The Penn HealthX Podcast

Today’s episode is Part 1 of a conversation Logan and I had with Dr. Shivan Mehta, who is the Associate Chief Innovation Officer at Penn Medicine. A gastroenterologist by training, Dr. Mehta is also the Director of Operations at the Penn Center for Healthcare Innovation, and works with the Leonard Davis Institute Center for Health Incentives and Behavioral Economics. He received his MD, MBA and Masters in Health Policy all from Penn. We had a great conversation with topics ranging from his background, The Center for Healthcare Innovation, and behavioral economics research and how it can be used to improve patient care. In Part 1, we learn more about Dr. Mehta and how he got where he is today, and in Part 2 we discuss more of his work and behavioral economics. Links Dr. Mehta's Bio https://healthcareinnovation.upenn.edu/bio/shivan-mehta-md-mba-mshp

In this episode, I speak with Logan Brock, my occasional co-host, and Dr. Scott Trerotola who is the Chief of Interventional Radiology as well as Vice Chair for Quality and Safety at the Hospital of the University of Pennsylvania. Dr. Trerotola is a mentor to many medical students, and pursues research in hemodialysis and venous access among many other topics. Along with his surgical and academic work, Dr. Treretola is also an inventor, holding numerous patents for medical device – one of which, the Arrow-Trerotola Device, is still used across the country. In the conversation, we hit on his time in medical at Penn, how he developed business acumen outside of the classroom, the field of interventional radiology, how to navigate the relationship with your research mentors and become a first author, and how medical device innovation can complement a career in academic medicine. It’s an incredible conversation filled with actionable advice and fascinating stories, and we are thankful that Dr. Treretola continues to take new medical students under his wing each and every year. Links Dr. Trerotola’s Bio https://www.med.upenn.edu/apps/faculty/index.php/g5165284/p15252 The Arrow-Trerotola Device https://www.teleflex.com/emea/documentLibrary/documents/941111-000001_ArrowTrerotola_PTD_1311.pdf Interventional Radiology https://en.wikipedia.org/wiki/Interventional_radiology The Evolution of Interventional Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036249/ Dialysis Access https://vascular.org/patient-resources/vascular-treatments/dialysis-access

In Part 2 of my conversation with Dr. Manaker, we discuss some of the common criticisms of the RUC, and why the group is structured the way it is. Long story short, it’s an imperfect group that was designed to most effectively do the otherwise overwhelmingly gargantuan task of determining the value of the procedures physicians bill for. For more background on the RUC and Dr. Manaker, check out Part 1. https://soundcloud.com/pennhealthxpodcast/31-dr-scott-manaker-the-ruc-and-determining-how-much-physicians-get-paid Dr. Scott Manaker is a an attending Pulmonary and Critical Care physician at the Hospital of the University of Pennsylvania. I first heard about Dr. Manaker being at Penn when I fell down the rabbit hole researching a fascinating part of the U.S Healthcare system – a group called the Specialty Society Relative Value Scale Update Committee, or the “RUC” for short. Dr. Manaker is a member of this group, and I felt really privileged to be able to sit down with him and pick his brain. I think you’ll find that rather than a secret organization that is sneakily carving up the healthcare dollars and distributing them as they see fit, they are a tenacious, dedicated group of specialists who are performing difficult, painstaking, and often thank-less work. Links AMA - RUC Websites www.ama-assn.org/rvs-update-committee-ruc www.ama-assn.org/about-us/composi…te-committee-ruc www.ama-assn.org/rbrvs-overview Articles Discussing RUC - some critical, some balanced washingtonmonthly.com/magazine/julya…/special-deal/ replacetheruc.net/key-articles-not-here/ economix.blogs.nytimes.com/2010/12/10/…st=cse&_r=0

