Healthcare Triage

What are biologic drugs? What about biosimilars? In a previous video we compared brand name and generic drugs. (https://www.youtube.com/watch?v=vqXrfzWgDkE) But we kind of left out a major player in the world of medicines; biologic drugs. These complicated little guys probably deserve a video all to themselves. Call them what you will -biologics, biotherapeutic medicines, or biopharmaceuticals- they're topic of this week's HealthCare triage. We had tons of help from Healthcare Triage intern Rachel Hoffman on this episode! Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=68795 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Next week's LIVE Show link: https://www.youtube.com/watch?v=ySZ_zOU4120 TIMECODE: 2:51 - IBS, hereditary? My mother,grandmother and myself all have it at varying degrees, mum is worst diarrhea after eating anything 4:42 - I left some food in my fridge too long and it got moldy. My mom says bleach it for 15 minutes then put it in the dishwasher. Is that okay or should I do something different? 6:22 - What are your thoughts on Trump's letter of health from his doctor? 7:22 - What are your thoughts on the latest Dr. Ioannidis (Standford University) paper stating the exaggeration of many statements or the impossiblity of repeating the experiments of many of them? 9:00 - What's your spaghetti policy? 9:50 - As a pediatrician and a parent, do you have any suggestions for soon-to-be parents about what to ask perspective docs during a pre-birth "interview"? 13:43 - On the exercise recommendations of 30 mim/day or 150 min a week, are there benefits/consequences to getting the 150 min/week in on one day rather then spreading it out over 5-7 days? 14:47 - Do you have any response to this "Marketing with Doctors" aired on Last Week Tonight with John Oliver? 18:02 - Is there an order of flossing and brushing teeth that is demonstrably better? That is, if I floss before brushing, am I likely to have better outcomes than if I brush before flossing? I've had one dentist tell me to do it one way and another tell me to do it the opposite way. What, if anything, does the research say? 19:13 - In the world of pediatric medicine autism seems to be always on the front page are there any other recent studies or discoveries in children's medicine that you are excited about? 21:37 - HOW WAS DISNEY? 22:44 - Could you discuss your thoughts about lightsaber wounds (if they were real)? Like how would you treat a cauterized wound? 24:45 - Is aloe vera effective for burn/sunburn relief or faster healing? 26:05 - Should I worry a lot about what laundry

Next week's LIVE Show: https://www.youtube.com/watch?v=XrF_FcUVOIU TIMECODE (Thanks to Jack Williams for doing this!) 1:59 - As someone who wears glasses, should I consider laser eye surgery if I work 12 hours a day in front of a computer? 2:58 - Does Bandaid help you heal faster? 5:12 - How do you feel about off-label prescriptions? Any relevant evidence? 7:50 - Scrubs vs business attire with a lab coat, what do you think non surgical doctors should wear? What did you wear while practicing? 10:20 - How effective is Tamiflu at treating and preventing influenza? I have heard scandals involving [the] company in the past and I wonder if it would be classified in the same category as Airborn at treating and preventing illness. 13:52 - Is it true that OB's in the US seem to overuse interventions beyond what evidence calls for? 16:30 - Diet is the key to weight loss, what food have low calories and will keep me full and functional the longest? Basically, how do I reduce calories without feeling hungry? 18:59 - I'm a UK medical student. I was wondering if you had any thoughts in the new contract our government wants to impose on junior doctors. Yesterday the juniors went on strike to protest against it. 20:24 - Teething tablets, baby Orajel, & infants Tylenol; do you recommend any of these for a 6-9 month old teething baby? 21:26 - How should we dispose of unneeded/expired medications? 22:59 - Why are women more likely to get STIs? What are some ways to prevent it? 24:38 - Are quail eggs better for health than chicken eggs? 25:20 - I'm going to Hawaii for my honeymoon. My fiancee wants us to do a session in a tanning bed to get a base tan. Bad idea? 26:47 - I've asked before about risks of lowered sperm count from laptops. My parents are now concerned about other mobile devices, like phones and tablets connected to chargers. Is there an actual risk here? 28:01 - Do you agree with the CDC's plan to eliminate Hep B with immunizing infants or do yo

Parents should talk to their kids about sex. We've got data. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=68893 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

The US Preventive Services Task Force was created in 1984 to make evidence-based recommendations about clinical services, like screening, that comprise essential elements of preventive care. It is comprised of expert volunteers in fields of primary care and preventive medicine, including pediatrics, family medicine, and internal medicine, as well as obstetrics and gynecology, nursing, and behavioral health. It's also the topic of this week's Healthcare Triage. This is based on a column Aaron wrote for the Upshot. Links to further references and reading can be found there: http://www.nytimes.com/2015/12/15/upshot/even-in-basic-health-decisions-you-cant-screen-out-politics.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

I know you all read my recent NEJM study (and the AcademyHealth blog post I wrote about it). If you didn't, though, it's also the topic of this week's Healthcare Triage News! Links and more can be found here: http://theincidentaleconomist.com/wordpress/?p=68965 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Next Week's LIVE Show: https://www.youtube.com/watch?v=AePZlPJG344 TIMECODE (Thanks, SmokyBirch) 1:42 - Are there any major "idiopathic" diseases that affect a large amount of people that we just sort of shrug at and have no idea about? 2:37 - Is the barefoot running technique better for your joints? 4:31 - Does wearing makeup have any ill effect on the skin? It makes people wash their face every night to remove it, but is it clogging pores or damaging the skin in any way? 5:32 - What do you think of Bernie Sanders' healthcare plan? 15:05 - What are your thoughts on Chlorine Dioxide or Miracle Mineral Supplement? 15:37 - Is there evidence to support if certain types of OTC pain relief medicines such as asprin and Tylenol work better for certain pains such as headaches or muscle pain? 18:33 - They say you should only lose 1-2 pounds a week, but is this a hard and fast rule? Is it okay to lose more than that? Does it matter if the person is just overweight vs (morbidly) obese? 22:12 - What do you think of Obama's call to cure cancer? Is it really feasible? 23:36 - Is there any research on when to start babies on solid foods? Many sources say 4-6 months, others say 6. 24:46 - I heard recently that applying ice to a soft tissue injury may not be helpful in assisting recovery. Is there evidence to back this up or is it a myth?

Basic Life Support (BLS) is basically CPR, and when bystanders are trained to help people suffering cardiac arrest with BLS and automated defibrillators, outcomes improve. Advanced Life Support (ALS) is a whole other story. We've got the research on it. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

ALS still doesn't appear to be better than BLS. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=68655 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Americans remain very overweight. According to the CDC, about 38% were obese in 2014, meaning that they had a body mass index of at least 30, compared to 32% just a decade ago. This is in spite of massive efforts to try and get people in the United States to eat more healthily. Policymakers continue to believe that this is a problem of information dissemination. One obvious solution, therefore, is to give people calorie counts of what they are eating in restaurants. Recent mandates have directed that by the end of next year, calorie labeling will be required on all menus in chair restaurants in the US. It is assumed that once Americans know what they are eating, they will eat less, or at least more health consciously. Will they? New data exist! That's the topic of this week's Healthcare Triage. This episode was based on a column Aaron wrote for the Upshot. Links to further reading can be found there: http://www.nytimes.com/2015/12/01/upshot/more-menus-have-calorie-labeling-but-obesity-rate-remains-high.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

TIMECODE (thanks to SmokyBirch): 1:06 - Is there any good data to support avoiding nitrates? I've been checking every lunchmeat label trying to avoid them (without much success), and I wonder if it isn't just another panic-du-jour? 3:15 - What are sulfites and why is there a "contains sulfites" warning on my wine bottle? 4:57 - I have heard of and seen ads for some DNA test services from companies like Ancestry and "23 and me". What's your opinion on these? Are they accurate and worth it? 6:34 - My in-laws tell me that drinking cold things while eating food with oils and fats will cause them to solidify and give me a heart attack. I think that's wrong, but how do I explain? 7:55 - What is your opinion on the value of the Coronary Calcium Scan test? 9:52 - I have Macrophage Activation syndrome, and I was wondering if you knew of any studies or information on it, like how often does it flare, how rare it is, what helps control it and life expectancy of those who have it etc? Really appreciate it thank you! 11:13 - What are your thoughts on sleep training and research-based best practice that you recommend to parents? 14:46 - What are your thoughts on people taking medicine to treat mild to moderate fever when a fever is the body's natural immune response? Any evidence to support that taking meds to suppress fever is bad? 16:33 - Risks or benefits to cleaning my ears with Q-tips? I like clean earbuds & end up removing orange wax from my ears about once a week. Is this safe as long as I don't go too deep? 17:39 - Are there any studies on health risks of being underweight? Is it just as bad as being overweight or better? 18:51 - Do you have an opinion on how likely Zika virus is to be causing microcephaly? Specifically that reported baseline rate of microcephaly in Brazil (~150/3 million births) is statistically impossible. 20:18 - What is the difference between a DO and MD degree? What is your opinion on osteopathy? An acquaintance I

A simple way to help people quit smoking and a simple way to prevent young women from getting melanoma. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69193 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

00:36 - Is there any research on of there are any health benefits with coconut oil? 1:16 - Are there any high quality research on the efficacy of ketogenic diets in adults to aid in seizure control? 3:23 - What do you think of this? Ketamines use in drug resistant depression. 5:13 - Is there any research to show if the graphic anti-smoking ads being effective? If so, could the same principle be applied to other unhealthy habits such as tanning? 9:10 - Like many people, I am watching events in Flint Michigan with horror. There is a lot of talk about how the lead exposure is going to effect the kids. I wonder if you could explain some of the science behind this, and what medical and other help those kids might benefit from. 11:35 - My daughter drinks one cup of a caffeinated tea every morning (think very weak black tea, only with more sugar) because it (quote) "Makes waking up so much easier". Is that much harmful? Should I consider getting one with no caffeine? 14:13 - Is there any research on "leaky gut syndrome" or is it all made up? 15:26 - Does blue light from cell phones really hurt sleep? 16:17 - My 2yo daughter has been sent home for stuff like excema and dry skin, and I'm wondering if the school's ANY rash = get sent home policy is evidence-based. 18:38 - Lack of agricultural research funding: How big of a public health issue? 19:47 - What are you thoughts on the new anticoagulants (rivaroxaban, apixaban, etc) that focus on less monitoring vs the older types like warfarin? Is that an effective strategy to have more resilient drugs? 22:00 - How long is a cold contagious for? I've been sick for 10 days and I'll be visiting someone on chemo this weekend. I don't want to get them sick, of course! 23:35 - (there was a glitch here with the livestream) You said your kids go to bed early is there any advantage or disadvantage of them going to be later.

