The Penn HealthX Podcast

Alistair Blake is a British-trained physician who went to Cambridge. He performed his residency in London, and has worked as health policy fellow for the NHS. He is currently an MBA-student at Wharton, and plans on working full time after graduation with the consulting firm, McKinsey. After speaking for a HealthX event on campus, he joined us to dive a bit deeper into his thoughts on the U.S vs. the U.K health systems, and what he has learned as a physician who wants to transition into the business world. Map 2:00 – Ali’s background and Education – growing up in Bradford, England and choosing medicine 3:45 – Medical education in the U.K is way different than in the U.S 7:40 – Why is Ali interested in health policy? 11:00 – working as a policy fellow for Professor Steve Field, the “head of primary care” 15:15 – incentivizing great practice to boost morale 17:15 – There are very few clinical voices high up in government, and junior clinicians can play a huge role 21:00 – Why come to Wharton? Why come to the U.S? How has Ali been enjoying his time in B-School? 24:30 – Trying to buy insurance as a foreigner after going to the emergency room 26:30 – McKinsey and consulting with a medical background 31:45 – The U.K system (NHS) and a few of the challenges it faces in the coming years 37:00 – The junior physician strike in the U.K 40:00 – What are some myths about the NHS and U.K system? 48:30 – What are Ali’s thoughts on where the U.S system should go from here? 55:20 – What is Ali’s long-term plan? Links Ali's LinkedIn https://www.linkedin.com/in/alastair-blake-md-9080413b/ Bradford - Where Ali Grew Up https://en.wikipedia.org/wiki/Bradford Fellowship Ali Had https://www.fmlm.ac.uk/programme-services/individual-support/national-medical-directors-clinical-fellow-scheme Care Quality Commission in the U.K http://www.cqc.org.uk/ Professor Steve Field http://www.cqc.org.uk/about-us/meet-our-team/professor-steve-field-cbe Coverage of the Junior Physician Strike in the U.K - BBC http://www.bbc.com/news/health-34775980 NICE https://www.nice.org.uk/ Tony Benn video – “If you can find money to kill people you can find money to help people” https://www.youtube.com/watch?v=9LnY-jy_cE0

For our last episode of 2017, I hosted Dr. Patrick Brennan, the current Chief Medical Officer (CMO) for the University of Pennsylvania Health System (UPHS). We touch on Dr. Brennan’s passion for infectious disease, how he began to take on leadership roles in medicine – including those with the Philadelphia Department of Public Health, and as an advisor to the CDC and Secretary of Health and Human Services – the role of a CMO at a large non-profit hospital, high-level coaching in healthcare, and advice for future healthcare leaders. It’s an episode packed with amazing takeaways and insights. Map 2:30 – Dr. Brennan’s novelty baseballs in his office and growing up a Philly sports fan 6:10 – Memories and epiphanies from medical school and residency at Temple University 10:30 – What influenced Dr. Brennan to focus on infectious disease and infection control? 15:05 – How do you get involved with administrative roles, and what do you have to watch out for? “Busy people get asked to do more.” 19:20 – Advising the Center for Disease Control (CDC) and the Secretary of Health and Human Services (HHS) 25:15 – The role of the Chief Medical Officer (CMO) in a large hospital system 30:00 – Pulling back the curtain on the day-to-day role of a CMO – what do you have to give up? 35:15 – The roles of coaches on Dr. Brennan’s life and career, and the role they serve at Penn Medicine – the “360 evaluation” 41:15 – What did Dr. Brennan need to improve upon to be a more effective leader? - giving feedback 44:55 – What would surprise people about how hospitals function? 47:30 – How has the ACA been both good and bad for hospitals? 50:30 – What would Dr. Brennan fix about the U.S healthcare system? 52:05 – What would Dr. Brennan do if he were starting his medical career over in 2017? 53:20 – Last thoughts and advice for future healthcare leaders. Links Release when Dr. Brennan was named CMO in 2005 (Bio) https://almanac.upenn.edu/archive/volumes/v52/n02/pb.html Atul Gawande’s New Yorker Article on Coaching in Medicine https://www.newyorker.com/magazine/2011/10/03/personal-best 360 Degree Feedback https://www.custominsight.com/360-degree-feedback/what-is-360-degree-feedback.asp

