In this episode, we break down the surprising and often overlooked history of how the U.S. healthcare system came to be—not through strategy or design, but through a series of accidents, policy compromises, and economic incentives that spiraled into today’s crisis.

We explore the roots of employer-based insurance, the rise of fee-for-service reimbursement, the unintended consequences of Medicare and the Affordable Care Act, and how hospitals, insurers, and physicians evolved into the fragmented landscape we live with today. From the explosive growth of consolidation to the misaligned incentives driving costs, access issues, and burnout, this episode explains why American healthcare works exactly as it does—and why fixing it requires understanding its origins.

Whether you’re a clinician, policymaker, administrator, or simply a curious listener trying to understand why U.S. healthcare is so complex and costly, this deep dive uncovers the structural forces that still shape the system. You’ll learn how major policy decisions, market power, and historical quirks created the misaligned incentives that fuel skyrocketing prices, consolidation, administrative waste, and persistent inequities.

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• How employer-based insurance began by accident during WWII wage freezes

• The rise of fee-for-service and how early insurance models locked in volume-based payment

• Medicare and Medicaid’s structural influence on cost and system design

• How technology and specialization shifted the system toward high-cost acute care

• Why the ACA unintentionally accelerated consolidation among insurers and hospital systems

• How misaligned incentives across hospitals, payers, physicians, and patients drive today’s dysfunction

• Why U.S. healthcare prioritizes volume, pricing power, and market share over actual health outcomes

• Why the system behaves exactly the way it does

• How economic incentives—not clinical priorities—shaped U.S. healthcare

• Why costs continue to rise regardless of reform efforts

• Why consolidation amplifies prices and reduces competition

• The historical context needed to understand meaningful solutions

• Clinicians

• Health policy professionals

• Students in medicine, public health, or health economics

• Anyone trying to understand why U.S. healthcare feels so broken

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Ragav Sharma, DO is a Physical Medicine and Rehabilitation (PM&R) physician with training in interventional spine and musculoskeletal medicine. He formerly set powerlifting records and has also completed several races including ultramarathons. He is an avid proponent of resistance training and has coached others, obtaining a Certified Strength and Conditioning Specialist (CSCS) certification, for both general health and powerlifting goals. 

In this episode, Dr. Ragav Sharma breaks down the science and strategy behind resistance training — one of the most powerful tools for improving long-term health, performance, and longevity. We explore what the evidence says about strength training for muscle growth, fat loss, metabolic health, injury prevention, and healthy aging. If you’ve ever wondered how often to lift, what exercises actually matter, or whether resistance training is “safe,” this episode gives you the no-nonsense, research-driven answers.

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Resistance training involves contracting skeletal muscle against external resistance to challenge strength and stimulate muscle growth. That resistance can come from:

• Bodyweight exercises

• Free weights (dumbbells, barbells, kettlebells)

• Resistance bands

• Machines

• Household objects (backpacks, water jugs, cinder blocks)

Strength training is not just for athletes or bodybuilders. It is one of the most potent therapeutic tools we have for improving overall function, mobility, and longevity — and it should be accessible to everyone.

Resistance training:

• Increases fat-free mass (muscle)

• Reduces overall and visceral fat

• Helps preserve muscle during weight loss or GLP-1/GIP therapy

• Predicts lower mortality independent of BMI

Muscle is metabolically protective. Higher muscle mass is associated with a lower risk of chronic disease and death, even in those with a high BMI.

Bone density peaks around age 25–30 and declines after 40, especially in women. Walking alone does little for bone mineral density.

Mechanical loading — squats, deadlifts, step-ups, weighted carries — is essential for:

• Increasing bone density

• Slowing osteopenia and osteoporosis

• Reducing fracture risk

• Maintaining physical function later in life

One of the strongest demonstrations is the Lift More Trial, where women 60+ with diagnosed osteoporosis safely performed heavy squats and deadlifts twice per week. They improved bone density significantly, with only one mild strain in over 2,600 sessions.

Many people assume aerobics is the only way to protect the heart. The data tells a different story:

• Any resistance training → 19% lower cardiovascular mortality

• Improves LDL, HDL, triglycerides, blood pressure

• Enhances functional capacity in heart failure patients

The best results come from combining aerobic exercise with strength training — but strength training alone has a meaningful impact.

Strength training increases insulin sensitivity through GLUT4 upregulation and:

• Lowers HbA1c in both type 1 and type 2 diabetes

• Reduces visceral fat, a major driver of insulin resistance

• Improves metabolic flexibility

For people unable to tolerate high-impact cardio, resistance training becomes even more important.

The psychological benefits are just as powerful:

• Significantly reduces anxiety symptoms

• Lowers depressive symptoms in adolescents and adults

• Benefits occur regardless of strength gains

Simply engaging in resistance training reliably improves mood and mental well-being.

Movement is medicine — and resistance training consistently reduces pain:

• Decreases chronic low back pain

• Improves pain and function in knee osteoarthritis

• Helps patients with fibromyalgia reduce fatigue and tender points

For general musculoskeletal pain (3–7/10), strength training should not be avoided — it is often one of the most effective treatments.

Inactive adults lose 3–8% of muscle per decade, accelerating after age 50. Resistance training:

• Rebuilds strength and muscle

• Improves gait speed, grip strength, and mobility

• Reduces fall risk

• Lowers frailty and functional decline

Most importantly:

This is one of the strongest arguments for making resistance training a standard part of preventive medicine.

Despite overwhelming evidence, only about 10% of adults meet strength training guidelines. Common barriers include:

• Fear of injury

• Lack of knowledge

• Lack of time

• Misconceptions about “proper form”

• Intimidation around gyms

• Poor clinician guidance

• Social stigma

• Limited access to equipment or facilities

But most barriers are built on incorrect assumptions — and many can be addressed effectively.

