The Doctors’ Lounge
The Doctors’ Lounge is a candid medical podcast co-hosted by Anish Koka, MD and Anthony DiGiorgio, DO. It features open discussions on healthcare policy, reform, physician autonomy, and patient care. The show aims to provide insider perspectives from practicing physicians, going beyond clinical topics to examine systemic issues. It is presented in English and targets a professional and general audience interested in the realities of modern medicine.
Episodes
Leaving the Employment Model: Dr. Mollie James on Going Independent
Send us Fan MailEpisode Summary Dr. Mollie James joins Anish Koka, MD and Anthony DiGiorgio to talk about what pushed her out of traditional employment, how she rebuilt her practice after bankruptcy and COVID, and why she believes more physicians need independent options. The conversation focuses on the pressures of hospital employment, the power of pricing and cash pay, and practical paths for do
From Addiction to Advocacy: Tom Wolf's Journey
Send us Fan MailSummaryIn this episode, Anthony DiGiorgio and Anish Koka engage with Tom Wolf, a recovery advocate, who shares his personal journey through addiction, homelessness, and eventual recovery. The conversation delves into the complexities of homelessness, the impact of substance use, and the evolving definitions and policies surrounding addiction treatment. Tom discusses the harm reduct
You Can't HSA That Away: Rachel Rosenthal on Medicare, Trade-offs, and Zero-COVID Singapore
Send us Fan MailEpisode Summary Rachel Rosenthal, an editorial board member at Bloomberg who writes on healthcare and education, joins Anthony DiGiorgio and Anish Koka for a wide-ranging conversation about healthcare reporting, COVID-era lessons, and why Medicare’s fiscal path matters beyond policy circles. The discussion gets into the incentives behind drug pricing, the limits of simplistic villa
Real Doc Speaks: Bureaucracy, Bad Incentives, and the Fight to Keep Doctors in Charge
Send us Fan MailIn this special add-on episode, Anish Koka and Anthony DiGiorgio welcome Dr. James O'Leary — a Mayo-trained OB-GYN with forty years of experience, former department chairman, ACO board member, and host of the Real Doc Speaks podcast — for a wide-ranging conversation on the erosion of physician-led care. The trio dissects a tragic Nashville case in which four outpatient knee-re
The Cost Cure: Ashish Jha's Case for Price Caps, Competition, and Biosurveillance
Send us Fan MailEpisode SummaryAnthony DiGiorgio and Anish Koka speak with Dr. Ashish Jha, co-founder and CEO of BioRadar, senior fellow at Harvard Belfer Center, and former White House COVID-19 response coordinator, about the future of American healthcare policy. The conversation moves from hospital pricing and insurance design to Medicaid, HSA-based models, and the political realities that shape
Congressman Tom Oliverson on 340b, the No Surprises Act, gold carding, and more
Send us Fan MailEpisode Summary In this episode of the Doctor's Lounge, Anthony DiGiorgio speaks with Hon. Tom Oliverson, MD, Texas State Representative for House District 130 and chair of the House Republican Caucus. Dr. Oliverson shares how he moved from medicine into public service, why practicing physicians should remain involved in policymaking, and what Texas is doing to address healthc
Vinay Prasad: COVID, the FDA, and Why Journalism Keeps Getting Medicine Wrong
Send us Fan MailThe prior uploaded file had 26 seconds that was corrupted. Restored on this version!Episode Summary:Dr. Vinay Prasad joins the Doctors Lounge in a recorded in person conversation that moves from his time at the FDA to bigger questions about evidence, incentives, and trust in medicine. The discussion focuses on how regulatory agencies actually function, why public health debates ha
The Ship Has Sailed: Mike Munger on Medicare, Markets, and Debt
Send us Fan MailEpisode SummaryDuke political economist and podcast host Mike Munger (The Answer is Transaction Costs) joins Anthony DiGiorgio and Anish Koka to argue that what Americans call "health insurance" isn't insurance at all — it's a social program where, as Bastiat put it, everyone tries to live at the expense of everyone else. Munger walks through why Medicare functi
900 Regulatory Hurdles: Why AI Isn't Replacing Doctors Yet
