2 Docs Talk: Medicine | Health | Healthcare Policy | Evidence Based Medicine

By Kendall Britt, MD and Amy Rogers, MD

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Description

Welcome to 2 Docs Talk, the podcast about healthcare, the science of medicine and everything in between. Join cohosts Kendall Britt, MD and Amy Rogers, MD for a 15 minute check-up on current issues in medicine and health policy. The doctor is always in.

Episode Date
Episode 122: Does everyone get healthcare in the U.S. when they really need it? (Rebroadcast)
10:44

If you've had many conversations about healthcare reform, it is likely you've heard some variation on this theme: 

"Hospitals have to provide care for people who show up. So everyone can get healthcare when they need it. So when people say that can't get healthcare, that isn't true."

Is there any merit to that argument? Spoiler: NO. But if you want to hear more about where that idea comes from, take a listen. 

Resources:

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/

http://www.kff.org/medicaid/state-indicator/medicaid-income-eligibility-limits-for-parents/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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Mar 19, 2018
Episode 121: Is There a Bright Side to SSRIs?
13:05

If you aren't taking an SSRI yourself, there it's almost certain you know someone who does. Selective Serotoning Reuptake Inhibitors are one of the most commonly prescribed classes of drugs out there.

Is their widespread use earned on the basis of good evidence? It's not clear - let's take a look.

References:

Genetic and clinical predictors of sexual dysfunction in citalopram-treated depressed patients.

Perlis RH, Laje G, Smoller JW, Fava M, Rush AJ, McMahon FJ

Neuropsychopharmacology. 2009;34(7):1819. Epub 2009 Mar 18. 

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Mar 12, 2018
Episode 120: Who do Right to Try Laws Really Help?
10:54

Right to Try laws have come about as a response to cumbersome paperwork required to access the FDA's compassionate use program. However, the FDA has lessened the paperwork required for terminally ill patients to access investigational drugs. 

So is Right to Try a meaningful movement, or is it simply one piece of an overaraching ideology.

Today, 2 Docs Talk about Right to Try laws and who they help.

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Mar 05, 2018
Episode 119: Is Alchohol Good for Your Health
13:52

For decades, much has been made of the healthvbenefits of drinking alcohol. And those benefits are real. But, what exactly are the benefits, and how do they stack up against the risks associated with alcohol? 

Today, 2 Docs Talk about the ways alcohol and help and harm your health, and we offer some of our opinions, too. 

Resources:

https://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/

https://www.cdc.gov/features/costsofdrinking/index.html

https://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf

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Feb 26, 2018
Episode 118: Scratching the Surface of Varicella
09:19

If you are of a certain age, you remember a time when pretty much every kid got chicken pox. But those days are behind us as most of our children are vaccinated agains varicella, the virus that causes chicken pox. But for us old folks, shingles is the still around to remind of the old days when we still got chicken pox. 

Today 2 docs talk about the effect of the varicella vaccine, the problem with shingles, and what you can do about it.

 

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Feb 19, 2018
Episode 117: Glioblastoma Multiforme - What would Jimmy V Do?
11:48

Senator McCain has a malignant brain tumor called a Glioblastoma Multiforme, orglioblastoma or GBM for short.

He’s not the first person politically connected to get one of these things. I think this is what Senator Ted Kennedy had back in 2008 and also Beau Biden, Joe Biden’s son died of a glioblastoma.

Glioblastomas are one of a class of brain tumors called Gliomas. Gliomas can be low grade which are considered pre-malginant or pre-cancerous or they can be high grade malignancies such as GBMs.  

Today 2 Docs Talk about Glioblastoma Multiforme, and the difficulties associated with treating - or not treating - the tumor. 

Resources:

Don't Tell John McCain to Fight His Cancer

FDA approval of Optune device for Glioblastoma

2 Docs Talk episode on hospice

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Feb 12, 2018
Episode 116: The Where, What and Why of Exercise
19:35

We all know that exercise is beneficial for our health. But how much  - how long - what type? Understanding what offers the best outcomes is tricky because it's difficult to conduct rigorous research with long term endpoints such as reduction of disease and death. 

Today 2 Docs Talk about some interesting studies on exercise and what they reveal about the benefits of physical activity. 

Resources:

https://www.ncbi.nlm.nih.gov/pubmed/25844730

https://www.ncbi.nlm.nih.gov/pubmed/25844882

https://www.hsph.harvard.edu/nutritionsource/mets-activity-table/

http://www.amjmed.com/article/S0002-9343%2814%2900138-7/abstract

https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-9-89

https://www.ncbi.nlm.nih.gov/pubmed/18332184

http://www.sciencedirect.com/science/article/pii/S0277953612003565

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852580/#R12

http://www.aacr.org/Newsroom/Pages/News-Release-Detail.aspx?ItemID=580#.Wlt9eSOZM_W

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Feb 05, 2018
Episode 115: Pressure to Treat Hypertension
14:09

The normally staid world of hypertension was a bit controversial in 2017, so this week 2 Docs Talk about the recent recommendations — and their accompanying controversies — for treating high blood pressure. 

Resources:

Systolic Hypertension in the Elderly (SHEP) Study

Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure trial.

Systolic Blood Pressure Intervention Trial (SPRINT)

JNC 8 blood pressure treatment guidelines

Jan 29, 2018
Episode 114: Supplemental Ethics?
12:33

Does your doctor sell dietary supplements? Have you considered the ethics of such an arrangement? The American Medical Association has, and they think it's a bad idea. 2 Docs Talk about the ethics of physicians profiting from supplement sales.

Resources:

About DSHEA 1994

ER visits due to supplements

Study showing supplement reduces LDL

AMA Ethics Statements on Supplement Sales

Pharmceutical marketing and prescribing habits

 

Jan 22, 2018
Episode 113: Influenza 2017-18 Update
11:18

This has been a particularly bad year for the flu. More people are getting sicker than in most years. And the vaccine is not working well. 

In this episode, 2 Docs Talk about why the influenza virus circulating this year is causing so many problems. Beware there is a little bit of basic science involved. But not too much.

Resources: 

Our information is from the Centers for Disease Control: https://www.cdc.gov/flu/about/season/current.htm

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Jan 15, 2018
Episode 112: Drug Pricing (Rebroadcast)
15:16

If you’ve paid any attention to the news over the past year or so, you’ve likely seen stories of greedy capitalists gouging the vulnerable by hiking up the prices of their life-saving drugs.

But are the prices hikes all that bad?

Yes. Yes, they are. And we talk about that to day on 2 Docs Talk.

Resources:

JAMA on Drug Pricing

Our episode on Hep C

Our episode on Alzheimers

Our episode on Pricing Transparency

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Jan 08, 2018
Episode 111: Drug Pricing (Rebroadcast)
15:16

If you’ve paid any attention to the news over the past year or so, you’ve likely seen stories of greedy capitalists gouging the vulnerable by hiking up the prices of their life-saving drugs.

But are the prices hikes all that bad?

Yes. Yes, they are. And we talk about that to day on 2 Docs Talk.

Resources:

JAMA on Drug Pricing

Our episode on Hep C

Our episode on Alzheimers

Our episode on Pricing Transparency

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Jan 01, 2018
Episode 110: The Prostate (Rebroadcast)
17:19

You’d think that something like screening for prostate cancer would be free of controversy, but that just isn’t the case. The benefits and risks of screening have been hotly debated by different medical organizations over the years.

Today, 2 Docs Talk about how prostate screening and the various issues surrounding it. This is a topic every man should discuss with his physicians, and we hope this hepls you know what questions to ask when you do.

Resources:

Weiner AB, Matulewicz RS, Eggener SE, Schaeffer EM. Increasing incidence of metastatic prostate cancer in the United States (2004-2013). Prostate Cancer Prostatic Dis. 2016 Jul 19.]

AU Tacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ. TI Serenoa repens for benign prostatic hyperplasia. SO Cochrane Database Syst Rev. 2012;12:CD001423.

https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq

 

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Dec 25, 2017
Episode 109: Healthcare Pricing Transparency (Rebroadcast)
12:58

If you’ve ever tried to figure out the price of a medical procedure, you know it’s not that easy. In fact, research shows that complete pricing for medical procedures is unavailable when requested over one-third of the time.

As healthcare deductibles rise and indidviduals are affected more and directly by these costs, the issue of pricing transparency is growing. In this episode we talk about the problem posed by opaque medical pricing practices. We also dig into two innovative practice models that solve this transparency problem, as well as a few other issues in the delivery of healthcare and medicine.

Resources:

Surgery Center of Oklahoma

Turntable Health

Iora Health

JAMA: Availability of Consumer Prices from US Hospitals for a Common Surgical Procedure

 

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Dec 18, 2017
Episode 108: Vaccines (Rebroadcast)
16:35

Vaccines are both one of the most widely used and most widely misunderstood preventive medical treatments available. People have concerns about autism, efficacy, the promotion of unhealthy behaviors. We dig into the evidence on some of those topics, as well as take a look at the effectiveness of vaccines against some of the scariest disease of our time – including cancer.

 

NEJM study on vaccines and autism

Lancet study on vaccines and autism

Adverse Effects of Vaccines: Evidence and Causality an ebook by the Institute of Medicine that states, “The evidence favors rejection of a causal relationship between MMR vaccine and autism.”

About Cancer vaccines

2014-2015 Flu vaccine info – why it was less effective, but did reduce disease severity

Information on current research into an ebola vaccine

 

 

Check out this episode!

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Dec 11, 2017
Episode 107: Testosterone Trending (Rebroadcast)
09:06

All you have to do is take a quick drive around town to see that low testosterone clinics are all the rage. A little math will tell you why. Males make up around 50 percent of the population, and their testosterone declines, naturally, at a rate of 1 percent per year after age 30. If that decline merits treatment, it’s no wonder those clinics are everywhere.