Weight training has one of the lowest injury rates of any physical activity:

• 0.05–0.31 injuries per 1,000 hoursCompare that to:

• Running: 2.5–33

• Basketball: ~8

• Tennis: 27–62

• Golf: 3–8

Strength training is far safer than most sports.

Data shows:

• Powerlifters report no major back injuries in squat/deadlift reviews

• Only 6.5% of disc herniations are related to heavy lifting

• Most herniations occur during daily tasks like mopping or twisting

A well-dosed program protects your back — it doesn’t harm it.

People with knee osteoarthritis benefit from resistance training:

• Reduced pain

• Improved strength

• Better function

• Lower disability

Even common “faults” like knee valgus are not inherently dangerous.

Strength training is safe and effective at any age — including people with:

• Osteoporosis

• Arthritis

• Chronic pain

• Frailty

The Lift More Trial proved heavy lifts can be safe even in 60+ adults with fragile bones.

The research shows:

• 60 minutes per week → maximum longevity benefit

• 15–20 minutes per week → effective for muscle and strength

• “Exercise snacking” (5 minutes) → still beneficial

Time is not the barrier — expectations are.

Form matters, but not the way most people think.

• CrossFit (irregular form) has injury rates similar to powerlifting

• Machines and free weights produce similar strength gains

• “Good form” is often just what feels natural and safe for the individual

The real risk factor isn’t form — it’s doing too much, too soon.

Here is a simple evidence-based template:

• Push (push-ups, machine press, overhead press)

• Pull (rows, pulldowns)

• Squat (goblet squat, leg press)

• Hinge (deadlift variation, hip thrust)

• Carry (farmer carry, loaded hold)

• 3 sets

• 8 repetitions

• Twice per week

That’s it. This template is enough to significantly improve strength, function, and metabolic health.

• Avoid nocebo language (“deadlifts will hurt your back”).

• Focus on function, not weight loss.

• Give general guidance — not detailed workout plans.

• Celebrate adherence to ACSM guidelines.

• Identify the patient’s stage of readiness to change.

• Provide reassurance, clarify myths, and help them feel capable.

A simple conversation can dramatically shift a patient’s willingness to exercise.

Resistance training isn’t just a fitness trend — it’s one of the most powerful interventions for:

• Chronic disease prevention

• Pain reduction

• Bone health

• Metabolic health

• Mental well-being

• Mobility and independence

• Longevity

And best of all, the maximum health benefit requires only one total hour per week.

If we could package resistance training into a prescription pill, it would be the most effective blockbuster drug in modern medicine.

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Join us for an inspiring conversation with Dr. Shounuck Patel, a leader at the forefront of interventional orthobiologics and musculoskeletal ultrasound. A proud alumnus of the Chicago College of Osteopathic Medicine (CCOM), Dr. Patel completed his residency at the prestigious Kessler Institute, followed by world-renowned fellowship training at the Orthopedic and Spine Specialists (OSS).

Dr. Patel is a master instructor for the Interventional Orthobiologics Foundation, where he trains physicians globally in cutting-edge regenerative techniques. As the founder of the Patel Center for Functional Regeneration in Newport Beach, he has established a premier destination for patients seeking advanced, evidence-based musculoskeletal care.

Internationally recognized for his expertise, Dr. Patel is a sought-after speaker on orthobiologics and ultrasound, sharing his knowledge at conferences and workshops around the world. He also serves as an associate clinical professor, mentoring the next generation of physicians at Western University and Touro College of Osteopathic Medicine.

Passionate about education, Dr. Patel regularly shares practical insights and procedural pearls on Instagram and YouTube (@Regendrpatel), making high-level regenerative medicine accessible to clinicians and patients alike.

Tune in to hear Dr. Patel’s journey, his approach to innovation in musculoskeletal medicine, and his commitment to teaching and advancing the field.

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1. What does preventive medicine mean to you?
2. What is regenerative medicine? Can it be used preventively to help regular folks and/or athletes injury free?
3. How did your career progress to what you do now? What does your practice look like on a day-to-day basis?
4. Do you think there is any merit to stem cell therapies found outside of the USA that people often use for biohacking or “reversing aging?”
5. What does the future of regenerative medicine look like?
6. If someone asks you how to get healthy? What do you tell them in 2 minutes?

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John Whyte, MD

Dr. John Whyte is a nationally recognized physician leader, public health communicator, and healthcare innovator. He currently serves as the Chief Executive Officer and Executive Vice President of the American Medical Association (AMA), where he leads the organization’s mission to advance the art and science of medicine and improve the health of the nation.

A board-certified internist, Dr. Whyte earned his MD from the University of Pennsylvania and his Master of Public Health from Harvard University. His distinguished career spans leadership roles across some of the most influential healthcare institutions in the United States. He has served as a Director at the U.S. Food and Drug Administration (FDA), as well as positions at the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS).

Prior to his role at the AMA, Dr. Whyte was the Chief Medical Officer at WebMD, where he became a trusted voice for evidence-based health information and patient education, reaching millions through his accessible communication style and media presence.

Known for his ability to bridge clinical medicine, public policy, and health communication, Dr. Whyte has dedicated his career to helping people make informed decisions about their health — embodying the rare combination of leadership, compassion, and clarity that defines the very best of medicine.

