The Doctor's Lounge

The Doctor's Lounge
  • 4.9 (45)
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Where scalpels meet systems — and physicians say what they really think. Co-hosted by Dutch Rojas, Anthony DiGiorgio, DO, with Anish Koka, MD, Dan Choi, MD, & Sanat Dixit, MD — candid talks on healthcare policy, reform, physician autonomy & patient care.

  1. 4D AGO

    The $2 Million Verdict: Inside the First Detransition Lawsuit Trial

    Benjamin Ryan was the only journalist in the courtroom for every day of the first detransition lawsuit to reach a jury verdict. In January 2025, a White Plains jury awarded $2 million to Fox Varian, who received a double mastectomy at age 16 after being diagnosed with gender dysphoria. Years later, she detransitioned and sued her psychologist and plastic surgeon. What happened in that courtroom tells a bigger story about how American medicine got here, why Europe is walking it back, and what happens when "affirmation" becomes the only acceptable path. Ben breaks down the testimony, the expert witnesses, the coerced mother, and why one of WPATH's own leaders sank the defense. This conversation covers the case details, the prefrontal lobotomy parallel, why the American Academy of Pediatrics can't back down, insurance incentives gone wrong, and what it's like to be the only journalist willing to cover the story everyone's afraid to touch. Chapter List 1:00 - Introduction: Benjamin Ryan, The Only Reporter in the Room4:00 - How Ben Got Into Trans Medicine Reporting7:00 - The Case Overview: Fox Varian vs Her Medical Team10:00 - Body Dysmorphia vs Gender Dysphoria: The Fatal Error13:00 - Ken Einhorn and the Philosophy of Affirmation17:00 - The Pride Center Records He Never Requested19:00 - Dr. Loren Schechter: WPATH's President-Elect Testifies for Plaintiff22:00 - Coercing the Mother: "You're Not in Reality, Mom"25:00 - Why Was the Plastic Surgeon Liable?29:00 - The Lobotomy Parallel: When Medicine Gets It Wrong33:00 - The Ethics of Taking Functioning Organs37:00 - Why the Plastic Surgeons Released a Statement39:00 - Expert Witness Testimony: The Game-Changer42:00 - Johanna Olson-Kennedy: "Live Son or Dead Daughter"44:00 - The Nose Job Fallacy: Breasts Have Function46:00 - How Did We Get Here? Internet, Social Media, Civil Rights50:00 - Why Europe Walked It Back and America Didn't54:00 - The Insurance Problem: Perverse Incentives59:00 - Why Medical Societies Can't Say "We Don't Know"1:02:00 - The Media Blackout: "No Institutional Bandwidth"1:05:00 - Closing: Follow Ben's Substack for Case Files Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSS Follow the Show: X: @drsloungepod Co-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @DrDiGiorgio Guest: Benjamin Ryan on Substack: Hazard Ratio (benryan.substack.com) Ben's Free Press Article : A Legal First That Could Change Gender Medicine

    1h 6m

  2. 6D AGO · BONUS

    Ed Gaines: How Independent Physicians Finally Got Leverage Against Insurance Companies