But, does it merit treatment?

Is testosterone replacement safe?

Is it even effective?

We dig into those questions on this episode of 2 Docs Talk.

Resources

JAMA: Effects of Testosterone on Subclinical Atherosclerosis

Testosterone Reduces Cardiovascular Risk

Testosterone Increases Cardiovascular Risk

FDA Drug Safety Communication on Testosterone

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Nov 27, 2017
Episode 106: Longevity (Rebroadcast)
11:17

In healthcare, the holy graille seems to be longevity. We look at whether a treatment increases lifespan and use that as a barometer for it's value. 

But should that be the yardstick we use? Or would we be better off with a more subjective measure of improving quality of life, even if that means sacrificing some of the quantity.

Today, 2 Docs Talk about this question propose some things to consider as you consider your approach to aging and healthcare.

 

Resources:

Colonoscopy study in the Annals of Internal Medicine 

Research on lifespan in Nature

The Austad/Olshansky Wager

 

Nov 20, 2017
Episode 105: Are GMO's or Frankenfood? (Rebroadcast)
10:16

One of the latest technological advances in food production is the introduction of GMOs, or genetically modified organisms, to the food supply. They have the potential to offer many benefits including increased productivity, pest and herbicide resistance, longer shelf life, and the list goes on.

But many are concerned that this relatively new technology isn’t safe – for health, the environment or the economy. We dig into the evidence surrounding GMOs in this episode. We might even share an opinion or two on whether the crops are just GMOs or Frankenfood.

Resources:

Primer on the retracted study that indicated GMOs caused tumors

How GMOs are tested for safety

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Nov 13, 2017
Episode 104: What to do About Chronic Back Pain (Rebroadcast)
13:47

Back pain is second only to cancer as a cause of long term disability. This health problem is damaging to individuals and costly to society. And we don’t have much in our arsenal that is effective at treating it.

This week, we discuss the difference between acute and chronic back pain with regard to treatment and outcomes. We also discuss the role of surgery, medications, alternative therapies, and some interesting new research on what helps resolve chronic back pain.

Resources:

Research on efficacy of epidural steroid injections for back pain

Trends in spinal fusion surgery

American College of Physicians Guidelines for the Treatment of Chronic Low Back Pain

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Nov 06, 2017
Episode 103: Screening Mammography (Rebroadcast)
19:17

Screening mammography is widely used throughout the U.S. and is thought of as a great success in the prevention of breast cancer deaths.

But what does the evidence say? Are we getting what we are paying for with mammography, or simply shouldering the extra cost of false positives and overdiagnosis? We examine these issues and more on this episode of 2 Docs Talk.

References:

What does the U.S. Preventive Services Task Force (USPSTF) do?

USPSTF current (2009) breast cancer screening recs 

USPSTF proposed (2015) breast cancer screening recs

American Cancer Society updated breast cancer screening recs

American College of Obstetricians and Radiologists breast cancer screening recs

American College of Radiology breast cancer screening recs

Switzerland’s stance on screening mammography

Cost of false positive mammograms

BMJ study that showed no benefit from screening mammography performed in 1980’s

JAMA Oncology study on ductal carcinoma in situ (DCIS)

An excellent (and long!) discussion of overdiagnosis and screening mammography

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Oct 30, 2017
Episode 102: Physician Burnout (Rebroadcast)
17:33

Physician burnout is a big issue in the medical community. According the the Medscape Lifestyle Report 2017, over half of physicians report burnout. But physician burnout isn’t just a problem for physicians. It is a problem for patients, for other medical staff, and for the health care economy.

Today we dig into the causes of physician burnout and how it can be addressed. Here’s a hint: It doesn’t involve meditation or counseling.

Resources:

Medscape Lifestyle Report 2017

2 Docs Talk About Pricing Transparency

2 Docs Talk About Medicare for All

2 Docs Talk About Drug Pricing

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Oct 23, 2017
Episode 101: Direct to Consumer Marketing (Rebroadcast)
12:42

If you watch any tv at all, it’s likely you’ve seen a drug ad. These ads generally show seemingly healthy people living normal lives, the message being the drug did this for them.

But are the drug ads telling the whole story? And should they even be advertising directly to consumers to begin with? We discuss this issue on today’s episode.

 

Resources:

Nivolumab Research from New England Journal of Medicine

What the FDA has to say about drug ads

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Oct 16, 2017
Episode 100: Depression and Suicide (Rebroadcast)
17:51

With the recent release of the Netflix series, 13 Reasons Why, depression and suicide have been getting a lot of press time. In this episode, we talk about depression, what it is, how it is treated and what’s on the horizon for this far too common disorder.

We also talk a bit about the Netflix series and the problem of suicide. Take a listen and see what you think.

If you think you may be depressed please seek help from a trusted healthcare provider. And if you are contemplating suicide, there is help for you – please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Someone will answer your call and help you find the resources you need to deal with your depression.

Brains of people with depression are different

Brain imaging reveals different types of depression

Summary of effectiveness of SSRIs and other antidepressant medications

 

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Oct 09, 2017
Episode 99: Cervical Cancer and the HPV Vaccine
17:59

Historically, cervical cancer has been one of the major killers of young women. But since the advent of the pap smear, death from the disease has dropped dramatically. However, treatment of lesions identified on pap smear can lead to significant issues including infertility. And in other parts of the world where screenign is not easily accessed, cervical cancer remains a significant cause of death for women in the prime of life.

As with any disease, prevention is better than treatment, and this is where the HPV vaccine comes into play. Known mainly by its trade name, Gardasil, the vaccine has been on the market for over a decade. That’s long enough to provide data to draw reasonable conclusions about its safety and efficacy.

Resources:

Prevalence of HPV after introduction of vaccine

Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era

 

Safety Resources:

https://www.ncbi.nlm.nih.gov/pubmed/21907257

https://www.ncbi.nlm.nih.gov/pubmed/23027469

https://www.ncbi.nlm.nih.gov/pubmed/24108159

http://jamanetwork.com/journals/jama/fullarticle/1886177

https://www.cdc.gov/vaccinesafety/pdf/data-summary-hpv-gardasil-vaccine-is-safe.pdf

 

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Oct 02, 2017
Episode 98: Medical Errors (Rebroadcast)
15:28

A BMJ report earlier this year declared that 1 in 3 hospital deaths were the result of medical errors. A flurry of headlines about the dangers of hospitals soon followed.

Just what is a medical error? What are the dangers of being in a hospital? And what can we do about it? We talk about these questions in today's episode. 

Resources:

BMJ on medical error

KATZ scale

To Err is Human: Building a Safer Health System

Hospital at Home

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Sep 25, 2017
Episode 97: The Flu, the Flu Shot, and the Future
12:16

Thousands of people die each year from influenza. The CDC recommends that almost all people (with a few rare exceptions) receive the flu vaccine every year. But the disease and the vaccine are poorly understood. In this episode, we discuss the flu, its treatment and its prevention.

Resources:

Influenza vaccine effectiveness in preventing outpatient, inpatient, and severe cases of laboratory-confirmed influenza

Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials.

 

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Sep 18, 2017
Episode 96: Hospice Care (Rebroadcast)
13:38

Kendall and Amy are in agreement that hospice care is an important, compassionate aspect of healthcare that humanizes what can be a very clinical, impersonal process. We've both experience with hospice - personally and professionally. 

Sadly, like most aspects of healthcare, the potential for profit has introduced some ugly practices into what should be focused solely on the needs of dying patients and their families.

Today, Kendall and Amy talk about the good and the bad of hospice as it exists in 2017.

Resources:

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Sep 11, 2017
Episode 95: Are We Overscreening for Thyroid Disease
12:38

Most people probably know someone who has had thyroid disease of some sort, most commonly hypothyroidism - the term low thyroid hormone.

But there has been a significant rise in diagnosed thyroid disease in the past couple of decades due to screening. These diagnoses include problems with thyroid hormone as well as thyroid cancers. It's easy to get excited about diagnosing more disease - you catch it earlier and help people prevent the consequences of the disease. Or do you?

Today we are going to talk about screening asymptomatic patients for thyroid disease. We're also going to address that slipppery category of "subclinical" thyroid disease. 

Resources

British Medical Journal on Increased Diagnosis of Thyroid Cancer

Thyroid Cancer in Korea

Sep 04, 2017
Episode 94: Medicaid, Medicaid Expansion and the Uninsured
12:07

Medicaid is the subject of a lot of talk in today's political environment. Sadly much of what is said isn't based in fact, or it focuses on parts of the program that represent a tiny portion of its cost. 

Today, 2 Docs Talk about Medicaid, who it serves, and how it was affected (or, rather, supposed to be affected) by the Affordable Care Act.

Aug 28, 2017
Episode 93: Ovarian Cysts
14:11
Aug 21, 2017
Episode 92: End Stage Renal Disease
12:56

End stage renal disease, ESRD, is a growing problem in the U.S. When Medicare began covering renal dialysis, there were on 16,000 patient who required that type of care. Today that number exceeds 650,000 and continues to grow.

Today, 2 Docs Talk about what causes end stage renal disease, how can it be treated, and, most importantly, how can it be prevented. 

 

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Aug 14, 2017
Episode 91: EMTALA
10:44

If you've had many conversations about healthcare reform, it is likely you've heard some variation on this theme: 

"Hospitals have to provide care for people who show up. So everyone can get healthcare when they need it. So when people say that can't get healthcare, that isn't true."

Is there any merit to that argument? Spoiler: NO. But if you want to hear more about where that idea comes from, take a listen. 

Resources:

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/

http://www.kff.org/medicaid/state-indicator/medicaid-income-eligibility-limits-for-parents/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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Aug 07, 2017
Episode 90: Cervical Cancer Screening
13:01

The pap smear has been one of the greatest public health wins of the past century. Deaths from cervical cancer in the U.S. have dropped from 37.5 per 100,000 women to 7.5 per 100,000 women as a result of the simple screening test.

