First Opinion Podcast

Pretty much everyone in the U.S. agrees that the American health care system is not working for patients. The disagreement comes over what to do about it. On this episode, law professor Charles M. Silver proposes that the U.S. should have a market-based system, just as we do for many other sectors of the economy. Insurance would still play a role, but a far more limited one. He discusses with editor Torie Bosch what this system would look like for health care consumers, how Social Security offers a model, and how realistic the proposal actually is.

No one goes to medical school because they want to type quickly while listening to patients talk. But that’s what practicing medicine means for many today: fingers flying over the keyboard to log data. Later, they will use that information to create a note for the patient’s file. Technology now offers a solution to this problem in the form of the AI ambient scribe, which records the encounter between physician and patient and then generates the summarizing note for the patient’s file. On this episode of the “First Opinion Podcast,” I spoke with two doctors, one who has embraced the AI scribe and another who is reluctant to use it. While part of me hoped they would have a knock-down, drag-out debate, it was instead a deeply thoughtful conversation about privacy, patient-physician rapport, burnout, and much more.

In the 19th century, medical schools were desperate for corpses from which their students could learn. Grave robbers would sell bodies; sometimes, janitors, students, or even instructors would dig up corpses themselves. Today’s medical students don’t have to go into cemeteries themselves, but schools still struggle to find cadavers that are both ethically sourced and affordable. So many are deciding to forgo the use of cadavers to teach students about human anatomy. First-year medical student Nadir Al-Saidi was disappointed to learn that his school was going to join that group. He joins the podcast to discuss what he has learned in the cadaver lab, and why technology can’t replace the real thing.

When a person with dementia gets something fundamental wrong — the year it is, your relationship to them — it can be difficult to know what to do. Do you correct them and risk upsetting them? Is it a lie or unethical to go along with it? Ted Johnson, who chairs the Department of Family and Preventive Medicine at the Emory School of Medicine, says that playing along is not only OK; it’s often the best thing for both the patient and the caretaker. In the past three years, Johnson and his colleagues have trained 1,500 care partners on how to use basic improv skills.

In 2024, as zoos were hit hard by H5N1 bird flu, big cats were particularly affected. But house cats are vulnerable to the virus, too, as veterinarian and epidemiologist Meghan F. Davis recently wrote with co-authors in a First Opinion essay. In this episode, editor Torie Bosch spoke with Davis about the lack of surveillance of H5N1 in pets, why cats seem to be at such risk, the danger of feeding pets raw milk and raw meat, and veterinary medicine’s key role in human health.

While the upheaval at the Department of Health and Human Services is getting more headlines, local public health organizations are also facing a moment of reckoning. Major cuts are leaving them with fewer resources and employees, which will have immediate ramifications. STAT editor Torie Bosch spoke with two directors of county-level public health departments: Raynard Washington of Mecklenburg County in North Carolina, and Michelle Taylor of Shelby County in Tennessee. The conversation was inspired by their recent First Opinion essay on the threat posed by the closure of the Centers for Disease Control and Prevention’s Office of HIV Prevention.

From our friends at Tradeoffs, a conversation with STAT's Tara Bannow on what to expect now that Mehmet Oz has been confirmed to lead the federal Centers for Medicare and Medicaid Services.

Donna Shalala, who served as Health and Human Services secretary under President Bill Clinton from 1993 to 2001, discusses her career in public health and her frustration with what’s happening at HHS now. She spoke with STAT editor Torie Bosch on Monday morning, after the reorganization of the department was announced but before “reduction in force” layoffs began Tuesday. The conversation was based in part on a recent First Opinion essay she wrote arguing that the reorganization was "silly" and "confusing."

On this episode of the “First Opinion Podcast,” host Torie Bosch talks to Vijay Agarwal, the neurosurgeon who consults on “Severance.” (His day job is chief of the Division of Skull Base and Minimally Invasive Surgery at Montefiore Medical Center.) They chat about the neuroscience behind severance, how Hollywood approaches medicine, and his cameo appearance on the show as, naturally, the surgeon performing the titular procedure. Note: Severance spoilers ahead.