Dr. Whyte’s Social Media:

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Outline/Transcript

1. What does preventive medicine mean to you?
2. Can you tell us a little bit about the overarching mission of the AMA and who it functions to serve?
3. How does the AMA promote preventive medicine?
4. What does the AMA identify as the biggest challenges physicians face in today’s world?
5. How does the AMA enact change in healthcare policies? What does the process look like for reflecting and enacting the changes physicians want?
6. What actions is the AMA taking to combat misinformation and the ongoing dismantling of evidence-based healthcare in the current political situation?
7. Insurance is becoming more expensive and seems to cover less and less with more barriers. What is the AMA’s involvement in trying to improve the situation?
8. What benefits do physicians have in getting involved in the AMA? How can individual physicians make a difference?
9. If someone asks you how to get healthy, what do you tell them in 2 minutes?

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Boyd Burns, MD

Dr. Boyd Burns is a distinguished leader in academic medicine and healthcare administration, currently serving as the Interim Dean of the Oklahoma University School of Medicine. He also holds dual leadership roles as Chair of the Department of Emergency Medicine and Chief of Staff at Hillcrest Healthcare System, where he plays a pivotal role in shaping clinical excellence and medical education across the region.

A former residency program director, Dr. Burns has trained and mentored countless physicians, emphasizing clinical rigor, leadership, and service to the community. Beyond his institutional roles, he remains deeply engaged in the broader landscape of emergency medicine, contributing to the leadership and governance of multiple professional organizations.

Dr. Burns’ career reflects a lifelong commitment to advancing patient care, medical education, and healthcare systems through innovation, collaboration, and evidence-based leadership.

Outline/Transcript:

1. What does preventive medicine mean to you?
2. How did your career evolve towards becoming so heavily involved in medical education and leadership?
3. How has the practice of emergency medicine evolved over your career and where do you think it’s headed?
4. Can you tell me about your role in educating medical students and their involvement in the community with the SCM Institute?
5. How do you think physicians and medicine can help create bridges to the community in order to assist those with lower SES?
6. What is the responsibility of physicians and hospital systems vs. that of the local, state, and national governments in assisting those who require the most assistance?
7. If someone asks you how to get healthy, what do you tell them?

Dr. Boyd Burns is a distinguished leader in academic medicine and healthcare administration, currently serving as the Interim Dean of the Oklahoma University School of Medicine. He also holds dual leadership roles as Chair of the Department of Emergency Medicine and Chief of Staff at Hillcrest Healthcare System, where he plays a pivotal role in shaping clinical excellence and medical education across the region.

A former residency program director, Dr. Burns has trained and mentored countless physicians, emphasizing clinical rigor, leadership, and service to the community. Beyond his institutional roles, he remains deeply engaged in the broader landscape of emergency medicine, contributing to the leadership and governance of multiple professional organizations.

Dr. Burns’ career reflects a lifelong commitment to advancing patient care, medical education, and healthcare systems through innovation, collaboration, and evidence-based leadership.

The podcast is back! I took time off of the podcast during residency to focus on really mastering my craft, and now that I am a fellow physician, feel it is the right time to start bringing back the message of prevention!

In this episode, I go over the history of the show, re-introduce myself, talk about current big topics in preventive medicine, things I find interesting in the world of preventive medicine right now, and talk about what to look forward to. 

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Kevin Walter, MD is a board certified pediatric sports medicine physician that specializes in helping children with various sports and musculoskeletal related problems. He is the medical director of pediatric and adolescent sports medicine at Children’s Hospital Wisconsin, an associate professor at the Medical College of Wisconsin, has published several papers on concussions in children, and is avidly active in advocacy for safety in youth sports. 

1. What does preventive medicine mean to you and how do you apply that to pediatrics?
2. Pediatric sports medicine is a pretty niche field until your kid breaks a bone or gets involved in sports. What led you to this field?
3. What are the biggest differences between adults and children when it comes to sports medicine?
4. Summer is coming, whats the best way to keep kids out of your exam room?
5. What’s the deal with concussions. What are they? How many can you have as a kid? Does this mean you won’t be as smart in the future?
6. Kids these days are in a hypercompetitive sports environment and find themselves playing a single sport year round so they can become the next tiger woods or michael phelps. What do you think about specialization at such an early age when it comes to sports?
7. How early is too early to start thinking about organized sports?
8. If there was one thing you wanted listeners to take away from this podcast? What would it be?

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This is a re-cast of an episode originally aired in June of 2020. This was an incredible episode that deserves to be heard by all new listeners! In this episode we discuss the role of resistance training for both patients and as a prescription by providers, the evidence behind various practices in prevention, the harms of over-screening, and much more!. Whether in the hospital inpatient floors or his clients in the gym, Dr. Baraki brings evidence-based information and suggestions to help those he works with.

Dr. Baraki is board certified in Internal Medicine, an assistant professor of medicine, and well known for his role with Barbell Medicine. 

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Question 1:  What is Barbell Medicine, why did you decide to get involved and what are it’s goals?

Question 2: Why did you decide to go into Internal Medicine given your athletic history and interest in exercise?

Question 3: What do you think other physicians that do not lift weights can learn from Barbell medicine, should they attend your seminars?

Question 4: Does the population of those attending your Barbell Medicine seminars trend more towards physicians or healthcare professionals?

Question 5: There are many silly ideas surrounding preventive medicine and other aspects regarding medicine, can you speak to the use of evidence when it comes to recommendations in preventive health?

Question 6: What does preventive medicine mean to you?

Question 7: Why is the allure of more screening with regards to preventive care problematic?

Question 8: How do you balance limiting the allure of physicians to use screenings widely as a way to “check-off” preventive care and patients that desire screening based on false notions of prevention?

Question 9: How do you communicate to patients who come in wanting to get unneeded screening such as a whole-body scan to determine all potential problems?