What is Zika? Should you be afraid? We try not to fall into the trap of discussing the "panic du jour" on Healthcare Triage, but sometimes people are concerned about things they should be concerned about. But it's still important for that level of concern to mirror the actual threat. For many viewers, the Zika virus hold pretty much no threat at all. But not all. It's really a problem, and we want you to be informed. The Zika virus is the topic of this week's Healthcare Triage. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69241 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Next week's episode: https://www.youtube.com/watch?v=C02CuZGFhZw TIMECODE: 1:32 - Are the health benefits of fatty foods like nuts, fish, & olive oil relative to other fatty foods or good replacements for any equivalent calorie. 3:23 - In observance of Ash Wednesday, many Catholics fast. What can one expect from a 24 hour fasting period? What about longer? 5:14 - I know that acetaminophen is bad for your liver, but I've heard lately (from a coworker) that ibuprofen is worse. What does the research say? 6:51 - Should we get tested for homocysteine and C-reactive protein for markers of inflammation and heart disease? 8:11 - As a medic I frequently hear that medical treatment in the service is abysmal, especially when it comes to treatment of chronic pain. Are there studies on this? Also, what's wrong with the VA? Why does it take so long for them to respond to a claim, and how effective is the treatment they provide? 11:15 - Naproxen or Ibuprofen? Which I use for what? A follow up to this question Both are readily available OTC NSAIDS in North America. Ibuprofen is definitely more popular. Why would I want to choose one over the other? 13:38 - What is your opinion on the CDC's new recommendation that ALL women not on birth control abstain from alcohol? 17:05 - Hi there, would you be able to talk about the advantages and disadvantages of using intention to treat vs. per protocol analyses in health research? Is one better than the other? 20:55 - What does the research say about various drugs used to treat anxiety disorders? Is there any evidence that antidepressants are effective at treating anxiety 22:27 - What would be the ramifications of the common Republican proposal to allow buying/selling insurance across state lines 26:52 - Got an MRI for monocular diplopia. Apparently a pinhole could just as easily have told them it wasn't neural (stroke, etc.). Would another country's system have denied the MRI? Have I been pampered? 2

Text messaging improves medication adherence, and parental depression is bad for kids in so many ways. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69347 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

While we have discussed the dangerous effects of alcohol abuse and misuse, that doesn't mean it's always bad. Besides being part of many complex and delicious beverages, there are any number of studies which show that alcohol is linked to health benefits. That doesn't mean it's all good news, either, or that the evidence is a slam dunk. There's certainly enough, though, to warrant a thorough review. That's the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. Links to further reading and references can be found there: http://www.nytimes.com/2015/12/22/upshot/alcohols-effect-on-health-what-the-science-says.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Next week's LIVE show: https://www.youtube.com/watch?v=-0xr3Y0ENn4 https://www.reddit.com/r/HCTriage/ This week's questions: 2:42 - How much sun exposure warrants sunscreen? What about artificial lighting? I know some of that emits UV too? 3:51 - I sit a lot for long periods. After watching your video on how bad stagnation is, I've started to set a 30 minute timer to remind me to knock that off. Is static stretching and a little bit of walking around fine, or should I do something more engaging? 4:57 - Could you please tell my friend that MSG is not bad for her? 6:54 - My parents are terrified of electromagnetic "radiation" or "electrical pollution" but I'm not. What studies are actually out there? 10:12 - Does microwaving food cause it to lose nutrients? 11:33 Laser health therapy: medicine or quackery? 13:26 - How do we balance the skyrocketing national costs of end of life care with the need for societal compassion? 14:45 - What data exist on the use of SSRIs for a period of several years or more? Is it a bad idea, or OK to stay on them to prevent relapse? 16:56 - Is it that people who don't drink enough water get kidney stones and thus need to drink more, or is it that some people have a predisposition to getting kidney stones and need to drink more water to counter that? 18:46 - What do you think of chiropractors that claim they can "scientifically" prevent SIDS with their adjustments in newborns? 20:26 - Could eating a variety of herbs and spices on a regular basis lead to better health/nutrition, or are the studies on this topic overblown? 21:45 - What do you think about eating high fiber foods? Do you support a high-fiber diet? 22:52 - Is there any research out there about the effectiveness of Telemedicine? How do you feel about it? 24:10 - My recent roommate insists that her immune system is compromised and that she cannot shower before bed because if she sleeps will wet hair she will catch a cold. Please explain why this is SO wrong

Recently, the American Academy of Pediatrics has come under fire for being too easy on kids' football. Football is dangerous, but is this simply an overreaction in the name of keeping any child from being injured ever? Aaron has opinions. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

The CDC's recommendations for women about alcohol and pregnancy caused an uproar on the internet recently. We've got Aaron's take on the situation. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Master Questions List: https://docs.google.com/document/d/1dk-KPVNfkzC1R4YDDF69Fn1Z4KcPxTl5Whis_VtNnDU/edit?usp=drive_web This week's questions: 1:08 - When we get food takeaways, often we don't know if the cook is sick or hasn't washed his hands. Is microwaving the food to high temperature be the most practical way to kill germ/virus? For how long? 2:28 - Is there any evidence on drinking water while eating dinner or lunch is not beneficial to digestion? If so, when should you drink water after a meal? 4:00 - A close relative to me asked my doctor (who happens to be also theirs) about my health. The doctor answered them. Is the doctor wrong? 5:30 - Circumcision have significant health benefits if so, does the EU experience worth health outcomes because of lower rates of circumcision. 9:01 - My primary doctor repeatedly suggested I take prescription diet pills for weight loss during my first physical with them. Is this normal? Are diet pills actually effective for weight loss? 10:18 - I was looking for evidence about this and found one study that looked at 3000 some odd SIDS deaths and found something like 75% of them were cosleeping... but this stat seems irrelevant to me. Isn't such a stat completely confounded by the percentage of infants cosleeping vs not? Don't we need to compare the rates of cosleeping infants who get SIDS to the percent of back in bassinet ones that are? (Aaron mentions a Indiana television commercial that aired many years back. You can watch it here: https://www.youtube.com/watch?v=ivNYTcazdiA) 14:29 - I follow basic precautions to avoid getting sick. I wash my hands before I eat and before touching my face. Some friends say this is bad for my immune system, because I'm not exposing myself to normal levels of pathogens. They imply I'll either develop an autoimmune disease because my immune system doesn't have enough foreign pathogens to fight off, or I will not develop immunity to common diseases, and I'll get sick more often. My

Aaron's been traveling, so this will be more of a quick hits episode. This is Healthcare Triage News...and we're talking about whether workplace premium incentives lead to employee weight loss, whether behavioral interventions improve health outcomes for students, and look at a study that indicates vaccines are CLEARLY a good investment for governments. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69548 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

When Aaron was an intern, or a first-year doctor in training, he knew something was wrong with him. He had trouble sleeping. He had difficulty feeling joy. He was prone to crying at inopportune times. Even worse, he had trouble connecting with patients. He felt like he couldn't please anyone, and he found himself susceptible to feelings of despair and panic. He wasn't alone. That's the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote at The Upshot. Links to further reading and references can be found there: http://www.nytimes.com/2016/01/12/upshot/silence-is-the-enemy-for-doctors-who-have-depression.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Lately, I've become a target for people who like to tell me that "I'm doing nutrition" wrong. Evidently, some people don't agree with my plea, "Don't judge" when it comes to what others eat. One of the things that horrifies my friends is that I don't eat breakfast. I'm just not hungry in the morning. A cup of coffee, and that's all I need until lunch. I've been that way for decades. This means that I'm subjected to periodic lectures on how breakfast is "the most important meal of the day". Yeah, that's a myth. It's also the topic of this week's Healthcare Triage. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69839 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

There are few things that seem to polarize people more quickly than home births. That's the topic of the week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. Links to references and further readings can be found there: http://www.nytimes.com/2016/01/26/upshot/how-to-make-home-birth-a-safer-option.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Labor induction doesn't lead to more C-sections, and the unintended birth rate is dropping in the US. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69960 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Aaron has three kids, age 14, 12, and almost 10. They're awesome, if I do say so myself. So he's not one of those people who thinks that kids are going to hell in a hand basket. If you read mass media, however, you'd think that kids were the worst we've ever seen. It's like everyone is that proverbial old man shaking his fist at the sky, shouting "get off my lawn!" They're wrong. So wrong. And even though we've done episodes like this before, new data exist. So once again – why kids today are so awesome is the topic of this week's Healthcare Triage. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=69991 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Our internet was very unreliable today--sorry! We're drilling a hole through the floor this week to connect ourselves to an ethernet jack to hopefully cut down on the skipping for next time. Here's a master list of questions we've asked in the past: http://ow.ly/Zy7W6 Next LIVE Show (Mar. 30): https://www.youtube.com/watch?v=7hzTV3bbjPU 0:59 Amber necklaces? I have a few a friends recommending these for our teething child. I keep thinking choking and strangulation hazard. Thoughts? 2:35 In The Martian, Mark Watney survives for a long time on just potatoes, water, and vitamins. Probably not a great idea, but is it possible? How long before you'd run into major medical issues? 3:33 How do you know when to have a mole checked out? Is it better to get a suspicious mole checked out sooner or can it wait? 4:19 I see quite a few questions on HTC Live starting with some sort of diet, drink, supplement, or activity, and ending with the question: is this thing better for me? AC seems to unerringly answer these questions with no, because there are no studies linking these things to positive differences in health outcomes. My problem is that I think these people don't really want to know how these things affect disease and death which are measurable health outcomes, but more difficult metrics like mood, comfort, and energy. These things are a big part of how we actually feel on a daily basis, but is there any way to actually study these things and what decisions have an impact on them? If there was, would we be less susceptible to all the products that claim to make us "feel better"? I would love to see this addressed on an HTC Live. 7:55 Does Neosporin actually speed up healing and/or reduce scarring for small wounds? 8:52 I'm learning about health care and systems in the states. I know that the creation of Medicare and Medicaid had an enormous impact on hospitalization rates in the U.S. (more old people/those in need acquired paid access), which also set the b

