The Doctors’ Lounge

The Doctor's Lounge
  • 4.9 (54)
  • Entrepreneurship

Where scalpels meet systems — and physicians say what they really think. Co-hosted by Anish Koka, MD & Anthony DiGiorgio, DO. Candid talks on healthcare policy, reform, physician autonomy & patient care.

  1. 6d ago

    Inside a $207 Million Verdict: What Every Physician Should Know About Malpractice Trials

    Send us Fan Mail Episode Summary In a special Tuesday episode, Anish Koka and Anthony DiGiorgio sit down with Heather Tereshko, a Principal at Post & Schell in Philadelphia and a 25-year veteran of medical malpractice defense, to break down the largest medical malpractice verdict in Pennsylvania history — a $207 million judgment against the University of Pennsylvania stemming from a delayed C-section and resulting anoxic brain injury. Using the case as a launching pad, the three walk through how verdict slips are constructed, why Pennsylvania's "increased risk of harm" standard makes cases easier for plaintiffs to win, how EMR documentation gets weaponized against physicians on the stand, how life-care-plan and non-economic damages get inflated (including "anchoring" tactics like invoking Jalen Hurts's salary), and why juries so often disregard clinical guidelines in favor of narrative and sympathy. The conversation closes with a practical, if sobering, discussion of what physicians could realistically lobby for — tighter expert witness standards, damage caps, and organized legislative pressure — and why none of it is coming easily. Chapter Markers 00:19 Special Tuesday episode and guest introduction: Heather Tereshko 03:22 Heather's background in malpractice defense 05:40 The $207M Penn verdict: how the case started 09:20 Why this is a typical "bad baby" case 11:49 EMR drop-downs and documentation gaps at the center of the case 14:45 The cord blood dispute and the mechanism-of-injury fight 16:01 Judge excludes key testimony on the blood draw 18:33 Inside the verdict slip: factual cause vs. increased risk of harm 25:50 Why "increased risk of harm" doesn't fit this case 27:20 The "team theory" of liability and how the verdict sheet was structured 31:39 Breaking down the $207M damages award 33:06 The life expectancy fight: 29 years vs. 70 years 36:20 Anchoring tactics and the Jalen Hurts salary comparison 39:21 How contingency fees work in Pennsylvania 42:04 "There's no winning": defensive medicine and no-win scenarios 45:14 When health system interests diverge from the individual physician's 46:25 Downstream effects: why community hospitals drop OB services 47:39 No-fault alternatives: New Zealand and Florida's birth injury fund 51:57 Expert witness accountability — or the lack of it 55:58 Venue selection and how it reshaped Philadelphia verdicts 59:04 Damage caps and why economic damages remain unbounded 1:01:54 What physicians can realistically lobby for 1:06:06 Closing thoughts Substack References (Dr. Anish Koka) Referenced during the episode — Anish's Substack posts on the Pennsylvania medical malpractice market and on the Penn ($207M) verdict: PA malpractice market / NAIC data post: https://anishkokamd.substack.com/p/pennsylvania-had-a-functioning-medical Penn verdict case breakdown post: https://anishkokamd.substack.com/p/twelve-people-three-hours-a-207-million Co-Host Handles @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