Question 10: Why is it important that patients are educated and develop a level of self-efficacy?

Question 11: Do you think helping patients develop a positive self-narrative is beneficial in the scope of preventive medicine?

Question 12: Do you think we do a poor job of letting our patients know that they should be striving to develop a more robust exercise program based on the current guidelines?

Question 13: How do we bridge the gap between personal trainers and physicians in bringing exercise programs and nutritional counseling to patients?

Question 14: In 2 minutes what do you tell someone who asks you “how do I get healthy?”

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It’s 2023. It’s time we separate our weight from our health. Everywhere we look, health and weight has been synonymous leading to body dysmorphia, poor relationships with food, and many other issues. Well, there’s many more benefits to eating well and physical activity! 

In this podcast, I go over some of the highlights from the podcast for the last year, some of my life events from 2022, podcast goals for this year, and then dive into dividing out health from fitness and nutrition.

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1. Top Episodes Links:
   1.  Dealing with Burnout, and ICU Physician Tells All – Jeremy Topin, MD: https://thepreventivemedicinepodcast.com/episode-58/
   2. The Dogma of Diets and Nutritional History – Alan Flanagan, MsC: https://thepreventivemedicinepodcast.com/episode-57/
   3. Are We Really in Control of Our Diet? – Stephen Guyenet, PhD: https://thepreventivemedicinepodcast.com/episode-56/
2. Article Suggestions:
   1.  The Beginner Prescription by Barbell Medicine
   2.  Health Priorities by Barbell Medicine

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If you listen to this podcast, you likely pay some sort of membership fee either for coaching, the gym, or another health related item. You get access to the facility, time with the coach, and whatever else is included in the fee. What if medicine was practiced the same way? Enter concierge medicine.

Dr. Ari Levy is a serial entrepreneur and physician who founded SHIFT which is a concierge medicine practice focused on integrating all aspects of health under one roof. In this episode we discuss what SHIFT is, what concierge medicine is, how Dr. Levy’s vision seems to be the gold standard when it comes to being mindful of prevention, and lastly the pitfalls of concierge medicine. 

Go check out: https://shiftlife.com/ for more information on SHIFT and to see if you would like to make the SHIFT! 

1. What does preventive medicine mean to you?
2. What is SHIFT and what inspired you to start this practice? What differentiates it from what people usually think of as their doctor?
3. Do you think physicians should get involved with advising patients on lifestyle modification or should we just focus on the medicine?
4. What results have you seen with the “life” package through SHIFT? Do people take advantage of their resources?
5. How does the model of concierge medicine work? Does this mean members don’t need insurance at all?
6. What does it take to have these kinds of services available for those of lower socioeconomic standing?
7. How do you keep it all evidence based when you hire for different positions?
8. If you were waiting for your coffee at Starbucks and someone who recognizes you asks “how do I get healthy,” what do you tell them in the 2 minutes you have?

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The holidays is a time for getting together with family, relaxation, and celebration until it’s not. There are many instances of holidays being ruined by preventive injuries and many unfortunate mortalities. In this episode, I take you through common holiday causes of morbidity and mortality for things to keep in mind during this festive time.

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Toy related injuries – https://www.cpsc.gov/s3fspublic/ToyRelatedDeathsandInjuries2021.pdf

Transportation related Injuries – https://injuryfacts.nsc.org/home-and-community/safety-topics/deaths-by-transportation-mode/

Red Cross Fire Safety – https://www.redcross.org/content/dam/redcross/atg/PDF_s/Preparedness___Disaster_Recovery/Disaster_Preparedness/Home_Fire/FireHolidayFactSheet.pdf

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We know smoking is bad for us, we’ve been hearing it for decades at this point. Unfortunately it wasn’t always this way. The use of cigarettes and smoking in general has changed dramatically within the last several decades and many still struggle with the addiction or with its chronic effects. In this episode, Dr. Baldassarri dives into smoking, cigarettes, addiction, and much more. 

Dr. Baldassarri completed his residency in Internal Medicine from the Yale School of Medicine before completing a fellowship in pulmonary and critical care medicine also from Yale. He is also board certified in addiction/preventive medicine and currently serves as an assistant professor of medicine at the Yale School of Medicine. He has appeared on other podcasts and is well-published on topics relating to smoking, addiction, and sleep.

1. How did you get interested in smoking cessation and addiction medicine with your pulmonary/crit care background?
2. What does preventive medicine mean to you?
3. How has the use of cigarettes changed in the last several years? Has the gap been filled by other devices such as vapes or by marijuana?
4. What interventions have helped bring the use of cigarettes down? How do you approach the conversation?
5. For those who have quit but have a significant smoking history, what can be done to reduce their risk of chronic lung disease?
6. Marijuana has gained a lot of popularity as an alternative medicine, what are the risks associated with marijuana use either through vape or smoking it?
7. If you’re at a coffee shop and someone asks you “how do I get healthy?” what do you tell them in the 2 minutes you’re waiting for your coffee?

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There is a lot more to health to health than what happens in an examination room. The decisions that are made at the municipal, state, and national levels make incredible impacts that often times can either make or break the health of a population at large. In fact, preventive medicine at the highest level has more to do with politics and policy than the supplement being touted on your feed as a miracle. 

In this episode, I talk with Dr. Abdul El-Sayed who has had many roles throughout his career; so many that he has a wikipedia page! Dr. El-Sayed trained as a physician with a gap to complete his PhD at Oxford in Public Health after which he became an assistant professor at Columbia University within the Department of Epidemiology. He then went on to become the youngest Health Director and Executive Director of the Detroit Health Department at just 30 years old before running for governor of Michigan in 2018. Unfortunately, he did not win that race but has continued writing and speaking about the relationship between politics and health through his two published books, podcast, and newsletter. He is a political commentator on television and continued to be active in improving the landscape for public health.