Send us Fan MailEpisode SummaryWith scheduled guest Dr. Geoff Manley pulled away by a medical emergency, hosts Anish Koka and Anthony DiGiorgio turn the episode into a news roundtable. They open on a JAMA op-ed by Neil Khosla and Ezekiel Emanuel arguing AI will replace physicians outright, and push back on both the regulatory timeline and the incentive structure behind it — including why hospitals
Inside a $207 Million Verdict: What Every Physician Should Know About Malpractice Trials
Send us Fan MailEpisode SummaryIn a special Tuesday episode, Anish Koka and Anthony DiGiorgio sit down with Heather Tereshko, a Principal at Post & Schell in Philadelphia and a 25-year veteran of medical malpractice defense, to break down the largest medical malpractice verdict in Pennsylvania history — a $207 million judgment against the University of Pennsylvania stemming from a delayed C-se
Right-to-Try 2.0: Inside the Montana Model with Niklas Anzinger
Send us Fan MailEpisode SummaryAnish Koka and Anthony DiGiorgio sit down with Niklas Anzinger, a venture capitalist and founder of Infinita VC, to unpack Montana SB535 — a new law that lets doctors administer treatments to patients that have only cleared FDA phase one trials, through licensed "experimental treatment centers" overseen by independent review boards. The conversation covers
Dan Donoho on Surgical Data Science, Regulation, and the Humanoid OR
Send us Fan MailEpisode SummaryAnthony DiGiorgio and Anish Koka sit down with Dr. Dan Donoho, an NIH-funded neurosurgeon-scientist at Children's National Hospital and George Washington University, and founder of the Surgical Data Science Collective and the Foundation for Digital Neurosurgery, for a wide-ranging conversation on AI in medicine. Donoho explains why surgeons get almost no structu
Dr. George Tolis on Physician Pay, Private Practice, and a Valve Gone Wrong
Send us Fan MailEpisode SummaryCardiothoracic surgeon Dr. George Tolis, chief of cardiothoracic surgery in Boston, returns to The Doctors Lounge with hosts Dr. Anish Koka and Dr. Anthony DiGiorgio for a wide-ranging conversation that opens with the newly proposed 2027 Medicare physician fee schedule and the budget-neutrality rule dating back to 1989 that forces cuts to one specialty to fund raises
Cremieux on FDA Reform, Fake Data, and the Columbia Admissions Hack
Send us Fan MailEpisode SummaryDrs. Anish Koka and Anthony DiGiorgio sit down with independent science writer Cremieux, the pseudonymous Substack author known for auditing primary data and calling out flawed research. The conversation ranges from FDA drug approval reform (Cremieux proposes a two-pathway system separating safety approval from insurer-facing efficacy approval), the divide between we
Scott Becker on Building Becker's Healthcare, Physician Supply, and Private Enterprise
Send us Fan MailEpisode SummaryAnish Koka and Anthony DiGiorgio sit down with Scott Becker, founder of Becker's Healthcare and partner at McGuireWoods, on the business of medicine — his path from healthcare lawyer to media mogul, the real story behind physician supply shortages, why private enterprise (not government) is driving healthcare's real progress, and the debate over breaking up
Martin Shkreli on Drug Pricing, Prison, and the Fraud That Shook Pharma
Send us Fan MailEpisode SummaryAnish Koka and Anthony DiGiorgio sit down with Martin Shkreli — the former hedge fund manager and pharma executive best known for the 2015 Daraprim price increase and his subsequent prison sentence — for a wide-ranging conversation on drug pricing, patent law, and the state of the pharmaceutical industry. Shkreli walks through his path from a teenage hedge fund inter
Do No Harm: Inside the Fight to Get Identity Politics Out of Medicine
Send us Fan MailEpisode SummaryDr. Stanley Goldfarb — nephrologist, former Associate Dean for Curriculum at Penn's Perelman School of Medicine, and founder of Do No Harm — joins Drs. Koka and DiGiorgio to trace how medical education drifted from clinical science toward social activism. Goldfarb recounts the battles at Penn that led to his 2019 WSJ op-ed, the professional fallout that followed
The Myocarditis Double Standard: COVID, the Vaccine, and the Pediatric Deaths That Went Unreported
Send us Fan MailEpisode SummaryDr. Tracy Beth Høeg returns alongside Dr. Venkatesh Murthy, NIH-funded cardiologist at the University of Michigan, to dissect the Senator Ron Johnson congressional memo detailing pediatric deaths following COVID-19 vaccination — deaths the FDA's own pharmacovigilance team flagged internally but never disclosed publicly. The conversation covers the well-documente