In this episode, I had a once in a lifetime opportunity to sit down with one of the most successful and respected healthcare leaders out there, Dr. Arthur Rubenstein. His accolades are too extensive to list in detail, but in short, Dr. Rubenstein is internationally known for his research achievements in endocrinology and diabetes, as well as for his role as the Dean of Penn’s Med School and as Executive Vice President of the University of Pennsylvania Healthcare System (UPHS) in the early 2000’s. We were able to touch on his upbringing and medical training in South Africa, how he found himself practicing in the U.S, being recruited to Penn Medicine to steer the system away from financial disaster, where he learned his leadership skills, and a bit about the roles that large academic medical centers play in their communities. Map 3:00 – Growing up in South Africa – playing cricket, choosing medicine, and his parent’s influence 7:50 – The influence of Apartheid, and the decision to leave South Africa 12:40 – Life in London, getting involved with research, and coming to the United States 18:35 – Dr. Rubenstein’s world-renowned diabetes research - the discovery and clinical usefulness of C-peptide 24:15 – Transitioning to administrative roles as a clinician 29:35 – Where did Dr. Rubenstein learn his leadership skills? 34:45 – Being recruited to Penn, and the dire financial situation of UPHS in the early 2000’s 41:45 – Changing the culture of a large institution – “the distributive leadership model” 48:30 – Building an outpatient center and raising money – enter Raymond Perelman and the Perelman Center for Advanced Medicine 54:30 – a second donation from Raymond Perelman – renaming Penn’s medical school, and boosting morale 1:00:00 – recruiting Ralph Muller, the CEO of UPHS, and the importance of their working relationship 1:07:05 – settling disagreements between the leaders of hospitals – the most common issues 1:11:20 – the role of large health systems in their communities 1:18:00 – What would you change about the current healthcare system? - coverage for everyone 1:20:20 – If you could only read 3 things for the rest of your life? – Shakespeare, Churchill, and William Osler 1:22:20 – Book recommendations – The Undoing Project, Good to Great, The Four 1:24:40 – What would Dr. Rubenstein do if he were starting his medical career in 2017? Links Apartheid in South Africa https://en.wikipedia.org/wiki/Apartheid Summary of Dr. Rubenstein’s Research Accomplishments in Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484474/ Article that Discusses Penn’s Financial Issues in the Early 2000’s http://impakter.com/adding-humanity-into-medicine/ Raymond Perelman https://en.wikipedia.org/wiki/Raymond_G._Perelman Ralph Muller, CEO of UPHS https://www.pennmedicine.org/about/leadership-and-organization/meet-our-ceo Judith Rodin’s (previous President of Penn) Book – The University and Urban Revival http://www.upenn.edu/pennpress/book/14337.html Kahneman and Tversky https://www.newyorker.com/books/page-turner/the-two-friends-who-changed-how-we-think-about-how-we-think The Undoing Project – Michael Lewis https://www.amazon.com/Undoing-Project-Friendship-Changed-Minds/dp/0393254593 Good to Great – Jim Collins https://www.amazon.com/Good-Great-Some-Companies-Others-ebook/dp/B0058DRUV6 The Four: The Hidden DNA of Apple, Amazon, Facebook, and Google – Scott Galloway https://www.amazon.com/Four-Hidden-Amazon-Facebook-Google/dp/0735213658 Other Coverage of Dr. Rubenstein https://www.bizjournals.com/philadelphia/blog/john-george/2011/06/rubenstein-reflects-penn-medical.html https://www.eurekalert.org/pub_releases/2009-11/uops-pah110509.php https://news.upenn.edu/news/arthur-h-rubenstein-mbbch-named-executive-vice-president-university-pennsylvania-health-system-