TIMECODE: 1:21 - In your video on cyclamate you only talk about cancer, but according to the NCI "The FDA's concerns about cyclamate are not cancer related." So what are the FDA's concerns? Should they concern me too? 2:05 - I actually get to watch live today! Aaron, quick, what is your favorite tabletop game? 3:00 - Is very high B12 (like 1500 pg/ml) for at least the last 3 years something to worry about? Doc's (2 PCP's and an endo) say it's non-toxic so no worries... but I found a bunch of studies saying there is correlation with high b12 and some cancers... is cancer screening warranted? 3:58 - All right, so, some background info. I'm 26, and I'm legally blind with Retinitis Pigmentosa. I tend to be pretty skeptical about most articles that get passed around on social networks and such. However, when it comes to stuff about vision issues, I tend to pay just a bit more attention, though I remain skeptical. I just got the following article about an "eye acupuncturist," and I wanted to ask in this subreddit (especially since Doc sounds pretty hoarse from his last episode.) The article: http://determinedtosee.com/?p=1633 So, on to the questions: 1: What studies are there about the effectiveness of acupuncture? From what I understand about it, it really shouldn't do much better than a placebo, right? 2: Does anyone else think the article seems a bit suspicious, or even quackish? 7:05 - Hi, do you have any thoughts on cord blood banks? Is it just a waste of money or a great idea worth investing in? What do we know about the quality of that material after a while (say a year)? Maybe it should be considered only by families with certain hereditary conditions? 8:49 - Is there any science behind the recommendation to do 10,000 steps per day? I heard it was a marketing message from a podometer manufacturerer (edited) 10:54 - People tell me that people with pre-existing conditions die while waiting for treatment in Canada, is this just scare tactics

Contralateral prophylactic mastectomies. Not helping. No one seems to care. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70017 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

When one of Aaron's best friends in medical school returned from an interview for a surgical residency program, he told him how some of the surgeons there bragged that they were worked so hard that the divorce rate among their trainees was greater than 100 percent - some of them burned through two marriages. They were proud of this. Aaron was horrified. He doubts this statistic was true, even 20 years ago, and he's even surer it's not true now. But it points to an important truth: Some physicians equate "suffering" with "commitment" and believe that a residency should be grueling and difficult. The limits on how we train residents, and what new studies say about it is the topic of this week's Healthcare Triage. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70030 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

I have written before about the use of premiums in Medicaid programs across the United States. But a new study in Pediatrics collects the evidence, and it's worth a look. "Medicaid and CHIP Premiums and Access to Care: A Systematic Review". This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70074 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Aaron is part of a weekly gaming group. Most of the time it's role playing games, although board games come into play as well. Most of the participants are doctors. We have a group text that we officially use to schedule, but unofficially it's the way that we share news stories about medicine that drive us insane. It's unfortunate that these gaming-group group-text (which is seriously one of the most qualified, educated, and thought-provoking feeds that only eight people get to access) can't be more widely shared. But today, we're going to go over some of those crazy news stories, and why you shouldn't believe every headline you read. That's the topic of this week's Healthcare Triage: Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70091 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

You guys and your Vitamin D. You ask me on HCT Live, you ask me on comments, you ask me on Twitter. I'm amazed at the persistence of this question, as study after study seems to show that Vitamin D isn't doing most of us much good at all. I finally got all my thoughts together on a recent post over at JAMA. But let's do it here, too. This is Healthcare Triage News. This was adapted from a column I wrote for the JAMA Forum. Links to references and further reading can be found there: http://newsatjama.jama.com/2016/03/24/jama-forum-why-take-vitamin-d-supplements-if-they-dont-improve-health/ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

A century ago, the top three causes of death were infectious diseases. More than half of all people dying in the United States died because of germs. Today, they account for a few percent of deaths at most. We owe much of that, of course, to antibiotics. The discovery of prontosil, the first synthetic modern antibiotic, earned Gerhard Dogagk the Nobel Prize in 1939. Mass-produced penicillin earned Alexander Fleming, Ernst Boris Chain and Howard Walter Florey one in 1945. It is hard to overstate how much less of a threat infectious diseases pose to us today. But we take antibiotics for granted. We use them inappropriately and indiscriminately. This has led many to worry that our days of receiving benefits from them are numbered. That's the topic of this week's Healthcare Triage. This episode was adapted from a column Aaron wrote for the Upshot. Links to further readings and references can be found there: http://www.nytimes.com/2016/03/08/upshot/were-losing-the-race-against-antibiotic-resistance-but-theres-also-reason-for-hope.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:22 - What is your opinion of free public access to research articles? 3:13 - I was wondering what the cognitive symptoms of mild, moderate and severe dehydration were. 3:59 - I got my flu shot yesterday, and, curiosity and a Google search lead me to a report saying the 2015-16 cycle has been 60% effective. Is that good? Seems less than impressive. 5:01 - Why most universal health care coverage don't cover teeth? Treating my cavities is part of my health as much as treating the flu isn't it? 5:50 - Is there any good research on (moderate - heavy) weightlifting increasing bone density? And if it is, is this possibly a good way to decrease bone fractures in the general population? 6:43 - How do they make glasses for babies? I have to read a tiny line to get glasses but they make them for babies? 8:05 - Are all prenatal vitamins created equally? Some are $5, some are $20. What's the difference? 8:58 - I've had a cough going on 3 months now. All the doctors find is I have low potassium in my blood work and nothing on my xrays. Should I go to another hospital for their opinion? 9:46 - Advice on how to explain to friends/family that they don't know how to treat themselves better than their doctors do? 10:29 - I move all the time for school/work, so I'm constantly changing healthcare providers and I don't have a regular physician. How am I supposed to keep track of my medical history? 11:20 - For an otherwise healthy person, is there any good reason to endure a headache as opposed to knocking back some paracetamol/ibuprofen/aspirin? 12:18 - What is Tetralogy of Fallot, my nephew has it and nobody can explain it to me very well. 14:58 - Do antibiotics applied to the skin have the same effect as those ingested? I regularly treat skin infections this way. Should I stop? 15:43 - Olympics in Brazil, should it be cancelled because of Zika?

Unless you were living under a rock this week, you heard there was a huge new study on life expectancy in America. It's worth our time. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70335 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

The news cameras have largely moved on from Flint, MI, where government failures have resulted in elevated lead levels in the city's drinking water. But the effects on Flint's residents, particularly its children, may not show up until long after the cameras have left town. That's the topic of this week's Healthcare Triage. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70349 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:42 - Pennsylvania just legalized medical marijuana. One of the conditions it claims to treat is Autism. Can you please explain how that works? 4:33 - What are your thoughts on growth attenuation therapy for the severely mentally disabled? 7:45 - What evidence is there to support waking up newborns every 2 hours to eat? 9:28 - Dairy-fat biomarkers associated with lower instances of diabetes. Is this study useful? Is there any correlation between dietary intake of fully fat dairy and these biomarkers? 10:51 - I just learned a bit about theories which say that certain types of parasitic infections may provide benefit in reducing harmful autoimmune function. What is the status of investigating and developing this as a therapy? 12:52 - What are some causes of postcoital bleeding other than cervical cancer? Most of the trans guys I know have experienced it at one point but it's statistically impossible for us all to have cervical cancer. 15:04 - From everyday experiences, it seems as if people in their forties and fifties are more prone to get diabetes. Is that true? If yes, why? 16:06 - I was told to get a partial colonoscopy by my doctor but I've heard from other doctors that they are inferior and you should only get full colonoscopies. What does the research say? 19:20 - Among medical professionals, do you think there's a bias in favor of pharmaceutical interventions and against behavioral interventions when treating disease? Why or why not? 20:03 - Is there a difference between how European food supplements are regulated and how it is done in the USA? 20:13 - How do you feel about a potential sugar tax? 22:01 - Do you think the fear of radiation from nuclear power plants is overblown? 23:22 - Is long-term low hemoglobin levels (10-10.5) a thing to worry about? My GP just shrugs but it's been 2 years now... 25:17 - Your thoughts on RLS (restless leg syndrome) do you believe it's a real disease or just a symptom?

There are a few topics here at Healthcare Triage that just won't seem to go away. Vaccines and autism. Diet and exercise. Survival rates. But the one that trumps them all is supplements. Americans seem obsessed with them. The one group I thought might not be overtaken by this craze was the elderly. Boy, was I wrong. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70370 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