Today’s episode is the first of a two part conversation I had with Dr. Scott Manaker, who is a an attending Pulmonary and Critical Care physician at the Hospital of the University of Pennsylvania. I first heard about Dr. Manaker being at Penn when I fell down the rabbit hole researching a fascinating part of the U.S Healthcare system – a group called the Specialty Society Relative Value Scale Update Committee, or the “RUC” for short. Dr. Manaker is a member of this group, and I felt really privileged to be able to sit down with him and pick his brain. I think you’ll find that rather than a secret organization that is sneakily carving up the healthcare dollars and distributing them as they see fit, they are a tenacious, dedicated group of specialists who are performing difficult, painstaking, and often thank-less work. Links AMA - RUC Websites https://www.ama-assn.org/rvs-update-committee-ruc https://www.ama-assn.org/about-us/composition-rvs-update-committee-ruc https://www.ama-assn.org/rbrvs-overview Articles Discussing RUC - some critical, some balanced https://washingtonmonthly.com/magazine/julyaugust-2013/special-deal/ https://replacetheruc.net/key-articles-not-here/ https://economix.blogs.nytimes.com/2010/12/10/the-little-known-decision-makers-for-medicare-physicans-fees/?scp=1&sq=economix%20REinhardt&st=cse&_r=0

This episode is the final internship minisode with Christina Bax, who spent last summer working in Botswana with Peek Health, a company originally discussed on this podcast in one of our first episodes with Ryan Littman-Quinn. Christina talks about how she approached figuring out what to do over the summer, her role as a medical student with the Peek team, working with design students, and how she transitioned to living in Africa! Links Peek Vision https://www.peekvision.org/ Upenn-Botswana Partnership http://www.med.upenn.edu/botswana/ Episode with Ryan Littman-Quinn https://soundcloud.com/pennhealthxpodcast/episode-3-ryan-littman-quinn-mhealth-and-botswana

This episode is a follow-up to the discussion with Dr. Alan Flake on fetal medicine and the artificial womb project. I speak with my good friend, and Penn Med classmate, Catherine Cullen about bioethics, and what we should think about as we continue to push forward, innovating in the realm of fetal medicine. With the advent of genomics, gene editing, and gene therapies, these types of conversations are more important now than ever. If you haven’t had the chance to listen to our episode with Dr. Flake, you definitely don’t want to miss out! Links https://www.nytimes.com/2017/05/08/health/artificial-wombs-ethics.html https://www.vox.com/the-big-idea/2017/8/23/16186468/artificial-wombs-radically-transform-abortion-debate

Today we bring you a long-awaited, and incredibly special episode! This is an interview I, along with the new co-VP of curriculum for Penn HealthX, Raymond Liu, did with Dr. Alan Flake after he spoke at the Penn HealthX conference last semester. Dr. Flake is an attending pediatric and fetal surgeon in the Division of Pediatric General, Thoracic and Fetal Surgery at Children’s Hospital of Philadelphia. He serves as Director of CHOP’s Center for Fetal Research and is a professor of Surgery and Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania. Today, he spearheads an active research laboratory focused on fetal stem cell and gene therapy. He has been at the forefront of cutting-edge studies aimed at treating genetic disorders before birth. Among all of his accolades, he is probably most known for his current work on development of an artificial womb. Though the research is still being done with lambs, the hope is that in the coming years, a device will be available for preterm human babies to improve their morbidity and mortality. Links Press: https://www.cnn.com/videos/health/2017/04/26/lamb-artificial-womb-study-jnd-orig-vstan.cnn https://www.theverge.com/2017/4/25/15421734/artificial-womb-fetus-biobag-uterus-lamb-sheep-birth-premie-preterm-infant https://www.theguardian.com/lifeandstyle/2017/sep/04/artifical-womb-women-ectogenesis-baby-fertility CHOP's Center for Fetal Research http://www.chop.edu/pages/center-fetal-research Artificial Wombs https://en.wikipedia.org/wiki/Artificial_uterus