David Zweig on Schools, Science, and the Media's COVID Failure
Send us Fan MailEpisode SummaryInvestigative journalist David Zweig joins Anish Koka and Anthony DiGiorgio to discuss his book An Abundance of Caution: American Schools, The Virus, and a Story of Bad Decisions — a heavily cited account of how public health authorities, the media, and a politically homogenous expert class got COVID policy badly wrong, especially for children. The conversation cover
Drug Pricing, Broken Incentives, and the 340b program Fixes Washington Won't Touch
Send us Fan MailEpisode SummaryRyan Long — former senior policy advisor to Speaker Kevin McCarthy and current non-resident senior scholar at the USC Schaefer Institute — joins Drs. Koka and DiGiorgio for a deep dive into the structural failures driving American drug pricing. The conversation covers the list-to-net price bubble and why patients pay cost-sharing on a fictitious number, how the IRA&a
The Atom Bomb Speaks: Tracy Høeg on COVID, Myocarditis, and the FDA From the Inside
Send us Fan MailEpisode SummaryDr. Tracy Høeg — physician, epidemiologist, and former Acting Director of the FDA's Center for Drug Evaluation and Research — joins Drs. Koka and DiGiorgio for her first interview since being fired from the agency in May 2025. She traces her unusual path from ophthalmology dropout to professional ultramarathoner to one of the most consequential and contested res
The ER Doc Who Quit the System - and Built His Own
Send us Fan MailEpisode SummaryDr. Noah Kaufman - board-certified emergency physician with 20 years in the ER, seven seasons on American Ninja Warrior, and a new direct acute care practice in Denver - joins Drs. Koka and DiGiorgio to talk about why he walked away from the employed medicine model and built Cough Care, a cash-pay, fully transparent urgent care. The conversation covers the broken eco
The Cholesterol Debate: What the Keto Influencers Get Right (and Wrong)
Send us Fan MailEpisode SummaryDr. Greg Katz, preventive cardiologist at NYU Langone and co-host of Beyond Journal Club, joins Anish to dissect the online cholesterol debate — specifically the claims made by science communicator Nick Norwitz, who has maintained an LDL over 500 mg/dL on a low-carb diet for seven years with no coronary plaque on CTA. Katz takes the data point seriously, walks throug
Gaming the System: LTACHs, Guidelines, and the Evidence Problem in American Medicine
Send us Fan MailEpisode SummaryDr. Anil Makam — hospitalist, health services researcher at UCSF, and faculty at Zuckerberg San Francisco General — joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the hidden mechanics of American healthcare. Makam breaks down long-term acute care hospitals (LTACHs): what they're for, how regional variation and perverse payment incentives have d
The FDA, Unicure, and the Limits of Accelerated Approval
Send us Fan MailEpisode SummaryAnish sits down with Adu, a med student and biotech investor, to work through the FDA's contested handling of Unicure's AMT-130 — a gene therapy for Huntington's disease delivered via stereotactic brain injection. They debate whether the underlying data justifies approval, why the agency's mid-course reversal has rattled the investor community, an
Salty About Medical Education: Bryan Carmody on What the System Gets Wrong
Send us Fan MailEpisode SummaryPediatric nephrologist, medical educator, and "Sheriff of Sodium" Dr. Bryan Carmody joins Drs. Koka and DiGiorgio to challenge some of the most persistent narratives in American medicine. From the AAMC's physician shortage projections — which Carmody argues serve the interests of medical schools more than patients — to the mechanics of the residency ma
Free Markets, Private Equity, and the Moral Case for Medicine
Send us Fan MailEpisode SummaryJared Rhoads, founder of the Center for Modern Health and senior lecturer in health policy at the Dartmouth Institute, joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the philosophical foundations of healthcare policy. Rhoads — an Objectivist in the tradition of Ayn Rand — argues that physicians have a right to pursue health, not a right to be given
George Tolis: TAVR, Broken Training, and What's Really Wrong With Cardiac Surgery.
