148 episodes

This is a show for all those who love medicine but have grown weary of this vast boondoggle called the health care system. We produce an episode once a week and we regularly bring in guests that we put on the hot seat. We discuss current topics in medical science, policy, economics, and ethics, always with an eye toward safeguarding the doctor-patient relationship. We bring fresh, provocative insights that resonate with physicians in the trenches who are determined not to let their passion for medicine be ground to a pulp.

The Accad and Koka Report Michel Accad and Anish Koka

    • Medicine
    • 5.0 • 53 Ratings

This is a show for all those who love medicine but have grown weary of this vast boondoggle called the health care system. We produce an episode once a week and we regularly bring in guests that we put on the hot seat. We discuss current topics in medical science, policy, economics, and ethics, always with an eye toward safeguarding the doctor-patient relationship. We bring fresh, provocative insights that resonate with physicians in the trenches who are determined not to let their passion for medicine be ground to a pulp.

    Ep. 146

    Ep. 146

    Our guests are Doyen Nguyen, OP, MD, STD and D. Alan Shewmon, MD. They join us to discuss troubling development on the legal treatment of brain death.
    Dr. Nguyen was previously an academic hematopathologist and is currently a Catholic moral theologian and bioethicist. She has authored books and articles both in medicine and in moral theology/bioethics and authored a 600-page monograph that takes a critical look at brain death from a variety of perspectives.
    Dr. Shewmon is Professor Emeritus of Pediatric Neurology at UCLA. His work, comprising decades of well-documented clinical observations and reflections, is now known as “Shewmon’s challenge,” a compelling rebuke to the principal arguments put forth to defend the concept of brain death.
    LINKS:
    Shewmon DA. "Chronic “brain death”: Meta-analysis and conceptual consequences. (https://www.ncbi.nlm.nih.gov/pubmed/9855499)" (in Neurology, 1998)
    Lewis A, et al. "Determination of Death by Neurologic Criteria in the United States: The Case for Revising the Uniform Determination of Death Act (https://journals.sagepub.com/doi/abs/10.1177/1073110519898039)" (in J. of Law, Medicine, and Ethics, 2019)
    President's Commission for the Study of Ethical Problems in Medicine, Biomedical and Behaviora Research. "Defining Death (https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1&isAllowed=y)" (1981)
    Nguyen D. (https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1&isAllowed=y). (2018, Amazon link)
    Nguyen, D. "Does the Uniform Determination of Death Act Need to Be Revised? (https://journals.sagepub.com/doi/abs/10.1177/0024363920926018)" (2020, Linacre)
    RELATED EPISODES:
    Ep. 35 Why Brain Death Isn't Death: An Introduction to "Shewmon's Challenge (https://accadandkoka.com/episodes/episode35/)" (with guest Alan Shewmon, MD)
    Ep. 45 Brain Death at the Bedside (https://accadandkoka.com/episodes/episode45/) (with guest Fred Rincon, MD)
    WATCH ON YOUTUBE:
    Watch the episode (https://www.youtube.com/watch?v=9TldPDbLYGA&feature=youtu.be) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page on and join our discussion group or receive a free book.

    • 1 hr
    Ep. 145 Damian Carabello on Surprise Billing

    Ep. 145 Damian Carabello on Surprise Billing

    Dr. Damian Carabello discusses the depths insurance companies go to make sure they end up on top.
    GUEST:
    Damian Carabello, MD: Twitter (https://twitter.com/813jaferd?lang=en)
    LINKS:
    Anish Koka long read (https://thehealthcareblog.com/blog/2019/11/26/guerilla-billing-missing-the-gorilla-in-the-midst/) on surprise billing
    Damian Carabello "Let's end surprise billing without a Trojan horse" blog (https://www.kevinmd.com/blog/2019/09/lets-end-surprise-billing-without-a-trojan-horse.html)on KevinMD about the problems with benchmarking.
    Twitter thread (https://twitter.com/813JAFERD/status/1266153650856038400?s=20) on the history of Ingenix
    Andy Slavitt's involvement (https://dailycaller.com/2015/08/02/obamas-top-healthcare-nominee-was-once-embroiled-in-medical-fraud-case/) with health insurance fraud case
    WATCH ON YOUTUBE:
    Watch the episode (https://youtu.be/jujUiF7agOo) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page on and join our discussion group or receive a free book.