Part 2! This episode is a conversation I had with Dr. Nisha Mehta, who is a Penn Med alum! She is currently a radiologist, writer, speaker, and physician advocate. Her writing has been featured in Forbes, PBS NewsHour, Doximity, and KevinMD, among many others. She writes and speaks on many topics in medicine, including physician burnout, work-life balance, wellness, and personal finance. She is also the founder of the Facebook group, Physician Side Gigs, where over 15,000 physicians share stories of how they pursue passion projects both in and out of clinical medicine. I first heard Dr. Mehta when she was a guest on the podcast Docs Outside the Box, and was so proud to see another amazing Penn Med alum out there making an impact. I’m thrilled to share this conversation with you all, and to join the Physician Side Gigs group in a few years. Links: Dr. Mehta's Website www.nishamehtamd.com/ Physician Sig Gigs Facebook Groups www.facebook.com/groups/physiciansidegigs Some of Dr. Mehta's Writing blog.doximity.com/articles/how-thi…ork-life-balance opmed.doximity.com/the-physician-s…ig-8fde6355bf0f www.forbes.com/sites/realspin/20…ebt/#4828d3847cf6 www.kevinmd.com/blog/post-author/nisha-mehta Doc's Outside the Box Podcast www.docsotb.com/ Side Hustles / Side Gigs https://www.physiciansidegigs.com/side-gigs

This episode is a conversation I had with Dr. Nisha Mehta, who is a Penn Med alum! She is currently a radiologist, writer, speaker, and physician advocate. Her writing has been featured in Forbes, PBS NewsHour, Doximity, and KevinMD, among many others. She writes and speaks on many topics in medicine, including physician burnout, work-life balance, wellness, and personal finance. She is also the founder of the Facebook group, Physician Side Gigs, where over 15,000 physicians share stories of how they pursue passion projects both in and out of clinical medicine. I first heard Dr. Mehta when she was a guest on the podcast Docs Outside the Box, and was so proud to see another amazing Penn Med alum out there making an impact. I’m thrilled to share this conversation with you all, and to join the Physician Side Gigs group in a few years. Links: Dr. Mehta's Website https://www.nishamehtamd.com/ Physician Sig Gigs Facebook Groups https://www.facebook.com/groups/physiciansidegigs Some of Dr. Mehta's Writing https://blog.doximity.com/articles/how-this-radiologist-tackles-work-life-balance https://opmed.doximity.com/the-physician-side-gig-8fde6355bf0f https://www.forbes.com/sites/realspin/2016/11/16/why-we-should-care-about-physician-debt/#4828d3847cf6 https://www.kevinmd.com/blog/post-author/nisha-mehta Doc's Outside the Box Podcast http://www.docsotb.com/ Side Hustles / Side Gigs https://www.physiciansidegigs.com/side-gigs

Today’s minisode is an interview with another one of the HealthX summer internship funding recipients, and another fellow MS2, Nancy Liu. Nancy spent the summer at UCSF learning about methods used in patient safety and quality improvement work. She cold-called a number of research teams to see if they would be interested in having her join, knowing that she could secure outside funding. She was also able to participate in the Telluride Experience which is a conference for medical students and residents interested in patient safety. We’ve put together these shorter minisodes focusing on past internship funding recipients, because it’s about that time of year where med students start thinking about what they want to do over their summer and begin applying. Hopefully these quick episodes give you a broader perspective on different opportunities. We encourage you to think outside of the box, and don’t be afraid to do something completely outside the typical expectations of clinical or basic research. They’ll always be there as an opportunity in the future, I promise. http://pennhealthx.com/nancy-liu https://diatribe.org/ http://telluridesummercamp.com/

Today’s episode is a quick minisode with one of my fellow MS2s, Alejandro Cazzulino, or Cazz. We chatted a bit about his experience working for a private equity firm Healthpoint Capital, and one of their spinoffs, Innovahealth Partners that invests in medical device companies. Cazz was able to secure this internship with the help of HealthX funding that is available every year for Penn Med students who are looking to take on some untraditional work in a HealthX-related field. Students who are interested should check out the website pennhealthx.com, or inquire with current HealthX leadership to find out when that application will be live. We encourage you to think outside the box, and feel free to reach out to companies, firms, and research groups that you might otherwise shy away from if didn’t think they’d be able to pay you. http://pennhealthx.com/alejandro-cazzulino