More than 86 million people, including 22 million people 65 or older, have pre-diabetes, which increases their risk of heart disease, strokes or diabetes. As we've watched that number grow, it has somehow felt that despite billions of dollars of research and intervention, there's little we can do. That feeling shifted recently when Sylvia Mathews Burwell, the secretary of health and human services, announced that Medicare was planning to pay for lifestyle interventions focusing on diet and physical activity to prevent Type 2 diabetes. It's an example of small-scale research efforts into health services that have worked and that have expanded to reach more people. That's the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. References and links to further reading can be found there: http://www.nytimes.com/2016/03/31/upshot/the-unsung-success-of-a-diabetes-prevention-program.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Although the ACA has significantly reduced the percent of Americans who are uninsured, we have not yet come close to universal coverage. This has become a topic of focused debate among Democratic primary candidates. Short of achieving full coverage by passing a single-payer plan (which seems very unlikely in the near future), further gains in insurance coverage will come through means available through the ACA. It's worth revisiting, therefore, exactly who constitute the uninsured at this point. A better understanding could allow policymakers and advocates to focus their efforts on those populations. A recent report from the Robert Wood Johnson Foundation and The Urban Institute covered just that. So do we, in this episode of Healthcare Triage News. This was adapted from a post Aaron wrote at the AcedemyHealth blog. Further reading and sources can be found there: http://blog.academyhealth.org/?p=4307 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Thanks, in part, to the generous support of the NIHCM, this month we are releasing four special episodes on Opioids. We hope you enjoy them. This week's episode: The History of Opioids - We will give a historical overview of people and opioids. We will look at when people first started using opioids, how they've changed over the years, and ways that they've been both amazingly positive as really effective painkillers and devastating to individuals and social orders. We will explore the early accounts of opiate use, addiction, and treatment, and touch on the Opium Wars in China. The evolution from raw opium latex to the powerful drugs derived from opium today traces a clear history of increasing addiction as opioids were available in more and more powerful preparations. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70453 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Leave your questions in the comments section and we'll get to as many as possible! The Machete order for watching Star Wars: http://www.nomachetejuggling.com/2011/11/11/the-star-wars-saga-suggested-viewing-order/ This week's questions: 00:53 - Should people be paying attention to expiration dates on prescriptions and over the counter medications? 2:15 - Preemptive wisdom tooth removal has very significant costs and risks. What evidence is there that my dentist is correct in saying that nearly everyone should get their wisdom teeth removed? 3:18 - Are there additional risks involved in drinking energy drinks over their regular or diet soda counterparts? Many people insist on them being terrible. 4:35 - Does medical research have an expiration date? I.e., do you trust studies from the 1950s that haven't been reverified by newer studies? 6:49 - The Affordable Care Act has resulted in a substantial reduction of uninsured. Yay! Is there evidence that this is having a positive impact on health in the US, or just a metric to check off? 8:29 - How's the Apple Watch? Do you think it's a helpful health device? 9:45 - I know your thoughts on supplements in general, but I've noticed you still recommended a prenatal supplement (folate especially). Why this double standard? 10:39 - In honor of today, what do you think is the best order for viewing the Star Wars films? 13:54 - Are there any health risks to being in the military that civilians wouldn't have? 15:03 - Are there any negative effects to eating the same food every day? 16:17 - If trying three different antidepressants hasn't helped, is there much merit in trying more, or is there as much value in more natural approaches like mindfulness, meditation, exercise, etc.? 17:31 - Everyone seems to be talking about "toxins" and how bad they are, but no one ever talks about what they are. What is a "toxin"? Are there any we really need to be aware of? 19:57 - Please comment on any research on the relationship

Three quick hits today. All from JAMA Pediatrics. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70507 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Thanks, in part, to the generous support of the NIHCM, this month we are releasing four special episodes on Opioids. We hope you enjoy them. This week's episode: The Science of Opioids - How do opioids work? We look at the physiological processes that let opioids produce their effects in human bodies. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70538 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:23 The infant formula milk industry is a multi-billion dollar industry. You cannot turn on the television without at least watching an advertisement hailing the mental and physical benefits of X baby formula. Since then, there is a prevailing belief that parents MUST purchase this or that brand of baby formula otherwise their child will be at a disadvantage. Your opinion on this? 3:17 The Food and Drug Administration said there are serious and sometimes disabling side effects from the commonly used class of antibiotics called fluoroquinolones. Is this just another FDA overreaction or do the risks outweigh the benefits? 4:30 Folate during Pregnancies causes autism? Are we being trolled? 8:30 Is there a difference in regulation between herbalsupplements and vitamin supplements? I take magnesium oxide (which comes from behind the pharmacy counter) to prevent migraines. 8:50 Why don't we use male birth control? 10:27 IGG food intolerances and Leaky Gut? 11:40 Is there a way to lessen tolerance to dexamphetamines. I've been prescribed them for the last 7 years (I'm 19 now). 12:22 What diseases often produce false positive tests? 13:47 What causes visual snow and why do some people see it all the time? Is there reason to be concerned about it?

Pay for performance. We've got all the bugs worked out now, right? Yeah... not so much. This is Healthcare triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70589 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Thanks, in part, to the generous support of the NIHCM, this month we are releasing four special episodes on Opioids. We hope you enjoy them. This week's episode: Opioid Abuse - Opioid drugs can be powerfully effective treatments for those in pain, but they can also be extremely dangerous. This episode explores how opioids can lead to dependence and addiction, and the effects that abuse have had in America. The episode explores how drug manufacturers, regulators, doctors, and patients have all contributed to the current crisis of opioid addiction. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70608 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

My physician-gaming-group-friends are being swamped by concerned parents because of a new study in Pediatrics that has led to many news articles declaring that swaddling - wrapping an infant tightly in a cloth or blanket - may increase the risk of Sudden Infant Death Syndrome, or SIDS.

Thanks, in part, to the generous support of the NIHCM, this month we are releasing four special episodes on Opioids. We hope you enjoy them. This week's episode: Treatment - The best way to deal with opioid addiction is to prevent it, but for a huge and growing number of Americans, it's too late for that. This episode looks at some of the pharmacotherapy and cognitive therapy options for treating opioid addiction, and looks at how we've so far largely failed to treat addicts. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=70751 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 2:53 Are there any studies on taking sleep inducing products like Melatonin or ZZZquyl? Long term hazards? 4:43 Everyone is getting nutritionists/naturopaths food sensitivity tests. Is it evidence-based, an overextended health claim, or totally bogus? 6:22 How much weight should we give to the studies about brain mapping? 8:51 What can you tell me about treating ADHD in adults? What worked for me as a kid doesn't seem to help as much as it used to now that I'm older. 10:48 How would you recommend bringing up/pointing out fat shaming to a doctor who repeatedly deflects my Q's and discussion of a chronic medical issue to talk about my weight, despite being unrelated? 13:32 My one year old isn't babbling yet. When I told the doctor he told me babies sometimes don't talk till 2-3. Is that also with babbling? 15:42 What are the chances of passing IBD to your child if one parent has Chron's? Should you worry about this, the meds are not cheap! 17:47 I was recently bit by a venomous spider and I went to urgent care and got treated. Then I went to my GP a few days later, but I was told it was just my anxiety acting up (diagnosed GAD). Is there anything I can do to prevent this from happening? 20:20 I live in Canada, where some provinces have stopped paying doctors for performing annual physical exams. The evidence seems to be point out that annual physicals do not affect morbidity or mortality. 23:26 How much damage is typically done if the brain is cut off from oxygen for less than a minute? 24:40 I've heard lots of talk about "oil pulling" or oil gargling as a way of whitening teeth or maintaining dental hygeine. Is there any scientific basis for this? 25:16 Can please you tell me more about amputees' phantom pain? How bad is it generally? How often does it occur? 27:39 How does Aaron feel about the longevity movement. Luigi fontana has fascinating work on calorie restriction. We also have aubrey de grey doing work to "fix the problems

"Sexual Harassment and Discrimination Experiences of Academic Medical Faculty". This study will depress you. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=71299 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

It has become an article of faith among many of my friends that when they are pregnant, they should eliminate foods that could lead to allergies in their children. They forego shellfish, they do without dairy, but most importantly, they avoid peanuts. This behavior continues after their children are born. While they are breastfeeding, they continue to abstain from certain foods. They certainly keep their children, themselves, from eating them. But research in the last few years had consistently shown that this may be the wrong approach. We may be doing more harm than good with all this avoidance. We might want to consider doing the opposite. That's the topic of this week's Healthcare Triage. This episode is adapted from a column Aaron wrote for the Upshot. References and links to further reading can be found there: http://www.nytimes.com/2016/04/26/upshot/avoiding-peanuts-to-avoid-an-allergy-is-a-bad-strategy-for-most.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:49 I know you've said that vitamins essentially make expensive pee, but what if you can't afford to get nutritious food often and are mostly eating carbs because you're super poor? Would vitamins help? 4:08 What do you recommend for weaning babies? Whole milk has been the traditional drink but what is the better alternative? 5:56 What are your thoughts of the new laws in California and a few other states that allow women to have access to birth control without seeing a doctor? 7:22 How/why does granular scar tissue form? If you have had issues with it once, what are the chances of having it happen again, particularly when it occurred postpartum? And why is it so darn painful? 9:13 Have you read any books or poetry about being a doctor? Any favorites or recommendations? 12:30 Have you seen the silly promotional video for the Squatty Potty? Is there truth to any of its health claims? 14:24 Other than rest, ice, compression, and elevation, is there anything else I should be doing for a calf strain? I'm on day 3. 15:16 Was wondering what the research says about how effective EPA and DHA fish-oil supplements are for treating depression? Particularly interested in how they can be used for treating depression in those with a history of being clinically underweight due to illness. 16:36 Due to the humidity, sometimes I just hate wearing my glasses (it feels icky). My mom said it will make my vision worse. Is that true? Does regularly not wearing prescriptions to correct vision problems have any long term cumulative effects? 19:08 I was diagnosed as a type I diabetic 20 years ago. Back then they said I'd probably be cured of it by now. What kind of realistic expectations should I set for the next 20 years? 22:43 How have EMRs affected physicians approaches to care? Helpful? Harmful? Burnout? 26:57 Can we as citizens do anything to lower healthcare costs? 27:26 Thoughts on Rogue One Trailer?

