective?

(No Ratings Yet)

With human papillomavirus vaccine in short supply around, moving from a three- or two-dose regimen to one dose would immediately double or treble supplies, cut costs, and simplify logistics.

A careful study in Cancer by this week’s guest, Ana Rodriguez, and her colleagues adds to the evidence that single-dosing is possible and protective against pre-cancerous cervical lesions.

Cancer article

Cancer editorial 

An earlier (2015) podcast on the question of the number of vaccine doses needed to confer protection

Running time: 16 minutes

February 13th, 2020

Podcast 252: We revisit our chat about chatting about guns

(2 votes, average: 3.00 out of 5)

Back in November, Ali Raja and Joe Elia talked with Garen Wintemute about his Health Affairs paper regarding addressing the topic of guns with patients.

Having encountered another of those weeks in which interviewees were either on vacation (richly deserved, we’re certain) or too busy to respond to Joe’s requests (get some sleep!), we’re going to offer that conversation again. We hope you’ll listen and vote — and if you do vote, please leave a comment as well.

URL for November’s original podcast

Running time: 19 minutes

February 7th, 2020

Podcast 251: Intermittent fasting

(16 votes, average: 3.25 out of 5)

Intermittent fasting has salutary effects. Listen how Dr. Mark P. Mattson, co-author of a recent NEJM review on the topic, assesses the practice — and how he’s managed to skip breakfast for the past 30 years or so.

Dr. Ali Raja joins Joe as co-host again this time.

Links:

de Cabo and Mattson’s review in the New England Journal of Medicine

Michael Mosley and Mimi Spencer’s book “The FastDiet”

Running time: 18 minutes

January 30th, 2020

Podcast 250: #MeToo in the OR

(5 votes, average: 4.20 out of 5)

It turns out that the disrespect starts even earlier — when women are questioned about their choice of a surgical specialty. Nor is the bad behavior the exclusive province of the “old guard.”

We talk with Dr. Pringl Miller, a Chicago surgeon who’s compiled a collection of instructive stories from women surgeons who’ve had to dodge demeaning questions (and sometimes, flying chairs in the OR). The stories appear in the latest issue of Narrative Inquiry in Bioethics.

“#MeToo in Surgery: Narratives by Women Surgeons” article in Narrative Inquiry in Bioethics

Recent NEJM article on harassment in surgical residency training

Time’s Up Healthcare website

Patricia Dawson’s book: “Forged by the Knife: The experience of surgical residency from the perspective of a woman of color”

Preeti John’s book: “Being a Woman Surgeon: Sixty women share their stories”

Joan Cassell’s book: “The Woman in the Surgeon’s Body”

Running time: 18 minutes

January 24th, 2020

Podcast 249: Quality time with your EHR — or just time?

(1 votes, average: 5.00 out of 5)

Why aren’t you able to navigate your electronic health record (EHR) as easily as you can find a recipe on, say, Google?

And, what about those requirements for documenting everything?

Listen to a chat with Julia Adler-Milstein, the author of an editorial that comments on a recent Annals of Internal Medicine study detailing the amount of time clinicians typically spend hunched over their EHRs during a patient visit.

Links:

Annals of Internal Medicine editorial

Annals paper on the time clinicians spend

Running time: 17 minutes

 

January 16th, 2020

Podcast 248: “Hotspotting” didn’t work in its home town — why?

(No Ratings Yet)

The process of identifying super-users of healthcare and reducing the frequency of their hospitalizations — so-called “hotspotting” — was subjected to a randomized, controlled trial in Camden, NJ, the birthplace of the idea. It failed there.

Those in the intervention group had a readmission rate within 6 months that was statistically identical to those getting usual care.

True, the Camden patients had particularly complex social and medical problems, so that doesn’t mean that the program can’t work elsewhere.

Listen to our chat with the report’s senior author, Prof. Joseph Doyle, and as well, listen to our interview with Dr. Jeffrey Brenner from 6 years ago — he’s the one who put “hotspotting” on the map. Despite the apparent failure of the trial, the Coalition still has a lot to offer.

Results of the randomized trial in NEJM

Interview with Dr. Jeffrey Brenner from 2013

Camden Coalition’s website

Running time: 15 minutes

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