    Guest: Ed Gaines, JD, CPC Vice President of Regulatory Affairs, Zotec Partners Honorary Member, American College of Emergency Physicians Episode Summary: If you're a hospital-based physician and you don't understand the No Surprises Act, you're missing the biggest shift in payment leverage in decades. Insurance companies estimated there would be 17,000 disputes. The actual number? Over 2.5 million. And physicians are winning 85-90% of them. Ed Gaines has been fighting for physician payment for 32 years—from the 1990s battle over 1099 independent contractors to today's war over Independent Dispute Resolution. He explains how California's "neutral" stance cost physicians dearly, why Trump's price transparency rule changed everything, and what Anthem's threat to cut hospital payments really means. 0:00 - Introduction & Opening 1:05 - Who is Ed Gaines? 2:25 - The Origin Story: From Healthcare Fascination to Capitol Hill 6:31 - The 1099 Battle: A Five-Year Fight (1997-2002) 14:19 - What is the No Surprises Act? 17:26 - State Laws vs. Federal Action 23:48 - California's Mistake: When the CMA Was "Neutral" 26:44 - The Consolidation Paradox 28:36 - The Legislative Battle: Ways and Means vs. Energy and Commerce 31:43 - Becerra's Sabotage: Four Lawsuits, Four Victories 37:39 - The Current Battle: Insurance Companies Strike Back 40:43 - The Trump Transparency Game-Changer 42:55 - Who's Really Using IDR? 43:50 - Anthem's New Tactic: Going After Hospitals 46:18 - The Antitrust Argument 47:40 - Closing Thoughts In This Episode: The 1099 battle (1997-2002): How persistence won a 5-year legislative fightWhy the California Medical Association regrets being "neutral" on AB 72The $50 billion that health plans tried to extract from physiciansHow HHS tried to sabotage the NSA—and lost in federal court four timesWhy CMS was off by 147X in predicting IDR case volumeTrump's transparency rule: The data that's winning cases for physiciansAnthem's new strategy: Threatening 10% payment cuts to hospitalsThe antitrust case against insurance company boycottsWhy 70% of IDR users are independent physicians, not just PE groupsKey Quotes: "CMS estimated 17,000 cases. The actual number was over 2.5 million. They missed by just a touch." "The judge literally said the agency tried to put their thumb on the scales of justice in favor of health plans." "The California Medical Association was neutral on benchmarking to 125% of Medicare. To their credit, they realized they'd made a mistake." "They're losing 85-90% of cases at 6, 7, 8X of Medicare. They didn't see this coming." "For years they got to unilaterally decide what out-of-network payment would be, then just blame doctors for balance billing." About Ed Gaines: Ed has worked in physician revenue cycle management for 32 years, supporting over 22,000 physicians across all 50 states. He specializes in emergency medicine, radiology, anesthesia, and orthopedics advocacy. The American College of Emergency Physicians made him an honorary member in 2010—rare recognition for a non-physician. Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSS

    48 min

  3. FEB 1

    Dr. Gantwerker: Medicare Advantage, Private Practice, and Why Doctors Need to Stop Fighting on X

    What happens when a spine surgeon who's been in private practice since the Obamacare era sits down with doctors across the political spectrum? You get one of the most honest conversations about healthcare reform we've had. Brian Gantwerker doesn't fit neatly into anyone's box. He's a private practice capitalist who thinks breaking up insurance companies is essential. He believes in "just pricing" for craniotomies (hint: it's more than $2,000). He thinks Medicare was actually a great payer—until Medicare Advantage ruined it. And he has strong opinions about why physicians spend so much time fighting each other on Twitter instead of finding common ground. This conversation covers the Medicare Advantage meltdown (UnitedHealthcare shares tanking), vertical integration nightmares, why the FTC needs to break up both insurers AND hospitals, and what it's like when your congressman literally saves your practice. Plus: the real reason healthcare policy debates get so toxic on social media, and why quote-tweeting might be making everything worse. 0:00 - Introduction: Doctors in the Lounge 0:33 - Who is Brian Gantwerker? 2:08 - Starting Private Practice in the Obamacare Era 5:34 - UnitedHealthcare: The Pontine Glioma of Healthcare 7:43 - Medicare Advantage vs Traditional Medicare 10:26 - The Medicare Advantage Denial Story 14:35 - Who Gets the Value in Value-Based Care? 16:07 - The Free Market That Doesn't Exist Yet 19:16 - What Should a Craniotomy Cost? 21:47 - Breaking Up the Monopolies: Insurers AND Hospitals 27:09 - The Labor Theory of Value Debate 30:21 - CPT Codes and Central Planning 32:20 - The "Just Price" vs Free Market 35:42 - HSAs for Medicaid Recipients 38:47 - Price Transparency: Why Can't Healthcare Be Like Amazon? 40:03 - The Workout Period Problem 43:52 - FTC and Vertical Integration 46:04 - Lobbying, Congress, and Changing Minds 48:07 - Why Twitter Makes Physicians Fight Each Other 51:24 - Political Rancor and Taking Sides 55:14 - The Dr. Asghar Tweet Controversy 59:24 - Quote-Tweeting: The Death of Dialogue 1:03:03 - X as Thunderdome vs Real Conversation 1:04:35 - The Ted Lieu Saves: When Congress Actually Helps 1:07:32 - Closing: Shah Rukh Khan Hair and Finding Common Ground Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSS Follow the Show: X: @TheDoctorsLo Co-hosts: @anish_koka | @drdanchoi | @dutchrojas | @drdigiorgio | @sdixitmd Guest: @cscla

