Date: 5/21/24
Name of podcast: Dr. Patient
Episode title and number: 19 US Drug Costs Are Insane, Part 2

Episode summary: Part 2 follows the last episode, where I reviewed how we got to where we are with insane drug costs in the US and a bit on how the Pharma system works. This week I did a deep dive on how someone can save on their medication costs. I review some cost comparing websites, online pharmacies, direct discounts from manufacturers and more.

Guest(s): none

Key Terms: none

References:
Convoluted drug cost diagram from last episode: https://www.wbur.org/onpoint/2023/12/14/pharmacy-benefit-managers-the-middleman-that-decides-what-you-pay-for-medications
How to shop around: https://www.webmd.com/health-insurance/features/medication-shop-around
How does a place like GoodRx work: https://support.goodrx.com/hc/en-us/articles/115004944026-What-is-GoodRx-How-does-it-work
Ozempic.com with discounts and coupon info: https://www.ozempic.com/savings-and-resources/save-on-ozempic.html?utm_medium=banner&utm_source=goodrx&utm_campaign=trizone&utm_content=wstpay25&utm_id=nmtDC00004081
General ideas on how to save: https://www.forbes.com/advisor/personal-finance/save-money-on-prescription-drugs/
How Medicare drug costs work: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage
Getting help with Medicare drug costs: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap/5-ways-to-get-help-with-prescription-costs
Overview of Medicare Part D Prescription Drug Benefits: https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/

Cost comparing websites:
GoodRx
RxSaver
WebMDRx
RxPriceQuotes
SingleCare
NeedyMeds

Online pharmacies:
HoneybeeHealth
DiRX
Mark Cuban’s CostPlus Drugs
Marley Drug

Date: 5/07/24
Name of podcast: Dr. Patient
Episode title and number: 18 US Drug Costs Are Insane, Part 1

Episode summary: Wow, drug costs in the US have skyrocket in recent years. The popularity of Ozempic and other weight loss drugs have really brought this issue into the light lately. Why do our drugs cost so much more than the same medications sold in other countries? How is the system set up? Who sets the list price? Hear answers to all these questions and more in this episode, part 1 of a 2 part series.

Guest(s): none

Key Terms: none

References:
CONVOLUTED DIAGRAM OF US DRUG COSTS: https://www.wbur.org/onpoint/2023/12/14/pharmacy-benefit-managers-the-middleman-that-decides-what-you-pay-for-medications
Flow of Money Through the Pharmaceutical Distribution System: https://healthpolicy.usc.edu/research/flow-of-money-through-the-pharmaceutical-distribution-system/
Why do your prescription drugs cost so much: https://www.health.harvard.edu/blog/why-do-your-prescription-drugs-cost-so-much-202401183007
Prescription Drug Payment Policy: Past, Present and Future: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193453/
Here's How Much More Ozempic Costs in the U.S. Compared to Other Countries: https://www.healthline.com/health-news/heres-how-much-more-ozempic-costs-in-the-u-s-compared-to-other-countries
Bernie Sanders's letter to Novo Nordisk CEO: https://www.sanders.senate.gov/wp-content/uploads/Letter-from-Sen.-Bernard-Sanders-to-Novo-Nordisk.pdf
Pharmacy Benefit Management (PBM) Industry: Definition: https://www.investopedia.com/articles/markets/070215/what-pharmacy-benefit-management-industry.asp

Date: 4/30/24
Name of podcast: Dr. Patient
Episode title and number: 17 Big Hospital Break Up

Episode summary: I’m breaking up with my hospital. I live in Chicago, with its plethora of academic medical centers. I’ve long believed that these are generally good places to receive healthcare, but I’ve become exhausted at how hard I have to work to receive the actual care. As a retired physician, and a daughter and sister of physicians, I cannot help but to speak out about the troubling way that today’s healthcare is being practiced. I did not name the hospital out of respect, but I’ll be sending them a copy of this break up letter, and also releasing it as a mini-episode on my podcast, Dr. Patient.

Guest(s): none

Key Terms: none

References: none

Date: 4/23/24
Name of podcast: Dr. Patient
Episode title and number: 16 Race and Healthcare: Teaching Med Students

Episode summary: Episode 3 of 3 of a miniseries on racial disparities in healthcare. We've heard from Linda Villarosa on how we got to where we are today and what some of the harsh realities of health disparities are, from Michael Tyler on a real life story of how his race actually impacted his care. Today we're pivoting towards solutions as I speak with Dr. Patricia Poitevien, Associate Dean at Brown University's medical school on how to teach this stuff to the next generation of physicians.

Guest(s): Dr. Patricia Poitevien, Senior Associate Dean of Diversity, Inclusion & Equity at Brown University's medical school. https://diversity.biomed.brown.edu/people/patricia-poitevien-md-msc-faap

Key Terms:
[22:57] MCAT - Medical College Admission Test; the test that college students take to be able to apply for medical school
[22:58] STEP - the examination that medical students take close to the end of school to be able to apply for residency training
[32:48] FTE - full time equivalent - 1.0 means a full time job

References:
none

Date: 4/16/24
Name of podcast: Dr. Patient
Episode title and number: 15 Race and Healthcare: One Man's Story

Episode summary: Last week we heard from Linda Villarosa on the impact slavery still has on our modern healthcare system and how it leads to racial health disparities in the US. Today we’ll hear from Michael Tyler, children’s author, about his specific experience with race impacting his care.

