The Doctor's 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. 12h ago

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

    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

  2. 1d ago

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

    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

  3. Jul 16

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

    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

  4. Jul 11

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

    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

  5. Jul 7

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

    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

  6. Jul 6

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

    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

  7. Jul 2

    The Myocarditis Double Standard: COVID, the Vaccine, and the Pediatric Deaths That Went Unreported

    Episode SummaryDr. Tracy Beth Høeg returns alongside Dr. Venkatesh Murthy, NIH-funded cardiologist at the University of Michigan, to dissect the Senator Ron Johnson congressional memo detailing pediatric deaths following COVID-19 vaccination — deaths the FDA's own pharmacovigilance team flagged internally but never disclosed publicly. The conversation covers the well-documented double standard applied to COVID myocarditis versus vaccine myocarditis, how journal editors killed papers not for scientific flaws but out of fear of social media backlash, why Korea's autopsy data revealed fatal cases that would never have been identified otherwise, the post-marketing commitment failures by Pfizer and Moderna, and what it means that we are still annually approving a vaccine with no randomized controlled trial evidence of clinical benefit in the current immune landscape. Chapter Markers00:00 Introduction: Why Dr. Høeg Is Back and What the Ron Johnson Memo Reveals 02:03 How Vaccine Myocarditis First Surfaced: Israel, the U.S. Military, and Early Warning Signs 05:36 Dr. Murthy on the Biology: Why the mRNA Vaccine Produced Cardiac Inflammation in a Different Population Than Expected 10:36 The Puntmann Paper: Statistical Problems, Confounding, and the Push to Close Schools and Cancel Sports 13:58 The Double Standard in Real Time: Subclinical MRI Findings vs. Kids Presenting With Chest Pain 16:26 Risk-Benefit Mismatch: Vaccine Myocarditis in Young Males vs. Genuine COVID Risk in That Population 21:05 Dr. Høeg's VAERS Analysis: Rates of One in Five Thousand, What the FDA's Own Data Showed, and the Paper That Almost Never Ran 24:03 Dr. Murthy Reveals: He Was a Reviewer for a Journal That Killed This Paper for Political Reasons 28:23 Inconsistency of Vaccine Skeptics: Who Was Questioning the Trials Before Election Day 35:52 Korea's Autopsy Program and Why the U.S. Has No Comparable Surveillance System 40:21 The Chikungunya Vaccine Withdrawal: One Death, One Action — and the Contrast With COVID 42:34 Inside the FDA: The OBPV Memo, the 10 Probable/Possible Deaths in Children, and What Happened Next 53:30 Senator Johnson's Subpoena and Why the Number Dropped from 10 to 7 58:20 Causal Attribution Double Standard: COVID Deaths vs. Vaccine Deaths 1:20:59 Should the COVID Vaccine Still Be Approved? Dr. Høeg on the Absence of Clinical Efficacy Evidence 1:23:31 The CDC-Blocked Study, Healthy Vaccinee Bias, and the Limits of Observational Data 1:28:08 What FDA Approval Actually Means — and What It Should Mean 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

  8. Jun 27

    David Zweig on Schools, Science, and the Media's COVID Failure

    Episode SummaryInvestigative journalist David Zweig joins Anish Koka and Anthony DiGiorgio to discuss his book An Abundance of Caution: American Schools, The Virus, and a Story of Bad Decisions — a heavily cited account of how public health authorities, the media, and a politically homogenous expert class got COVID policy badly wrong, especially for children. The conversation covers why U.S. media coverage was uniquely alarmist compared to the rest of the world, how Americans overestimated child COVID mortality by as much as 40 times, the role of "technological solutionism" in making school closures possible when they never would have been before, and what it would actually take to rebuild public trust in institutions that squandered it. The episode opens with a discussion of MidJourney's foray into medical imaging and what it reveals about AI hype cycles in medicine. Resource: David's Book: https://www.amazon.com/Abundance-Caution-American-Schools-Decisions/dp/0262053993 Chapter Markers00:00 Welcome and intro: David Zweig 01:14 MidJourney enters medical imaging — hype or breakthrough? 05:35 Incidentalomas, cash-pay scanning, and who bears the cost 08:55 Ultrasound physics and why AI won't replace radiologists yet 14:00 Transition to the book: An Abundance of Caution 17:00 The Twitter Files and Zweig's COVID journalism 23:00 Political monoculture in public health and legacy media 41:43 Sweden, BLM protests, and the shifting COVID rules 43:06 The empirics on children: what the data actually showed 50:29 American media's uniquely alarmist pandemic coverage 56:31 Living in a deep blue area: why data couldn't penetrate the narrative 58:18 Anthony's ICU story and the Gellman Amnesia moment 59:50 How do we rebuild trust in public health? 1:08:28 Technological solutionism: why school closures were impossible before Zoom 1:10:07 1950s flu epidemics — schools stayed open with 50% of kids out sick 1:25:20 Newsroom monoculture, book publishing, and the conservative imprint problem 1:28:08 Reforming institutions vs. questioning their foundations 1:36:39 Wrap-up: the pandemic as a case study in how society functions Co-Host Handles @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

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4.9
out of 5
54 Ratings

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
    71
  • Rating
    Explicit
  • Copyright
    © 2026 The Doctor's Lounge
  • Show Website
    The Doctor's Lounge

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