Abdul’s Website

The America Dissected Podcast

The Incision Newsletter

Abdul’s Books

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1. You have held a lot of roles and do many things, why do you do what you do?
2. What does preventive medicine mean to you?
3. What responsibilities does a top official of a health department have compared to a practicing physician? How much of an impact on the day to day lives of people does this role have?
4. Why did you decide to run for governor of Michigan and how much impact can someone in this role have in the health of their constituents?
5. What does the landscape for healthcare reform look like on the political level? Do politicians realize the issues that regular people face?
6. If someone asks you how to get healthy while you are waiting for your coffee at starbucks, what do you tell them in 2 minutes?

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Hospitals do a lot for their patients, but what about others in the community? The Boston Medical Center has made it it’s mission to provide healthcare to everyone despite ability to pay; furthermore, the Health Equity Accelerator to transform the landscape of health equity within the Boston community.

Led by Dr. Elena Mendez-Escobar and Dr. Thea James, the Health Equity Accelerator focuses its resources on maternal and child health, infectious diseases, behavioral health, chronic conditions, oncology, and end-stage renal disease through reaching those who otherwise would not receive as equitable care. In this episode, learn more about what the program is, what hospitals can do to help their communities, and a lot more about health equity! 

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1. What are your roles within BMC? What do you do on a day to day basis?
2. What does preventive medicine mean to you?
3. How did the health equity accelerator come about? What does it do?
4. Do you believe that hospitals have an obligation to their communities in reaching “hard to reach” patients?
5. Given some of the deep origins of health inequities, how can hospitals and hospital initiatives make quantitative change within the community such that the stats actually change?
6. Where does the money come for programs such as the health equity accelerator given the capitalistic and profit-driven nature of many hospitals?
7. How can the health equity accelerator be replicated in other cities? What are the barriers to more widespread adoption?
8. For those from a lower socioeconomic status – if someone were to ask you “How do I get healthy” while you were waiting for your coffee, what do you tell them in 2 minutes?

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Climate change has been happening for some time and, while we may not actively notice it, has been harming the health of millions across the globe for some time now. Dr. Kristie Ebi is a professor of Global Health and Environmental & Occupational Health Sciences at the University of Washington and a globally renowned expert in the effect of heat on our health. 

In this episode we dive into how climate change impacts our health, why the heat is so dangerous, who and where the majority of the effects take effect. We also talk about how to prepare from the individual level all the way to the global level.

This episode is like none other that we have on the podcast!

1. Can you briefly describe what you do and areas you are actively researching?
2. What does prevention mean to you?
3. Can you explain what kind of climate change we are seeing and what we expect to see within the next 50 years?
4. Why is excess heat so dangerous to our health?
5. Who is going to suffer the effects of climate change the most and what kinds of health issues/outcomes will they be facing?
6. What can we do to prepare and prevent excess morbidity and mortality related to climate change on a personal level?
7. How do communities and countries prepare for and prevent the excess morbidity and mortality related to climate change?
8. What does the forecast look like for health outcomes? How bad is it going to get? There are those who are very apocalyptic about our future and those who have unrivaled optimism. What’s your take?
9. If you’re waiting for your coffee at Starbucks and someone asks you “how do I prepare for climate change?” What do you tell them in 2 minutes?

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Most of us are very privileged when it comes to healthcare. We expect not only to get better from whatever ails us, but that we have easily accessible care equipped with all the necessary medicines, diagnostic tools, and staff. Unfortunately, many parts of the world have much less in the way of healthcare! 

Dr. James Sanders is a global health expert having practiced in setting such as Zambia, The Republic of Georgia, and Southeast Asia among other locations. In this episode, Dr. Sanders shares his insights on what preventive care, or just medical care in general, looks like in various parts of the world and the lessons he applied from his travels to his care as a local physician. This episode is fully of many stories so make sure to listen to the whole thing!

1. Can you tell us a little bit about your career and why you were interested in global health at a time it wasn’t really popular?
2. What does preventive medicine mean to you?
3. What is the MPH degree, why did you get it on top of the MD, and how did you utilize it during your career?
4. Given the vast differences in resources, what are the biggest differences in care when it comes to the wealthy and the poor? Many people say that those who are poor have worse health because of personal choices, is this the case?
5. What does healthcare look like in a country like Zambia which did not have a family medicine training program until your arrival? Many of our listeners might not even know what that looks like!
6. In the united states we talk about preventive medicine from a very privileged position largely with nutrition, exercise, yearly checkups, etc. What does preventive medicine look like in a country with lesser resources such as The Republic of Georgia?
7. How do impoverished populations differ in other parts of the world than in the united states?
8. What lessons have you learned during your career as a clinician that are guiding your decisions now on the insurance side of things?
9. If someone asked you how to get healthy while you were waiting for your coffee at starbucks, what would you tell them in 2 minutes?

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Science has gone under attack and many silly or harmful ideas have taken hold in society under the guise of “science.” The thing is, there’s a lot more to science than just claiming something to be scientific. In this episode, you’ll hear all about what it means to follow the scientific method, what it means to be scientific, and what to do about those who erroneously claim science. 

Dr. Grimes earned his PhD in ultraviolet radiation physics followed by a post doctoral fellowship in medical physics and oncology but now largely operates as a science communicator. He is the author of the book “Good Thinking – why flawed logic puts us all at risk and how critical thinking can save the world.” He is also often seen as a panelist and contributor on news stations such as BBC world news, CBS, CNN, and also in written mediums such as the New York Times, Guardian, and Washington Post among others. 