In this episode, Ryan sits down with Chris Molaro and Adam Pardes, the co-founders of the Philadelphia start-up NeuroFlow. NeuroFlow is a digital health software firm that uses advanced data analytics and machine learning algorithms on real-time biometric data to quantify stress, focus and relaxation for mental health. Map 5:10 – The NeuroFlow Pitch – Chris 8:45 – Why Adam felt compelled to co-found NeuroFlow 10:05 – How did Chris and Adam meet? How did they come up with the idea for NeuroFlow? 14:45 – How did they have the courage to even start? 18:30 – How Chris and Adam complement each other as co-founders 20:45 – Creating “Values” for a company and ensuring everyone on the team follows through 24:55 – Thinking about the hiring process and how you can be “so good they can’t ignore you” 30:50 – FDA and the 510K exclusion – being classified as a “clinical support tool” 33:50 – Performing a clinical trial at Penn 36:00 – Starting a company vs. doing a research project 39:50 – Importance of marketing, and making sure you back up the hype 42:45 – Getting funding early on 47:10 – Getting feedback from investors 49:00 – The value of taking the “Medical Devices” course at Wharton – making connections and getting guidance from speakers 50:45 – The hardest decisions they’ve had to make 53:15 – The proudest moments they’ve had 55:40 – What will success look like for NeuroFlow? Links NeuroFlow Website http://www.neuroflowsolution.com/ NeuroFlow Facebook https://www.facebook.com/neuroflowlive/?ref=br_rs Chris’s Huffington Post Article https://www.huffingtonpost.com/entry/college-campuses-fail-to-fully-decode-mental-illness_us_5a0c6cece4b06d8966cf3417 Article on NeuroFlow Seed Money https://technical.ly/philly/2017/10/18/neuroflow-1-25-million-seed-round-mental-health/ So Good They Can’t Ignore You – Cal Newport (Book) https://www.amazon.com/Good-They-Cant-Ignore-You/dp/1455509124 FDA – 510K https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/510kClearances/ More Press http://philadelphia.cbslocal.com/2017/11/19/philly-startup-creates-tech-to-measure-mental-health/ https://www.cnbc.com/2017/11/11/new-ptsd-treatment-options-for-military-veterans-focus-on-technology.html Another Interview with Chris Molaro – Wharton Business Radio https://soundcloud.com/user-414944777/christopher-molaro

In this episode, I was able to sit down with Dr. Neha Vapiwala who is one of my mentors, and overall one of my absolute favorite people at Penn Med. She just began work as the new Assistant Dean of Student Affairs for the Perelman School of Medicine. We touch on her time at Johns Hopkins where she studied biology and Hispanic studies, and even worked with Dr. Ben Carson! We then discussed her time at Penn Med, the decision to pursue radiation oncology, how she began to take on leadership roles in medicine, and her goals as the new Assistant Dean of Student Affairs. I really appreciated hearing Dr. Vapiwala share a bit about the areas she had to personally work on in order to be an effective leader. It was also great to hear her talk in depth about what makes her so passionate about oncology and more specifically the field of radiation oncology. Map 1:50 – Restaurants in Philly that Dr. Vapiwala recommends 4:20 – Coming to the U.S as a child, Ellis Island, and growing up in Jersey 7:40 – Studying Biology and Hispanic Studies at Johns Hopkins – “why do a minor when you can do a major?” 11:20 – Why medicine? 13:40 – Doing research with, and being mentored by Dr. Ben Carson 15:45 – Thoughts on being a woman in medicine – What else did she have to consider? Did she have female mentors in medicine? 21:00 – Choosing radiation oncology – do you have to love physics? 29:50 – What are the current technologies in radiation oncology? Proton Therapy 37:00 – What does the future of radiation oncology look like? What will future researchers and innovators have to solve? 45:00 – When did Dr. Vapiwala begin to take on leadership roles in medicine? 51:30 – How did she learn to be a leader? 55:15 – What is one thing she needed to work on to be a better leader? 57:45 – Her new role as Assistant Dean of Student Affairs at Penn Med - how is she balancing this role with her clinical duties? 1:03:00 – What are some of Dr. Vapiwala’s goals for the next year? 1:05:00 – Advice she would give to her first year Penn Med self Links Dr. Vapiwala’s Profile https://www.pennmedicine.org/providers/profile/neha-vapiwala Radiation Oncology https://en.wikipedia.org/wiki/Radiation_oncologist OncoLink – Dr. Vapiwala’s Scholarly Project while at Penn Med https://www.oncolink.org/ Proton Therapy https://en.wikipedia.org/wiki/Proton_therapy