Guest(s): Michael Tyler, children's author: www.michaeltylerwrites.com

Key Terms:
[00:36] – link to something about how all old studies were on white men
[07:02] PSA – prostate specific antigen, a blood-based screening tool for prostate cancer
[08:30] BPH – Benign Prostate Hypertrophy, a condition where the prostate enlarges and causes urinary symptoms. Annoying, but generally not dangerous
[08:38] Biomarkers - https://www.health.harvard.edu/mens-health/biomarkers-for-better-prostate-cancer-screening#:~:text=Biomarkers%20are%20%22chemicals%22%20that%20can,and%20potentially%20catch%20it%20early
[10:35] “Broke the seal” and Prostatectomy – a tumor has “broken the seal” of the prostate when it grows outside of the actual prostate wall. A prostatectomy is the partial or complete removal of the prostate
[19:35] “Prostate cancer gene” – some cases of prostate cancer are caused by genetics. There are some genes that can be inherited (sort of like the BRCA breast cancer genes for women. Men with variants in these genes have a high risk of developing prostate cancer and, in some cases, other cancers during their lifetimes

References:
2014 Study about the difference in location of prostate biopsies depending on race: “Pathological examination of Radical Prostatectomy Specimens in Men with Very Low Risk Disease at Biopsy Reveals Distinct Zonal Distribution of Cancer in Black American Men”: https://www.auajournals.org/doi/abs/10.1016/j.juro.2013.06.021

Date: 4/9/24
Name of podcast: Dr. Patient
Episode title and number: 14 Race and Healthcare: Historical Roots
Episode summary: Many of the health inequities that we see in healthcare today stem from beliefs held in the time of slavery that have led to "myths" about black bodies and black health. Compounded by historical policy making related to socioeconomics, red lining, civil rights and more, people of color in the US are still facing inequity in healthcare today, from access to treatment to outcomes. Linda Villarosa is an author on race and health in America, professor and journalist in residence at The City College of New York, contributing writer to the NY Times and a contributor to the 1619 project.

Guest(s): Linda Villarosa

Key Terms:
11:12 – Drapetomania
11:32 – Spirometer
23:04 – Momnibus bill

References:
03:29 – Black women in the US have a higher death rate in pregnancy than white women with the same socioeconomic status
03:39 – Big review article showing how black patients receive pain meds less often
03:45 – Study from University of Virginia 2016 medical students beliefs about black body myths
04:04 – Race correction on PFTs (pulmonary function tests)
05:51 – A black woman with a PhD is more likely to die in childbirth than a white woman with a high school degree
07:51 – The history of Dr. J Marion Sims
09:23 – Statue of Dr. J Marion Sims taken down in NYC
09:39 – Anarcha, Lucy, and Betsey (The Mothers of Gynecology) art installation in Montgomery, AL
09:47 – Say Anarcha book
10:20 – Dr. Cartwright
12:32 – (Lack of) science behind the spirometer race correction
15:07 – Weathering book
21:23 – CA maternal death rates
23:41 – Dr. Mary Bassett, NY Health Commissioner, requires anti-bias training
26:03 – “Lightly Black and Green” movement at HBCUs

Date: 4/2/24
Name of podcast: Dr. Patient
Episode title and number: 13 Claim Craziness Pt 1

Episode summary: Have you ever spent hours, days or weeks trying to get money back from a health insurance claim? If you have, this episode will let you know that you're not alone. If you haven't, this will give you some insight into the process. This week's episode is just me, letting you in on an insane claim fiasco that I'm going through with my health insurance company. The claim is for about $108, and at another time in my life I might just give up on trying to get that money back because of all of the roadblocks my insurance company is putting up. But for your sake (and mine), I'm not giving up. Join me for some Claim Craziness part 1.

Guest(s): none

Key Terms: none

References: none

Date: 3/25/24
Name of podcast: Dr. Patient
Episode title and number: 12 Bosom Buddies

Episode summary:
Today's episode is a fly-on-the-wall perspective for you of how friends talk about cancer. A couple of my friends and I all had cancer within a couple of years of each other, and this is a full-length, unedited conversation that we had about it last year. Warning there's some foul language and tough discussions.

Guest(s): Laura and Melissa

Key Terms:
portacath [15:04] - a device that is placed under the skin, usually on the right side of the chest, with a tube that goes deeper into a blood vessel. Medications and IV fluids can be given through it
medical oncologist [multiple times] - a doctor that specializes in the chemical treatment of cancers, primary chemotherapy
surgical oncologist [multiple times] - a doctor that specializes in performing surgical removals of cancers
ecchymosis [29:36] - this is the medical term for a bruise

References:
none for this episode