    1h 8m

  4. JAN 30 · BONUS

    The DPC Revolution: Dr. Josh Umbehr on Making Healthcare Affordable Again

    Guest: Josh Umbehr, MD | Co-founder & CEO, Atlas MD | DPC Pioneer Summary: In 2010, Josh Umbehr launched Atlas MD charging $50/month for unlimited primary care with no insurance billing. Other doctors said it wasn't sustainable. Fourteen years later, he runs a platform serving 1,800+ practices and built his own insurance company. This conversation covers the full journey: wholesale medication costs ($0.01/pill metformin), the $2M it takes to start insurance, why Singapore's model works, and why 80% of healthcare spending is eliminable. Key Topics: DPC Economics: How $50/month works ($2 CBC tests, cutting 5-6 staff)Building Insurance: $2M startup, actuarial challenges, association modelSingapore Healthcare: What economists miss about primary careFractional Specialists: 1,800 practices sharing one cardiologistCMS Meeting: "We can't participate and innovate"GLP-1 Pricing: Why insurance coverage raises costsVaccine Nuance: Risk/benefit in contextThe 80% Solution: Eliminating waste, not rationingTop Quotes: "80% of $4-5 trillion could be cut out. That's reasonable math, not wishful thinking.""We can't participate and innovate" [to CMS Administrator]"Best way to make GLP-1s affordable: stop covering with insurance""Biggest DPC problem isn't the model—it's getting people to understand high quality + affordable price"

    1h 7m

  5. JAN 25

    Journalist Alex Berenson: Fraud and Abuse with Autism therapy in the Medicaid Program

    Keywords Alex Berenson, COVID vaccine, Medicaid fraud, autism services, healthcare, investigative journalism, MCOs, AI in healthcare, public health, healthcare policy Summary In this conversation, Anish Koka and Alex Berenson delve into critical issues surrounding the COVID vaccine, Medicaid fraud, and the financial incentives within autism services. They discuss the implications of investigative journalism in public health, the role of Managed Care Organizations (MCOs), and the potential future of healthcare with the integration of AI. Berenson emphasizes the need for accountability and transparency in healthcare spending, particularly in Medicaid, which has ballooned to a trillion-dollar program with significant fraud and abuse. The discussion highlights the importance of asking tough questions and the consequences of ignoring systemic issues in healthcare policy. Takeaways Alex Berenson is a notable investigative journalist who challenges mainstream narratives. The COVID vaccine's efficacy was overestimated, leading to misguided public health policies. Medicaid fraud is rampant, with significant financial implications for taxpayers. The autism services sector has seen explosive growth in spending without adequate oversight. Managed Care Organizations (MCOs) often lack the incentive to control costs in Medicaid. There is a need for more physician oversight in Medicaid-funded services. The financial incentives in healthcare can lead to waste and abuse of funds. AI's role in healthcare could complicate oversight and accountability. Public support for Medicaid could diminish if fraud and waste are not addressed. The conversation underscores the importance of transparency in healthcare spending. Chapters 00:00 Introduction to Alex Berenson 06:11 Investigating COVID Vaccine Efficacy 12:22 Exploring Medicaid Fraud and Abuse 20:00 Autism Services and Financial Incentives 30:08 The Role of MCOs in Medicaid 36:50 The Future of Healthcare and AI Links: Berenson Substack on Medicaid and Autism: (100) Medicaid fraud and abuse are hitting unthinkable levels @X handles: @alexberenson @anish_koka @DrDiGiorgio @drdanchoi @sdixitmd