Aaron Bhole is a first year med student at the Thomas Jefferson University Sidney Kimmel Medical College in Philadelphia. He is involved with a group at Jefferson called Physician Executive Leadership – or PEL – which is a HealthX like organization that focuses on developing future physician leaders. We were able to hit on Aaron’s interest in the intersection of business and medicine, PEL, drug pricing, orphan drugs, and many other topics. Register for the Penn HealthX conference happening THIS SUNDAY, December 2nd here: http://pennhealthx.com/events/conference#Registration Map 3:15 – Aaron’s time at Cornell, the 3+2 Program to get an MBA, and field ecology/cancer research 6:20 – getting interested in the “macro” of healthcare and the value of having an MBA before starting med school 9:30 – Physician Executive Leadership (PEL) at Jefferson Med 11:00 – Why should people care about rising drug prices? 15:40 – Generic Drugs, The Hatch Waxman Act 22:10 – Patent Life (~20 years) vs. Exclusivity (5-7 years, indication specific) 25:00 – How do companies decide how to price a drug? 30:15 – Negotiating drug prices? Would it work in the U.S? Spoiler – probably not 36:00 – Ryan’s thoughts on the patent system in the U.S 39:09 – Aaron’s response – improving how we incentivize “actual innovation” as opposed to marginal innovation 42:10 – Are current price transparency laws any good? (recent California law) 47:40 – Orphan Drugs – what are they? ; The Orphan Drug Act of 1983 – incentivizing the development of orphan drugs (small patient populations) 51:00 – Orphan drugs are expensive and the laws are being taken advantage of – “salami slicing” 56:45 – What is FDA (and Scott Gottlieb) doing now? 61:00 – Last few questions/wrap up Links GOP Tax plan may get rid of Orphan Drug R+D tax credit https://www.npr.org/sections/health-shots/2017/11/03/561805484/house-republicans-aim-to-eliminate-tax-credits-for-orphan-drugs?sc=tw 
Airspeed of a Swallow https://www.youtube.com/watch?v=liIlW-ovx0Y Physician Executive Leadership (PEL) http://www.physicianexecutiveleadership.com/ Healthcare Spending Pie Chart (bit outdated) http://bit.ly/2AEkSrz Hatch-Waxman Act https://en.wikipedia.org/wiki/Drug_Price_Competition_and_Patent_Term_Restoration_Act A Primer of Acronyms and Different Drug Price “Types” http://www.hivforum.org/storage/documents/2014/Geeneric_ARVs/cross_fchrgenerics_31mar14.pdf Graphs showing How Much Brand Drug Price decreases with increasing Generic Competition http://bit.ly/2Aezddo Articles on How Gilead Chose to Price it’s HepC Drugs http://bit.ly/2i0uguc http://bit.ly/2BuHlnN National Institute for Health and Care Excellence (NICE) – U.K https://en.wikipedia.org/wiki/National_Institute_for_Health_and_Care_Excellence ICER (Institute for Clinical and Economic Review) – U.S https://icer-review.org/ Having Medicare Negotiate Drug Prices Probably Won’t Help (Articles) http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicaire-negotiate-20170111-story.html https://www.statnews.com/2017/06/13/drug-prices-government-negotiation/ Is California’s Drug Price Transparency Law any good? These articles say no https://www.healthaffairs.org/do/10.1377/hblog20171002.062240/full/ http://www.drugchannels.net/2017/10/thanks-california-sb17-will-trigger.html Orphan Drug Act of 1983 https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983 https://en.wikipedia.org/wiki/Orphan_drug Orphan Drugs are Big Business http://wapo.st/2iYgf0H http://n.pr/2Ak2Esb FDA Attempting to Get Rid of “Salami Slicing” http://n.pr/2Bla0v0