For many, many years we've been hearing about gene therapy – the chance that we can get into people's DNA and fix it to resolve problems and fix disease. In a recent piece in Science, Stuart Orkin and Philip Reilly discuss what finally achieving success might mean. Let's talk about that. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=71469 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

In 2012, the American Academy of Pediatrics published a policy statement in which they said that the benefits of male circumcision outweighed the risks of the procedure. They cited health benefits which, while not great enough to warrant a recommendation for all males to undergo the procedure, were significant enough to make sure all who wanted it could get it, and that it should be covered by insurance. Not long after, the CDC concurred. But what is the evidence for and against circumcision? That's the topic of this week's Healthcare Triage. This episode was adapted from a column Aaron wrote for the Upshot. Links to further reading and sources can be found there: http://www.nytimes.com/2016/05/10/upshot/why-science-cant-help-you-much-in-deciding-on-circumcision.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

More than once, I've considered packing up the family and taking a job in a different city. Each time, my wife and I thought about what it might do to them if we moved. But we were just guessing. There are data! This is Healthcare Triage News. Is moving hard on kids? Turns out, yes. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=71571 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Following the tragic events in Orlando earlier this month, there were many reports of gay men being turned away when they went to donate blood. Why do non-celibate gay men have their blood donations rejected? Turns out, it's an outdated guideline from the early days of HIV AIDS. This week, Aaron looks at the FDA's guidelines for blood donation, and the modern tools we have to screen blood. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Aaron and his wife both work. When one of their kids wakes up complaining of a sore throat, they begin a ritual staredown to determine which of them is going to have to wait for the doctor's office to open, call them, wait on hold, schedule an appointment (which will inevitably be in the middle of the day), take off work, pick the kid up from school, wait in the waiting room (surrounded by other sick kids), get seen, get the rapid strep test, find out if the kid is infected, and then take them to the pharmacy or back to school, before returning to work. Or, one of them could just take the kid to a retail clinic on the way to work/school and be done in 30 minutes. The undeniable convenience and reliability of retail clinics is the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. Links to sources and further reading can be found there: http://www.nytimes.com/2016/04/13/upshot/the-undeniable-convenience-and-reliability-of-retail-health-clinics.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:54 Most regular painkillers can be dangerous to use for people with IBD (colitis & crohn's). What over the counter medications are considered less harmful? 3:40 Are there actual ways to relieve sore muscles (after workout soreness) or are all home remedies basically useless? 6:01 I've always heard the foster care system is hard on kids. Do we know the long term health and mental outcomes of foster care children vs non-foster care children (like children living with parents). 8:13 Have you seen any studies on Kombucha tea? It claims to be probiotic, but I'm hesitant after all we've been through (over and over) with the live cultures in the yogurt. 9:35 What is the latest best treatment for a skin burn, where the blister has popped. Cover or not cover? 11:11 Thoughts on MIT RNA programmable vaccines? 14:08 Friends have been post a video on Facebook claiming chemotherapy does not work 97% of the time, (work is not defined) and is only being used because it is profitable. I'm assuming this is misleading at best and was wondering what the real probabilities of positive outcome are with chemotherapy. 17:18 How do insurers justify refusing to pay for drugs that are FDA-approved but still "experimental"? Is it too cynical to think "experimental" is code for "not cheap yet"? 18:32 Is it safe for non-smoking Ulcerative Colitis patients to use nicotine patches (as additional medication for UC) or are there negative effects in the long term? 21:00 Is there any evidence supporting the use of enemas for matters other than constipation (e.g. general health and well-being)? 23:23 Is there a limit to how many calories the body can absorb when gorging such as on a cheat day? 24:47 What are your views on the use of propaganda to address non-compliance and public health objectives?  STD/STI fear-mongering, anti-drug programs, and programs that espouse particular social or religious aims that align with public health objectives still seem commonplac

When I was a medical student, I remember doing a psych rotation on a pediatric ward. I was struck by how many of the admissions were for eating disorders. Even before then, I was aware that more than a small number of my female friends and acquaintances were suffering from some form of disordered eating. So when I saw a study on the topic, I was more than a little intrigued. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=71784 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

We've covered e-cigarettes before, but there's new evidence, and new policies. You deserve an update. That's the topic of this week's Healthcare Triage. This was adapted from a column I wrote for the Upshot. Links to references and further readings can be found there: http://www.nytimes.com/2016/05/11/upshot/e-cigarettes-are-safer-but-not-exactly-safe.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Studies show that sunscreen is too expensive, and it probably encourages people not to use enough. Also, unequal pay for women is still very much a thing in medicine. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping:

Salty foods are delicious, but for decades we've been told that sodium in our diets is a bad thing. Recent studies suggest that while limiting salt intake is probably a good idea for people with high blood pressure, it probably isn't helpful for people who don't have blood pressure issues. In fact, an extremely low salt diet may even be more harmful than a more standard intake. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 3:39 Transcendental Meditation makes some wacky claims (tumor prevention), but they make an interesting claim that TM is more effective than other forms of meditation. Is there any merit to this? 5:26 Why does it seem like American dentists are so intent on removing wisdom teeth? Do most people really need this procedure? 7:03 Is sugar addictive? If sugar addiction is a behavioral addiction, is sugar addictive? 8:12 Does sunscreen expire? If I have a bottle left over from last summer, would it still be okay to use? 9:06 I'm a young adult in decent health, but I've been having dizzy spells from time to time. Doctor did bloodwork and it looked normal. How concerned should I be? Is it normal for coffee to cause it? 10:33 In sodium video, it suggested adverse effects for sodium consumption lower than 3g. What sort of people fall into this category? Are they from poorer countries? 12:07 Anyone know what the deal is with microwave popcorn? I was eating some in front of my mother in law the other day and she told me it was going to give me cancer. I'm naturally suspicious of those claims but a cursory Internet search brought up articles on diacetyl, PFOA, TBHQ, popcorn lung, etc. Nothing seemed very convincing but I'm curious if anyone has good evidence one way or another? 14:39 I was wondering whether you've seen any research on phimosis in the elderly. I've worked with several patients who have had it. Just curious if that's normal for the uncircumcised elderly. 15:22 Has there been any study initiated that Pokémon Go has had a positive effect on blood sugar levels or other values? 18:26 I'm curious, are vaccination and booster shot "due dates" different for every person, or totally generic? Does missing the dates by a week, month, year, etc. change their effectiveness? 19:38 Does the use of Aluminium products increase the chance of getting Alzheimer's? 20:32 Why is it so hard to install universal healthcare system!! 22:39 As and MD/p

So often, when we implement new policy, I wish we had better ways to capture its effects so that we could expand our knowledge base as to how decisions change health and health care. The Oregon Health Insurance Experiment, and its older brother the RAND HIE, were RCTs designed to look at how insurance affected utilization and health. While these were impressive studies, they had their flaws. RCTs are hard to do, though; they're also expensive. Sometimes, other designs are necessary. Recently, in Annals of Internal Medicine, Laura Wherry and Sarah Miller looked at how the Medicaid expansion has changed things. Let's discuss. This is Healthcare Triage News. This was adapted from a post Aaron wrote for AcademyHealth: http://blog.academyhealth.org/so-what-did-the-medicaid-expansion-actually-do/ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

Aside from whatever a visit to the doctor costs you in money, it also costs you in time. A lot of it. Can we make that better? That's the topic of this week's Healthcare Triage. This episode was adapted from a column friend-of-the-show Austin Frakt wrote for the Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2016/05/17/upshot/you-mean-i-dont-have-to-show-up-the-promise-of-telemedicine.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Though you may not have realized it, there's a good chance that a doctor has prescribed you a medication for a use other than what it was approved for. This off-label use is perfectly legal, but isn't as safe as it might be, in part because incentives to invest in costly clinical trials to test such uses are weak. Efficient use of off-label drugs is the topic of this week's Healthcare Triage. This episode was adapted from a column Austin Frakt wrote for The Upshot. Links to further reading and references can be found there: http://www.nytimes.com/2016/02/23/upshot/drugs-fda.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 5:39 What healthy steps would you recommend a person in their 20s take that would benefit over their lifetime? 7:31 Hi, is diabetes type 2 reversible? 8:50 Is it true that cutting lettuce leaves with a knife lessens its nutritional value more than shredding it with your hands would? 10:45 What's P-Hacking? And how prevalent is it in medical research? 13:54 Does stretching actually help with exercise or recovery? 14:57 Are there any other safe methods to get rid of excessive earwax than just hydrogen peroxide? 16:47 My 23 year old girlfriend was recently recommended by a surgeon to get knee surgery. Do you believe that patients should usually seek a second opinion in matters like this? 19:13 Recently saw an article that says that slowing metabolism after weight loss is due to loss of muscle mass, and that muscle building exercises 2x per week can keep metabolism high. Your response? 21:25 I'm aspiring to become a young healthcare administrator from Cornell University. What is one thing you would like to see from administration in the future? 23:50 Are there SSRIs that don't cause drowsiness? 24:13 What are your thoughts on the recent news on flossing? Flossing - yes or Flossing - no? 25:28 My step dad recently got diagnosed with lewy body dementia(at 48). He is already hallucinating and having muscle loss. What information can you give me on LBD ? Any info or advice? 26:19 I'm going to try to appeal to your speciality, how do you feel about treating adolescent with amphetamines Derivatives?

Having a low BMI is associated with increased mortality. High BMI is too. Keep it in that normal range, y'all. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72032 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Americans seem very afraid of cancer. Much of this fear is legitimate. Cancer is a significant cause of death. Unlike other causes, it often seems to come out of nowhere. It's the "silent killer". But evidence increasingly argues that cancer may be preventable, too. Unfortunately, this has inflamed as much as it has assuaged people's fears. Cancer prevention is the topic of this week's Healthcare Triage. This episode was adapted from a column Aaron wrote for The Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2016/07/06/upshot/helpless-to-prevent-cancer-actually-a-lot-is-in-your-control.html?_r=0 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Do Alcoholics Anonymous participants do better at abstinence than nonparticipants because they are more motivated? Or is it because of something inherent in the A.A. program? How researchers answered these questions in a recent study offers insight into challenges of evidence-based medicine and evidence-informed policy. That's the topic of this week's Healthcare Triage. This episode was adapted from one of Austin Frakt's Upshot columns. Links to references and further reading can be found there: http://www.nytimes.com/2015/04/07/upshot/alcoholics-anonymous-and-the-challenge-of-evidence-based-medicine.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 1:56 What do you think about Pres. Obama's article on the ACA in JAMA? Is it ok because it's relevant to healthcare in the US, or bad because it politicizes a scientific publication? 4:06 My son was recently diagnosed with ADHD/ODD, and his pediatrician recommended a gluten-free, dairy-free diet. He has improved on this diet (placebo?), but I can't find any good research. Thoughts? 5:35 Should I be concerned about the possible health risks of ingesting too much maltodextrin? I drink Soylent and am wondering if the high level of maltodextrin contained within it is unhealthy? Thanks! 6:50 Hi, I've just seen a video on infant self-rescue and I was wanting to know you're opinion as a pediatrician? 8:29 Are there any long term side effects of Accutane? I'm in my 4th month, and still no side effects! 9:08 What is the most effective management of common cold? 11:14 What evidence is there for blue light, specifically from LEDs, being bad for you? Saw a sign at the eye doctor advertising special lenses to protect you from "eye strain, retinal damage, sleep problems and ADHD" caused by the blue light from LEDs. As a physicist, I am deeply skeptical that the narrowband blue light from LEDs are any worse than broader band blue light from supposedly safe sources. What does the research say? 12:56 I don't trust Dr. Google to diagnose me -- at all -- but sometimes searching yields a plausible fit for my symptoms. What's the best place to start when talking to a physician? 15:02 Hi! What does the recent developments with Aetna mean for the ACA? 19:46 Can you dumb down what a single payer system is to a Tweet length? 20:11 I have a question about a video in the past about Wisdom Teeth removal and why the US like to remove them, can you list some reasons when/why it should be removed? 21:06 Your opinion about "Quantum Medicine" and "Quantum Therapy". Are there any proven benefits of this or is just a gimmick? Are there any particular areas where th

