John and Adam discuss our hopes for Vinay’s tenure at the FDA and how we intend to keep Sensible Medicine a vibrant place on Substack, a place where we will continue to showcase a range of ideas and opinions about all things bio-medicine. We also answer some of the questions from our recent “ask us anything” post.
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Vinay at FDA; what's next for Sensible Medicine; ask us anything answers
Sensible Medicine
Common sense and original thinking in bio-medicine
A platform for diverse views and debate
Common sense and original thinking in bio-medicine
A platform for diverse views and debate
Appears in episode
Adam Cifu, MD
John Mandrola
Recent Episodes
Best of luck to Dr. Prasad and I'm excited to follow you guy sin Vinay.
As long as I, as a resident, get part of the payment that's billed when I see the patient, I'm okay paying a tax premium if I decide to open a concierge practice. The amount of money spent on this new tax would seem more punitive than economically sound. Maybe it's better to take that money and see what the outcomes are for concierge docs vs mainstream docs - if it's the same, it's great information for the consumer of healthcare. If it's better access, better care, better outcomes, and less overall spending, maybe more people will save to be able to afford a concierge doctor in their future.
Re burnout: I graduated med school in 1964 when the majority of docs took a year of general internship and then went into general practice. I did a general Internal Medicine internship and residency (at SFGH and UCSF by the way) and then practiced independently back home in PA., Saw my patients in the hospital or when they ended up in nursing homes, shared office space with others on and off, shared call only on Sat night and Sunday. Mostly 10 hour days and on occasion going back to the hospital, sometimes at 2AM. For the first 5 years while building my practice money was limited. I worked and took call every day. I ran my business, paid for my own vacations, meetings, malpractice, pensions, etc. Worked till I was 77. In those days I never heard of doctor burnout.
Now docs go to work for big organizations, make big salaries with all the amenities, 8 to 5, office only, no weekends and strict scheduling. No squeezing in patients after hours. No administrative worries. But on the social networking sites everybody's complaining.
What's the difference? As close as I can tell it's independence and working to please the patients by helping them the best I could. I loved what I did and was proud of it. I sure wouldn't want to change it for the employee servitude of today from what I hear about on the web.
I have learned so much about critical appraisal of the literature from Vinay's YouTube videos. I share that knowledge with my nursing students. Unfortunately, it seems to be the trend that you can only "support" someone if you agree 100% with every word, belief, and previous policy decisions. There is no human on this planet that we should agree 100% with everything ever said, believed, etc. I have "followed" Vinay since 2020, and it is wonderful to watch his progress. I am excited to see what he does as the head of CBER.
Thank you!
Thank you also for the ask anything answers--you mentioned you did the other questions elsewhere, somehow I missed them, could you please point me to where they are?
Coming next week!
Very happy to continue following you ! Both wise men 😬