The External Medicine Podcast is a podcast exploring some of the most exciting ideas in medicine. Resident physicians Daniel Belkin and Mitch Belkin interview physicians, scientists, and outside-the-box thinkers for evidence-based, practice-changing knowledge. The podcast focuses on diverse topics not typically covered in medical education, including medical transhumanism.
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Eliot Siegel, MD: Pioneer in Radiology and Theragnostics
1:20:30
1:20:30
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1:20:30
In this episode, Daniel Belkin and Mitch Belkin interview Eliot Siegel, MD about developing the first filmless healthcare enterprise at the Baltimore, VA in 1993 which revolutionized the practice of medicine. They discuss the challenges of this innovation, including the costs of computing, the difficulties of imaging compression and data management…
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Marc Gosselin, MD: Overdiagnosis, Critical Thinking, Burnout, and Other Topics in Radiology
1:20:22
1:20:22
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1:20:22
In this episode, Daniel Belkin and Mitch Belkin interview Marc Gosselin, MD about his journey to radiology, being a radiology program director, dealing with burnout, transitioning from academics to private practice, and overdiagnosis in radiology. They discuss in situ thrombosis versus pulmonary emboli, whether medical evidence should have an expir…
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Hussam Alkaissi, MD: Solving Difficult Medical Cases
1:19:56
1:19:56
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1:19:56
In this episode, Daniel Belkin and Mitch Belkin interview Hussam Alkaissi, MD about his journey in medicine, experience with populations with high consanguinity, and uncovering of rare diseases. They touch on several unusual cases Hussam has solved including one of CHILD syndrome, homocystinuria, and acute hypercalcemia. Who is Hussam Alkaissi? Dr.…
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Bryan Carmody, MD: Physician Shortages, Resident Unionization, and the OB/GYN ERAS Divorce
1:01:41
1:01:41
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1:01:41
In this episode, Daniel Belkin and Mitch Belkin interview Bryan Carmody, MD, about physician shortages, resident unionization, and the OB/GYN ERAS divorce. They discuss the recent changes to legislation in Tennessee which allows international medical graduates to bypass the US residency system. They also touch on the Weisman versus Barnes Jewish Ho…
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Joann Elmore, MD: Mammography Guidelines and Other Controversies
39:41
39:41
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39:41
In this episode, Daniel Belkin and Mitch Belkin interview Joann Elmore, MD, about screening mammography. Dr. Elmore shares insights on the USPSTF's new draft mammography recommendations, which lowers the breast cancer screening age from 50 to 40. They discuss the difference in American and European call back rates for biopsy and whether mammography…
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Dan Morgan, MD: Diagnostic Stewardship, Medical Overuse, and Contact Precautions
1:03:14
1:03:14
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1:03:14
In this conversation, Daniel Belkin and Mitch Belkin interview infectious diseases physician and epidemiologist Dan Morgan, MD, about infection prevention, diagnostic stewardship, diagnostic reasoning, and medical overuse. They discuss regional differences in medical use and delve into a cluster-randomized controlled trial of contact precautions in…
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Robin Hanson, PhD: Healthcare Signaling, the Conspicuous Caring Hypothesis, and Prediction Markets in Medicine
1:24:12
1:24:12
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1:24:12
In this conversation, Daniel Belkin and Mitch Belkin interview Robin Hanson, PhD, about healthcare and medicine. They discuss three randomized controlled trials on the population-wide benefits of medicine (RAND health insurance experiment, Oregon Health Insurance Experiment, and the Karnataka Hospital Insurance Experiment), which do not demonstrate…
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Simon Whitney, MD, JD: Unethical Research, Unintended Consequences, and the Critical Need for IRB Reform
1:18:43
1:18:43
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1:18:43
In this conversation, Daniel Belkin and Mitch Belkin interview Simon Whitney, MD, JD, about his book From Oversight to Overkill. They discuss the history of Institutional Review Boards (IRBs), including ethically questionable experiments such as Chester Southam's cancer cell injections, the Willowbrook experiment, as well as the US Public Health Se…
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John Ayers, PhD: ChatGPT and the Future of Medicine