  2. Aug 11

    Right-to-Try 2.0: Inside the Montana Model with Niklas Anzinger

    Send us Fan Mail Episode Summary Anish Koka and Anthony DiGiorgio sit down with Niklas Anzinger, a venture capitalist and founder of Infinita VC, to unpack Montana SB535 — a new law that lets doctors administer treatments to patients that have only cleared FDA phase one trials, through licensed "experimental treatment centers" overseen by independent review boards. The conversation covers why Eroom's Law has made drug development slower and more expensive despite scientific advances, how the Montana model differs from existing right-to-try and expanded access programs, the thorny question of who pays when a treatment sits outside FDA approval and insurance coverage, the risks of messy observational data replacing randomized controlled trials, and how Anzinger's work connects to special economic zones like Prospera in Honduras, where he's speaking to the hosts from. Chapter Markers 00:22 Introducing Niklas Anzinger and his path from economics and VC to biotech policy 03:05 Montana SB535 explained — right-to-try, but with a for-profit pathway 06:01 Phase 1 vs phase 2 vs phase 3, and why bypass the later stages 11:37 Does SB535 cover devices as well as drugs 14:15 The semaglutide timeline as a case study in regulatory delay 18:36 Federal right-to-try, the baby KJ case, and why it isn't enough 23:25 The payment problem — how a non-FDA-approved treatment actually gets paid for 33:11 What "smart regulation" would look like with carte blanche over the FDA 48:31 Why Montana's biggest need right now is clinicians, not biotechs 49:57 The practical burden on a private practice running these treatments 53:32 Observational data vs. randomized trials — the risk of junk data 59:15 Is this a domestic answer to China's faster phase one pathway 1:04:22 Roatan, Prospera, and the case for special economic zones in medicine 1:09:18 Closing thoughts and where to find Anzinger's Stranded Technologies podcast Co-Host Handles @anish_koka and @DrDiGiorgio Show Handle @DRsLoungePod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Mr. Niklas Anzinger on X:  @NiklasAnzinger Mr. Niklas Anzinger Podcast: Stranded Technologies podcast 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Right-to-Try 2.0: Inside the Montana Model with Niklas Anzinger

  3. Aug 1

    Dan Donoho on Surgical Data Science, Regulation, and the Humanoid OR

    Send us Fan Mail Episode SummaryAnthony DiGiorgio and Anish Koka sit down with Dr. Dan Donoho, an NIH-funded neurosurgeon-scientist at Children's National Hospital and George Washington University, and founder of the Surgical Data Science Collective and the Foundation for Digital Neurosurgery, for a wide-ranging conversation on AI in medicine. Donoho explains why surgeons get almost no structured feedback after a case, walks through a randomized controlled trial showing AI-coached medical students outperformed those coached by humans on simulated tumor resections, and argues that most regulatory "barriers" to deploying AI in healthcare are cultural rather than statutory. The conversation moves through the limits of tactile sensation in surgical AI, why he expects innovation to come from small agile practices rather than large insurance-pay hospitals, his family's data science lineage, humanoid robots performing laparoscopic surgery, the anti-data-center backlash, and ongoing surgical AI trials in Ethiopia and Tanzania. Chapter Markers00:16 Introduction and guest background 01:16 The Surgical Data Science Collective and the problem of lost surgical knowledge 03:26 How AI could replace the mentor's voice in a surgeon's head 06:50 Tactile feedback and the limits of video-based AI in surgery 08:47 The RCT: AI coaching vs. human coaching in medical students 11:48 What's the gold standard for grading surgical performance 14:42 Who validates the AI — the EKG problem and patient outcomes as the real judge 17:19 Humanoid robots, self-driving cars, and low-hanging AI fruit in clinics 20:27 Regulatory barriers to AI in EHRs — culture vs. statute 22:09 Doctronic, AI prescribing, and licensure 25:12 Where Dan's interest in data science started 26:39 His father, statistician David Donoho, and the rise of empiricism 28:09 The "don't go into medicine" narrative and why it's wrong 30:26 COVID as a case study in bureaucratic drag on technology adoption 33:27 Should the FDA regulate surgical AI products 35:50 Andromeda Surgical, humanoid robots in the OR, and the cost gap 38:27 The anti-data-center movement and the history of sabotage 39:54 Global AI competition and China's Kimi K3 model 42:41 How to measure whether an AI model is actually better 44:34 Model size vs. training — why prompting changes performance 45:46 What the surgical community currently measures, and why it's the wrong thing 47:23 The Tanzania surgical AI trial and other real-world deployments 49:03 What actually scares Dan about AI 51:21 Will AI democratize power or concentrate it 52:15 Closing questions — what's next, including the Ethiopia partnership Co-Host Handle @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Dr. Daniel Donoho Website & X Website: https://www.surgicalvideo.io/ X: https://x.com/ddonoho 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Dan Donoho on Surgical Data Science, Regulation, and the Humanoid OR