But with our increasing understanding of the role of human papillomavirus (HPV) in the development of cervical cancer, the pap test may end up being pushed aside by HPV screening.

Today, 2 Docs Talk about Pap smears, HPV screening, the current recommendations for cervical cancer screening, and the research that may push us to shifting away from the pap smear to the HPV test.

Resources:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60644-9/fulltext?rss=yes

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

https://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/cervical-cancer-screening#consider

Jul 31, 2017
Episode 89: The Ethics of New Drug Approvals (Rebroadcast)
12:31

The process of drug approval is long and expensive. To complicate matters, pharmaceutical companies, patients, an the FDA are all invested in the process, for different reasons – and they aren’t always the same.

Today we discuss the story of how a new drug came to market and the unusual circumstances around its approval. 

Resources:

FDA grants accelerated approval to first drug for Duchenne muscular dystrophy

CDC on Duchenne Muscular Dystrophy

Right to Try

Compassionate Use

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Jul 24, 2017
Episode 88: The Past, Present and Future (we hope) of Contraception (Rebroadcast)
16:48

If there is a hot button issue in politics these days, it's abortion. But abortion is the result of a long line of issues that are being inadequately addressed in this country. Today we take a look at contraception - what it is, how it works, its history and its future. 

We also offer a look at an innovative program that has the potential to help both pro-choice and pro-life groups happy. 

 

Resources:

Details on various types of birth control

The Choice Project

Use of LARCs in Colorado

Slang for using a condom (adult humor - you've been warned)

 

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Jul 17, 2017
Episode 87: Gun Violence is a Public Health Issue (Rebroadcast)
15:06

As we enter primary season for this election year, gun violence and control is a hot topic. However, much of the discussion lives in one of two extremes, and little of it is based on actual evidence. 

With over 30,000 gun deaths each year, and over 20,000 of those death from suicide, the reality is that gun violence is a public health issue. This means we need to treat this issue from the point of view of the medical evidence. 

Today we look at the scope of the problem, what has and hasn't worked, and some thougths about what lies ahead. 

Resources:

CDC All Injuries Statistics

CDC Accidental Death Statistics

CDC Homicide and Assault Statistics

CDC Suicide and Self-Inflicted Injury Statistics

CDC Depression Statistics

Discussion of Australia's Gun Laws in the New York Times

Discussion of Missouri's Gun Laws in the New York Times

Survey of Defensive Gun Use Cited Frequently by NRA 

Methodological issues with Defensive Gun Use Survey

Jul 10, 2017
Episode 86: Concussions (Rebroadcast)
20:04

Concussions are not uncommon in contact sports such as football, soccer and basketball.  But we aren't trying to scare or shock anyone. On today's podcast we'd like to educate and inform so that parents and players can make decisions that aren't based on fear and misinformation.

We'll cover

  • concussions
  • return-to-play policies
  • second impact syndrome
  • post-concussive syndrome
  • chronic traumatic encephalopathy

Take a listen and let us know what you think.

Article referenced in podcast:

McKinney ISD Concussion Protocol

Jul 03, 2017
Episode 85: Medical Marijuana (Rebroadcast)
14:25

As the the political winds shift in favor of legalizing medical marijuana, it's important to consider the evidence that supports it. 

But the 23 states that have legalized it and the FDA don't agree on when marijuana helps and when it doesn't. In this episode, we take a look at the evidence supporting the move toward legalizing the use of marijuana and cannabinoids for medical purposes.

 

References from the show:

Cannabinoids for Medical Use: A Systematic Review and Meta-Analysis

Jun 26, 2017
Episode 84: Choosing Wisely (Rebroadcast)
14:32

We’ve got a lot of questions marks ahead of us this year when it comes to healthcare. What will happen with the Affordable Care Act, Medicare, Medicaid, Planned Parenthood, etc. etc.

The future of healthcare under the new administration is a big unknown. But one thing we do know - healthcare costs far too much.

One of the key contributors to these costs is the over $200 billion per year in unnecessary medical care. 

In today's episode, we dig in to the reasons for these costs, and more importantly, we talk about the things we can do as healthcare consumers to reduce unnecessary medical care in our own lives. 

Resources:

Unnecessary Medical Costs

Low Value Care in Medicine

Unnecessary Tests and Treatments

Freakonomics Radio: Bad Medicine

Choosing Wisely

 

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Jun 19, 2017
Episode 83: Parkinson Disease
12:07

Parkinson Disease is the second most common neurodegenerative disease in the U.S. and it appears to be increasing in prevalence. So what is Parkinson Disease, what causes it and what can we do about it? 2 Docs Talk about it today.

Resources:

JAMA Neurology Increasing Incidence of Parkinson Disease

Metformin and Parkinson Disease

Braak Hypothesis

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Jun 12, 2017
Episode 82: Headline Round Up
12:21

Sometimes there are news items that just need to be discussed, but they don't really generate enough material for a podcast of their own. Today we are talking about those headlines.

Resources:

Stroke Study: Diet Soda, Stroke, and Dementia

Association of Hormonal Contraception with Depression

Tom Price on Preventive Services Mandate

New York Times on the Contraception Mandate

CNN Report on Minnesota Measles Outbreak

Stat Review of Vaxxed

California Immunization Rates After SB277

Handgun Acquisition After Mass Shootings

Bystander CPR and Outcomes After Cardiac Arrest

Learn CPR

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Jun 05, 2017
Episode 81: Lyme Disease
11:21

Lyme Disease has been a known tickborne infectious disease since the early 80s. Treatment for Lyme Disease is surprisingly straightforward, but you would never guess that from the controversy surrouding the infection.

Part of the problem stems from "Chronic Lyme Disease," which is now more appropriately knwon as Post-Treatment Lyme Disease Syndrome, to indicate that the infection is no longer present in these patients. There is some explanation for their symtoms other than persisttent bacteremia.

Todayw e talk about all this, and dig into a little of the history and the controversy surroudning Lyme Disease.

Resources:

http://www.nejm.org/doi/full/10.1056/NEJMoa1505425

http://www.sciencedirect.com/science/article/pii/S0891552015000203

http://www.nejm.org/doi/full/10.1056/NEJMra072023#t=article

http://www.nejm.org/doi/full/10.1056/NEJM200107123450202#t=abstract

https://www.ncbi.nlm.nih.gov/pubmed/18452806

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May 29, 2017
Episode 80: Depression
17:15

With the recent release of the Netflix series, 13 Reasons Why, depression and suicide have been getting a lot of press time. In this episode, we talk about depression, what it is, how it is treated and what's on the horizon for this far too common disorder. 

We also talk a bit about the Netflix series and the problem of suicide. Take a listen and see what you think.

If you think you may be depressed please seek help from a trusted healthcare provider. And if you are contemplating suicide, there is help for you - please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Someone will answer your call and help you find the resources you need to deal with your depression. 

RESOURCES:

Brains of people with depression are different

Brain imaging reveals different types of depression

Summary of effectiveness of SSRIs and other antidepressant medications

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May 22, 2017
Episode 79: The Mumps
11:45

So spring breakers on South Padre Island in Texas are coming down with the mumps. Since the MMR (measles, mumps, rubella) vaccine was introduced in 1967, we've stopped expecting these outbreaks. 

But recent increases in those who choose to have their children forego vaccines has led to a loss of herd immunity and an increase in these outbreaks.

To further complicate the issue, it seems that immunity wanes with time, which is why many college students (hello spring break!) find themselves falling ill eight to ten years after their last booster at age 12 to 15. 

Resources:

Mumps at South Padre

Learn more about the Mumps and the Mumps vaccine from the CDC

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May 15, 2017
Episode 78: What Evidence Can You Trust?
10:11

If you've ever felt like you had a handle on the evidence about a certain medical topic only to read a headline telling you science now says the opposite, you aren't alone. 

But science isn't about headlines. It's about evaluating the evidence to decide what's real, and it doesn't always conform to what we want. But that doesn't stop the media, (and maybe some journals), from selectively reporting the research that will generate the most buzz.

Today we talk about this issue and ideas that are being discussed to help be sure all the evidence, including the unremarkable evidence, is adequately reported.

Resources:

Nurse's Health Study

Women's Health Initiative

Calcium and Heart Disease Risk

Results-Blind Study

PLOS on Data

2 Docs Talk about Hormone Replacement Therapy

2 Docs Talk about Supplements

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May 08, 2017
Episode 77: USPSTF Evidence
17:55

Each year, under Obamacare rules, the USPSTF is required to issue a report on evidence gaps. These are areas of preventive medicine that they decide we are lacking sufficient evidence to determine if the harms outweight the risk.

This week, we take a look at the primary areas of evidence shortfall. If you are wondering about a screening test, take a listen to see if it made the list.

 

Resources:

Sixth Annual Report to Congress on High Priority Evidence Gaps

2 Docs Talk about Smoking Cessation

2 Docs Talk about dietary supplements

2 Docs Talk about skin cancer prevention

May 01, 2017
Episode 76: Do You Want a Long Lifespan? Or a Long Healthspan?
11:17

In healthcare, the holy graille seems to be longevity. We look at whether a treatment increases lifespan and use that as a barometer for it's value. 

But should that be the yardstick we use? Or would we be better off with a more subjective measure of improving quality of life, even if that means sacrificing some of the quantity.

Today, 2 Docs Talk about this question propose some things to consider as you consider your approach to aging and healthcare.

 

Resources:

Colonoscopy study in the Annals of Internal Medicine 

Research on lifespan in Nature

The Austad/Olshansky Wager

Apr 24, 2017
Episode 75: Are We Overscreening for Thyroid Disease
12:16

Most people probably know someone who has had thyroid disease of some sort, most commonly hypothyroidism - the term low thyroid hormone.