Never disrespect the randomized controlled trial. This is Healthcare Triage News. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Many more babies die in the United States than you might think. In 2014, more than 23,000 infants died in their first year of life, or about six for every 1,000 born. According to the Centers for Disease Control and Prevention, 25 other industrialized nations do better than the United States at keeping babies alive. Infant mortality is the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. Links to further reading and references can be found there: http://www.nytimes.com/2016/06/07/upshot/the-us-is-failing-in-infant-mortality-starting-at-one-month-old.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 2:06 Are kids with type 3 supracondylar fractures at an increased risk of elbow issues later in life (arthritis, ulnar nerve compression, etc)? If so, can they do anything preventative to mitigate it? 2:57 What can explain the recent skyrocketing cost of an epiPen? What can we do as patients who need this med and can't afford the $600? 8:47 How do drugs like Saxenda work for those who are insulin resistant but not yet diabetic? 9:10 Any new research or information on ssri's/snri's? 9:36 What would you do to improve mental health care? Should we all be screened for anxiety/depression etc? 12:26 Is fructose like really bad for health? Lots of em in soft drinks and juices right? 13:57 Any research about thermodynamic calorie burning (e.g. weight loss through cold exposure)? Presume not, but if not, why wouldn't it work (as it makes perfect sense from a purely chemical perspective)? 16:35 Are there any scientifically proven factors which increase the risk of appendicitis? 17:48 I saw the video on milk however when I tell my parents they say it's for the calcium... So is that a sound rebuttal? Especially for kids and the elderly 20:21 I'm an educator, and the new en vogue research is the Adverse Childhood Experiences Survey (ACEs). How legitimate is this study and has it been backed up by other studies? 21:54 For those allergic to eggs, what are the vaccine options? (I promise I'll ask my doc next week.) 22:28 You said that an hour of exercise isn't enough to impact weight loss greatly. So, what type of lifestyle changes would you recommend to someone looking to lose weight?

No studies this week. We're actually going to do news. It's time for an Addyi update. Addyi, or Flibanserin was touted as the "female Viagra" despite the fact that it isn't very similar to Viagra. It still doesn't work very well or for very many patients. And it has a lot of side effects. Oh, and you can't drink or take hormonal birth control while you're on it. And you have to take it every day. Believe it or not, it's not selling very well. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72475 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Can we keep drug prices low without hurting innovation? Well, drugs are a lot cheaper in Europe than in the US, and there's still plenty of innovation over there. So what's going on? It's called reference pricing, and it's pretty much genius. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72475 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 2:39 What does the scientific evidence say about the effectiveness of acupuncture? Wikipedia says, "Systematic reviews found little evidence of acupuncture's effectiveness in treating pain." 4:50 I've been on a few rounds of steroids trying to clear up a UC flareup. At first we were trying corticosteroids, but now my doctor has me on glucocorticosteroids. What's the difference? 5:48 Is it true that consuming soy milk will increase estrogen levels & negatively affect health? I drink soy milk and people always tell me that I should switch to other milk substitutes like almond milk. 7:21 When should children begin seeing the dentist? Every source lists a different age. 8:17 What are antioxidants and what are they for and why do we need them (or don't)? 10:17 I've heard differing answers on how often I should see a dermatologist. Is it different for people who are high-risk for skin cancer? 12:18 3yo has eczema that we are really struggling with. We have a wonderful allergist, and we did tons of allergy testing about a year ago, which identified eggs, and eliminating them has helped tremendously, but recently the eczema seems to be getting worse again. How do we know when it might be time to do more allergy testing? I don't want to put him through unnecessary testing. 14:42 Can you talk more about when you would recommend someone see a therapist? What sorts of indications? How to find a good one? What to say when scheduling an appointment? 17:03 What do you think are some key points of each presidential candidate's healthcare policies that we should pay attention to? 24:19 Which medical skill, besides CPR, would you wish the general public to master? 25:25 Dr. Carroll, I've got way too many bodybuilder friends who tote protein shakes and high-protein diets. Are there any studies for or against the effect of high-protein intake on muscle development?

This week's questions: 3:24 Yesterday an article in the Annals of Internal Med found that for every hour with patients doctors spend 2 hours with EHRs plus 1-2 hours at home with EHRs. Is this news or is this already known? 5:09 You said you reserve judgement on parents who spank, but how do you know when they've crossed into problematic uses? 6:58 In Ontario, guidelines say that women don't need pap tests until they've had sexual skin-to-skin contact. Elsewhere I've heard it's by age 21, even with no sexual history. What does the evidence say? 8:11 Hi Dr C! Was wondering about the tissue paper seat covers in public bathrooms. What are they trying to protect me from? An STI? Norovirus? Can they possibly be effective? 9:58 The rise in superbugs has triggered a meeting of the UN general assembly. What, if anything, do you think will happen at this meeting? 11:39 I have a small patch of ringworm on my leg, and my mother insists I use essential oils for it. I think iodine would work better,and is proven to work. How do I tell her essential oils are snake oil? 12:48 On a personal level, what is your reaction when people respond to your publications by calling you an "industry shill?" which topics get the most of these reactions? 18:09 Is there a difference between ionized water, alkaline water and distilled water? 18:31 Should we really follow FDA instructions and wash our hands for 20 seconds? I do and everyone laughs at me. 20:13 What do you know about migraines and CGRP (Calcitonin Gene-Related Peptide)? What natural purpose does the CGRP serve and why would it be elevated during migraines? 21:06 Is 5 small meals instead of regular 3 meals actually healthier? 22:09 Does being a frequent flyer affect health? Such as flying around for business to various countries. 24:02 Do you think medical errors (may be third leading cost of death) will ever be reduced to the point where the medical industry will be high reliability like the airline industry?

I spend a fair amount of time talking about how social determinants of health come into play, with respect to health care outcomes. I also talk a lot about things that don't work, and therefore constitute waste in that they don't affect outcomes positively, and cost money. But there are some aspects of health care (many, in fact) that do matter, and when research points that out, it's worth highlighting. This is Healthcare Triage News. This episode was adapted from a post Aaroon wrote for AcademyHealth. Links to sources can be found there: http://blog.academyhealth.org/experience-matters-when-it-comes-to-outcomes-and-safety/ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Three times in the last two weeks, people - a patient, a colleague and my wife - told me stories about how out of control the price of EpiPens were. Monday, my New York Times colleagues recounted in detail how expensive the devices have become in recent years. All tell the tale of how much even basic health care can cost in the United States. But by digging a bit further, the story of EpiPens can also explain so much of what's wrong with our health care system. That's the topic of this week's Healthcare Triage. This episode was adapted from a column Aaron wrote for The Upshot. Links to further reading and sources can be found there: http://www.nytimes.com/2016/08/24/upshot/the-epipen-a-case-study-in-health-care-system-dysfunction.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

We had some internet troubles on this broadcast (we checked the version stored on our computer and it had the same issues). You'll probably be better off listening to this in the background OR listening to the podcast version over on soundcloud.com/healthcaretriage. We'll be back with the LIVE Show on October 12, in the mean time you can leave your questions in the comments section of youtube.com/healthcaretriage/live This week's questions: 2:05 Is there a line between EHRs using a central database, or keeping a record of every hospital you visit, and telling them before your visit every hospital has records on said person. 4:01 What would you look for to differentiate a pica disorders from toddlers just putting everything in their mouth? 5:13 This one is from my mom: Is waking up a few times a night to rollover or whatever a problem I should be trying to solve if I'm not tired. How do I know if I'm getting enough REM? 6:24 What's your opinion on "delayed umbilical cord clamping" after birth? The American Congress of Obstetricians and Gynecologists hasn't come out in support of it, but the WHO seems to recommend it. 7:48 Any thoughts on Gary Johnson's healthcare free market ideas? 12:04 Any thoughts on the conspiracy of why kratom is being reschedule a schedule1 drug (aka big pharma)? 12:51 Could you talk about "3-Parent Babies" and other future uses for gene therapy? 14:01 Several groups characterize porn use as "harmful" and a "mental health crisis," citing addiction, warped expectations, and early onset ED. Is there evidence of such harm in porn exposure and use? 16:43 What are the treatments for food allergies in kids? Is there a way to desensitize them? Or do they need to avoid that food for their whole life? 17:47 Certain kids get multiple cases of chicken pox when young, and then also have a minor shingles outbreak around age 10. Should those people still get the shingles vaccine when elderly? 20:52 What does the research say about ASMR?