    45 min

  6. JAN 19

    The Trump Healthcare plan, AI in Medicine, Medical Liability, and the sketchy 340b drug program

    Send us a text Summary In this episode of the Doctor's Lounge, hosts Anish Koka, Anthony DiGiorgio, and Sanat Dixit delve into the complexities of healthcare policy, particularly focusing on recent statements made by former President Trump regarding healthcare reform. They discuss the implications of Trump's proposed 'Great Healthcare Plan,' which aims to lower drug prices and insurance premiums while increasing price transparency. The conversation highlights the need for deeper reforms, such as relaxing insurance regulations and addressing hospital consolidation, to truly lower healthcare costs. The hosts express a mix of cautious optimism and skepticism about the effectiveness of these proposals, emphasizing the importance of patient empowerment in the healthcare marketplace. The discussion then shifts to the role of AI in healthcare, particularly in clinical decision-making. The hosts explore the regulatory landscape surrounding AI tools and the potential for these technologies to enhance patient care while also raising concerns about accountability and the need for oversight. They conclude with a critical examination of the 340B drug discount program, discussing its unintended consequences and the need for reform to ensure that it serves its intended purpose of aiding low-income patients rather than enriching large health systems. Overall, the episode provides a nuanced look at the intersection of policy, technology, and patient care in the evolving healthcare landscape. Keywords healthcare reform, Trump healthcare plan, AI in healthcare, 340B program, healthcare policy, patient empowerment, drug pricing, insurance premiums, healthcare costs, medical malpractice Chapters 00:00 Introduction to Healthcare Complexity 01:12 Trump's Healthcare Plan Overview 04:38 The Role of AI in Healthcare 09:31 FDA Regulations on AI Tools 17:34 Ethics and Accountability in AI 31:53 Case Study: Whole Body MRI and Malpractice 34:30 The Prenuvo Case and Medical Liability 38:59 Defensive Medicine and Its Implications 43:09 The 340B Drug Discount Program Explained 50:54 Critique of the 340B Program and Its Impact 01:00:02 Reimagining Healthcare Funding and Patient Care 🔗 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

    1h 1m
  7. The ACA Subsidies, New Vaccine Schedules, Ezekiel Emmanuel, AI in Medicine

    JAN 10

    The ACA Subsidies, New Vaccine Schedules, Ezekiel Emmanuel, AI in Medicine

    Send us a text Keywords healthcare, ACA subsidies, vaccine schedule, AI in healthcare, concierge medicine, food pyramid, healthcare policy, public health, physician autonomy, healthcare costs Summary In this episode, the hosts delve into the complexities of healthcare, discussing the ongoing saga of ACA subsidies, recent changes to vaccine schedules, and the implications of AI in healthcare. They explore the pros and cons of concierge medicine and the recent shift in dietary guidelines, emphasizing the need for a more patient-centered approach in healthcare policy. The conversation highlights the philosophical debates surrounding healthcare access, autonomy, and the role of government in managing health systems. Takeaways Healthcare plans are more complicated than they seem. The ACA subsidies have been extended amidst political maneuvering. Changes in vaccine schedules reflect a shift towards shared decision-making. AI is becoming increasingly integrated into healthcare practices. Concierge medicine offers personalized care but raises equity concerns. The food pyramid has been updated to reflect healthier eating guidelines. Patients deserve autonomy in their healthcare decisions. Government involvement in healthcare often leads to inefficiencies. The healthcare system needs to prioritize patient relationships. Philosophical debates about healthcare access continue to evolve. Chapters 00:00 The Complexity of Healthcare Plans 01:11 The ACA Subsidies Debate 04:58 Vaccination Schedules and Public Health 12:46 AI in Healthcare: Innovations and Concerns 37:53 Ezekiel Emanuel and the Affordable Care Act 40:09 Critique of Healthcare Policies and Ideologies 43:48 The Flaws of Central Planning in Healthcare 46:55 Concerns Over Incremental Changes in Healthcare 49:37 Cultural Shifts and the Future of American Healthcare 54:50 Concierge Medicine: Access and Quality of Care 01:00:07 Dietary Changes and Public Health Messaging 🔗 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

