Conversations on Health: How We Get There - with Stephani Shelton

Stephani Shelton
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Conversations On Health: How We Get There - with Stephani Shelton is a podcast series about health care, health care systems and the connections we need to make them better. Each podcast will explore a different aspect of health or health care. Or a different country’s health care system as it compares to ours in the US. As a veteran reporter - I want to know why so many Americans still don’t have access to the comprehensive health care so normal in other advanced countries? How are health systems dealing with higher costs and changing demographics? And if, after the disastrous response to COVID 19, the US and other nations are now prepared for another major public health crisis.

  1. Jun 16

    Episode 45: A Conversation with Dr. Racquel Moore, VP, Optum on the US Health System’s Speedy Integration of AI

    I think most of us know that AI is rapidly changing the meaning of that now rather old fashioned-sounding phrase – “I’m going to the doctor’s”. If you go for a scan of some kind – AI’s now involved. Same with making appointments or the patient portals that almost all of us use now – willingly or not. If the AI is well integrated and works well – it saves time. If it isn’t – and that’s too often the case at the moment – we hate it. But the speed that some version of an AI is moving into all aspects of American health care is accelerating and it appears there’s no stopping it. And indeed – if AI is improving your healthcare – why would you want to stop it?  So – is it? In Episode 43 we learned what a well-integrated AI can do in an advanced, well organized healthcare system. As they have in Israel. And Israel is already far ahead of the US in using AI to improve direct patient care. In our own, more fragmented, more competitive, mostly for-profit system – the deployment is primarily in the largest hospital, imaging and doctor groups and in the big insurance companies. So in this episode we’re talking to someone who’s at the helm of AI rollout at Optum – the huge, health services and technology arm of United Health. Dr. Racquel Moore is Vice President of EHR Strategy, Governance, and Special Projects at Optum. EHR, which I had to look up too, stands for “electronic health record”. It has broadly replaced most paper records. At Optum – Dr. Moore leads enterprise AI and digital strategy across a large, multi-platform healthcare network. Her work focuses on how AI tools are evaluated, implemented, and responsibly scaled to improve provider efficiency and reduce administrative burden, while maintaining strong clinical and governance oversight. With a background that spans frontline clinical work, quality and compliance, and enterprise strategy, she brings both a practical and strategic perspective to the evolving role of AI in healthcare. So that ultimately – both providers and patients should benefit. As always in these informal conversations – we used first names. YouTube Episode Link: YouTube Channel Link: @conversationsonhealthhowwe482

    44 min

  2. May 19

    Episode 44: An Update on Menopause from Dr. Michelle P. Warren, Endocrinologist, Gynecologist. Medical Director, Center for Menopause, Hormonal Disorders & Women’s Health NYC

    It’s been a while since we did the episode on women’s health. You can tell by the number – Episode 29.  Since then quite a bit has changed about the management and treatment of menopause. (no – sorry – there is still no way to make menopause disappear). But. I do think it’s time for an update. There have been many new drugs approved for menopause symptoms. And after new studies, Hormone Replacement Therapy (HRT) is again being prescribed – often in the form of a simple patch. Dr. Michelle P. Warren kindly agreed to come back to talk about all this. She’s a distinguished New York City physician who specializes in both endocrinology and gynecology and has spent her lifetime focused on women’s health issues. In 1997 Dr. Warren founded and remains the medical director of the Center for Menopause, Hormonal Disorders and Women’s Health at Columbia University Medical Center.  Where she is the Wyeth Professor Emeritus of Obstetrics, Gynecology and Medicine. Full disclosure - I have been her patient for many years. http://www.center-for-menopause.com/ https://menopause.org/ YouTube Episode Link: https://youtu.be/fF6tVLJVuIQ YouTube Channel Link: @conversationsonhealthhowwe482

    31 min

  3. Apr 21

    Episode 43: A Conversation with Dr. Ran Balicer, Physician, Scientist, Executive and Israel’s Leading Healthcare Innovator

