The External Medicine Podcast The External Medicine Podcast

In this episode, Daniel Belkin and Mitch Belkin interview Marc Gosselin, MD about his journey to radiology, being a radiology program director, dealing with burnout, transitioning from academics to private practice, and overdiagnosis in radiology. They discuss in situ thrombosis versus pulmonary emboli, whether medical evidence should have an expiration date, and why physicians should admit fault when they are wrong.


Who is Marc Gosselin?


Dr. Marc Gosselin is the head of cardiopulmonary imaging at Vision radiology, a retired full professor at Oregon Health and Science University. Previously, Dr. Gosselin was a program director of the University of Utah’s radiology program.


References:


Clinical Features of Pulmonary Embolism (1961)Sensible Medicine: Why statins do not cause diabetesSupport the show
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In this episode, Daniel Belkin and Mitch Belkin interview Hussam Alkaissi, MD about his journey in medicine, experience with populations with high consanguinity, and uncovering of rare diseases. They touch on several unusual cases Hussam has solved including one of CHILD syndrome, homocystinuria, and acute hypercalcemia.
Who is Hussam Alkaissi?
Dr. Hussam Alkaissi is an Endocrinology Clinical Fellow at the NIH/NIDDK. He has an interest in diabetes, glucose metabolism, insulin signaling, and insulin resistance.
References:
Hussam's TwitterHussam's Academic WorksNature paper on link between EBV and Multiple Sclerosis Gadolinium, NALCN channel, and metastasis in Mice Support the show
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In this episode, Daniel Belkin and Mitch Belkin interview Bryan Carmody, MD, about physician shortages, resident unionization, and the OB/GYN ERAS divorce. They discuss the recent changes to legislation in Tennessee which allows international medical graduates to bypass the US residency system. They also touch on the Weisman versus Barnes Jewish Hospital court case.
If you missed the initial episode with Bryan Carmody Episode #6, be sure to check that out.


Who is Bryan Carmody?
Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process.
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In this episode, Daniel Belkin and Mitch Belkin interview Joann Elmore, MD, about screening mammography. Dr. Elmore shares insights on the USPSTF's new draft mammography recommendations, which lowers the breast cancer screening age from 50 to 40. They discuss the difference in American and European call back rates for biopsy and whether mammography screening programs have substantially improved breast cancer mortality rates or if improvements are primarily due to enhanced treatment methods. They also touch on the potential for AI to transform radiology and pathology.
Who is Joann Elmore?
Joann G. Elmore is as a professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. Her research interests include diagnostic accuracy, physician variability, cancer screening, patient engagement, and AI/machine learning in diagnostics. She has over 200 publications.
References:
Joann Elmore's UCLA pageUSPSTF May 2023 - proposed changes to Mammography ScreeningNEJM: Variability in Radiologists' Interpretations of MammogramsSupport the show
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In this conversation, Daniel Belkin and Mitch Belkin interview infectious diseases physician and epidemiologist Dan Morgan, MD, about infection prevention, diagnostic stewardship, diagnostic reasoning, and medical overuse. They discuss regional differences in medical use and delve into a cluster-randomized controlled trial of contact precautions in ICU patients to evaluate whether this prevents C. Diff, MRSA, and VRE. They also touch on AI's potential role in clinical decision support, and the question of how to improve clinician statistical reasoning.
Who is Dan Morgan?
Dan Morgan, MD, MS is a physician and epidemiologist at University of Maryland School of Medicine. He directs the Center for Innovation in Diagnosis and is Chief of Epidemiology at the VA Maryland Healthcare System. His research interests include probability in medicine, medical overuse, diagnostic stewardship, and infection prevention.
If you enjoyed this episode, be sure to check out our episodes with Paul Offit and Deborah Korenstein on medical overuse.
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In this conversation, Daniel Belkin and Mitch Belkin interview Robin Hanson, PhD, about healthcare and medicine. They discuss three randomized controlled trials on the population-wide benefits of medicine (RAND health insurance experiment, Oregon Health Insurance Experiment, and the Karnataka Hospital Insurance Experiment), which do not demonstrate benefit for more medical care. They talk about the conspicuous caring hypothesis put forward in Robin's book The Elephant in the Brain. Other topics discussed include end-of-life care, medicine as something Sacred, and prediction markets in medicine.
Who is Robin Hanson?
Robin Hanson, PhD, is an associate professor of economics at George Mason University and a research associate at Oxford University. He is known for his wide-ranging interests, including artificial intelligence, prediction markets, and signaling. He is the author of several books, including The Age of Em and The Elephant in the Brain.
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