    • 1 hr
    Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn't Mix

    Ep. 144 John Mandrola: Why Doctoring and Politics Shouldn't Mix

    Dr. John Mandrola returns to the show to discuss why doctoring and politics shouldn't mix and how he got into hot water on Twitter for holding that unacceptable view.
    Dr. Mandrola is an electrophysiologist in Louisville, Kentucky. He is is cardiology editor on Medscape where he writes a regular column and produces a weekly podcast.
    GUEST:
    John Mandrola, MD: Website (https://drjohnm.org/)
    LINKS:
    John Mandrola: "Doctoring and Activism (https://www.drjohnm.org/2020/08/doctoring-and-activism/)"
    Sally Satel: "The Hypocritical Oath (https://www.persuasion.community/p/the-hypocritical-oath?token=eyJ1c2VyX2lkIjoyNzI0OTg2LCJwb3N0X2lkIjo4NzcwMTgsIl8iOiJ6NjN2aCIsImlhdCI6MTU5ODE4MTM1NywiZXhwIjoxNTk4MTg0OTU3LCJpc3MiOiJwdWItNjE1NzkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.S2QxImMkLvPWbDFVuywoO8r6RfFy7wjqkdi9eKCQ09o)"
    Mandrola et al: The Case for Being a Medical Conservative (https://www.amjmed.com/article/S0002-9343(19)30167-6/fulltext) (in the American Journal of Medicine)
    PREVIOUS GUEST APPEARANCES:
    Ep. 12 John Mandrola: The Case for "Less-Is-More" (https://accadandkoka.com/episodes/episode12/)
    Ep. 107 Independent Nurse Practitioners: Public Health Threat or Libertarian Step Forward? (https://accadandkoka.com/episodes/episode107/)
    WATCH ON YOUTUBE:
    Watch the episode (https://youtu.be/d31S2fMBYMI) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page on and join our discussion group or receive a free book.

    • 57 min
    Ep. 143 Adam Mortara on Litigating Affirmative Action

    Ep. 143 Adam Mortara on Litigating Affirmative Action

    Our guest is Adam Mortara, lead trial counsel in the case of (https://en.wikipedia.org/wiki/Students_for_Fair_Admissions_v._Harvard) We discuss the legal aspects of affirmative action in light of the paper by Dr. Norman Wang which set off a storm of controversy in academic medicine.
    GUEST:
    Adam Mortara, JD: Professional page (https://www.bartlit-beck.com/lawyers-AdamMortara)
    LINK:
    Norman Wang's paper: Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America from 1969 to 2019. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428635/pdf/JAH3-9-e015959.pdf)
    WATCH ON YOUTUBE:
    Watch the episode (https://youtu.be/xuausAuWlEo) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page and join our discussion group or receive a free book.

    • 1 hr 28 min
    Ep. 142 Robert Yeh on Harnessing Real World Evidence

    Ep. 142 Robert Yeh on Harnessing Real World Evidence

    Our guest is Robert Yeh, Associate Professor of Medicine at Harvard Medical School and Director of the Smith Center for Outcomes Research in Cardiology at the Beth Israel Deaconess Medical Center in Boston. We discuss the challenges of outcomes research and his excellent work to improve the reliability of observational studies
    GUEST:
    Robert W. Yeh, MD: professional web page (https://connects.catalyst.harvard.edu/Profiles/display/Person/30625)
    LINKS:
    Strom JB, et al. Use of Administrative Claims Data to Assess Outcomes and Treatment Effects in Randomized Trials of Transcatheter Aortic Valve Replacement (in (https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.046159))
    Faridi KM, et al. Use of Administrative Claims Data to Estimate Treatment Effects for 30 days versus 12 months of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention (in (https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.047729))
    Konstam M. Real World Data as trial End Points: Off and Running with a Long Way to Go (editorial in (https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.048019))
    PREVIOUS GUEST APPEARANCE:
    Ep. 19 Public Reporting: Necessary Evil or Harmful Fake News? (https://accadandkoka.com/episodes/episode19/)
    WATCH ON YOUTUBE:
    Watch the episode (https://youtu.be/2YvPg6_DTRo) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page on and join our discussion group or receive a free book.

    • 57 min
    Ep. 141 Amy Wax on Wokeness in Medicine

    Ep. 141 Amy Wax on Wokeness in Medicine

    Our guest is Amy Wax, Robert Mundheim Professor of Law at the University of Pennsylvania Law School. Before attending law school she obtained her undergraduate degree from Yale University in biophysics and biochemistry, graduating summa cum laude. She then attended Harvard Medical School and trained as a neurologist at New York Hospital - Cornell Medical Center before completing her law degree at Columbia University. She is the author of (https://www.amazon.com/gp/product/B004EHZYVA/) In 2017, she was the target of academic backlash after co-authoring an opinion piece in the Philadelphia Inquirer on the societal benefits of "bourgeois values."
    GUEST:
    Amy Wax: Wikipedia entry (https://en.wikipedia.org/wiki/Amy_Wax)
    WATCH ON YOUTUBE:
    Watch the episode (https://youtu.be/jZnbDhrw_DI) on our YouTube channel
    SUPPORT THE SHOW:
    Make a small donation (https://www.patreon.com/accadandkoka) on our Patreon page on and join our discussion group or receive a free book.

    • 1 hr 13 min

Customer Reviews

5.0 out of 5
53 Ratings

53 Ratings

Nicolechamp ,

As an ER nurse ....

A MUST LISTEN!

practicaldoc ,

Breath of fresh air

Outstanding guests, informed hosts. Tackle very important questions at the micro and macro crossroads where medicine meets society. I learn a lot.

Dch112 ,

Great insights on our healthcare system

Anybody who wants to learn about what is truly ailing our healthcare system needs to listen to this podcast. Michel and Anish do a great job showing what is jeopardizing the patient physician relationship. Entertaining and informative!

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