1:19:59
1:19:59
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1:19:59
In this conversation, Daniel Belkin and Mitch Belkin interview John Ayers, PhD about ChatGPT and its potential to revolutionize the practice of medicine. We delve into his recent JAMA internal medicine study, which evaluated ChatGPT answers to questions posed on the subreddit r/AskDocs. We also touch on responses to his article discussed on a recen…
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Andrew Foy, MD: Critical Appraisal, Austrian Economics, and Medical Conservatism vs Medical Liberalism
1:07:22
1:07:22
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1:07:22
In this conversation, Daniel Belkin and Mitch Belkin interview Andrew Foy, MD, about evidence-based medicine, applying Guideline-Directed Medical Therapy (GDMT) to hospitalized patients, and evaluating aggressive versus conservative blood pressure goals in patients with comorbitidies. They discuss Dr. Foy's article on Hayek, critical appraisal of t…
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Parker Rogers: How FDA Deregulation Promotes Medical Device Innovation & Safety
1:06:32
1:06:32
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1:06:32
In this conversation, Daniel Belkin and Mitch Belkin interview Parker Rogers about his recent job-market paper "Regulating the Innovators: Approval Costs and Innovation in Medical Technologies" which examines the impact of FDA regulation on innovation, market structure, and product safety. They discuss the FDA's medical device risk classification a…
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Ross Levine, MD, PhD: Deep Dive on Acute Myeloid Leukemia
45:39
45:39
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45:39
In this conversation, Daniel Belkin and Mitch Belkin interview Ross Levine, MD, PhD about Acute Myeloid Leukemia and its treatment. They discuss the different types of leukemias, the history of AML treatment, including chemotherapy and stem cell transplantation. They touch on Graft vs Host Disease, treatment after relapse, and open questions in leu…
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Adam J Brown, MD: History of Rheumatology, The Black Death, and Why You Shouldn't Inject Uric Acid Crystals into Your Knee
1:00:52
1:00:52
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1:00:52
In this conversation, Daniel Belkin and Mitch Belkin interview Adam J Brown, MD about the field of Rheumatology, autoimmune diseases, and his podcast Rheuminations. They discuss the history of gout, plaquenil, the relationship between infectious diseases and rheumatologic conditions, the inflammasome, autoinflammatory disorders, vasculitis, fibromy…
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Saloni Dattani: Peer Review, Division of Labor in Science, and the Genetics of Psychiatric Disorders
1:11:34
1:11:34
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1:11:34
In this conversation, Daniel Belkin and Mitch Belkin interview Saloni Dattani about the genetics of psychiatric disorders and how to improve science. They discuss the lack of division of labor in academia, the history of peer review, ways to improve peer review, human challenge trials, and much more. Who is Saloni Dattani? Saloni Dattani is a PhD s…
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Polly Matzinger, PhD: Dangerous Ideas in Immunology
1:34:46
1:34:46
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1:34:46
In this conversation, Daniel Belkin and Mitch Belkin interview Polly Matzinger, PhD, about her model of immunology, which she calls 'The Danger Model'. They discuss how The Danger Model helps explain aspects of immunology ignored by the self/non-self model, including why mothers don't reject their fetuses, autoimmune diseases, organ transplant reje…
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Derek Lowe, PhD: A Medicinal Chemist's Thoughts on Drug Discovery and the Future of Pharma
1:05:25
1:05:25
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1:05:25
In this conversation, Daniel Belkin and Mitch Belkin interview Derek Lowe, PhD, about drug discovery, clinical trials, drug patents, Alzheimer’s disease, the FDA, and his blog “In The Pipeline”. They discuss the potential role for machine learning in pharmaceutical development, whether Big Pharma spends excessively on marketing, and much much more.…
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Jean Hébert, PhD: Aging, Brain Plasticity, and Replacing the Neocortex
45:38
45:38
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45:38
In this conversation, Daniel Belkin and Mitch Belkin interview Jean Hébert, PhD about aging, brain plasticity, and progressive neocortical replacement. They discuss one hallmark of aging—extracellular matrix damage—as well as how tissue replacement is a possible solution to aging. In addition, they explore the practicalities of progressive neocorte…