Today’s episode is a conversation I had with Emily Kramer-Golinkoff, who spoke to Penn HealthX last semester about her experience as a patient with Cystic Fibrosis, and in founding Emily’s Entourage, a 501c3 that accelerates research for new treatments and a cure for CF. Since 2011, Emily’s Entourage has raised around $3 million, and has invested in research projects and start-up companies looking to develop drugs for rare missense mutations that cause CF. Emily received her undergraduate degree and Masters in Bioethics from Penn, and since founing Emily’s Entourage has been named a White House Precision Medicine “Champion of Change”, and received the 2016 RARE Champion of Hope for Advocacy Award. To learn more about Emily’s story and Emily’s Entourage, check out emilysentourage.org, or look for them on any social media platform. Map 2:00 – What is Cystic Fibrosis? What is a nonsense mutation, and why does it matter? 7:20 – What was Emily’s do-or-die moment that led her and her family to found Emily’s Entourage? Where do you even start? 12:35 – Marketing, storytelling, and sharing personal information on social media 17:00 – When did Emily’s Entourage begin to mature, and how do you keep it going? 20:00 – Working with The Cystic Fibrosis Foundation 23:10 – Helping launch Talee Bio, a gene therapy company looking to cure CF, and venture philanthropy 30:00 – How can future physician leaders help empower patients to be champions for their disease? 32:30 – Meeting Cheryl Sandberg, and shaking President Obama’s hand at the White House 35:00 – Where to find more info/plugs Links Emily’s Entourage Website https://www.emilysentourage.org/ Social Media https://www.youtube.com/user/EmilysEntourage https://www.facebook.com/EmilysEntourage/ Publicity http://www.cnn.com/2016/04/08/health/cystic-fibrosis-emilys-entourage-turning-points/index.html https://inspirationalwomenseries.org/2017/07/14/inspirational-woman-interview-emily-kramer-golinkoff/ Talee Bio http://taleebio.com/ https://gallery.mailchimp.com/692ad2becf8753ce1c9c9a24e/files/53d6e425-a5b8-426d-9513-6626d0d1ab31/Philadelphia_startup_Talee_Bio_seeking_...brosis_Philadelphia_Business_Journal_copy.pdf The Cystic Fibrosis Foundation https://www.google.com/search?q=cystic+fibrosis+foundation&oq=cystic+fibrosis&aqs=chrome.1.69i57j0l5.2446j0j4&sourceid=chrome&ie=UTF-8 Vertex Pharmaceuticals https://www.vrtx.com/

Today’s episode is a conversation I had with Dr. Jake Brenner, who is pulmonary and critical care physician at Penn who splits his time between clinical work, developing technologies in the lab, and founding companies to bring those technologies to market. He completed his MD/PhD at Stanford, and participated in their Stanford Biodesign Fellowship program. He was able to spin two separate companies out of his involvement with that program, and is currently working on another called RightAir. In the episode, we hit on the Stanford Biodesign program, how to think like an entrepreneur, the companies he’s founded, advice for young medical entrepreneurs and engineers, and a bit on his future goals. This is an incredible episode for anyone interested in using their clinical knowledge to design, build, and commercialize medical technologies. Map 2:30 – Dr. Brenner’s Background and why he chose medicine and the MD/PhD 9:05 – Stanford and moving away from strictly biomedical research 14:35 – What does it mean to be an engineer? 19:00 – The Stanford Biodesign Fellowship 28:00 – Getting the inspiration to found Pevalon to help treat fecal incontinence in women 37:00 – Narrowing down the list of ideas from 300 to 8 - what makes a good idea? 44:00 – Choosing to specialize in pulmonary medicine and critical care, coming to Penn, and balancing having a family with the risks of being an entrepreneur 50:00 – Penn Health Tech, founding RightAir, and future goals Links Dr. Brenner’s Bio https://www.med.upenn.edu/apps/faculty/index.php/g353/p8561789 Br. Brenner’s LinkedIn https://www.linkedin.com/in/jakebrennermdphd/ Penn Health Tech Website https://healthtech.upenn.edu/ Stanford Biodesign http://biodesign.stanford.edu/ Pevalon and Fecal Incontinence http://eclipsesystem.com/ RightAir https://entrepreneurship.wharton.upenn.edu/startup-challenge-semifinalist-rightair/ https://www.design.upenn.edu/news/post/2016-idesign-finalist-spotlight-rightair https://soundcloud.com/user-414944777/thomas-uhler