    We all know how fast AI models are moving in almost every industry. Healthcare is no exception. But here in the US – you’re more apt to notice the difference in small ways. How quickly your blood tests are posted in your patient portal or sent to your doctor. In Radiology. For example my last mammogram was AI-read and the results were available to me and my gynecologist less than 2 hours after I walked out of the imaging room. In most hospitals AI now identifies patients at high risk of being hospitalized again soon after release. And of course AI has been at work in insurance and other administrative functions for some time as well as in tasks like remote monitoring. But what if I were to tell you that AI embedded in a primary care system could look at a patient’s blood tests and before they even get to the doctor – recommend that patient’s diabetic medications be changed because there are very early signs of kidney function failure? It’s really quite amazing and yet quite normal in Israel’s universal healthcare system. As my guest, Dr. Ran Balicer, will explain. He’s a physician, scientist and executive who’s the Chief Innovation Officer at Clalit – Israel’s largest healthcare organization. He also works with the Clalit Research Institute, the World Health Organization and other organizations and universities in Israel and beyond, planning, developing and implementing novel AI solutions in healthcare. And also -  quite amazing to me on the other side of the world – we Zoomed just a few days after Isreal and the US attacked Iran – with Ran in a safe and quiet place where he works. We start with a quick overview of the Israeli health system so you’ll understand why Clalit was able to adopt AI so quickly. YouTube Episode Link: https://youtu.be/xIZ_yt4qiAE YouTube Channel Link: @conversationsonhealthhowwe482

    46 min

  4. Mar 17

    Episode 42: A Conversation with Dr. Karen Hacker, Emory University Adjunct Professor and former CDC Director for Chronic Disease Prevention and Health Promotion

    Under Robert F. Kennedy Jr.’s stewardship – the  CDC – once the premier health and health data organization in the world - continues to shed scientists, physicians, researchers – and internationally respected leaders. As i record this in early March – the CDC still doesn’t have a Presidentially nominated and Senate confirmed Director. And although much of the agency’s basic public health information and professionally recognized studies remain available on the CDC website – much is also gone. Among the missing at the CDC is my guest on this episode - Dr. Karen Hacker. Who headed the National Center for Chronic Disease Prevention and Health Promotion. Remember – the main purpose of both federal and state health agencies is implementing and overseeing ways of improving the health of all Americans. Thus the term “public health”. Remember  - that in terms of outcomes for money spent – the US continues to have the lowest life expectancy and the highest rates of preventable mortality among high income nations. And that’s despite spending nearly twice as much on healthcare. One major but very complicated goal is ending or at least drastically cutting chronic disease. Diabetes brought on by obesity is one example. Lung cancer or COPD as a result of cigarette smoking is another. So as I said – we are all very fortunate that Dr. Karen Hacker – with all her experience – is here for this conversation. Dr. Hacker – who has both an MD and MPH - is an Adjunct Professor and Health Policy Fellow at Emory University in the Rollins School of Public health. She is the former Director of the National Center for Chronic Disease Prevention and Health Promotion at the CDC (2019 to 2025) where she oversaw a budget of $1.4b and a staff of 1000. Dr. Hacker has over two decades of leadership experience in the public sector serving at the city, county and federal levels. Her expertise spans public health, policy, healthcare, and research.  Prior to the CDC, she was the Director of the Allegheny County Health Department in Pennsylvania. Dr. Hacker uniquely bridges critical community needs with national health policy and is recognized for her practical, solutions-focused approach to complex challenges. She is also widely published with over 100 peer-reviewed articles and an expert in community-based participatory research. Dr. Hacker has a Bachelor of Arts (BA) from Yale University, a medical degree (MD) from Northwestern University School of Medicine, and a Master of Public Health (MPH) from the Boston University School of Public Health. And as usual, we use first names in this informal “conversation”.  YouTube Episode Link: YouTube Channel Link: @conversationsonhealthhowwe4827

    56 min

  5. Feb 17

    Episode 41: A Conversation with Registered Dietitian Nutritionist Stephanie Hodges on RFK Jr.’s New USDA Food Guidelines