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Paul Offit, MD: The Cost of Medical Innovation, DDT and Malaria, and Bivalent Covid-19 Boosters
58:28
58:28
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58:28
In this conversation, Daniel Belkin and Mitch Belkin interview Paul Offit, MD about his book You Bet Your Life, how banning DDT caused increased deaths from malaria, and the data regarding the bivalent booster as of October 2022. They discuss the human price paid for medical advances, sins of commission versus sins of omission, which populations sh…
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Carl Schneider, JD: Patient Decision-Making, Questioning Informed Consent, and Why IRBs Should Be Abolished
2:07:26
2:07:26
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2:07:26
In this colorful conversation, Daniel Belkin and Mitch Belkin speak with Carl Schneider, JD about informed consent and the problematic nature of IRBs. We discuss the difficulties of patient education and whether patients actually want medical knowledge in order to guide their decision-making. We discuss the onerousness of IRB regulation, event lice…
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Adam Cifu, MD: On Ending Medical Reversals and Reimagining Medical Education
1:02:32
1:02:32
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1:02:32
In this conversation, Daniel Belkin and Mitch Belkin speak with Adam Cifu, MD, about how to improve medical education, the importance of evidence-based medicine, and medical reversals. We discuss his collaboration with Vinay Prasad, MD, why we should swap the order of medical school curricula, and landmark trials that changed his clinical practice …
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Sekar Kathiresan, MD: Pioneering Single Dose Medications to Cure Cardiovascular Disease
1:09:40
1:09:40
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1:09:40
In this conversation, Daniel Belkin and Mitch Belkin speak with Sekar Kathiresan, MD, about using gene editing medications to treat cardiovascular disease. We discuss Dr. Kathiresan’s company Verve Therapeutics, which has pioneered a lipid nanoparticle delivery system of a CRISPR-based gene editing technology. We delve into the pathophysiology of c…
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Joel Topf, MD: Acute Kidney Injury, Contrast-Associated Nephropathy, and Precious Bodily Fluids
1:07:06
1:07:06
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1:07:06
In this conversation, Daniel Belkin and Mitch Belkin speak with Joel Topf, MD, about contrast-associated nephropathy. We discuss Acute Kidney Injury (AKI), the value of creatinine as a marker for AKI, how to evaluate volume status, the evidence around contrast-induced/contrast-associated nephropathy, recommendations on fluids to prevent AKI in pati…
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John Cochrane, PhD: The Economics of Affordable Healthcare
1:01:48
1:01:48
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1:01:48
In this conversation, Daniel Belkin and Mitch Belkin speak with Professor John Cochrane about the economics of the American healthcare system. We discuss the lack of clarity around US healthcare pricing, as well as how employer-sponsored health insurance and the persistence of massive cross subsidies contribute to dysfunction in the US healthcare m…
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Christy Chapin, PhD: Bad Incentives, the AMA, and How US Healthcare Became Dysfunctional
1:20:56
1:20:56
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1:20:56
In this conversation, Daniel Belkin and Mitch Belkin speak with Professor Christy Chapin, who is an Associate Professor of History at University of Maryland Baltimore County. We discuss how the American insurance company-based model of healthcare developed in the first half of the 20th century. Specifically, we explore the role of some of the major…
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Jason Ryan, MD: Physician Entrepreneurship, Boards and Beyond, and How to Improve Medical Education
49:33
49:33
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49:33
In this conversation, Mitch Belkin and Daniel Belkin speak with Dr. Jason Ryan, the creator of Boards and Beyond. We discuss how he started Boards and Beyond, what aspects of medical education are in need of reform, and why he is bullish on med ed entrepreneurship. In this episode, we cover Dr. Ryan's background, his roots in chemical engineering, …
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Rick Johnson, MD: Fructose, Metabolic Syndrome, and Bipolar Disorder
57:05
57:05
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57:05
In this conversation, Mitch Belkin and Daniel Belkin speak with Rick Johnson, MD, about how his views on fructose metabolism have evolved over the past decade. If you haven’t checked out Episode 9 with Dr. Johnson, check that out for more background. In this episode, Dr. Rick Johnson talks about endogenous fructose metabolism, the thrifty gene hypo…