But there has been a significant rise in diagnosed thyroid disease in the past couple of decades due to screening. These diagnoses include problems with thyroid hormone as well as thyroid cancers. It's easy to get excited about diagnosing more disease - you catch it earlier and help people prevent the consequences of the disease. Or do you?

Today we are going to talk about screening asymptomatic patients for thyroid disease. We're also going to address that slipppery category of "subclinical" thyroid disease. 

Resources

British Medical Journal on Increased Diagnosis of Thyroid Cancer

Thyroid Cancer in Korea

Apr 17, 2017
Episode 74: The Evidence on GERD
13:13

GERD or gastroesophageal reflux disease is the very common disorder where acid backs up from the stomach into the esophagus. It results in that all too common problem we call heartburn, along with a slew of other symptoms.

Today we take a look at GERD, the commonly recommended remedies, and the one thing the evidence shows really works to get rid of the burn.

Resources

Risk of dementia in elderly patients with the use of proton pump inhibitors.

Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis.

Acupuncture for functional gastrointestinal disorders.

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Apr 10, 2017
Episode 73: Hospice
13:14

Kendall and Amy are in agreement that hospice care is an important, compassionate aspect of healthcare that humanizes what can be a very clinical, impersonal process. We've both experience with hospice - personally and professionally. 

Sadly, like most aspects of healthcare, the potential for profit has introduced some ugly practices into what should be focused solely on the needs of dying patients and their families.

Today, Kendall and Amy talk about the good and the bad of hospice as it exists in 2017.

Resources:

 

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Apr 03, 2017
Episode 72: Death Panels
11:33

Ever since Sarah Palin famously accused Obamacare of promoting death panels, the idea remains a fixture for some politicians to fall back on to impugn the healhcare law. 

But were death panels ever a part of the original healthcare law? And more importantly, how should patients and their physicians be approaching the topic of death, if at all?

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Mar 27, 2017
Episode 71: Our Thoughts on Trumpcare, Part 2
12:52

In this follow up episode to last week, we dig in to how the American Healthcare Act, aka Trumpcare, will affect Medicaid, and who will benefit from all the tax breaks. 

We recorded this episode before the Congressional Budget Office came out with their evaluation of the plan. We weren't too far off, if anything we may have been generous with Trumpcare. We've linked the CBO report in the resources below in case you want to check it out for yourself.

Also, I mistakenly credited the Vox article to Ezra Klein, but it was Sarah Kliff who wrote the excellent summary of the AHCA. It's also linked below.

Resources:

Health Affairs Blog on AHCA

Kaiser’s side-by-side comparison of Obamacare and AHCA

Obamacare Essential Healht Benefits

Vox Article by Sarah Kliff

Summary of Congressional Budget Office Report

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Mar 20, 2017
Episode 70: Our Thoughts on Trumpcare, Part 1
14:30

UPDATE: Since the episode aired (like the very next day) the Congressional Budget Office came out with their assessment of the American Healthcare Act. It was not positive. Stay tuned to the second part of this episode coming out on Monday, March 20, where we will discuss what they had to say.

_________________

Over the past week, we've finally gotten to take a look at the elusive Republican healthcare plan, the proposed replacement for Obamacare.

In this episode we talk about the faults opponent found with Obamacare, and how the proposed plan, which we call Trumpcare, attempts to address those issues.

This is the first installment of a two-part episode on Trumpcare, so be sure to listen this week and next week to get our full analysis.

Resources:

Health Affairs Blog on AHCA

Kaiser's side-by-side comparison of Obamacare and AHCA

Obamacare Essential Healht Benefits

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Mar 13, 2017
Episode 69: Hepatitis C (Rebroadcast)
12:45

Hepatitis C infection is on the rise in recent years. The growing opioid epidemic has multiplied the problem, as the primary means of spread is IV drug use. 

Surprisingly only 35 percent of those infected received treatment even though excellent treatment available is for this devastating disease. Not surprisingly, drug costs are a major factor in this issue.

Join us as we discuss the issue of Hep C and what can be done about it.

Resources:

American Journal of Managed Care Special Issue on Hepatitis C Virus

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Mar 06, 2017
Episode 68: Pediculosis Rebroadcast
12:53

 

Lice are an issue that many parents of elementary students have to deal with, often more than once.

In this episode we discuss the three different types of lice - body lice, pubic lice, and head lice - how to get them, the health threats associated with them, and what works to get rid of them. 

Resources:

The CDC on head lice treatment

An Interesting Paper if You Want to Get Totally Geeky on Lice

Dr. Pearlman's Site on the Cetaphil Treatment and Lice

 

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Feb 27, 2017
Episode 67: The 3 Main Reasons for Physician Burnout
17:12

Physician burnout is a big issue in the medical community. According the the Medscape Lifestyle Report 2017, over half of physicians report burnout. But physician burnout isn't just a problem for physicians. It is a problem for patients, for other medical staff, and for the health care economy. 

Today we dig into the causes of physician burnout and how it can be addressed. Here's a hint: It doesn't involve meditation or counseling.

Resources:

Medscape Lifestyle Report 2017

2 Docs Talk About Pricing Transparency

2 Docs Talk About Medicare for All

2 Docs Talk About Drug Pricing

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Feb 20, 2017
Episode 66: What's New With Diabetes
18:38

Diabetes is an old disease that hasn't had a many new solutions in a long time. In this episode we look at what Type 1 and Type 2 diabetes are, how they are treated, and some potential game changers for their treatment on the horizon.

Resources:

Diabetes Stats

The exorbitant cost of diabetes

ACP Guidelines for Treatment of Type 2 Diabetes

Digital Start-up Trying to Help Low Income Diabetes Patients

Research into the Utility of the BCG Vaccine for the Treatment of Diabetes

 

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Feb 13, 2017
Episode 65: Cervical Cancer and the HPV Vaccine
17:27

Historically, cervical cancer has been one of the major killers of young women. But since the advent of the pap smear, death from the disease has dropped dramatically. However, treatment of lesions identified on pap smear can lead to significant issues including infertility. And in other parts of the world where screenign is not easily accessed, cervical cancer remains a significant cause of death for women in the prime of life.

As with any disease, prevention is better than treatment, and this is where the HPV vaccine comes into play. Known mainly by its trade name, Gardasil, the vaccine has been on the market for over a decade. That's long enough to provide data to draw reasonable conclusions about its safety and efficacy.

Resources:

Prevalence of HPV after introduction of vaccine

Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era

 

Safety Resources:

https://www.ncbi.nlm.nih.gov/pubmed/21907257

https://www.ncbi.nlm.nih.gov/pubmed/23027469

https://www.ncbi.nlm.nih.gov/pubmed/24108159

http://jamanetwork.com/journals/jama/fullarticle/1886177

https://www.cdc.gov/vaccinesafety/pdf/data-summary-hpv-gardasil-vaccine-is-safe.pdf

 

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Feb 06, 2017
Episode 64: What's Up With Zika?
14:33
Jan 30, 2017
Episode 63: The 21st Century Cures Act
11:21

The 21st Century Cures Act was passed by both bodies of Congress and signed into law by President Obama on December 7, 2016. The bill received overwhelming bipartisan support, with only a small number (of notable) exceptions.

On the surface, the law sounds like a triumph for healthcare and medical research. But a closer look at funding for the act brings its staying power into question. The only provisions of the law that don't require further action to maintain funding benefit one lucky group. 

Here's a hint: it's not patients. 

So today, 2 Docs Talk about what the 21st Century Cures Act accomplishes and what it doesn't accomplish. Buckle up. 

Resources:

Legislative history and text of 21st Century Cures Act

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Jan 23, 2017
Episode 62: Unnecessary Medical Services
14:06

We’ve got a lot of questions marks ahead of us this year when it comes to healthcare. What will happen with the Affordable Care Act, Medicare, Medicaid, Planned Parenthood, etc. etc.

The future of healthcare under the new administration is a big unknown. But one thing we do know - healthcare costs far too much.

One of the key contributors to these costs is the over $200 billion per year in unnecessary medical care. 

In today's episode, we dig in to the reasons for these costs, and more importantly, we talk about the things we can do as healthcare consumers to reduce unnecessary medical care in our own lives. 

Resources:

Unnecessary Medical Costs

Low Value Care in Medicine

Unnecessary Tests and Treatments

Freakonomics Radio: Bad Medicine

Choosing Wisely

 

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Jan 16, 2017
Episode 61: Artificial Sweeteners (Rebroadcast)
11:26

In a country (the U.S.) where people drink, on average, 44.7 gallons of soda per person, it's smart to think about what we are putting into our bodies. 

Most of us have figured out that all that sugar is a bad idea, but what about sugar substitutes? Diet sodas make up a big portion of that 44.7 gallons. But is it really any better than plain old sugar?

Resources:

Generally Recognized as Safe

San Antonio Heart Study

Fueling the obesity epidemic: Artificially sweetened beverage use and long term weight gain

Artificial Sweeteners and Gut Microbiota in Rats

 

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Jan 09, 2017
Episode 60: Lessons from the Biggest Loser (Rebroadcast)
21:08

America has a weight problem. A full one third of us are classified as obese, and other third are obese. This has implications for individuals, families and society that cut across social and economic factors.

We take a look at a handful of studies that take a look at the weight problem from a variety of angles.

Metabolic rate, BMI, whole grain intake,physical inactivity, and more.

 

Resources:

CDC Info on Obesity

“The Biggest Loser” Study

BMI study

Whole Grain Study

Exercise to Offset Sitting

Cost of Physical Inactivity

 

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Jan 02, 2017
Episode 59: Vaping (Rebroadcast)
13:10

These days you can buy e-Books  for your e-Reader and participate in e-Commerce. You can send your friends Evites, e-file your taxes, and meet the love of your life on eHarmony.