Today’s episode is a conversation I had a few months ago with Justin Larkin, who is a fellow Penn Med student. Justin is one of the co-founders, and current CMO of WellSheet, which is a start-up that is using machine learning to identify, prioritize, and visualize patient health data across electronic health records. This company was launched out of the Penn HealthX Labs incubator completion, and remains one of the programs greatest success stories. Now that I’ve started my clinical rotations and have been working with EHR’s, it’s so clear why we need innovation in this space – EHR’s are a total mess. Justin studied at Brigham Young University before attending Penn Med for his MD, and taking time off to get his MBA at Stanford. He also has experience as an intern at Verily, otherwise known as Google Life Sciences, and he was the co-chair of HealthX from 2013-2015. In the episode, we discuss a bit about his background and how he ended up in medicine, founding Well-Sheet as a medical student, going to Stanford for his MBA and participating in the Stanford Biodesign program, and what his future plans are. A great episode for anyone who is still trying to find out how they want to best use their skills and interests in medicine, business, and innovation to improve the healthcare system. Map 2:00 – Going to BYU, playing football, and studying Portuguese 4:35 – Doing mission work for The Church of Jesus Christ of Latter-day Saints in Brazil 8:30 – Research at BYU, developing interest in health systems, and deciding to pursue medicine 13:20 – Getting involved with Penn HealthX and growing the program 15:40 – Founding WellSheet to fix EHRs and improve physician workflow 20:30 – History of EHRs – where did we go wrong? 27:30 – The early days of WellSheet – defining the problem youa re working on 29:00 – Being recognized by The Office of the National Coordinator for Health Information Technology (ONC), and the next steps – figuring out WellSheet was the real deal 32:45 – Becoming the CMO and deciding how much to commit to the company 36:40 – Knowing when to get help from mentors, and partnering with the big EHR companies 42:20 – Getting an MBA at Stanford, and the difference between MBA programs 45:10 – Balancing family, school, and being CMO of WellSheet from across the country 46:45 – Stanford Biodesign – innovating in the med tech space 48:40 – Working at Verily (Google Life Sciences) and the role of tech companies in healthcare 53:55 – Where does Justin see his career going? 58:00 – Advice for those starting their medical education – branch out Links Justin’s LinkedIn https://www.linkedin.com/in/justinlarkin WellSheet Website https://www.wellsheet.com/ The Office of the National Coordinator for Health Information Technology (ONC) https://www.healthit.gov/newsroom/about-onc Stanford Biodesign http://biodesign.stanford.edu/ Verily (Google Life Sciences) https://verily.com/ STAT Article on IBM Watson https://www.statnews.com/2017/09/05/watson-ibm-cancer/

Today’s episode is a conversation that Logan recorded with Dr. Ali Behbahani when he was here for the Penn HealthX conference in December to lead a workshop on thinking like a Venture Capitalist. Ali’s story is especially interesting because he actually worked in the business and investment world before completing his MD/MBA dual degree at Penn, and then decided to go straight back into finance and investing when he graduated. This is obviously not common for someone who goes to medical school, and it’s interesting to hear what Ali thinks about the path he took, and how he thought through his decisions. Map 2:00 – Ali’s Background and how he became interested in the business side of science/medicine 5:20 –Working in healthcare investment banking after graduating from Duke 9:35 – Going to medical school and completing a n MD/MBA degree 16:10 – Deciding to go back into the investment world after graduation 18:30 – Venture Capital and New Enteprise Associates (NEA) 32:15 – What does Ali wish he knew sooner in his career? Links Ali’s Bio http://www.nea.com/team/ali-behbahani-md