  4. Jul 31

    Dr. George Tolis on Physician Pay, Private Practice, and a Valve Gone Wrong

    Send us Fan Mail Episode Summary Cardiothoracic surgeon Dr. George Tolis, chief of cardiothoracic surgery in Boston, returns to The Doctors Lounge with hosts Dr. Anish Koka and Dr. Anthony DiGiorgio for a wide-ranging conversation that opens with the newly proposed 2027 Medicare physician fee schedule and the budget-neutrality rule dating back to 1989 that forces cuts to one specialty to fund raises to another. The conversation moves into why true independent private practice has effectively disappeared, how hospital systems control physician hiring, firing, and pay regardless of what Medicare reimburses, and how locum tenens pay and device pricing expose the arbitrariness of professional fees. The back half of the episode turns to a widely discussed case of a cardiac valve implanted upside down in a young patient, with Tolis walking through how tunnel vision and ECMO can mask a never event for days, why he holds the surgeon fully accountable while condemning the social media pile-on that followed, and how palliative care should never be initiated without physician involvement. The episode closes on innovation in cardiac surgery — minimally invasive and robotic mitral repair, the Ross procedure, bilateral mammary artery use, valve selection, and how thirty-day outcome metrics quietly discourage surgeons from doing what's best for patients long-term — along with a candid discussion of industry money and conflicts of interest in medicine. Chapter Markers 00:00 Welcome back, Dr. George Tolis 01:09 The proposed 2027 physician fee schedule 05:20 Budget neutrality since 1989 and the flat physician bucket 10:09 Tolis: physicians are compensated less, not necessarily paid less 16:41 Barriers to going private and the PSA model 21:03 The painful transition to an independent physician ecosystem 25:25 Locum tenens pay, valve pricing, and "it's all by design" 33:51 The case: a valve placed upside down 40:01 Tunnel vision, distraction, and 110% concentration in the OR 50:45 Palliative care involvement and the organ-harvesting narrative 55:50 Reader comments: minimally invasive mitral surgery pushback 1:03:02 Competition, capitalism, and information asymmetry in medicine 1:13:02 Bio AVR vs. mechanical valve in a 57-year-old 1:15:28 Bilateral mammary arteries and the 30-day outcomes problem 1:17:46 Prospective payment, DRGs, and device cost incentives 1:25:08 Industry relationships and physician disclosures 1:29:05 GLP-1s, honoraria, and what counts as conflict of interest Co-Host Handles @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Dr. George Tolis's Previous Appearance on The Doctor's Lounge Dr. Tolis first joined The Doctor's Lounge about two months ago. Watch that episode here: https://x.com/DRsLoungePod/status/2055619280855515141?s=20 Dr. George Tolis on X @georgetolisjr 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Dr. George Tolis on Physician Pay, Private Practice, and a Valve Gone Wrong