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Nikhil Krishnan: Healthtech Startups, Dank Memes, and Zero to One in Healthcare
1:02:55
1:02:55
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1:02:55
In this conversation, Mitch Belkin and Daniel Belkin speak with Nikhil Krishnan about his healthcare newsletter (OutofPocket), why he’s optimistic about healthcare startups, and what he’s learned from investing in health tech companies. He talks about his preferred business models and gives advice to healthcare entrepreneurs on the zero-to-one phas…
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Robert Montgomery, MD: Immunology, Pig Organs, and the Future of Transplantation
52:44
52:44
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52:44
In this episode, Mitch Belkin and Daniel Belkin speak with Robert Montgomery, MD, DPhil, about his background, family history of cardiomyopathy, as well as his work in immunology and transplantation. They discuss the 3 types of organ rejection, how to manage and prevent rejection, porcine endogenous viruses, as well as Dr. Montgomery's work on xeno…
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Ben White, MD: Radiology, Medical Education, and Blogging
1:02:33
1:02:33
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1:02:33
In this episode, Mitch Belkin and Daniel Belkin speak with Ben White about his background and reasons for selecting radiology. They discuss ways to improve radiology residency training and medical school education. They briefly touch on physician shortages, Dr. White’s blogging at BenWhite.com, and his nano-fiction project (Nanoism). Who is Ben Whi…
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Michael Levin, PhD: Limb Regeneration, Bioelectricity, and Why Neurons Aren’t Special
1:18:26
1:18:26
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1:18:26
In this exciting episode, Mitch Belkin and Daniel Belkin speak with Professor Michael Levin about bioelectricity, the electrical potentials that cells use to communicate with one another. Professor Levin argues that bioelectricity is the software of cellular communication and is the medium through which we can control top-down modular programs for …
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Daniel Burka: How to Design Successful and User-friendly Healthcare Applications
1:12:29
1:12:29
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In this episode, Mitch Belkin and Daniel Belkin speak with Daniel Burka about his work at Resolve to Save Lives and the project Simple.org, a hypertension reduction application. They discuss the importance of iterative building processes that trial various ideas and then quantifiably measure success. Daniel Burka stresses the importance of understa…
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Stephan Guyenet, PhD: GLP-1, Semaglutide, and the Big Future of Weight Loss Therapies
1:04:39
1:04:39
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1:04:39
In this interview, Mitch Belkin and Daniel Belkin speak with Stephan Guyenet, PhD, about Glucagon-like peptide-1 (GLP-1) and Semaglutide. They discuss GLP-1’s mechanisms of action, Anthony Sclafoni’s experiments on food reinforcement and nutrient receptors in the small intestines. Finally, they touch on some exciting new weight loss drugs that may …
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Emily Oster, PhD: Breastfeeding Recommendations, Rising C-section Rates, and Other Controversies
1:03:54
1:03:54
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In this interview, Mitch Belkin and Daniel Belkin speak with Brown Economics Professor Emily Oster about the studies behind breastfeeding recommendations, the dramatic increase in the U.S. C-section delivery rate over the last half century, and how she approaches analyzing studies. Who is Emily Oster? Emily Oster is the Royce Family Professor of Te…
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Katherine Flegal, PhD: The Obesity Wars and the Politicization of Science
57:39
57:39
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57:39
In this interview, Mitch Belkin and Daniel Belkin speak with Katherine Flegal about the relationship between BMI and excess mortality. Dr. Flegal's publication of two papers in JAMA led to substantial controversy among obesity researchers. They discuss the data regarding the U-shaped mortality curve, the history of BMI, as well as the politicizatio…
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Karl Friston on Understanding Schizophrenia using the Free Energy Principle
1:15:43
1:15:43
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1:15:43
In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Karl Fristonabout his proposed free energy principle and how it applies to various psychiatric and neurological disorders including schizophrenia, depression, autism, and Parkinson’s. They also touch on the disconnection hypothesis of schizophrenia, how theories of schizophrenia have …