Send us Fan MailEpisode SummaryDr. George Tolis, section chief of coronary and general cardiac surgery at Brigham and Women's Hospital, joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the state of cardiac surgery. He makes the case that TAVR — while genuinely transformative for the right patient — is being systematically applied too broadly, driven by industry incentive and t
Center-Right in a White Coat: Pradeep Shanker on AI, Vaccines, and Medical Orthodoxy
Send us Fan MailEpisode SummaryRadiologist, National Review senior contributor, and prominent center-right voice in medicine Pradeep Shanker joins Anish Koka and Anthony DiGiorgio for a wide-ranging conversation that covers AI's real (and overstated) role in radiology, the structural dysfunction of GME funding and physician immigration, what went wrong with COVID policy from both the left and
The Surgeon Who Refused to Bow: Dr. Eithan Haim on Blowing the Whistle at Texas Children's
Send us Fan MailEpisode SummaryDr. Eithan Haim, a general surgeon in the Dallas area, joins Anish to walk through the events that took him from chief resident at Baylor to facing four federal felony counts and up to 10 years in prison. While rotating at Texas Children's Hospital in 2022 and 2023, Haim learned that the hospital's pediatric gender medicine program — which TCH had publicly
From Babylon to Baylor: How Insurance Went Off the Rails
Send us Fan MailAnish and Dr. DiGiorgio trace the history of insurance from ancient Babylonian bottomery contracts through Egyptian workers' guilds, Greek risk-pooling societies, Lloyd's of London, and the birth of actuarial science — then walk forward into the Great Fire of London, the 1929 Baylor hospital plan, Henry Kaiser's vertically integrated care, the World War II wage-freez
Outpatient Brain Surgery: How Buffalo Built America's Only Neurosurgical ASC
Send us Fan MailEpisode SummaryAnish and Anthony are joined by Dr. Elad Levy — Professor and Chair of Neurosurgery at the University at Buffalo, holder of the L. Nelson Hopkins Endowed Chair, and one of the country's most prolific physician innovators — for a wide-ranging conversation on how he and his partners built Atlas Surgery Center, the only physician-owned outpatient neurosurgery cente
The Intellectual Case Against Medicare: Buchanan, Tullock, and the Rules of the Game
Send us Fan MailAnish and Dr. DiGiorgio dig into the intellectual debate that preceded the 1965 passage of Medicare, focusing on the economists — James Buchanan, Gordon Tullock, Friedrich Hayek, Ludwig von Mises, Milton Friedman, and George Stigler — whose arguments against centralized healthcare proved remarkably prescient. They trace how Buchanan's public choice theory (political actors beh
Rural Health Myths, Mark Cuban's HSA Gambit, and How Neurocritical Care Was Born
Send us Fan MailBack from hiatus, Anish and Dr. DiGiorgio swap travel notes on Japan and San Diego before diving into Anish's recent Substack piece mapping emergency cardiac care access across the United States — where 98% of Americans live within 90 minutes of a PCI-capable hospital, a level of coverage no peer country (including Canada) comes close to matching. They extend the analysis to t
From Tehran to the C-Suite: Biotech CEO Ali Mortazavi on AI, Drug Discovery, and the Me-Too Problem
Send us Fan MailGuest: Ali Mortazavi | CEO, Tangram Therapeutics (formerly E-Therapeutics), London, UKEpisode Summary:Ali Mortazavi is not your typical biotech CEO. A computer scientist by training, former professional chess player, and veteran of financial markets, he invested in an RNAi company in 2012 — and then, by his own admission, made the crazy decision to become its CEO with zero backgrou
Dr. DiGiorgio Goes to Washington: Site Neutrality, Stark Law Physician-Owned Hospitals & More
Send us Fan MailEpisode SummaryDr. DiGiorgio returns from testifying before the House Energy and Commerce Subcommittee on Health, the third in a series of hearings on healthcare costs covering the provider landscape. The two break down the major policy levers discussed in his testimony — site-neutral payment, Stark Law reform, physician-owned hospitals, and Certificate of Need laws — and why so ma
The Cost of Dissent: How a Viral Newsweek Op-Ed Led to Medical School Dismissal
Send us Fan MailKevin Bass, PhD, joins Anish and Dr. DiGiorgio to tell the story of how a viral Newsweek op-ed apologizing for his support of COVID lockdowns and mandates set off a chain of events that ended in his dismissal from Texas Tech's MD/PhD program. Kevin walks through the internal emails, sham professionalism hearings, and rigged dismissal process he uncovered through FERPA records