  5. Jul 16

    Cremieux on FDA Reform, Fake Data, and the Columbia Admissions Hack

    Send us Fan Mail Episode SummaryDrs. Anish Koka and Anthony DiGiorgio sit down with independent science writer Cremieux, the pseudonymous Substack author known for auditing primary data and calling out flawed research. The conversation ranges from FDA drug approval reform (Cremieux proposes a two-pathway system separating safety approval from insurer-facing efficacy approval), the divide between well-evidenced GLP-1s and unregulated peptides like BPC-157, and the HRT black-box warning controversy, to the Columbia and NYU admissions data leaks that made national news and implicated NYC mayor Zohran Mamdani. The back half digs into research methodology: why observational studies rarely replicate RCT findings, how Cremieux debunked a widely-cited Jonathan Haidt social media/cognition study, why the "administrator growth" chart doctors love to cite is likely exaggerated, and how publication bias correction methods work. Chapter Markers00:00 Introduction and guest background 02:00 Why the pseudonym "Cremieux" 03:11 How he got into primary data analysis and writing 04:46 FDA drug approval reform — a two-pathway proposal 05:57 The peptide market: GLP-1s vs. unproven peptides like BPC-157 09:39 Should drug authority come from the FDA or "bubble up" from trusted voices? 11:25 Regulatory capture and ideas for FDA reform 16:10 HRT, the black box warning, and communicating risk to patients 21:40 Decentralizing medical decision-making 22:45 DEI in medicine and the Columbia/NYU admissions data leak 34:28 Proving discrimination: causal inference standards for university admissions 36:42 Busting myths from observational studies with multiverse analysis 40:29 Debunking the Jonathan Haidt social media/cognition study 46:46 Does the US healthcare system explain lower life expectancy? 49:56 Is the administrator-to-physician growth chart accurate? 54:22 How publication bias correction methods work Co-Host Handles @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Mr. Jordan Lasker X Handle / Substack X handle: https://x.com/cremieuxrecueil Substack: https://substack.com/@cremieux 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Cremieux on FDA Reform, Fake Data, and the Columbia Admissions Hack

  6. Jul 11

    Scott Becker on Building Becker's Healthcare, Physician Supply, and Private Enterprise

    Send us Fan Mail Episode SummaryAnish Koka and Anthony DiGiorgio sit down with Scott Becker, founder of Becker's Healthcare and partner at McGuireWoods, on the business of medicine — his path from healthcare lawyer to media mogul, the real story behind physician supply shortages, why private enterprise (not government) is driving healthcare's real progress, and the debate over breaking up consolidated hospital systems. Chapter Markers00:00 Welcome and introducing Scott Becker 01:22 Origin story: building Becker's Healthcare 09:53 The "teach and entertain" media philosophy 14:57 Law school with Barack Obama 16:57 Physician supply and the ACA's coverage-without-supply gap 19:48 Healthcare inflation and third-party payment 24:41 Is there really a spine surgeon shortage? 37:10 Physician burnout, autonomy, and leaving clinical medicine 41:08 Reagan, Mamdani, and government vs. private healthcare 46:00 Pushing back: is "nothing we can do" a real answer? 48:30 340B reform, site-neutral payments, hospital margins 53:41 Lina Khan, Mark Cuban, and health system consolidation 57:18 Can private industry absorb hospital revenue losses? 1:04:47 Payers as the real customer, price transparency 1:06:16 Keeping Becker's Healthcare editorially independent 1:13:44 Closing thoughts and the new book Co-Host Handle @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Resource: Dr. Scott Becker Book:Building Great Businesses: Create Momentum, Overcome Setbacks, and Scale with Confidence — Scott Becker & Molly Gamble https://www.amazon.com/Building-Great-Businesses-Momentum-Confidence/dp/1637635400 Becker's Healthcare: https://www.beckershospitalreview.com/ Scott Becker on X: @becker_sbecker Becker's Healthcare Show Handle: @BeckersHR 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Scott Becker on Building Becker's Healthcare, Physician Supply, and Private Enterprise