So it’s really no surpise that e-Cigarettes have become as popular as they are. Hats off to whoever named them, since they are actually physical items that you can hold in your hands, unlike most e-products.

The question, of course, is if there are any health advantages to e-Cigarettes. Do they really help you stop smoking?

And, do they create their own set of health problems?

That’s what we’re talking about this week.

 

Resources:

E-Cigs and Poison Control

Southern California Children’s Health Study

USPSTF on Smoking Cessation

Aphthous Ulcers and Nicotine

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Dec 26, 2016
Episode 58: Are Hormones Beneficial in Menopause (Rebroadcast)
14:26

Over the last couple of decades, the conversation surrounding hormone replacement therapy and menopause has been confusing. Does it work? Is it safe? What about alternative therapies? it’s hard to sort out conflicting information coming from various sources. In this episode we discuss:

  • The recent history of hormone replacement therapy (HRT)
  • HRT for symptom relief
  • HRT, endometrial hyperplasia, and uterine cancer
  • HRT and cardiovascular disease
  • HRT and breast cancer
  • Bioidentical hormones
  • And more.

Resources

The Bitch is Back

Study of Women’s Health Across the Naiton (SWAN)

The Women’s Health Initiative

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Dec 19, 2016
Episode 57: December Updates
18:09

 

In this episode we take a look back at our first year of podcasting and some of the more interesting topics we've discussed. Remember medical marijuana? What about vaccines or telemedicine? There are new developments in these areas and more and we discuss these new developments and more. Also, if you hang on to the end, you'll hear one of the few times we disagree. We disagreed, we discussed, we still like eachother. Kendall didn't even tweet about what yuuuge loser Amy is.

Podcasts we discuss in this episode:

Vaccines

Pricing Transparency

Medical Marijuana

Planned Parenthood

Birth Control

Back Pain

Telemedicine

 

Resources

MMR and SSPE

California Drug Price Relief Act (It didn't pass)

Voting Habits by Medical Specialty

Reclassification of Marijuana

CMS on Post-partum Reimbursements for LARCs

Yoga for Back Pain

FDA Approves Manufacture of Digital Stethescopes for Telemedicine by Tytocare

 

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Dec 12, 2016
Episode 56: Heart Attacks
13:38

The media serves us a lot of news about some very flashy diseases. Sometimes is skews our perception of what the most serious threats to our health really are. But no matter what new danger the latest headlines proclaim, heart disease remains the number one cause of death in the United States. Often, those deaths are caused by heart attacks. 

In today's episode, 2 Docs Talk about heart attacks, what they are, how they are treated, and how you should respond if you think you or someone near you is having one. 

Resources:

Prognosis after out of hospital cardiac arrest with and without automatic external defibrillation.

A stem cell treatment for heart disease currently being pursued.

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Dec 05, 2016
Episode 55: Laugher is the Best Medicine
10:14

With the very stressful election we've all just been through, we thought it might be a good idea to lighten things up and have a little fun this week. So we are taking a look at the medical news this week to find teh fun and lightness we are all needing right about now. If you want to learn more about the items we talked about today, the links are listed below.

Why are we ticklish

http://www.latimes.com/science/sciencenow/la-sci-sn-tickling-rats-20161110-story.htm

Flu risk and birth year

http://www.cnn.com/2016/11/10/health/flu-risk-birth-year/

Cannabis gym

http://hoodline.com/2016/11/world-s-first-cannabis-gym-to-debut-in-the-mission-this-spring

Sugar-sweetened beverage tax passed in four cities

http://theincidentaleconomist.com/wordpress/misapplication-of-the-berkeley-soda-tax-to-diet-drinks/

FIT for colorectal screening

http://annals.org/aim/article/2571716/colorectal-cancer-screening-united-states-what-best-fit

Roller coaster kidney stones

http://jaoa.org/article.aspx?articleid=2557373

 

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Nov 28, 2016
Episode 54: What Does Planned Parenthood Actually Do? (Rebroadcast)
14:17

If you live anywhere but under a rock, you know that Planned Parenthood has been the center of controversy in recent months. In this episode, we discuss the history of the organization and its founder Margaret Sanger. Then we dig into Planned Parenthood as it exists today and the controversy surrounding it.

The coverage of the controversy in the media is filled with innuendo and half-truths from both sides of the political spectrum. We wanted to know the facts, so we did a little searching. Since we recorded this episode, the courts in Houston did too, and found no evidence that they were profiting from the sale of fetal tissue or organs.

But, what role does Planned Parenthood play in healthcare today?

Do they provide needed services? What are those services? Is abortion their primary business? Should Medicaid funds cover their services? And finally, is there anything that can be done to curb the number of abortions performed today? (Hint: yes there is, and it has nothing to do with Roe v. Wade.)

Resources:

Where are Planned Parenthood Clinics Located?

Texas Tribune Articles on Planned Parenthood

Planned Parenthood Services by the Numbers

CDC Abortion Surveillance Report - 2012

New England Journal of Medicine on Planned Parenthood

Long Acting Reversible Contraception in Colorado

The Choice Project - LARCs in Colorado

 

Nov 21, 2016
Episode 53: Healthcare in a Donald Trump Presidency
12:28

November 8, 2016 has come and gone and no matter what box you checked you are probably a little surprised by the outcome. Donald Trump will be the 45th POTUS. 

This has the potential to shake things up in a lot of areas of American life, but we want to focus today on the healcare ramifications of a  Donald Trump presidency. What did he say he would do? Will he do it? And what will it look like if he does.

We refer to a couple of our previous podcasts in this show and they are worth a listen as you evaluate the plans Donald Trump is offering up:

Episode 10: What Does Planned Parenthood Actually Do?

Episode 6: Pricing Transparents in Medicine and Healthcare

Nov 14, 2016
Episode 52: The Ethic of New Drug Approvals
11:41

The process of drug approval is long and expensive. To complicate matters, pharmaceutical companies, patients, an the FDA are all invested in the process, for different reasons - and they aren't always the same.

Today we discuss the story of how a new drug came to market and the unusual circumstances around its approval. 

Resources:

FDA grants accelerated approval to first drug for Duchenne muscular dystrophy

CDC on Duchenne Muscular Dystrophy

Right to Try

Compassionate Use

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Nov 07, 2016
Episode 51: What's New With Acne Treatment?
14:25

It's one of those things that doesn't feel so big and important compared to other medical problems, but in reality, acne can be a difficult problem to deal with.

For teens it can be a huge blow to already fragile self-confidence. It isn't a walk in the park for adults who find themselves with a break-out, either.

So today, we are talking about what causes acne, what the science says about dietary approaches to reducing it, and what the most current treatments are. 

Resources:

Acne: A Disease of Western Civilization

Prevalence, severity, and severity risk factors of acne in high school pupils: a community-based study.

Our podcast on supplements

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Oct 31, 2016
Episode 50: Why are Drug Prices Going Up?
15:16

If you've paid any attention to the news over the past year or so, you've likely seen stories of greedy capitalists gouging the vulnerable by hiking up the prices of their life-saving drugs.

But are the prices hikes all that bad?

Yes. Yes, they are. And we talk about that to day on 2 Docs Talk.

Resources:

JAMA on Drug Pricing

Our episode on Hep C

Our episode on Alzheimers

Our episode on Pricing Transparency

Oct 24, 2016
Episode 49: The Prostate
17:19

You'd think that something like screening for prostate cancer would be free of controversy, but that just isn't the case. The benefits and risks of screening have been hotly debated by different medical organizations over the years.

Today, 2 Docs Talk about how prostate screening and the various issues surrounding it. This is a topic every man should discuss with his physicians, and we hope this hepls you know what questions to ask when you do.

Resources:

Weiner AB, Matulewicz RS, Eggener SE, Schaeffer EM. Increasing incidence of metastatic prostate cancer in the United States (2004-2013). Prostate Cancer Prostatic Dis. 2016 Jul 19.]

AU Tacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ. TI Serenoa repens for benign prostatic hyperplasia. SO Cochrane Database Syst Rev. 2012;12:CD001423.

https://www.cancer.gov/types/prostate/hp/prostate-screening-pdq

Oct 17, 2016
Episode 48: Medical Errors
15:09

A BMJ report earlier this year declared that 1 in 3 hospital deaths were the result of medical errors. A flurry of headlines about the dangers of hospitals soon followed.

Just what is a medical error? What are the dangers of being in a hospital? And what can we do about it? We talk about these questions in today's episode. 

Resources:

BMJ on medical error

KATZ scale

To Err is Human: Building a Safer Health System

Hospital at Home

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Oct 10, 2016
Episode 47: Which Statistics Should You Trust?
09:51

If you've ever felt like you had a handle on the evidence about a certain medical topic only to read a headline telling you science now says the opposite, you aren't alone. 

But science isn't about headlines. It's about evaluating the evidence to decide what's real, and it doesn't always conform to what we want. But that doesn't stop the media, (and maybe some journals), from selectively reporting the research that will generate the most buzz.

Today we talk about this issue and ideas that are being discussed to help be sure all the evidence, including the unremarkable evidence, is adequately reported.

Resources:

Nurse's Health Study

Women's Health Initiative

Calcium and Heart Disease Risk

Results-Blind Study

PLOS on Data

2 Docs Talk about Hormone Replacement Therapy

2 Docs Talk about Supplements

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Oct 03, 2016
Episode 46: E-Cigs
12:25

These days you can buy e-Books  for your e-Reader and participate in e-Commerce. You can send your friends Evites, e-file your taxes, and meet the love of your life on eHarmony. 

So it's really no surpise that e-Cigarettes have become as popular as they are. Hats off to whoever named them, since they are actually physical items that you can hold in your hands, unlike most e-products.