On Friday, medical students around the U.S. will learn what residency program they have matched into. Match Day is not just momentous for those students, though. It also tells the rest of us what fields of medicine are having trouble attracting new physicians. In 2024, about 8% of pediatrics positions went unfilled, an increase from about 3% in 2023. Meanwhile, children’s hospitals report large numbers of vacancies in many pediatric subspecialties.  All of this is particularly worrisome given the rise in measles cases. On this episode of the “First Opinion Podcast,” Faith Crittenden, a pediatric endocrinology fellow, and Jared E. Boyce, an M.D.-Ph.D. candidate who is interested in entering pediatrics, share the many reasons for the shortage. There’s the money — pediatricians are paid less than many other doctors, which can be a deal-breaker if you’re graduating with $200,000 in loans.

Tuesday marked the fifth anniversary of the World Health Organization declaring Covid-19 a global pandemic. For science writer Carl Zimmer, a columnist for the New York Times, covering Covid meant “watching [scientists] figuring out this disease in real time.” Notably, “there were a lot of mysteries about it. I was really struck as, as others were, by how strange it was that, that the just a fundamental question of how Covid spread was so unclear and was leading to so much argument,” he said. Intrigued by both the public and scientific confusion over airborne infection, he began examining history. Eventually, he realized, “I’m writing about life in the air, and it turns out to have this incredible history that goes back many centuries and involves all sorts of people.” That led to his latest book, “Air-Borne: The Hidden History of the Life We Breathe,” which he discussed with guest host and STAT science writer Megan Molteni on this episode of the “First Opinion Podcast,” which is back for a new season.

You’ve probably come across Will Flanary, aka Dr. Glaucomflecken, the internet’s most famous physician/comedian. For more than four years, the ophthalmologist has been gently roasting medicine by playing a rotating cast of characters — the emergency physician clad in cyclist gear, the “ortho bro,” the pediatrician in a unicorn headband. But he's also used his comedy to skewer the business of health care, including the confounding bureaucracies of insurance — with a special emphasis on UnitedHealthcare. First Opinion editor Torie Bosch spoke with Flanary about punching up in comedy and the reaction to the shooting of UnitedHealthcare CEO Brian Thompson.

Have you ever taken phenylephrine for a stuffed-up nose and then felt better? If so, you might have been perplexed when Food and Drug Administration experts said last year that that the drug — which is in some versions of DayQuil, Sudafed, and other medicines — is no more effective than a placebo. On this episode of the “First Opinion Podcast,” we talk with professor and researcher Michael Bernstein about the placebo effect and its counterpart, the “nocebo effect” — if you tell patients something will make them feel worse, it generally comes true.

Biomedical engineer Jeff Karp’s famous lab has created medical tape inspired by spider webs, waterproof adhesive bandages that take inspiration from geckos, needles reminiscent of porcupine quills. But as an elementary school student, Karp told me on the “First Opinion Podcast,” he struggled. His second-grade teacher wanted to hold him back a year. “I was getting all these labels from teachers like ‘lazy’ and ‘lost cause,’ ” he said. But according to Karp, what made him struggle — undiagnosed ADHD — also became his “super power,” giving him an ability to hyper-focus, connect emotionally in different ways, and think creatively. Now, he emphasizes the importance of neurodiversity and interdisciplinary approaches in his own lab, and he also tries to talk to students and parents about how ADHD can be a strength.

About 75% of U.S. hospitals use chaplains, who are either employed by the health care center or are spiritual leaders from the local community. Physician Robert Klitzman and chaplain Molly O’Neil Frank join today’s podcast to discuss why chaplains are a critical part of patient care. Perhaps counterintuitively, they say, chaplains' roles have become even more important as religious affiliation has declined in the country.