  7. Jul 7

    Martin Shkreli on Drug Pricing, Prison, and the Fraud That Shook Pharma

    Send us Fan Mail Episode SummaryAnish Koka and Anthony DiGiorgio sit down with Martin Shkreli — the former hedge fund manager and pharma executive best known for the 2015 Daraprim price increase and his subsequent prison sentence — for a wide-ranging conversation on drug pricing, patent law, and the state of the pharmaceutical industry. Shkreli walks through his path from a teenage hedge fund intern to founding Retrophin and Turing Pharmaceuticals, defends orphan drug economics and the Orphan Drug Act's seven-year exclusivity window, and argues that patent terms haven't kept pace with the realities of modern drug development. The conversation turns to the Chemocentrics/Amgen scandal — in which trial data for a rare vasculitis drug was allegedly unblinded, manipulated, and relocked to manufacture statistical significance — which Shkreli calls one of the worst frauds in the history of medicine. The episode closes with discussion of the Sarepta/DMD approval controversy, the limits of randomized trials in surgery and rare disease, AI's parallels to neuroscience, and the state of media coverage of the FDA. Chapter Markers00:00 Intro and Martin Shkreli's backstory 02:40 Origin story: from hedge fund to founding drug companies 07:58 The Daraprim price increase and Shkreli's pricing philosophy 17:14 What it actually takes to bring a drug to market 35:25 The case for the pharmaceutical industry 38:00 The Orphan Drug Act and patent exclusivity 57:31 The Chemocentrics scandal: manipulated trial data at Amgen 1:22:09 Vinay Prasad, Sarepta, and the DMD approval fights 1:34:35 Neurosurgery, clinical trials, and the limits of RCTs 1:37:30 AI, neural networks, and the future of psychiatric drugs 1:40:40 Cardiovascular disease and LDL lowering 1:42:28 Media coverage of the FDA and closing thoughts Co-Host Handles @anish_koka and @drdigiorgio Show Handles @drsloungepod Subscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Martin Shkreli on Drug Pricing, Prison, and the Fraud That Shook Pharma

  8. Jul 6

    Do No Harm: Inside the Fight to Get Identity Politics Out of Medicine

    Send us Fan Mail Episode SummaryDr. Stanley Goldfarb — nephrologist, former Associate Dean for Curriculum at Penn's Perelman School of Medicine, and founder of Do No Harm — joins Drs. Koka and DiGiorgio to trace how medical education drifted from clinical science toward social activism. Goldfarb recounts the battles at Penn that led to his 2019 WSJ op-ed, the professional fallout that followed, and why he built Do No Harm into a 54,000-member organization with an active litigation strategy. The conversation covers DEI in admissions, implicit bias training, gender-affirming care in minors, nonprofit hospital tax exemption, and what it actually takes to change entrenched institutions through legislation and the courts. Chapter Markers00:00 Introduction — Dr. Stanley Goldfarb 01:37 The 2019 Wall Street Journal op-ed 12:57 The tweet that ended his relationship with Penn and UpToDate 17:04 What 550 FOIA requests revealed about who's driving DEI in academia 21:01 Is there a case for modernizing the medical curriculum? 27:29 How students gained control of the agenda 32:10 How admissions committees began selecting for activists 36:34 The two missions of Do No Harm 47:18 Nonprofit hospital tax exemption and ideological spending 53:44 The constitutional framework 1:07:19 Do demographic quotas ever make sense? 1:09:31 Closing — how to get involved with Do No Harm ResourcesBooks Doing Great Harm (2025) — Amazon: https://www.amazon.com/Doing-Great-Harm-Infecting-Healthcare_and/dp/B0FD3ZP9WN Take Two Aspirin and Call Me By My Pronouns (2022) — Amazon: https://www.amazon.com/s?k=Take+Two+Aspirin+Call+Me+By+My+Pronouns+Goldfarb Articles & Op-Eds 2019 WSJ op-ed: https://www.wsj.com/articles/take-two-aspirin-and-call-me-by-my-pronouns-11568325291 City Journal archive: https://www.city-journal.org/person/stanley-goldfarb Do No Harm: https://donoharmmedicine.org Follow Dr. Goldfarb X: https://x.com/donoharm?lang=en Co-Host Handles @anish_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod 🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X

    Do No Harm: Inside the Fight to Get Identity Politics Out of Medicine
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About

Where scalpels meet systems — and physicians say what they really think. Co-hosted by Anish Koka, MD & Anthony DiGiorgio, DO. Candid talks on healthcare policy, reform, physician autonomy & patient care.

Information

  • Creator
    The Doctor's Lounge
  • Years Active
    2025 - 2026
  • Episodes
    73
  • Rating
    Explicit
  • Copyright
    © 2026 The Doctors’ Lounge
  • Show Website
    The Doctors’ Lounge