The question, of course, is if there are any health advantages to e-Cigarettes. Do they really help you stop smoking?

And, do they create their own set of health problems? 

That's what we're talking about this week.

 

Resources:

E-Cigs and Poison Control

Southern California Children's Health Study

USPSTF on Smoking Cessation

Aphthous Ulcers and Nicotine

 

Sep 26, 2016
Episode 45: Birth Control
16:15

If there is a hot button issue in politics these days, it's abortion. But abortion is the result of a long line of issues that are being inadequately addressed in this country. Today we take a look at contraception - what it is, how it works, its history and its future. 

We also offer a look at an innovative program that has the potential to help both pro-choice and pro-life groups happy. 

 

Resources:

Details on various types of birth control

The Choice Project

Use of LARCs in Colorado

Slang for using a condom (adult humor - you've been warned)

 

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Sep 19, 2016
Episode 44: Artificial Sweeteners
11:02

In a country (the U.S.) where people drink, on average, 44.7 gallons of soda per person, it's smart to think about what we are putting into our bodies. 

Most of us have figured out that all that sugar is a bad idea, but what about sugar substitutes? Diet sodas make up a big portion of that 44.7 gallons. But is it really any better than plain old sugar?

Resources:

Generally Recognized as Safe

San Antonio Heart Study

Fueling the obesity epidemic: Artificially sweetened beverage use and long term weight gain

Artificial Sweeteners and Gut Microbiota in Rats

 

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Sep 12, 2016
Episode 43: The Flu, the Shot, the Future
11:57

Thousands of people die each year from influenza. The CDC recommends that almost all people (with a few rare exceptions) receive the flu vaccine every year. But the disease and the vaccine are poorly understood. In this episode, we discuss the flu, its treatment and its prevention.

Resources:

Influenza vaccine effectiveness in preventing outpatient, inpatient, and severe cases of laboratory-confirmed influenza

Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials.

 

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Sep 05, 2016
Episode 42: Urinary Tract Infections
12:23

Urinary tract infections are one of the most common infections we humans get. In fact, estimates suggest 60-70% of women will have at least one in their lifetime. And many women suffer from them repeatedly.

So what causes these infections and how can you treat them? Is there any way to prevent them? And what does diet have to do with it? 

We discuss these issues and more in this episode. 

Resources:

CDC article on E. coli in our food supply and its role in UTIs

 

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Aug 29, 2016
Episode 41: The Biggest Loser and Other News on Obesity and Health
20:09

America has a weight problem. A full one third of us are classified as obese, and other third are obese. This has implications for individuals, families and society that cut across social and economic factors. 

We take a look at a handful of studies that take a look at the weight problem from a variety of angles. 

Metabolic rate, BMI, whole grain intake,physical inactivity, and more. 

 

Resources:

CDC Info on Obesity

"The Biggest Loser" Study

BMI study

Whole Grain Study

Exercise to Offset Sitting

Cost of Physical Inactivity

 

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Aug 22, 2016
Episode 40: Sun - Friend and Foe
12:56

Everyone thinks of the sun in a different way. Some people crave it and some avoid it. And it turns out there are good health reasons for both.

Today on 2 Docs Talk, we'll be covering how the sun affects your health and how to maximize its benefits while minimizing its damage. We'll talk about:

  • UVA vs. UVB rays
  • The UV Index
  • Sunscreen
  • Skin cancer
  • Vitamin D 
  • and more.

 

Take a listen and get a little info to help you stay sun healthy.

 

EPA UV Index Database

Swedish Studyon Sun Exposure and Smoking

American Academy of Dermatology Sunscreen FAQ

 

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Aug 15, 2016
Episode 39: Insomnia - The Epidemic? (Rebroadcast)
13:57

 

Our understanding of what sleep is and why it is important grows daily. It's clear that poor sleep plays a role in all sorts of disease states. Sadly, more and more people report sleep disturbances to their doctors. 

Is this a new epidemic we are facing, or is it just our awareness of the issue that makes it seem so?

In this episode, we take a look at the role sleep plays in our health, what happens when sleep is disturbed, and how insomnia can be treated. Take a listen and see what you think. We try not to put you to sleep, but you might want to grab a cup of coffee whiel you listen anyway.

Resources:

Arianna Huffington's story

Sleep and Chronic Disease

Sleep loss and inflammation

Sleep, ghrelin, leptin and weight gain

Meta analyis of melatoning and sleep duration

Cognitive Behavioral Therapy for insomnia

 

Aug 08, 2016
Episode 38: Cholesterol - What We Don't Know (Rebroadcast)
13:25

Because individuals with high cholesterol levels often develop heart disease, we've come to accept that high cholesterol - especially "bad" cholesterol, or LDL - causes heart disease.

But it can't be said often enough that correlation does not equal causation, and it is beginning to look more and more like a causal realtionship between cholesterol and heart disease just isn't there. 

In this episode we talk about the status of treating cholesterol to prevent heart disease and about a drug trial that punctuates the whole process with a giant question mark. 

Take a listen and see what you think.

Resources:

Number Needed to Treat with Statins for Primary Prevention

Number Needed to Treat with Statins for Secondary Prevention

Evacitrapib Study Stopped Because of Clinical Futility

American Heart Association Guidelines for Prevention with Statins

 

Aug 01, 2016
Episode 37: Medicare for All (Rebroadcast)
12:46

In this episode, we dig into the terms being bandied about by politicians this year. Medicare for all, single-payer, socialized medicine. What do they all mean? Are they all the same or are there differences between these systems. 

And what would we do, today, to start making healthcare work a little better?

Resources:

Per Capita Health Spending by Country

Gallup Poll on Healthcare Satisfaction by Country

 

Jul 25, 2016
Episode 36: The Current Status of Alzheimer Disease (Rebroadcast)
13:46

One of the big scary pieces of growing old is the possiblity of developing Alzheimer Dementia. This progressive neurological disease is poorly understood, meaning the options for prevention and treatment have a long way to go.

In this episode, we talk about what the disease is, current options for treatment, the reality of prevention, and an approach to choosing long term care.

 

Resources:

Systematic review of studies on cholinesterase inhibitors

JAMA Neurology meta analysis of memantine

Risk reducing effect of education on in Alzheimer's disease

Lumosity fined $2 million for deceptive advertising

Non-profit vs. for profit nursing homes

CMS Five Star Rating

 

Jul 18, 2016
Episode 35: Is Gluten Free the Answer
16:05

The gluten-free phenomenon has grown into a $2.5 billion industry in the U.S. The question we have to ask is if the medical concern from gluten is enough to justify such a huge national expenditure. In this episode, we look at the disorders behind gluten and wheat allergies, gluten sensitivities and the science that supports these diagnoses.

 

Jul 11, 2016
Episode 34: Are Supplements Good Medicine? (Rebroadcast)
14:14

The supplement industry is a big one - estimates place it anywhere from $12 billion to $37 billion. 

However, if you put that number in the context of healthcare spending overall, it's not too crazy...if supplements are effective and safe.

But issues with the approval and regulations of dietary supplements make leave us with many unanswered questions about the so-called "natural" products on the market.

In this episode we examine supplements, homeopathic remedies, the placebo effect and much more. So take a listen, and leave a comment if you have thoughts on the topic.

References:

Dietary Supplement Health and Education Act of 1994

National Center for Complementary and Integrative Health

Placebos Without Deception

Perception of Drug Cost Influences Placebo Effect

Be sure and leave a comment if you have any thoughts on the show. And you know we'd appreciate it so much if you would leave us a review in iTunes!

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Jul 04, 2016
Episode 33: Hepatitis C - The Solution is Here
12:33

 

 

Hepatitis C infection is on the rise in recent years. The growing opioid epidemic has multiplied the problem, as the primary means of spread is IV drug use. 

Surprisingly only 35 percent of those infected received treatment even though excellent treatment available is for this devastating disease. Not surprisingly, drug costs are a major factor in this issue.

Join us as we discuss the issue of Hep C and what can be done about it.

Resources:

American Journal of Managed Care Special Issue on Hepatitis C Virus

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Jun 27, 2016
Episode 32: Direct-to-Consumer Marketing
12:24

 

If you watch any tv at all, it's likely you've seen a drug ad. These ads generally show seemingly healthy people living normal lives, the message being the drug did this for them.

But are the drug ads telling the whole story? And should they even be advertising directly to consumers to begin with? We discuss this issue on today's episode.

 

Resources:

Nivolumab Research from New England Journal of Medicine

What the FDA has to say about drug ads

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Jun 20, 2016
Episode 31: Pediculosis, aka, Head Lice
12:40

 

Lice are an issue that many parents of elementary students have to deal with, often more than once.

In this episode we discuss the three different types of lice - body lice, pubic lice, and head lice - how to get them, the health threats associated with them, and what works to get rid of them. 

Resources:

The CDC on head lice treatment

An Interesting Paper if You Want to Get Totally Geeky on Lice

Dr. Pearlman's Site on the Cetaphil Treatment and Lice

 

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Jun 13, 2016
Episode 30: What to Do About Chronic Back Pain
13:47

Back pain is second only to cancer as a cause of long term disability. This health problem is damaging to individuals and costly to society. And we don't have much in our arsenal that is effective at treating it.

This week, we discuss the difference between acute and chronic back pain with regard to treatment and outcomes. We also discuss the role of surgery, medications, alternative therapies, and some interesting new research on what helps resolve chronic back pain.

Resources:

Research on efficacy of epidural steroid injections for back pain

Trends in spinal fusion surgery

American College of Physicians Guidelines for the Treatment of Chronic Low Back Pain

Jun 06, 2016
Episode 29: Insomnia - The Epidemic?
13:27

 

Our understanding of what sleep is and why it is important grows daily. It's clear that poor sleep plays a role in all sorts of disease states. Sadly, more and more people report sleep disturbances to their doctors. 