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Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD
1:06:17
1:06:17
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This conversation was recorded on June 24th, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Johnson about fructose and its relationship to fat storage. They discuss uric acid as a cause of kidney inflammation and essential hypertension, how glucose intake can trigger endogenous fructose production, and the relationship betwe…
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Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD
53:14
53:14
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53:14
This conversation with Dr. John Mandrola was recorded on July 11th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Mandrola about a 2019 article he co-authored entitled The Case for Being a Medical Conservative. They discuss concerns about vaccine-induced myocarditis in children, vaccine mandates, and whether the AMA and oth…
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The Epigenetics of Aging & Dispelling mRNA Vaccine Myths with Yuri Deigin
55:39
55:39
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55:39
This conversation with Yuri Deigin was recorded on June 25th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Yuri about aging, which he argues is fundamentally an epigenetic phenomenon. We discuss partial reprogramming using Yamanaka factors, evolutionary explanations of aging, and recent in vivo experiments which suggest that a…
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The Case for Medical Education Reform with Bryan Carmody, MD
1:08:24
1:08:24
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1:08:24
This conversation with Dr. Bryan Carmody was recorded on June 21st, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Carmody about the history of the USMLEs, the value of standardized test scores, and the arms race in the residency admissions process. They touch on conflict of interest in medical education and the rising cost …
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Diagnostic Reasoning and Medical Overuse with Deborah Korenstein, MD
1:04:12
1:04:12
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This conversation was recorded on June 7th, 2021. In this interview, we talk with Deborah Korenstein, MD, about medical overuse and overdiagnosis. We discuss her April 2021 publication in JAMA Internal Medicine, the Accuracy of Practitioner Estimates of Probability of Diagnosis Before and After Testing as well as the diagnostic process, the teachab…
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The Invisible Graveyard: A Conversation with Economist Alex Tabarrok
1:01:40
1:01:40
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1:01:40
In this interview, Mitch Belkin and Daniel Belkin speak with Professor Alex Tabarrok about what economists can bring to discussions of the pandemic, the US government’s response to COVID-19, the performance of the FDA and the CDC, regulatory nationalism, the first doses first campaign, and why America should vaccinate the world. This conversation w…
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When Modern Medicine Goes Too Far: A Discussion with Paul Offit, MD
55:43
55:43
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55:43
This conversation was recorded on April 5, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Paul Offit about mRNA vaccine technology as well as a number of topics from his book, Overkill: When Modern Medicine Goes Too Far. They discuss the use of antipyretics to treat a fever, the overuse of antibiotics, vitamin D and C, as we…
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Metformin and the Biology of Aging with Nir Barzilai, MD
58:03
58:03
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58:03
In this episode, Daniel Belkin and Mitch Belkin interview Nir Barzilai, MD, the founding director of the Institute for Aging Research and an expert in the genetics of longevity. Dr. Barzilai is a professor in the departments of Medicine and Genetics at the Albert Einstein College of Medicine. He is the recipient of numerous awards and grants. He ha…
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Fluvoxamine as a potential treatment for COVID-19
48:54
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48:54
*Since recording this podcast in January 2021, Steve Kirsch has publicly made misleading allegations regarding vaccine effectiveness and safety (e.g., Kirsch has claimed that mRNA vaccines are ineffective and are responsible for large numbers of deaths). While ExMedPod believes diverse viewpoints ought to be publicly discussed, we do not endorse Ki…
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