Ryan is joined by Dr Saurabh Jha to discuss writing and tweeting as a physician, and how medical students can most effectively ease themselves into that world. We discuss a number of Dr. Jha's articles, touch briefly on the future of radiology, and learn about some of Dr. Jha's favorite writers. Map 3:15 – coming to the U.S and choosing radiology 7:00 – when and why did he become interested in writing about the healthcare system and his first article on the Breast Density Law 10:30 – why share your thoughts publicly if there is a risk in the modern political climate, and how to even start? 14:00 – Twitter as a platform for building a community and getting information 18:30 – where should med students start? – how to get your news, and who to follow 22:15 – Ryan discusses his article on KevinMD and his concerns about alienating others through expressing political opinions 24:00 – how to deal with political topics knowing full well that medicine is wildly political 30:00 – med students are quite savvy these days, and should be entitled to an opinion 32:45 – Dr. Jha’s article on the hospital “Chargemaster” and costs in healthcare; learning from everyone around you, including cabdrivers 42:45 – the field of radiology – where is it heading? Will radiologists be replaced? 50:00 – what would Dr. Jha do if he was starting in 2017? – hint: still radiology, but through global health 52:00 – Dr. Jha’s most popular blog post and tweet 54:25 – what other writers does he read and respect? 58:10 – last thoughts and advice for future physicians Links Dr. Jha’s KevinMD portfolio - https://www.kevinmd.com/blog/post-author/dr-saurabh-jha Dr. Jha's first article on the Breast Density Law - https://www.kevinmd.com/blog/2013/11/breast-density-laws-based-anecdote.html Dr. Jha's twitter account - https://twitter.com/RogueRad HealthNewsreview.org - http://www.healthnewsreview.org/ Ryan's first article on KevinMD – https://www.kevinmd.com/blog/2017/10/want-change-medicine-work-finance.html Dr. Jha’s KevinMD article on the "chargemaster" - https://www.kevinmd.com/blog/2017/07/chargemaster-health-cares-evil-component.html The Patient Will See You Now (book) – https://www.amazon.com/Patient-Will-See-You-Now/dp/0465054749 Dr. Jha's most popular blog post – topic of public reporting - https://www.kevinmd.com/blog/2015/07/when-a-bad-surgeon-is-the-one-you-want-propublica-introduces-a-paradox.html Atul Gawande’s Complications (book) – “required reading” according to Dr. Jha https://www.amazon.com/Complications-Surgeons-Notes-Imperfect-Science/dp/0312421702 Theodore Dalrymple – one of Dr. Jha’s favorite writers - https://en.wikipedia.org/wiki/Theodore_Dalrymple Dr. Lisa Rosenbaum Twitter - https://twitter.com/lisarosenbaum17?lang=en Dr. Anish Koka - http://thehealthcareblog.com/blog/tag/anish-koka/

On the most recent episode of the Penn HealthX Podcast, we were able to speak with Dr. Dana Kuhn. Dr. Kuhn shared his heartbreaking story of finding out he was infected with HIV after receiving treatment for hemophilia. He then unknowingly passed the virus on to his wife, who then died of AIDS-related pneumonia a few years later. While taking time to recuperate with his children, Dr. Kuhn found work as a counselor for patients with chronic illnesses. He then turned to patient advocacy, first working on The Trail of AIDS, and fighting to push legislators to clean up the national blood supply. Dr. Kuhn then founded Patient Services Inc. (PSI), a non-profit organization that helps patients with chronic and rare diseases pay for their insurance premiums and drug co-pays. Premiums and co-pays have been steadily rising over the last number of years, making the affordability for drugs and coverage out of reach of certain patients who fall on hard times. PSI was meant to be a "short-term" solution, and I think Dr. Kuhn would agree that it's up to future healthcare leaders to design policy and innovate to ensure that the work of PSI becomes obsolete. It's one of the most important challenges the we face in the future of the U.S healthcare system. Map 3:16 – Dr. Kuhn’s Story 7:30 – Finding out he was HIV positive and losing his wife to AIDS 11:30 – AIDS phobia in the 80’s 15:45 – getting a job counseling patients with chronic illnesses 17:00 – The Trail of AIDS and advocacy – cleaning up the blood bank 23:30 – The motivation for founding Patient Services Inc. 28:45 – The first step – raising money 32:30 – Where do the donations come from? 35:00 – How do you decide what disease types to fund, and which specific patients? 39:30 – Why design the model this way? – PSI was supposed to be a “short-fix” 45:00 – Are pharmaceutical companies being altruistic, or doing it because there’s something in it for them? 49:00 – The difficulty with getting individuals to donate vs. companies when you aren’t a well-known charity 52:30 – Is PSI fighting a losing battle? Is it sustainable? How can we make it obsolete? 55:50 – Advice for future innovators Links Registration for the Penn HealthX Conference - 12/2/17 http://pennhealthx.com/events/conference#Logo Dr. Dana Kuhn – President and Founder of PSI http://www.patientservicesinc.org/Who-We-Are/Leadership https://www.patientservicesinc.org/Our-Story And the Band Played On Book and Documentary https://en.wikipedia.org/wiki/And_the_Band_Played_On Patient Services Inc. Link https://www.patientservicesinc.org/ Other Co-Pay Charities Supported by Medicare https://www.medicarerights.org/pdf/copay_charities.pdf Kaiser Family Foundation – 2017 Employer Health Benefits Survey https://www.kff.org/health-costs/report/2017-employer-health-benefits-survey/ Past Coverage of the Relationship between Co-Pay Charities and Pharma http://www.nytimes.com/2013/12/19/business/shake-up-at-big-co-pay-fund-raises-scrutiny-on-similar-charities.html https://www.bloomberg.com/news/articles/2017-06-29/charity-funded-by-drugmakers-draws-irs-probe-on-tax-exemption https://www.usatoday.com/story/news/politics/2016/06/08/drug-co-pay-assistance-programs-facing-increasing-state-federal-scrutiny/85547788/ http://www.fiercepharma.com/pharma/irs-probes-whether-patient-charity-acted-as-a-conduit-for-big-pharma