On Monday, we talked about how EpiPens are a perfect example of the dysfunction of the American Health care system. Evidently, America agreed. Days after the NYT published my and other pieces, a whole bunch of stuff happened. Let's review. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72752 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

When my wife's water broke, minutes after I went to bed back in January of 2002, I remember driving her to the hospital and anguishing over one thought: "I'm never going to be well rested again". If there's one things all new parents wish, it's for a good night's sleep. Unfortunately, infants sometimes make that impossible. They wake up repeatedly, needing to be fed, changed, and comforted. Eventually, they reach an age when they should sleep through the night. Some don't, though. What to do with them continues to be a topic of a heated debate in parenting circles. That's the topic of this week's Healthcare Triage. This was adapted from a column Aaron wrote for the Upshot. Links to further reading and sources can be found there: http://www.nytimes.com/2016/08/02/upshot/putting-your-baby-to-sleep-some-advice-and-good-news.html?_r=0 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Our coverage of the campaigns' healthcare plans: http://www.youtube.com/watch?v=6tlMALdsZ28 You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

I'm sure you've heard this when you're sitting in the dentist's chair: "Would you like bitewing X-rays?" They likely recommend them every year. They're painless, they don't take much time, and, they won't cost you penny if you're covered by insurance. But do you need them? That's the topic of this week's Healthcare Triage. This episode was adapted from a column Austin Frakt wrote for The Upshot. Links to sources and further reading can be found there: http://www.nytimes.com/2016/07/26/upshot/you-probably-dont-need-dental-x-rays-every-year.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Celiac disease prevalence is stable; gluten free diets are not. And does contraception work? Spoiler… yes. This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72894 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Things sometimes go wrong with airbags, food and drugs, prompting recalls. It can also happen with medical devices, though you'd think lifesaving devices like heart defibrillators or artificial hips would be closely monitored. But the data needed to systematically and rapidly identify dangerous medical devices are not routinely collected in the United States. Why not? It wouldn't be that hard to do. That's the topic of this week's Healthcare Triage. This episode was adapted from a column Austin Frakt wrote for the Upshot. Links to sources and further readings can be found there: http://www.nytimes.com/2016/04/19/upshot/why-medical-devices-arent-safer.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

People aren't paying enough attention! This is Healthcare Triage News. Those of you who want to read more can go here: http://theincidentaleconomist.com/wordpress/?p=72981 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Studies report that hundreds of thousands of people die from preventable medical errors in the US each year. But is that right? This week we talk about times when smart people come to different conclusions from the same facts. It makes headlines to claim medical errors are killing more people than guns, but we should look beyond the headlines. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

For decades, public health experts have known that syringe exchange programs reduce the spread of certain viral infections - like H.I.V.,hepatitis B and hepatitis C - by removing infected needles from circulation. Studies have shown that programs using sterile injection equipment are both safe and save money. And yet they are rarely seen in the United States. Why not? That's the topic of this week's Healthcare Triage. This episode was adapted from a column Austin wrote for The Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2016/09/05/upshot/politics-are-tricky-but-science-is-clear-needle-exchanges-work.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Medicaid is expensive, and critics argue that it get people insured at the expense of the private sector. But study after study find that Medicaid has a huge return on investment for state and federal government. This episode was adapted from a column Aaron wrote for the Upshot. Links to further reading and sources can be found there: http://www.nytimes.com/2016/09/27/upshot/its-easy-for-obamacare-critics-to-overlook-the-merits-of-medicaid-expansion.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

As we approach the election this fall, it seems like the news media report on little else. Unfortunately, too little news coverage addresses health care reform. That's wackadoo, because there is still so much to be done to improve the cost, quality, and access for patients within the US health care system. So let's talk about the major health policy issues we in the US face. This is Healthcare Triage News. This episode was adapted from a post Aaron wrote for the JAMA Forum. Links to further reading and sources can be found there: https://newsatjama.jama.com/2016/09/21/jama-forum-re-engaging-in-health-care-reform/ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

We've got an election coming up here. It's pretty much a dumpster fire. But we've still got a country to run, and a health care system that's far from ideal. There are two main candidates, two main health care reform plans, and we're going to break them down and discuss them. That's the topic of this week's Healthcare Triage. And make sure to tune in to Healthcare Triage LIVE this Wednesday at 11:30 AM Eastern, where we'll take all your questions on this topic. http://www.youtube.com/healthcaretriage/live You can read Hillary Clinton's health care plan here: https://www.hillaryclinton.com/issues/health-care/ You can read Donald Trump's health care plan here: https://www.donaldjtrump.com/POSITIONS/HEALTHCARE-REFORM More links for your perusal: What credit card history can tell us about state lines: http://www.slate.com/articles/news_and_politics/jurisprudence/2008/05/reverse_robin_hood.html Health Savings Accounts and the ACA: https://www.manhattan-institute.org/html/health-savings-accounts-under-affordable-care-act-5945.html My own take on state lines: http://theincidentaleconomist.com/wordpress/meme-busting-selling-insurance-across-state-lines-will-lower-costs/ Margot Sanger-Katz's take on state lines: http://www.nytimes.com/2015/09/01/upshot/the-problem-with-gop-plans-to-sell-health-insurance-across-state-lines.html Block granting Medicaid: http://theincidentaleconomist.com/wordpress/medicaid-theres-no-magic-in-block-granting/ More Medicaid block granting: https://newsatjama.jama.com/2012/04/20/jama-forum-innovation-isnt-easy-when-it-comes-to-medicaid/ HCT covers drug pricing: https://www.youtube.com/user/thehealthcaretriage/videos?view=0&shelf_id=2&sort=dd HCT covers EpiPens: https://www.youtube.com/watch?v=BdY38YL39g0 More HCT on EpiPens: https://www.youtube.com/watch?v=U-lYKFoVPGM HCT explains how insurance works: https://www.youtube.com/watch?v=dF3Dcol5XLg HCT explains the US healthcare system: https://www.youtube.com/watch?v=yN-MkRcOJ

Our coverage of the campaigns' healthcare plans: http://www.youtube.com/watch?v=6tlMALdsZ28 This week's questions: 3:46 what is the difference between cardiac rehab and exercise after a heart attack? 4:38 Our doc recommended vitamins for our infant, tri-vi-sol, what's the research on infant vitamins needs and are they regulated? 5:55 how should I handle a clinic that has not given me my test results in a timely manner? it's happened like 5 times! 7:33 NPR and other news outlets have reported extensively on the upcoming rise in rates on the ACA exchanges. Why and what steps can be taken to reduce the costs? 12:19 How to decipher actual advice from pseudo science that some MDs sell in books? 14:04 What's the truth behind cleanses and protein shakes and all that other fad crap! 14:46 Sleep quality as it relates to aging, when is more sleep worse? 15:45 Can I continuously eat 5g of creatine monohydrate each day without cycles? And why do my joints feel much better when I eat creatine, and start to hurt during/after the physical exercises when I stop eating it? 16:54 Thoughts on basic medical education in primary and secondary schools? my highschool taught me CPR, first aid and AED in health class but I've learned that they no longer do so. 17:51 Do you need to change your mattress every 8 years to avoid back injury or is that a marketing ploy? 18:26 Is the breast self-examination working or is it causing more harm because of needless biopsies, surgery, anxiety? 19:31 When you have a cold, is it better to constantly spit/blow out the phlegm from your nose and throat? Is it better to get the gunk out of your body or might it be better to keep it inside, maybe because you get more dehydrated (plus spread more germs) by purging it?? 20:53 Why is the recent nutrition fad to tell us to eat more protein? It all feels like the low carb diet again even though it doesnt seem necessary to take in that much protein. (i.e. My vegan sister and her 5 young kids mos

Every time health care reform comes up for debate, I see people arguing about whether a publicly or privately funded system would be better. The Affordable Care Act, in an attempt to forestall this debate, decided to split the baby, and give half of its newly insured beneficiaries public insurance (Medicaid) and half private insurance (insurance exchanges).

Hospitals and many insurance carriers care about patient satisfaction. It especially matters to hospitals because insurance payments can be influenced by how patients rate the care they receive, as well as by the health of the patient, which hospitals usually report. Many people in the health care profession are put off by this. They argue that patient satisfaction scores aren't necessarily aligned with outcomes. Moreover, they say that trying to improve satisfaction is a waste of time. It's possible, however, that patient satisfaction is being rewarded already, and that the efforts we are making to highlight it aren't helping as much as we think. That's the topic of this week's Healthcare Triage. This episode was adapted from a column I wrote for the Upshot. Links to sources and further reading can be found there: http://www.nytimes.com/2016/09/13/upshot/how-yelp-reviews-can-help-improve-patient-care.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Our coverage of the campaigns' healthcare plans: http://www.youtube.com/watch?v=6tlMALdsZ28 This week's questions: 3:04 Is there a way, within the current American health care system, to disallow or prohibit the system of networks so that patients can go where they want rather than being constrained? 5:26 You've spoken before on how physicians, despite evidence, are slow to change their behaviour towards best practises. Have there been studies done to determine how best to change that behaviour? Follow up: would checklists be a good stand in to make sure doctors don't miss steps / bypass best practises? 7:23 What do you expect the future of healthcare and healthcare policy to look like for the next 4 - 8 years? 10:20 I've heard that men experience vasovagal fainting more than women. Is there any evidence to that or is it just something the nurses say to make guys feel better? 12:27 Do soda taxes lead to long term positive health outcomes for populations? 12:46 Question: Open enrollment is now and plan on having a family next year. What should I look for? Is out of pocket max the only thing? 14:01 Why is it so hard for some women to lose weight while breastfeeding? The "weight just melted away!" stories drive me crazy when I have to fight tooth and nail for every half pound. 15:16 What are some ways you would recommend to fix and improve medicare? 16:56 Are there any proven benefits of a baby/infant/child seeing a pediatrician over a regular family doctor? I ask because my wife and I are in the hospital about to give birth. 17:48 Do you agree with animal testing in medical science or would you rather see other, less cruel methods? 19:05 What does listening to me breathe deeply through a stethoscope really do? 20:01 Is there any truth to "cheat days" part of diets where you can eat everything you want, as much as you want, once a week, having a positive effect on weight loss efforts? Think The Rock's cheat day. 21:21 My pediatrician won't do all