    1h 5m
  8. TDL Year End Review: the BBB Vindicated,First Principles in Health Policy and Popular 2025 Tweets

    JAN 4

    TDL Year End Review: the BBB Vindicated,First Principles in Health Policy and Popular 2025 Tweets

    Send us a text Keywordshealthcare policy, Medicaid, ACA, fraud, social media, bureaucracy, primary care, immigration, healthcare reform, insuranceTakeawaysThe One Big Beautiful Bill aimed to reform Medicaid and tighten eligibility checks.Fraud in Medicaid has been highlighted by recent cases, particularly in Minnesota.Work requirements for Medicaid recipients are seen as a reasonable eligibility check.The expiration of ACA subsidies has led to increased healthcare costs for many.Social media has become a platform for impactful healthcare discussions.Bureaucracy in healthcare is under scrutiny, with calls for more accountability.First principles thinking is essential for developing effective healthcare solutions.Physicians must consider how their income and practices are perceived in society.Immigration policies impact the supply of physicians in the US healthcare system.Access to primary care is crucial for reducing ER congestion and improving health outcomes.SummaryIn this New Year's episode, Anthony DiGiorgio and Anish Koka reflect on the significant healthcare policy changes of 2025, focusing on the One Big Beautiful Bill and its impact on Medicaid. They discuss the recent fraud cases in Minnesota, the expiration of ACA subsidies, and the role of social media in shaping healthcare conversations. The conversation also touches on the importance of primary care access, the perception of physicians, and the need for first principles thinking in healthcare reform. As they look ahead to 2026, they express hope for more accountability and innovative solutions in the healthcare system.Sound bites"Bureaucracy in healthcare is under scrutiny.""Physicians must consider their income perception.""Immigration policies impact physician supply."Chapters00:00 New Year Reflections on Healthcare Policy10:44 The Impact of ACA Subsidy Expiration14:53 Social Media Influence in Healthcare Discussions19:53 Examining Bureaucracy and Professional Organizations25:12 First Principles in Healthcare Solutions33:58 The Fairness of Medical Training and Immigration34:27 The Role of Third-Payer Systems in Healthcare35:25 Collectivism vs. Individualism in Healthcare36:16 The Future of Healthcare: Leftist Movements and Universal Care37:34 Populism and Promises in Politics38:33 Uncovering Medicaid Fraud and Healthcare Spending40:29 The Impact of High Salaries in Healthcare41:45 The Dangers of Single-Payer Systems42:13 The Canadian Healthcare System: A Case Study44:21 Primary Care and Emergency Room Dynamics46:19 Price Signals in Healthcare49:22 The Debate on Hospital Capacity and Access51:45 The Misconceptions of Universal Healthcare53:31 The Role of Private Insurance in Universal Systems55:42 Healthcare Innovation and Market Dynamics57:24 The Economics of Healthcare Employment59:11 The High-Speed Rail Controversy and Government Spending01:01:35 Looking Ahead: Hopes for 2026 🔗 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

    1h 1m
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Ratings & Reviews

4.9
out of 5
45 Ratings

About

Where scalpels meet systems — and physicians say what they really think. Co-hosted by Dutch Rojas, Anthony DiGiorgio, DO, with Anish Koka, MD, Dan Choi, MD, & Sanat Dixit, MD — candid talks on healthcare policy, reform, physician autonomy & patient care.

Information

  • Creator
    The Doctor's Lounge
  • Years Active
    2025 - 2026
  • Episodes
    41
  • Rating
    Explicit
  • Copyright
    © 2026 The Doctor's Lounge
  • Show Website
    The Doctor's Lounge

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