In this episode, Ryan is joined by the three founders of Spectrum Scores - Phil Williams, Naveen Jain, and Jun Jeon. We discuss how they came up with the idea for Spectrum Scores - a website dedicated to helping LGBTQ+ patients find competent healthcare providers who are able to address their unique healthcare needs - and the experience of getting it off the ground. Map: 3:30 – October 11th – Releasing Spectrum Scores and National Coming Out Day 5:15 – Phil’s Background 7:00 – Naveen’s Background 9:00 – Jun’s Background 12:00 – forming their HealthX Labs team 15:45 – early ideas for their team 17:30 – coming up with the idea for Spectrum Scores 22:00 – where do you even start one you have your idea? 27:00 – HealthX Labs Demo Day presentation, and getting feedback 34:00 – deciding what the purpose of Spectrum Scores is, and pivoting after feedback 37:00 – How does Spectrum Scores rate healthcare providers? 42:30 – dividing up work and deciding roles 46:00 – getting publicity and marketing Spectrum Scores 50:00 – where is Spectrum Scores now, and what are future directions? 55:45 – what have they learned throughout the process? Links: HealthX Conference Registration pennhealthx.com/events/conference#Registration Spectrum Scores Website www.spectrumscores.org/ More on The Founders www.spectrumscores.org/about Spectrum Scores Fbook Page www.facebook.com/SpectrumScores/ NBC Article www.nbcnews.com/feature/nbc-out/m…e-doctors-n793861