Is this a new epidemic we are facing, or is it just our awareness of the issue that makes it seem so?

In this episode, we take a look at the role sleep plays in our health, what happens when sleep is disturbed, and how insomnia can be treated. Take a listen and see what you think. We try not to put you to sleep, but you might want to grab a cup of coffee whiel you listen anyway.

Resources:

Arianna Huffington's story

Sleep and Chronic Disease

Sleep loss and inflammation

Sleep, ghrelin, leptin and weight gain

Meta analyis of melatoning and sleep duration

Cognitive Behavioral Therapy for insomnia

May 30, 2016
Episode 28: Telemedicine and Its Role as We Know It
13:14

In a world when concerns about healthcare costs, access to care, and medical complications create significant barriers to medical care, telemedicine has an obvious role to fill. 

But what are the potential downsides of a technology that is being adopted faster than we can track? Is it effective? Is it safe? Is it a door for the unscrupulous ot take advantage of the unsuspecting?

We discuss these and other issues of the growing field of telemedicine. 

Resources:

AMA policy on telemedicine

AAFP debate on telemedicine policy

AAP on telemedicine and the "medical home"

Hospital at Home

Use of telemedicine to prevent preterm labor

May 23, 2016
Episode 27: Pets and Pathogens
14:55

Both of us, Kendall and Amy, have dogs named Goose. This was purely coincidental, and we are as surprised by that fact as anyone. It's a little uncanny how much they resemble one another, too. If you'd like to see the Geese, we've added their pictures over at 2DocsTalk.com. These two certainly live the life of Riley, but they aren't the only canines who have it so good.

We are a country of pet lovers. We spend over $60 billion annually on food, vet bills, toys, and silly extravagances for our animal companions. We love them, and can't imagine life without them. But did you know your pet can make you sick - and the other way around? 

Today we discuss zoonotic infections - those infections that are spread from animal to human. Rabies, toxoplasmosis, and leptospirosis are a few diseases that fall into this category. We'll talk about how they are spread and treated, and give some tips on how to prevent the.

We'll also talk about how we can make our pets sick, too. It's a fun show!

Resources:

The Thanksgiving Effect

The CDC on pets and salmonella

CDC info on rabies 

May 16, 2016
Episode 26: Do Hormones Make Sense During Menopause?
12:30

Over the last couple of decades, the conversation surrounding hormone replacement therapy and menopause has been confusing. Does it work? Is it safe? What about alternative therapies? it's hard to sort out conflicting information coming from various sources. In this episode we discuss:

  • The recent history of hormone replacement therapy (HRT)
  • HRT for symptom relief
  • HRT, endometrial hyperplasia, and uterine cancer
  • HRT and cardiovascular disease
  • HRT and breast cancer
  • Bioidentical hormones
  • And more.

Resources

The Bitch is Back

Study of Women's Health Across the Naiton (SWAN)

The Women's Health Initiative

May 09, 2016
Ep 25: Cholesterol and Heart Disease: What We Don't Know
12:55

Because individuals with high cholesterol levels often develop heart disease, we've come to accept that high cholesterol - especially "bad" cholesterol, or LDL - causes heart disease.

But it can't be said often enough that correlation does not equal causation, and it is beginning to look more and more like a causal realtionship between cholesterol and heart disease just isn't there. 

In this episode we talk about the status of treating cholesterol to prevent heart disease and about a drug trial that punctuates the whole process with a giant question mark. 

Take a listen and see what you think.

Resources:

Number Needed to Treat with Statins for Primary Prevention

Number Needed to Treat with Statins for Secondary Prevention

Evacitrapib Study Stopped Because of Clinical Futility

American Heart Association Guidelines for Prevention with Statins

May 02, 2016
Ep 24: The Mediterranean Diet and Low Fat Folly
13:23

For decades we've been told that our high fat diet is making us obese and killing us with heart disease. But here's the deal. The concept of a lowfat diet, exemplified in the Mediterranean Diet, is based on faulty science. 

In this episode, we discuss how the high fat hypothesis became accepted science and public policy, without any good research to back it up. We also talk about the various kinds of fats that are out there and what we think is the biggest culprit in our obesity problems.

Resources:

The Big Fat Surprise

PREDIMED Study

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis

Profiling Food Consumption in America

Apr 25, 2016
Episode 23: What's the Deal with Stem Cell Therapy
11:38

Stem cell research, regenerative medicine, or whatever you want to call it, was a real hot button issue for a while. The policitics around it have cooled somewhat, but controversy remains even if the media isn't reporting on it.

What have we learned from stem cell research, what advances have been made, and can we really trust it? 

We get in to all this and more on this week's episode.

Resources:

 ISCCR Draft Guidelines for Stem Cell Science Translation

A nice summary of where the FDA got involved with Stem Cell therapy and who many of the players are

Apr 18, 2016
Episode 22: Are GMOs Safe Food or Frankenfood?
10:16

One of the latest technological advances in food production is the introduction of GMOs, or genetically modified organisms, to the food supply. They have the potential to offer many benefits including increased productivity, pest and herbicide resistance, longer shelf life, and the list goes on.

But many are concerned that this relatively new technology isn't safe - for health, the environment or the economy. We dig into the evidence surrounding GMOs in this episode. We might even share an opinion or two.

Resources:

Primer on the retracted study that indicated GMOs caused tumors

How GMOs are tested for safety

 

Apr 11, 2016
Episode 21: Testosterone Trending
09:06

All you have to do is take a quick drive around town to see that low testosterone clinics are all the rage. A little math will tell you why. Males make up around 50 percent of the population, and their testosterone declines, naturally, at a rate of 1 percent per year after age 30. If that decline merits treatment, it's no wonder those clinics are everywhere.

But, does it merit treatment?

Is testosterone replacement safe?

Is it even effective?

We dig into those questions on this episode of 2 Docs Talk.

Resources

JAMA: Effects of Testosterone on Subclinical Atherosclerosis

Testosterone Reduces Cardiovascular Risk

Testosterone Increases Cardiovascular Risk

FDA Drug Safety Communication on Testosterone

Apr 04, 2016
Episode 20: Medicare for All
12:16

In this episode, we dig into the terms being bandied about by politicians this year. Medicare for all, single-payer, socialized medicine. What do they all mean? Are they all the same or are there differences between these systems. 

And what would we do, today, to start making healthcare work a little better?

Resources:

Per Capita Health Spending by Country

Gallup Poll on Healthcare Satisfaction by Country

Mar 28, 2016
Episode 19: Intro Redux
02:43

As we've produced more episodes, we've continues to see our listening audience grow. We appreciate the listeners, the comments, the emails, and the sharing of our little show. Since new listeners are showing up each week, we thought we'd re-run our intro episode so everyone knows where we're coming from and what we're all about.

Mar 25, 2016
Episode 18: Tasty But Deadly: A Closer Look at Food Borne Illness
14:18

If you've paid any attention to the news in the last year you've heard about the trials of businesses such as Blue Bell Ice Cream and Chipotle. The outbreaks of food borne illnesses from these and other establishments have cause disease, death, and no small amount of economic hardship. 

Why is it that these issues feel like they are happening more frequently? And more importantly, what can we do to keep ourselves healthy, if anything?

On this episode of 2 Docs Talk, we dig into the facts about food borne illness.

Resources:

A great list of facts about raw vs. pasteurized milk, with an excellent list of references at the end.

States that permit the sale of raw milk in retail stores include:

Arizona,California, Connecticut, Idaho, Maine, New Mexico, Nevada, Pennsylvania. South Carolina, Utah, Washington, New Hampshire

States that allow the sale of raw milk on the farm include:

Arkansas, Illinois, Kansas, Kentucky, Massachusetts, Minnesota, Nebraska, New York, Oklahoma, Rhode Island, Texas, Wisconsin, Mississippi

**Arkansas, Kentucky, Mississippi and Rhode Island restrict sales to goat milk, with Kentucky and Rhode Island requiring a prescription from a physician.

Five states allow for the sale of raw milk at farmers’ markets or through other avenues:

Colorado, South Dakota, Missouri, Vermont, Oregon

We referred to a couple of previous podcasts in this episode. If you haven't already listened to these, there is some good info in them:

Is Gluten Free the Answer?

Bugs and Drugs

Mar 21, 2016
Episode 17: The Current Status of Alzheimer Disease
13:16

One of the big scary pieces of growing old is the possiblity of developing Alzheimer Dementia. This progressive neurological disease is poorly understood, meaning the options for prevention and treatment have a long way to go.

In this episode, we talk about what the disease is, current options for treatment, the reality of prevention, and an approach to choosing long term care.

 

Resources:

Systematic review of studies on cholinesterase inhibitors

JAMA Neurology meta analysis of memantine

Risk reducing effect of education on in Alzheimer's disease

Lumosity fined $2 million for deceptive advertising

Non-profit vs. for profit nursing homes

CMS Five Star Rating

Mar 14, 2016
Episdoe 16: Can You Trust the Scientific Process?
14:51

One of the foundational values of this show is emphasizing the importance of using the best available evidence when making decisions about medical care. 

Unfortunately the drive to publish has driven some to game the scientific publishing system. From circumventing the peer-review process to outright fraud, scientific literature is plagued with misinformation.

The scientific community is responding, though. With tools like retraction databases, research reproducibility efforts and post-publication peer review, scientists are working to maintain the highest level of inegrity in the scientific literature.

Be sure to listen all the way to the end, we get a littel personal.

Nature Magazine on the Peer Review Scam

Retraction Watch Leaderboard

Retraction Watch Timeline of Events Regarding Dr. Macchiarini

PubPeer

The Reproducibility Initiative

Why Asparagus Makes Your Pee Stink

Mar 07, 2016
Episode 15: Emerging Vector Borne Diseases: Should We Be Worried
14:15

With Zika in the news, it seemed like a good time to examine the vector borne diseases making headway here in the U.S.