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1. How did you go from being a cancer researcher to broad science communicator? Tell us a little bit about why you are so passionate about what you do?
2. What does preventive medicine mean to you?
3. Can you talk about the history of the scientific method and why “scientific” people would believe in things like the 4 humors of the body or leeches? How did we go from there to where we are now?
4. What does it mean to follow the scientific method?
5. Why do even prolific scientists like Dr. Linus Pauling who you write about in your book, fall into certain dogmas
6. Misinformation seems to condense into a very vocal minority that has outsized effects on public discourse – can you speak to why this seemingly always ends up being the case?
7. What do we do about misinformation? It seems exhausting to be constantly combatting it and relies on the “good” scientists to work 10x as hard.
8. How can science literacy be increased – for those in applied science (doctors etc.), and the lay person?
9. How do you find good information? How do you sift through the garbage?
10. If someone asks you how to get healthy, what do you tell them in 2 minutes?

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The last episode released was on May 22nd, 2022 and a lot has happened since then! Since then I have gotten married, finished my intern year of residency, moved to a different state, and started training within my specialty of choice. In all this the podcast fell by the wayside but it is back! 

In this episode, you’ll be re-introduced to me, the podcast, hear about the major life events in the way of the podcast, my reflections on intern year, what my specialty – Physical Medicine and Rehabilitation – is all about, and where the podcast is headed!

I’m excited to bring the podcast back and if you want to help it grow make sure to rate and review the show! 

1. Major life events and updates since the last episode released on May 22nd, 2022

2. My reflections after completing intern year

3. All about Physical Medicine and Rehabilitation

4. Future plans for the podcast!

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ICU Physicians go through a lot. Facing constant life-or-death scenarios along with other demands, they are often lead to burnout. Burnout can manifest in many different ways but certainly goes against the principles of preventive medicine in living your best life possible. Hear from Dr. Jeremy Topin about his story of burnout, how views of work-life balance and much more in this episode. Dr. Topin completed his residency in Internal Medicine at the University of Chicago before completing a fellowship in Pulmonary and Critical Care medicine at Feinberg School of Medicine. He writes about various topics on his website jtopinmd.com, has been featured in podcasts and traditional news outlets, and is also an avid triathlete, water polo enthusiast

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1. What lead you to critical care medicine, when did you realize you were burnt out, and what do you do now?
2. What does preventive medicine mean to you?
3. How do you stay out of the ICU and from various critical care scenarios and conditions?
4. What does the feeling of burnout entail, and how can it be prevented?
5. How do we reduce burnout in stressful careers within medicine such as critical care, what about other stressful healthcare careers?
6. Work life balance is an ideal that many aim to achieve but never really do; is it possible, and if so, how does one create this for themselves? What does it look like for you?
7. When did you start writing?
8. What was your experience like in Ukraine as a volunteer? What does preventive medicine look like at this level, is it even possible?
9. If someone asks you “How do I get healthy?” while you’re waiting for your coffee at Starbucks, what do you tell them in 2 minutes?

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Have advances in food science been a net positive or negative for society? What contribution does the food industry have in influencing our day to day nutritional choices and what does thsi have to do with SES? What can we do about the significant dogma around certain diets and How does the field of law translate into becoming a better nutrition researcher and communicator? This week we are once again looking at the contextual factors behind our diets with lawyer turned PhD candidate Alan Flanagan!

Alan was previously a practicing barrister (lawyer) before turning to his passion of nutrition and now holds a masters in nutritional medicine while currently pursuing his PhD. He is the founder of Alinea nutrition which aims to promote science-based nutrition for healthcare professionals. he is also a contributor for sigma nutrition with Danny lennon who has been on this show before. lastly, he is also the host of the Cut Through Nutrition Podcast.

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1. What made you go from being a barrister (lawyer) to getting a masters and now pursuing a PhD in nutrition? Why do you do what you do?
2. What does preventive medicine mean to you?
3. What has the evolution of nutritional science looked like over the years? How has food science evolved, do you think this has been a net positive or negative?
4. How do we as humans develop our dietary patterns? What influences shape our choices throughout our life cycle?
5. Is there any truth to the notion of the food industry making and keeping us fat with various chemicals designed to make foods “as addictive as cocaine?”
6. Why do people buy into fad diets no matter their educational level? How does the cycle of fad dieting get broken?
7. How can the science of nutrition be better translated to a larger populace given people don’t tend to trust guidelines? People dont tend to trust experts, so why go get a PhD yourself?
8. What can be done to improve the nutrition of those with lower SES status who might not even be able to follow dietary guidelines based on food availability?
9. If you’re waiting for your coffee at Starbucks and someone asks you, “How do I get healthy,” what do you tell them in 2 minutes?

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Are we really in control of our diet? What influences what we either put or keep out of our mouths? Why is fast food so prevalent and why do we as humans gravitate towards it so much? There’s so much more to nutrition than calories in vs. calories out as explained by Dr. Stephan Guyenet in this episode.

Dr. Guyenet completed his PhD in neuroscience followed by a post doctoral fellowship in the neuroscience of obesity and eating. He is the founder of redpenreviews.org, an editor for Frontiers in Nutrition, and a scientific reviewer for examine.com among other endeavors. Dr. Guyenet is passionate not only about nutrition, but in what sets the background for our diets and how they have evolved over time. In this episode we talk about the concept of an “ideal body weight,” the drivers behind our urge to eat, our culture around food, and the obesity epidemic. 