In this bonus episode of The Penn HealthX Podcast, we'd like to share a conversation host Ryan O'Keefe had with Nathan Dollinger, the host of The Future of Healthcare Podcast. Ryan and Nathan discuss why they started their podcasts, some of their favorite guests, and riff on some topics in healthcare that they are passionate about. If you enjoy The Penn HealthX Podcast, you'll love The Future of Healthcare. Thanks to Nathan for letting us share. Rate the podcast!! Find us on iTunes here: https://itunes.apple.com/us/podcast/the-penn-healthx-podcast/id1271378904?mt=2 Learn how to rate on iTunes and the podcast app below: https://pennhealthx.blog/2017/09/05/how-to-rate-the-podcast/ Map: (thanks Nathan for putting this together) - Who is Ryan O’Keefe and why he started his podcast [6:40] – Why start a podcast? [10:35] – Interviewing Dr. David Fajgenbaum [15:45] – discussing healthcare providers and costs [21:30] – What’s the focus of Penn HealthX [25:40] – Figuring out his aspiration through the podcast [29:50] – A blog, Epi-pen, and prices of healthcare [35:30] – Health Policy research and Ryan's realization [37:50] – History of health reforms and where we are today in healthcare [42:55] – Technology and how it affects healthcare [51:02] – Bad eating habits, addiction, and how it affects the world today [57:35] – How to truly prevent health conditions (better than drugs) [1:03:40] – Gamification and getting people addicted [1:06:30] – Creating a world where being healthy is easy [1:10:00] – How biohacking plays a role [1:12:00] – Controversial medicine and pseudoscience [1:13:45] – Book that influenced Ryan - America's Bitter Pill [1:19:20] – If Ryan could change anything about our healthcare and fitness space what would that be and why? [1:26:08] – Ryan’s advice for future health professionals. [1:27:30] – End of interview [1:31:25] Links: The Future of Healthcare website https://wearethefutureofhealthcare.com/ Nathan's Twitter https://twitter.com/NathanDollinger Ryan's Article on Kevin MD http://www.kevinmd.com/blog/2017/10/want-change-medicine-work-finance.html New Yorker - How Medicare Was Made (article) https://www.newyorker.com/news/news-desk/medicare-made Stephen Down/Tincture (writes for Medium) https://tincture.io/@stephenjdowns?gi=c4dc56f07a90 America's Bitter Pill by Steven Brill (Ryan's recommendation) https://www.amazon.com/Americas-Bitter-Pill-Politics-Healthcare-ebook/dp/B00LYXY05S Hooked by Nir Eyal https://www.amazon.com/Hooked-How-Build-Habit-Forming-Products/dp/1591847788 Drug Channels - pharmaceutical supply chain blog http://www.drugchannels.net/ NYTimes Article on Obesity in Developing Countries https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html?_r=0 Dr. Paul Offit - (addressing pseudoscience and alternative medicines) http://paul-offit.com/

BA Sillah joins the Penn HealthX Podcast to discuss getting an MBA, and investing in healthcare in Africa. 3:00 – The MBA year at Wharton 7:30 – deciding not to go into residency 15:30 – rising interest in business in medicine 19:00 – working in Africa 26:00 – addressing problems unique to the healthcare systems of emerging countries 33:00 – the downside to charity care 38:40 – working for Excelsior and investing to benefit a community Links BA's LinkedIn https://www.linkedin.com/in/barthalomew-sillah-5433b614/ King's Sierra Leone Partnership http://kslp.org.uk/ Excelsior Group http://excelsior-group.com/ Ghana National Health Insurance Website http://www.nhis.gov.gh/

Eric Heil joins the Penn HealthX Podcast to discuss his career, passion for systems engineering, and experience founding, and eventually exiting, RIghtCare Solutions. RightCare, a company focused on reducing acute care hospital readmissions, was acquired by NaviHealth. 2:45 – growing up in Iowa 4:00 – going to Penn to play basketball 5:45 – playing in the NCAA tournament 7:15 – choosing to study engineering 8:45 – what is systems engineering? 10:15 – why focus on the healthcare space? 11:45 – other jobs Eric took on after graduating from Penn 17:00 – from VC to becoming an entrepreneur 22:00 – the idea to start RightCare 24:45 – rationale for getting an MBA 27:20 – what exactly did RightCare do, and what problems did it solve? 34:45 – challenges of being the leader of a health-tech company 39:45 – exiting RightCare – being bought by NaviHealth (a Cardinal Health company) 41:45 – starting a new project – trying to make lightning strike twice with BehaveCare 44:35 – lessons learned from successfully leading BehaveCare Links: Eric’s Linkedin https://www.linkedin.com/in/eheil/ Kathy Bowles – co-founder of RightCare https://ldi.upenn.edu/expert/kathryn-h-bowles-phd-rn-faan-facmi RightCare Solutions Exit (article) https://medcitynews.com/2015/12/rightcare-solutions-acquisition/ Domain Associates (website) https://www.domainvc.com/ BehaveCare (website) https://www.behavecare.us/about-us A Past Interview with Eric http://executiveleadersradio.com/heil-eric-4297.aspx Letters to a Young Entrepreneur by Ricardo B Levy (Book) https://www.amazon.com/Letters-Young-Entrepreneur-Succeeding-Business/dp/0996670602 JP Morgan Healthcare Conference (old link) https://www.jpmorgan.com/global/healthcareconference