    Early in the new year – January 7th to be exact – Robert F. Kennedy Jr., the head of Health and Human Services, quietly posted a new set of food guidelines on the USDA website and an upside-down (or inverted as he called it) Food Pyramid. Replacing the “My Plate” pictograph of the Biden years. The guidelines themselves are updated every 5 years - and at a quickly organized White House news conference, RFK Jr. promoted the changes. Which push lots of red meat, whole milk and butter. He said, “We are endng the war on saturated fats.” The guidelines also include beef tallow as an alternate to olive oil or butter for cooking. And feature the MAHA mantra of ignoring highly processed foods. That part medical associations applauded, even as the American Heart Association warned again about the risks of eating a lot of high fat animal products. Very healthy whole grains are at the very bottom of the upside-down Pyramid; they had been featured, along with fruit and vegetables, on the previous “My Plate” guidelines. The Food Guidelines are important to a number of government food programs – and to dietitians. Many of us remember learning about the older Food Pyramids in grammar school.  My Boston school served a hot lunch but most of us brought our own sandwiches and washed them down with the free cartons of milk delivered daily to all city schools and - yes, it was 8 ounces of whole milk.   So. I went looking for a Registered Dietitian who could explain what’s good or bad or just different about RFK Jr.’s 2026 Inverted Pyramid. And I found one of the best. Stephanie Hodges has MS, MPH and RDN degrees. She’s a Registered Dietitian and food policy expert who has spent more than a decade improving access to healthy food through public health nutrition programs and policy. She’s the founder of “The Nourished Principles” which supports clients in strengthening public health nutrition programs and policies, writing and implementing grants, and translating complex nutrition topics for diverse audiences. Here’s a link to her website . She’s really good at this! YouTube Episode Link: https://youtu.be/BwDozyX5ffI YouTube Channel Link: @conversationsonhealthhowwe4827

    44 min

  6. Jan 20

    Episode 40: A Conversation with Former CDC Official Daniel Jernigan, MD, MPH On Vaccines, Infectious Diseases and RFK Jr.’s CDC

    Donald Trump has changed America in many ways since his second term began a year ago.  But perhaps in none so personally important as our overall health and health care. On February 25th 2025 the Senate confirmed Robert F. Kennedy Jr. as Secretary of Health and Human Services. Nearly a year later he has managed to dismantle or re-direct much of it. Among the multitude of public health agencies administered by H-H-S, the one where we’ve seen perhaps the biggest changes is the Centers for Disease Control and Prevention – or as we usually call it – the CDC. Many experienced scientists and other employees have resigned or been let go. Many research grants to universities or non-profits - cancelled or cut back. And many long-term health policies have been changed. RFK Jr. has tried to promote a long debunked link between childhood vaccines and autism, and between Tylenol during pregnancy and autism. This last was definitively shot down this month by a retrospective study in the prestigious women’s health journal - Lancet. A meta-analysis of 60 studies found no association between Tylenol when taken as recommended and autism - as well as with intellectual disability or ADHD. The other big area attacked by RFK Jr. and his appointees has been vaccines. For both adults and children. Routine recommendations have been removed from the CDC website and the members of the Advisory Committee on Immunization fired and replaced with RFK Jr’s choices. Including a number of vaccine skeptics. Perhaps the most controversial change, posted in early January, is the Childhood Vaccine Schedule – reducing the number of routine vaccines from 17 diseases to 11. After much discussion - measles remained on the list – as a measles outbreak raged in South Carolina, doubling in just a week and spreading to at least 3 other states. The outbreak mostly among unvaccinated kids. In late August a  group of CDC senior officials and scientists resigned - after CDC Director Dr. Susan Monarez was fired. She refused to implement RFK Jr’s vaccine policy changes. And among those who walked away from their long-term CDC careers is my guest on this episode – Daniel Jernigan MD, MPH. Dr. Jernigan is a nationally recognized public health leader with more than 30 years at the CDC. Most recently he directed the National Center for Emerging and Zoonotic Infectious Diseases and the Influenza Division. He has led responses to major health crises including anthrax, SARS, H1N1, Ebola, MERS, and COVID-19. He’s authored over 160 scientific publications and is a recipient of the Service to America Medal. Dr. Jernigan is a graduate of Duke University, Baylor College of Medicine, and the University of Texas School of Public Health and has completed residencies in Internal Medicine and Preventive Medicine. Our conversation clarified a lot of now “murky” health issues. YouTube Episode Link: https://youtu.be/3RtVJOq7K7I YouTube Channel Link:  @conversationsonhealthhowwe4827

    52 min

  7. Jan 13

    Episode 40 Promo for A Conversation with Dr. Daniel Jernigan on Health in the Age of RFK Jr.’s CDC