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1. How did you fall into the world of nutrition science and what gets you up every morning?
2. What does preventive medicine mean to you?
3. Is there an ideal weight? What can the average person do to get past their ‘setpoint” to an “ideal weight?” How should one construct their diet in accordance with impulses/preferences/nutrition?
4. What are the factors that influence our weight the most? Is it all “will-power” as many claim it to be? Why is it so hard to understand that it’s more than just will power?
5. What drives our desire to eat? Can you talk about the neuroscience behind hunger? Why do we like ultra-processed foods so much?
6. People tend to blame various specific nutrients such as sugar, fat, processed foods, etc. for the obesity epidemic. What do you think is there to blame for the obesity epidemic?
7. How did the food environment come to be the way it is?
8. How can we design a better food environment for ourselves? What can we do on a systems and community level?
9. How do physicians and healthcare providers fit into helping patients/clients create a better food environment?
10. If someone asks you, “How do I get healthy” while you’re waiting for your coffee at Starbucks, what do you tell them in 2 minutes?

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What is gut health. What even is the microbiome and how does it play a role in our gut let alone our overall health? What are pre and pro-biotics all about? What should someone do who might be experiencing digestive issues? Who do they see? Does maintaining a healthy gut really prevent many diseases from developing? Hear from gut health expert Gabrielle Fundaro, PhD on all of these topics and more on this episode! Dr. Fundaro received her PhD in Human nutrition, foods, and exercise; is an ISSN sports nutrionist, owner of her own lifestyle coaching company Vitamin PhD Nutrition; and the author of “The Science of Gut Health” which dives deep into what gut health is all about. This episode has a lot of gems within it, make sure to give it a listen!

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1. What do you do on a day to day basis? Why do you do what you do?
2. What does preventive medicine mean to you?
3. Many people claim the gut is the key to good health – thus working on gut health becoming “preventive” for many other conditions such as depression, diabetes, etc. When did the gut become linked with health? Is it a big deal or not?
4. In the name of prevention, many people consume probiotics/prebiotiscs. What is the difference between pro and pre-biotics? When should these be consumed?
5. Do certain foods “ruin” the gut microbiome? What about medications?
6. What should someone do who is having digestive issues? How do they know if their symptoms are related to their gut?
7. Who is qualified to give advice regarding gut health? Physicians vs. online coaches vs. PhDs, etc.
8. What do you think about the future of gut health research? I’ve always heard, we are at the “beginning” of discovery but what potential lays ahead?
9. If you are asked “how do I get healthy?” while waiting for your coffee at starbucks, what do you tell them in 2 minutes?

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While the function of healthcare is to improve our health, how we pay for healthcare matters. With many Americans experiencing medical debt and many others battling insurance companies to have medications covered, payment is at the backbone of healthcare. Dr. Joshua Liao is the Associate Professor of Medicine and and Associate Chair for Health Systems in the Department of Medicine among other positions he holds at The University of Washington. He is also the founder and director of the Value and Systems Science Lab at UW which aims to bring value into payment and care delivery models. Lastly, he advises policy makers through a number of avenues, including service on the US department of Health and Human Services through his role on PTAC (the physician focused payment model advisory technical committee).

In this episode, we discover the depths of payment for medical services, how preventive services and care might be promoted within a value based payment model, and how to make healthcare more equitable and accessible for those in need. This episode covers a lot and answers many questions about payment in healthcare. The opinions, views, and statements made in this podcast are solely those of Dr. Liao and do not reflect those of his employer or any group he’s affiliated with.

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1. What gets you up every morning, why do you do what you do?
2. What does preventive medicine mean to you?
3. How do people pay for healthcare and how did it get so complicated?
4. Where do preventive services fall in the reimbursement model?
5. What is the Value and Systems Science Lab and why did you start it?
6. How do we reduce the overuse of health systems? How does reducing the overuse of healthcare impact patient care?
7. Even with preventive services available, they are often not accessible to those who need them most. How can the right services be made available to those who need them?
8. What does incentivizing preventive care in a healthcare system look like?
9. You serve on some committees at a higher level such as the PTAC, what is their take on payment for healthcare? Is this acknowledged as a problem?
10. What is your ideal payment approach for improving the efficiency and value of healthcare delivery

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With over 50 episodes filled with incredible guests, there has been a lot of very powerful information shared. In this episode, hear some of my takeaways from talking to nearly 50 experts in their fields of study specifically from episodes 26-51! Listen to the main takeaways from podcasts with personal trainers, PhDs, ER physicians, sports medicine physicians, and many other unique perspectives around preventive medicine.