Tim Carlon joins us to talk about his MBA year, and his interest in value-based care. We touch on ACO's, bundled payments, MACRA, and other fun acronyms like MIPS. If you plan on being a physician, you will undoubtedly be impacted by the shift to value-based care. Take notes. 4:45 – Tim’s interest in IR 6:10 – why get the MD/MBA? 14:45 – becoming interested in value-based care payment models 22:20 – explaining ACO’s 27:00 – how have ACO’s been doing? 30:45 – what can med students and young physicians bring to the table? 32:55 – bundled payments 36:00 – What is MACRA? 45:00 – should doctors be worried? Links Tim's LinkedIn https://www.linkedin.com/in/timothy-carlon/ CMS Page on MACRA, MIPS, and APMS http://go.cms.gov/1Gb6GDL CMS Page on ACO's http://go.cms.gov/2nf9mvC Penn Bundled Payments Press Release http://bit.ly/2ivGtZc

Gregg Khodorov and Julia Tartaglia, the co-presidents of the Biomedical Entrepreneurship Network (BEN) at the Rutgers Robert Wood Johnson Medical School, join me to discuss their interests, BEN, and The Scientista Foundation. Map: 4:00 – Gregg – getting the MBA before med school 7:11 – working for Pfizer 9:45 – undergrad at GW and deciding to go into medicine 12:15 – Julia’s path to medicine – studying human behavior, getting a post-bacc 15:45 – starting the Scientista Foundation 20:05 – barriers she faced, and barriers women face in STEM careers 24:00 – what does the Scientista Foundation do? 28:00 – BEN, the summit, and cross-disciplinary programs 37:00 – integrating business and innovation skills into medical school curriculum 45:00 – things Gregg and Julia are looking forward to in the next year Links Gregg's LinkedIn https://www.linkedin.com/in/greggkhod/ Julia's LinkedIn https://www.linkedin.com/in/juliatartaglia/ BEN Website http://benrwj.com/ BEN Facebook https://www.facebook.com/BENRWJMS/ Scientista Foundation Website http://www.scientistafoundation.com/ Wharton Business in Healthcare Conference - last year's site http://www.whcbc.org/conf2017/

Nora Becker joins me to discuss her research on the ACA and it's effects on contraceptive usage. Map: 5:15 – her time at Pomona and becoming interested in public health 7:15 – deferring acceptance to Penn’s MD/PhD program to work for the Obama Campaign 10:00 – doing research at Wharton and getting a PhD not in basic science 13:00 – the value in appreciating health policy these days and how quickly health policy news/narratives/discussions can change 17:45 – Nora’s research – How the ACA has impacted contraceptive usage 24:00 – does contraceptive use save insurers money? 28:00 – paying for care specific to women’s health 35:00 – does being a mother change perspective on these issues? 38:45 – having your research tweeted by Obama, and the perils of your research becoming political and/or misinterpreted 47:30 – the fickle nature and frustrations of dedicating your life to researching health policy 54:00 – how we think about and frame healthcare spending 58:00 – how do you convince people it’s good to pay for other people’s health care? Links: Nora's Old Bio https://hcmg.wharton.upenn.edu/profile/norab/ List of Essential Health Benefits https://www.healthcare.gov/coverage/what-marketplace-plans-cover/ The Oregon Medicaid Health Insurance Experiment https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment Her Papers http://content.healthaffairs.org/content/34/7/1204.abstract Coverage of Her Work https://ldi.upenn.edu/new-penn-contraceptives-and-aca-study-gets-wide-media-pickup http://www.npr.org/sections/health-shots/2015/07/08/421140260/women-are-saving-money-thanks-to-expanded-birth-control-coverage https://www.cnbc.com/2015/07/07/birth-controls-big-cost-control-gains-from-obamacare.html https://www.nytimes.com/2015/07/08/health/after-health-care-act-sharp-drop-in-spending-on-birth-control.html Wharton Healthcare Management site https://hcmg.wharton.upenn.edu/