    What will happen in the US if cases of a now contained virus – or a totally new one -  suddenly start multiplying by the millions? The CDC has drastically cut back on vaccine research as well as childhood vaccine recommendations. What diseases may come roaring back? Episode 40 drops on Tuesday January 20th with some answers from Daniel Jernigan, MD, MPH - one of the former top officials at the CDC. Links to the major podcast platforms and show notes on https://stephanishelton.com/conversations Video link https://youtube.com/shorts/lHunlffqTRg

    2 min

  8. 12/16/2025

    Episode A-40: A Conversation Between Me and You

    It’s not exactly an episode – thus the A-40 label. It’s just me talking to you for a few minutes.  We had some last minute cancellations – which of course can happen as the holidays as well as the end of the business and financial year approach.  The historically long US government shut down also took its toll. On virtually everything. So -- we will resume the usual episodes on the third Tuesday of January – the 20th to be precise - with Episode 40. Please check the podcast page on my website for guest and subject info; it will be there as soon as I know it – stephanishelton.com/conversations.  And while you’re there you may want to review the notes on Episode 37 and then the podcast itself  - the Emergency Update on Autism. You’ll get the actual scientific facts about autism – which Trump appointee and vaccine skeptic Robert F. Kennedy Jr. Is now trying irresponsibly to link to the one drug pregnant women can take to reduce dangerously high fevers – Tylenol. There’s an earlier and more detailed podcast on autism as well – Episode 34 – both with autism expert Amy Wetherby of Florida State University. One of the subjects I hope to discuss during the coming year is what’s happened to the CDC and the FDA under RFK Jr. And the whole, once highly respected, scientifically factual, federal public health data base. And the government grant money which would normally be going to areas like cancer research and the virtually miracle-like mRNA base for everything from individualized cancer treatments to new vaccines for potential pandemics. Remember – smallpox was eradicated globally thanks to vaccines. And in the US the routine vaccination of children had virtually wiped out measles, polio and many other diseases. Now measles is coming back big time here. It’s a dangerous disease which can and is killing babies, children and even unvaccinated adults. And don’t forget Covid. It still makes a lot of people really sick and still kills a surprising number of them – and not just the very old and ill. Lots of people live their whole life in what we might call fragile health. Vulnerable to many diseases because their immune systems are suppressed by their diseases or by the drugs they take to control those diseases. I could go on a total rant about what RFK Jr. has done to the credibility of any US government report on any disease and what he and the unscientific people he’s appointed to key positions at the CDC and FDA are doing to the overall health and potential health outcomes of the American people. But I’ll leave that for the guests I hope to have in 2026 discussing this situation and where it’s taking us. I don’t think a lot of people actually understand science. It’s not immutable, not unchangeable. It is called science precisely because as researchers and scientists keep testing what they know, they often learn something new which modifies specifics about a disease or a treatment or a procedure. And so what health professionals use as their guidelines often get rewritten by new discoveries. Which, i think, lots of us find confusing. And when you’re confused you tend to stop believing. In anything. Of course none of us knows what 2026 will bring. Sadly it’s a pretty sure bet that many people on Obamacare health insurance now won’t be able to afford it after January first – unless there’s a small miracle in the few days left before Congress goes home for its holiday break. On the podcast – I hope to discuss that along with subjects like how venture capital contributes to drug, device and treatment breakthroughs. The extension of the 9-11 Fund for First Responders. And likely some personal stories which a lot of us can identify with. And in small, understandable chunks – i want to discuss more about how all health systems – hybrid like ours or totally government controlled like the rest of the world – will have to change in order to pay for expensive new treatments and the social care that virtually every health system seems to put on the back burner. I want to thank all of you who have subscribed to this podcast and especially those who have stayed with me over these 3 years. Please tell your friends and colleagues about us. And if you have suggestions for episodes – please let me know. May 2026 bring you and yours health and happiness and the courage to follow your dreams. YouTube video link:  https://youtu.be/UlTpOZzAMfw

    6 min
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Conversations On Health: How We Get There - with Stephani Shelton is a podcast series about health care, health care systems and the connections we need to make them better. Each podcast will explore a different aspect of health or health care. Or a different country’s health care system as it compares to ours in the US. As a veteran reporter - I want to know why so many Americans still don’t have access to the comprehensive health care so normal in other advanced countries? How are health systems dealing with higher costs and changing demographics? And if, after the disastrous response to COVID 19, the US and other nations are now prepared for another major public health crisis.

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