Episode 26: Adam Meakins, PT – Musculoskeletal medicine

Episode 27: Ragav Sharma, DO, CSCS – 1 year anniversary episode

Episode 28: Robert Bowers, DO, PhD – Musculoskeletal medicine, sports medicine

Episode 29: Jeffrey Linder, MD – Annual well-visits

Episode 30: Jim Eubanks, MD – Musculoskeletal medicine, spinal medicine

Episode 31: Karl Nadolsky, DO – Obesity, endocrinology

Episode 32: Jeb Dunkelburger, MS – Healthcare and Insurance

Episode 33: Leah Lutz – Weight Loss and Women’s Training

Episode 34: Ragav Sharma, DO, CSCS – What is preventive medicine 

Episode 35: Mike Albert, MD – Obesity Medicine

Episode 36: Jonathan Alessi & Ragav Sharma, DO, CSCS – Weight Loss Journey’s

Episode 37: Danny Lennon, MS – Nutrition Deep Dive

Episode 38: Mark Lewis, MD – Oncology

Episode 39: Chris Winter, MD – Sleeping Disorders

Episode 40: Jade Wu, PhD – Sleep psychology and Insomnia

Episode 41: Zain Husain, MD – Dermatology and Skin Care

Episode 42: Eliud Sierra, DC – Exercise selection in Rehabilitation

Episode 43: Ragav Sharma, DO, CSCS – Exercise in Prevention

Episode 44: Ragav Sharma, DO, CSCS – New Year Outlook

Episode 45: Stephen Trevick, MD – Neurocritical care and psychiatric crises

Episode 46: Nicole Piemonte, PhD – Death and Dying in Healthcare

Episode 47: Sameena Rehman, MD – Women’s Health

Episode 48: Jordan Syatt – Goal Setting and Common Sense

Episode 49: Gerald Ernat, RD, MS – Supplements

Episode 50: Leoson Hoay, MS – Big Data and Public Health

Episode 51: Natasha Poulopoulos, PhD – Pediatric Psychology

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With over 50 episodes filled with incredible guests, there has been a lot of very powerful information shared. In this episode, hear some of my takeaways from talking to nearly 50 experts in their fields of study. Listen to the main takeaways from podcasts with personal trainers, PhDs, ER physicians, sports medicine physicians, and many other unique perspectives around preventive medicine. This is part 1 covering episodes 1-25, stay tuned for part 2!

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What better time to start thinking about prevention than in the pediatric population. Yes, the fountain of youth often keeps pediatric patients physically healthy but what about their mental health? Dr. Natasha Poulopoulos is a pediatric psychologist with both a masters and Ph.D in clinical psychology. She has authored several peer reviewed publications, given multiple seminars and presentations, and loves educating on the topic! She is also an avid advocate for the LGBTQ+ community.

In this episode we talk about pediatric mental health, the reality behind the youth mental health crisis, what parents need to look out for and can do to improve the mental health of their children, and much much more! Tune into this fascinating episode and let us know what you think!

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1. Tell us a little bit about yourself and why you do what you do?
2. What does preventive medicine mean to you?
3. What are the differences between adult and child psychology?
4. Why are we seeing a rise in youth suicide? What factors are contributing to this and what can we do about it?
5. Has virtual schooling had an impact on the mental development of children? What about masks?
6. What are the warning signs that something might be wrong or a child might be suffering due to mental health struggles?
7. What can we do to prevent children from suffering due deteriorating mental health?
8. Are LGBTQ+ youth specifically susceptible to mental health struggle compared to their peers? Why? What do we do about it?
9. If someone stops you at Starbucks and asks you “How do I get healthy?” What do you tell them in 2 minutes?

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How does big data help make large public health decisions? How do we set up the collection, the analysis, and interoperate the data to create infrastructure? Leoson Hoay serves as a Research Analyst and Data Steward at the University of Chicago Urban Labs, working with the Health Lab team to support the creation of data-driven solutions to public health problems. Prior to joining the Urban Labs, he had worked in various fields spanning data engineering, mental health counseling, and environmental remediation with organizations in the US, Singapore, and Australia. Leoson received his MA in Computational Social Science from the University of Chicago, and his undergraduate degree in Psychology from the National University of Singapore. He is currently pursuing an MS in Computer Science at the Georgia Institute of Technology.

In this episode we discuss many big questions invovling the use of big data to solve large problems. We dive into two projects Leoson has contributed to and generally discuss what big data means in the context of health decisions. Check it out!

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1. Tell us a little bit about what lead you to this path and what you do on a day to day basis?
2. What does preventive medicine mean to you?
3. How are large amounts of data able to be used to solve problems? What does the process look like? What are the challenges with this process?
4. You have done research into the homeless population cycling between the streets, hospitals, and jails. Can you tell us about this project?
5. Can you tell us a little bit more about your research with insurance backed psychiatric placement and providers?
6. How do you measure the impact of these projects?
7. What impact does the collection of data make on these projects and what changes were or could be made? How does data lead to infrastructure?
8. Do you think that community social services can help prevent problems from occurring or are they most active at solving acute problems?
9. Healthcare adds on a level of complexity for data collection with HIPPA and insurance companies. Are hospitals and insurance companies willing partners?
10. What are some of the protective measures to safeguard privacy when working with healthcare data?
11. If someone asks you how data contributes to health, what do you tell them?

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Are supplements a necessary part of a healthy lifestyle? What supplements should you be taking with health in mind? Are there any to avoid? We answer all of these questions and more on this podcast with Team BioLayne dietitian Gerald Ernat! Gerald holds a master’s degree in nutrition and physical performance, is a certified specialist in sports dietetics (CSSD) as well as a registered dietitian making him more than qualified to talk about the use of supplements as part of a healthy diet. 

In this episode we talk about what appropriate scenarios for the use of supplements, what supplements are worth taking, how to pick a specific product out of the sea of companies and products, and when to seek help with your nutritional needs. There is a lot of good information in this podcast so make sure to check it out! This is actually the first podcast Gerald has been on so go over to his social media pages and let him know he did a fantastic job!

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1. Tell us a little bit about your background and why you do what you do
2. What does preventive medicine mean to you
3. What is a supplement and in what scenarios would you recommend people to take supplements?
4. What are supplements you’d recommend to most people? Should EVERYONE be taking a particular supplement?
5. Are there any supplements you would recommend NO one take? What are some useless supplements out there?
6. With so many products out there people have difficulty deciding which one is right for them. What should people look for when finding supplements?
7. Supplements aren’t all that make up an athletes diet and as stated they are “supplements.” How do you coach an athlete through construction of their diet? How do you build a successful diet for performance?
8. When should someone seek out help for their nutrition? When does a sports nutritionist come into play?
9. Ask about dietitian vs nutritionist
10. If you’re at a Starbucks and someone asks you, “How do I get healthy in 2 minutes?” what do you tell them?

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