This election season has seen relatively little campaigning on health care reform. Short of the occasional cry to "repeal Obamacare" or the offhand complaint about how much health care costs, there's been relatively little focus on how reform, of health care in general, must be addressed in the next Presidential administration. What little news there is seems to focus on the exchanges, as I've noted over at other venues. Almost no attention is being paid to Medicaid, or its expansion as part of the Affordable Care Act. A newly released study in JAMA focuses on how the Medicaid expansion affected hospital finances in the US, though, and it's worth our time. This is Healthcare Triage News. This episode was adapted from a post Aaron wrote for the AcademyHealth blog. Links to further reading and sources can be found there: http://www.academyhealth.org/blog/2016-11/how-has-medicaid-expansion-affected-hospital-finances John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Often, when discussing the obesity crisis facing the United States, especially when I'm pointing out another failed effort to help people change their eating habits, it feels like there's nothing we can do. But sometimes it's actually more like there's nothing we will do. There's a difference. That's especially true with The Supplemental Nutrition Assistance Program, or SNAP. That's the topic of this week's Healthcare Triage. This episode was based on a column Aaron wrote for the Upshot. Links to further reading and sources can be found there: http://www.nytimes.com/2016/09/23/upshot/restrictions-on-food-stamp-purchases-can-improve-diets.html​ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com​

Every time I write about a nutrition study, someone screams "BIAS!" at me. At least, they do when they don't like the results. It is assumed, and not totally without merit, that when industry sponsors studies, they get the results they prefer. But do they? To the research! This is Healthcare Triage News. For those of you who want to read more: http://theincidentaleconomist.com/wordpress/?p=73499 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

We covered the Five Second Rule a couple years ago. And, just a few weeks ago, colleagues at the New York Times (and many other news sources) wrote about a new study debunking the five second rule. This was not the first such study to argue that there is "no safe time" for food to be left on the floor. Our continued focus on this "threat" has long baffled me, though. Why are we so worried about the floor? So many things are more dangerous than that. That's the topic of this week's Healthcare Triage This episode is based on an article Aaron wrote for the New York Times' Upshot column. You can read it here: http://www.nytimes.com/2016/10/11/upshot/im-a-doctor-if-i-drop-food-on-the-kitchen-floor-i-still-eat-it.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com​

This week's questions: 1:44 What are the risks of IUDs? 2:51 With Verma picked to head CMS, can you discuss her work on the Healthy Indiana Program? Specifically I'm curious about having Medicaid recipients pay premiums or else being locked out of coverage. 7:08 I have issues of muscle cramps (where the muscle seizes and will not let go), in my calves, when exercising. I use compression sleeves which usually work, but I will still get them-any other advice? 7:51 Could turmeric be used as an effective anti-inflammatory treatment? What does the research say? 8:27 Hi Dr. Carroll. A teacher of mine mentioned some people are using extremely high doses of IV vitamin C to treat cancer. Any info on this claim? What does the research say about this treatment? 9:53 I worked with a doctor in an ER who didn't know whether a patient had a PPO or an HMO based on their insurance card. Is it common for doctors not to know a lot about their patient's insurance plans? 11:03 Have you had a chance to read the new study on artificial sweeteners from PLOS? Any thoughts? 14:38 What are your thoughts on radioembolization to treat tumors in the liver? 15:03 If diet is the key to weight loss, as you've pointed out heavy exercise is not, aside from finding a diet you can stick to, are there any factors to focus on? Fibre, food water content, etc. 18:03 Hi! I'm from Mexico & I don't get why the ACA is so divisive? Who or what does it damage? It's not communist AT ALL. 19:11 Can you please explain how losing weight eases GERD symptoms? 19:47 What measures should people living in the developed world take to help prevent the incidence of immunoinflammatory disease? 20:41 Is it really bad for your throat to swallow pills without water/some kind of liquid? I always gag on pills if I don't just put them on the back of my tongue and swallow without any liquid. 21:45 are there any studies on the effects of listening to music and doing homework/work? does it help or harm concentration?

What policy changes would be minimally necessary for Republicans to claim that they've succeeded in "replacing" Obamacare? Health wonk and Incidental Economist Editor Adrianna McIntyre asked what would be seen as sufficient to rebrand the law. Let's discuss. This is Healthcare Triage News. This episode was adapted from one of Adrianna McIntyre's recent posts at TIE. Links to references and further readings can be found there: http://theincidentaleconomist.com/wordpress/what-might-a-minimum-replacement-plan-look-like/ John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.

At a time when health care spending seems only to go up, an initiative in California has slashed the prices of many common procedures. The California Public Employees' Retirement System (Calpers) started paying hospitals differently for 450,000 of its members beginning in 2011. It set a maximum contribution it would make toward what a hospital was paid for knee and hip replacement surgery, colonoscopies, cataract removal surgery, and several other elective procedures. Under this new approach, called reference pricing, patients who wished to get a procedure at a higher-priced hospital paid the difference themselves. And reference pricing is the topic of this week's Healthcare Triage. This episode was adapted from a column friend-of-the-show Austin Frakt wrote for the Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2015/10/20/upshot/to-reduce-the-cost-of-drugs-look-to-europe.html?_r=0 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

This week's questions: 2:32 Do studies show if there are any health benefits by having indoor plants to improve air quality (not including psychological benefits)? 3:42 What studies have been done on frequency and timing of tooth brushing? (say brushing immediately after eating vs. 1 hour later ... or brushing once a day vs. after every meal) 5:13 I've been seeing a lot of stories about the use of psychedelics for depression (such as psilocybin, ketamine, and mdma), what do you know of any research being done on this? 6:12 I frequently wake up in the morning and grab a zero cal. zero sugar energy drink. I know you have done episodes on artificial sweeteners and coffee. Is this an unhealthy habit? Coffee tears me up. 7:23 My mom wants me to see a doctor who does integrative medicine, but I haven't found one who isn't endorsing stuff like aromatherapy, or even crystals. What's your take on this type of practice? 9:14 If you could perform a longitudinal cohort study on the American population, what question(s) would you focus on? 11:17 I'm considering medical school, but I have misophonia ("select sound sensitivity syndrome") triggered by sniffing (weird, I know). This sometimes leads to anxiety attacks. CBT hasn't helped much and the SSRI I tried made me feel sick. Though I'm interested in fields like pathology and OB/GYN where I wouldn't be exposed to these sounds as much, I'm worried about my ability to get through medical school. Will this have a large enough impact on my ability to care for patients or to obtain a license that I should avoid a career in medicine? 12:33 Your job(s) sound(s) awesome. How did you get where you are? 14:39 I've heard next year Congress could fund Medicaid with block grants or per-capita allotments. Could you discuss the pros and cons of each? How do they both work? 16:25 What care do you provide to kids as a peds. Doc for depression and other mental health problems? Any preventive care? 17:22 Do you find the health info/fe

When I was a resident, I always marvelled at how on nights and weekends, remarkably fewer people were "required" to take care of patients than on weekdays during work hours. Logic dictated that either people must be receiving substandard care on off hours, because there were fewer personnel, or else perhaps those extra people weren't necessary. Was I right? To the research. This is Healthcare Triage News. This episode was adapted from a post Aaron wrote for the AcademyHealth blog. For links to further reading and sources, go there: http://www.academyhealth.org/blog/2016-11/time-cpr-and-likelihood-survival-kids-hospital John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Maybe the person working near you, the one who dragged himself to work and is now coughing and sneezing, couldn't afford to stay home. Each week about 1.5 million Americans without paid sick leave go to work despite feeling ill. At least half of employees of restaurants and hospitals - two settings where disease is easily spread - go to work when they have a cold or the flu, according to a recent poll. To address that issue, Chipotle began offering paid sick leave to all its employees in the United States this year. The restaurant chain is hoping to reduce the spread of infectious disease - like the norovirus outbreaks traced to its restaurants last year and earlier this year. Though many other industrialized countries already require employers to offer paid sick leave to all employees, the United States does not. Shocked you are, I know. That's the topic of this week's Healthcare Triage. Special thanks to Austin Frakt, from whose Upshot column this episode was adapted. Links to sources and further reading can be found there: http://www.nytimes.com/2016/11/01/upshot/the-high-costs-of-not-offering-paid-sick-leave.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Many are still unhappy with Obamacare.The main intent of the Affordable Care Act was to expand the safety net (Medicaid), regulate the non-employer-based private insurance market (the insurance exchanges) and help people buy that insurance (subsidies) in order to reduce the number of Americans who are uninsured. On those metrics, it appears to be succeeding. First and foremost, Obamacare was about improving access to health care. While it did improve access to insurance, in many, many other ways the United States is falling short. Things are likely to get worse before they get better. That's the topic of this week's Healthcare Triage. This episode was adapted from a column I wrote for the Upshot. Links to references and further reading can be found there: http://www.nytimes.com/2016/10/25/upshot/why-the-us-still-trails-many-wealthy-nations-in-access-to-care.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

In a recent Health Affairs article, the Commonwealth Foundation conducted their periodic survey of eleven countries to see how access issues might have improved or worsened. We've covered these data before. Let's update. This is Healthcare Triage News. This episode was adapted from a post I wrote for the AcademyHealth blog. Links to references and further reading can be found there: http://www.academyhealth.org/blog/2016-12/surprise-out-network-doctor-bills-are-much-more-common-we-thought John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

Many people have to wait too long to see a doctor. And it could get worse. If, as many people believe, we have a shortage of doctors in the United States, then it follows that we can fix this only by training and hiring more physicians. As with almost everything in our health care system, though, it's complicated. Some people think there's no shortage at all - just a poor distribution of the doctors we have. That's the topic of this week's Healthcare Triage. This episode was adapted from a column Aaron wrote for the Upshot. Links to sources and further reading can be found there: http://www.nytimes.com/2016/11/08/upshot/a-doctor-shortage-lets-take-a-closer-look.html John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com

We know that Human Papillomavirus causes genital warts and cancer. We know that the vaccine protects people against the seven high-risk variants of the virus which are responsible for about 90% of cervical cancers. It also protects against two more variants which cause like 90% of warts. We currently recommend that adolescents get three doses of the vaccine. But maybe two would do? We have such a hard time getting all those shots to kids. Also, when it's time for HPV shots, it can be more effective to just announce to patients and parents that now is the time to get this vaccine. Treating it like any other vaccine on the schedule leads to a higher acceptance rate. Couching at as something parents might want to refuse can lead to refusals. John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen -- Graphics http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com You can directly support Healthcare Triage on Patreon: http://vid.io/xqXr If you can afford to pay a little every month, it really helps us to continue producing great content.