In addition to Zika, we need to pay attention to Dengue Fever. Like the West Nile virus and yellow fever, these viruses are spread by the Aedes mosquito - most often Aedes aegypti. 

But don't think mosquitoes are the only issue. The Kissing Bug, which isn't nearly as sweet as it sounds, is responsible for the increasing burden of Chagas disease in the southern states. Without giving away their secret, let me just say you might not want to listen to this episode right before bedtime.

Note: This episode was recorded in mid-February. Our understanding of Zika, and its impact on the U.S. is rapidly evolving. Please keep an eye on the CDC pages linked below for the most current information.

Resources:

CDC map of areas affected by Zika

Sexual Transmission of Zika

Zika Virus

Dengue Virus

Chagas Disease

61% of Kissing Bugs Carrying Trypansoma Cruzii

Feb 29, 2016
Episode 14: Bugs and Drugs
13:30

This week we started talking about bugs and drugs, or infections and their treatments and we got into Clostridium difficile infection and fecal transplants. Because when it comes to this topic, we are all middle school boys. We can't not talk about it. 

In all seriousness, C. diff can be a devastating disease and the success of this treatment is beyond exciting. As Kendall likes to remind us, though, we have to watch out for the law of unintended consequences.

 

World Health Organization Survey on Antibiotic Use

Great Explainer Video About C. Difficile and Fecal Transplant

Freeze-dried poop for weight loss (I told you so)

Everything You Don't Want to Have to Know About Norovirus from the CDC

Feb 22, 2016
Episode 13: Update 1
06:20

After a few of our previous episodes we got some great questions from a few of our listeners. In this brief update, we answer questions about our episodes on medical marijuana, breast cancer screening and concussions.

Feb 19, 2016
Episode 12: The Rising Problem of Opioid Abuse
11:49

Opioid abuse is at an ever increasing high in the U.S. with overdose being a significant cause of death. 

What role do physicians, pharmaceutical companies, and the drug users themselves play in this epidemic. We examine these questions and more in this episode on the opioid problem in the United States.

Resources:

Drug Overdose Deaths by State

Draft CDC Guidelines for Prescribing Opioids for Chronic Pain

Specific Populations and Prescription Drug Misuse and Abuse

Feb 15, 2016
Episode 11: What's on the Horizon for Colon Cancer Screening?
09:54

Colorectal screening is an effective tool in the prevention of deaths from colon cancer. The question is if the screening tools we use now are the most effective and safe available to us. Technological advances are making less invasive, safer tests a possibility - and sooner rather than later if we're lucky.

But today, what tests do we have, which ones work, and what should you as a patient choose when it comes to your own screening.

Resources:

Current USPSTF Guidelines for Colorectal Screening

USPSTF Draft Update Status for Colorectal Screening

Pillcam Accuracy and Safety

Cologard and FIT (Fecal Immunochemical Testing)

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Feb 08, 2016
Episode 10:What Does Planned Parenthood Actually Do?
13:50

If you live anywhere but under a rock, you know that Planned Parenthood has been the center of controversy in recent months. In this episode, we discuss the history of the organization and its founder Margaret Sanger. Then we dig into Planned Parenthood as it exists today and the controversy surrounding it.

The coverage of the controversy in the media is filled with innuendo and half-truths from both sides of the political spectrum. We wanted to know the facts, so we did a little searching. Since we recorded this episode, the courts in Houston did too, and found no evidence that they were profiting from the sale of fetal tissue or organs.

But, what role does Planned Parenthood play in healthcare today?

Do they provide needed services? What are those services? Is abortion their primary business? Should Medicaid funds cover their services? And finally, is there anything that can be done to curb the number of abortions performed today? (Hint: yes there is, and it has nothing to do with Roe v. Wade.)

Resources:

Where are Planned Parenthood Clinics Located?

Texas Tribune Articles on Planned Parenthood

Planned Parenthood Services by the Numbers

CDC Abortion Surveillance Report - 2012

New England Journal of Medicine on Planned Parenthood

Long Acting Reversible Contraception in Colorado

The Choice Project - LARCs in Colorado

Feb 01, 2016
Episode 9: Gun Violence is a Public Health Issue
14:40

As we enter primary season for this election year, gun violence and control is a hot topic. However, much of the discussion lives in one of two extremes, and little of it is based on actual evidence. 

With over 30,000 gun deaths each year, and over 20,000 of those death from suicide, the reality is that gun violence is a public health issue. This means we need to treat this issue from the point of view of the medical evidence. 

Today we look at the scope of the problem, what has and hasn't worked, and some thougths about what lies ahead. 

Resources:

CDC All Injuries Statistics

CDC Accidental Death Statistics

CDC Homicide and Assault Statistics

CDC Suicide and Self-Inflicted Injury Statistics

CDC Depression Statistics

Discussion of Australia's Gun Laws in the New York Times

Discussion of Missouri's Gun Laws in the New York Times

Survey of Defensive Gun Use Cited Frequently by NRA 

Methodological issues with Defensive Gun Use Survey

Jan 25, 2016
Episode 8: Are Supplements Good Medicine?
14:14

The supplement industry is a big one - estimates place it anywhere from $12 billion to $37 billion. 

However, if you put that number in the context of healthcare spending overall, it's not too crazy...if supplements are effective and safe.

But issues with the approval and regulations of dietary supplements make leave us with many unanswered questions about the so-called "natural" products on the market.

In this episode we examine supplements, homeopathic remedies, the placebo effect and much more. So take a listen, and leave a comment if you have thoughts on the topic.

References:

Dietary Supplement Health and Education Act of 1994

National Center for Complementary and Integrative Health

Placebos Without Deception

Perception of Drug Cost Influences Placebo Effect

Be sure and leave a comment if you have any thoughts on the show. And you know we'd appreciate it so much if you would leave us a review in iTunes!

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Jan 18, 2016
Episode 7: Is Gluten Free the Answer?
15:35

The gluten-free phenomenon has grown into a $2.5 billion industry in the U.S. The question we have to ask is if the medical concern from gluten is enough to justify such a huge national expenditure. In this episode, we look at the disorders behind gluten and wheat allergies, gluten sensitivities and the science that supports these diagnoses.

Jan 11, 2016
Episode 6: Pricing Transparency in Medicine and Healthcare
12:58

If you've ever tried to figure out the price of a medical procedure, you know it's not that easy. In fact, research shows that complete pricing for medical procedures is unavailable when requested over one-third of the time. 

As healthcare deductibles rise and indidviduals are affected more and directly by these costs, the issue of pricing transparency is growing. In this episode we talk about the problem posed by opaque medical pricing practices. We also dig into two innovative practice models that solve this transparency problem, as well as a few other issues in the delivery of healthcare and medicine.

Resources:

Surgery Center of Oklahoma

Turntable Health

Iora Health

JAMA: Availability of Consumer Prices from US Hospitals for a Common Surgical Procedure

Jan 04, 2016
Episode 5: Vaccines Past, Present and Future
16:35

Vaccines are both one of the most widely used and most widely misunderstood preventive medical treatments available. People have concerns about autism, efficacy, the promotion of unhealthy behaviors. We dig into the evidence on some of those topics, as well as take a look at the effectiveness of vaccines against some of the scariest disease of our time - including cancer.

 

NEJM study on vaccines and autism

Lancet study on vaccines and autism

Adverse Effects of Vaccines: Evidence and Causality an ebook by the Institute of Medicine that states, "The evidence favors rejection of a causal relationship between MMR vaccine and autism."

About Cancer vaccines

2014-2015 Flu vaccine info - why it was less effective, but did reduce disease severity

Information on current research into an ebola vaccine

 

 

Dec 28, 2015
Episode 4: Is Screening Mammography All That?
18:58
Dec 21, 2015
Episode 3: Affordable Care Act
16:59

Since March 2010, health care in the U.S. has been subject to the Affordable Care Act, also known as Obamacare.

There is a significant amount of confusion about what exactly this law does or does not do. In this episode, we talk about the key provisions of the law and how it affects the delivery of healthcare in the U.S.

We cover:

  • the effect of the law on insurance
  • subsidies
  • the pre-exisiting conditions clause
  • the mandatory coverage provision
  • pharmaceutical pricing
  • and other key requirements of the law.

In this episode we refer to the following information:

Insurance companies requesting rate reviews under Obamacare

Dec 10, 2015
Episode 2: Concussions
19:50

Concussions are not uncommon in contact sports such as football, soccer and basketball.  But we aren't trying to scare or shock anyone. On today's podcast we'd like to educate and inform so that parents and players can make decisions that aren't based on fear and misinformation.

We'll cover

  • concussions
  • return-to-play policies
  • second impact syndrome
  • post-concussive syndrome
  • chronic traumatic encephalopathy

Take a listen and let us know what you think.

Article referenced in podcast:

McKinney ISD Concussion Protocol

Dec 10, 2015
Episode 1: Medical Marijuana
13:59

As the the political winds shift in favor of legalizing medical marijuana, it's important to consider the evidence that supports it. 

But the 23 states that have legalized it and the FDA don't agree on when marijuana helps and when it doesn't. In this episode, we take a look at the evidence supporting the move toward legalizing the use of marijuana and cannabinoids for medical purposes.

 

References from the show:

Cannabinoids for Medical Use: A Systematic Review and Meta-Analysis

Dec 10, 2015
Episode 0: Introduction
02:22

Hi and welcome to 2 Docs Talk, the podcast about healthcare, the science of medicine, and everything in between. We are your hosts, Kendall Britt, MD and Amy Rogers, MD and we look forward to sharing our thoughts on the best and worst of medical evidence and healthcare policy. Join us for a 15 minute appointment where the doctor is always in.

Dec 10, 2015