The Shah's Spleen, Quality Metrics, Health Insurance & the FDA
Send us Fan MailDr. Anish Koka and Dr. Anthony DiGiorgio open with the little-known medical story behind the death of the Shah of Iran — how Mohammed Reza Pahlavi came to be operated on in Cairo in 1980 by legendary cardiovascular surgeon Michael DeBakey, and how the "comforting explanation" bias may have contributed to his death from a post-operative abscess rather than his underlying c
Dr. Mary Talley Bowden Battles the Health System
Send us Fan MailIn this conversation, Dr. Mary Talley Bowden shares her experiences as an independent physician during the COVID-19 pandemic, detailing her courageous battle against health systems and the Texas Medical Board. She discusses the challenges faced by healthcare professionals, the impact of politics on medical practices, and the importance of patient care and medical freedom. Dr. Bowde
The Week in Review and Understanding the Medicaid Data Dump with Samir Unni
Send us Fan MailEpisode Title: The Medicaid Data Dump: $1.7 Billion in Billing From Shell Companies and Why Nobody Stopped ItGuest: Samir Unni | Biomedical Engineer, former Palantir healthcare data lead, currently working on federal data modernization effortsChapters00:00 Introduction and Technical Difficulties02:47 Reflections on Jay Bhattacharya's Insights06:04 Navigating Polarization in Sc
NIH Director Jay Bhattacharya
Send us Fan MailIn this engaging conversation, Dr. Jay Bhattacharya discusses his unique perspective as a health economist and the impact of his training on his approach to public health, particularly during the COVID-19 pandemic. He reflects on the Great Barrington Declaration, the importance of dissent in science, and the need for reform within the NIH to foster innovation and address the replic
The $2 Million Verdict: Inside the First Detransition Lawsuit Trial
Send us Fan MailBenjamin Ryan was the only journalist in the courtroom for every day of the first detransition lawsuit to reach a jury verdict. In January 2025, a White Plains jury awarded $2 million to Fox Varian, who received a double mastectomy at age 16 after being diagnosed with gender dysphoria. Years later, she detransitioned and sued her psychologist and plastic surgeon.What happened in th
Ed Gaines: How Independent Physicians Finally Got Leverage Against Insurance Companies
Send us Fan MailGuest: Ed Gaines, JD, CPC Vice President of Regulatory Affairs, Zotec Partners Honorary Member, American College of Emergency PhysiciansEpisode Summary:If you're a hospital-based physician and you don't understand the No Surprises Act, you're missing the biggest shift in payment leverage in decades. Insurance companies estimated there would be 17,000 disputes. The ac
Dr. Gantwerker: Medicare Advantage, Private Practice, and Why Doctors Need to Stop Fighting on X
Send us Fan MailWhat happens when a spine surgeon who's been in private practice since the Obamacare era sits down with doctors across the political spectrum? You get one of the most honest conversations about healthcare reform we've had.Brian Gantwerker doesn't fit neatly into anyone's box. He's a private practice capitalist who thinks breaking up insurance companies is e
The DPC Revolution: Dr. Josh Umbehr on Making Healthcare Affordable Again
Send us Fan MailGuest: Josh Umbehr, MD | Co-founder & CEO, Atlas MD | DPC PioneerSummary: In 2010, Josh Umbehr launched Atlas MD charging $50/month for unlimited primary care with no insurance billing. Other doctors said it wasn't sustainable. Fourteen years later, he runs a platform serving 1,800+ practices and built his own insurance company. This conversation covers the full journey: w
Journalist Alex Berenson: Fraud and Abuse with Autism therapy in the Medicaid Program
Send us Fan MailKeywordsAlex Berenson, COVID vaccine, Medicaid fraud, autism services, healthcare, investigative journalism, MCOs, AI in healthcare, public health, healthcare policySummaryIn this conversation, Anish Koka and Alex Berenson delve into critical issues surrounding the COVID vaccine, Medicaid fraud, and the financial incentives within autism services. They discuss the implications of i
The Trump Healthcare plan, AI in Medicine, Medical Liability, and the sketchy 340b drug program
Send us Fan MailSend us a textSummaryIn this episode of the Doctor's Lounge, hosts Anish Koka, Anthony DiGiorgio, and Sanat Dixit delve into the complexities of healthcare policy, particularly focusing on recent statements made by former President Trump regarding healthcare reform. They discuss the implications of Trump's proposed 'Great Healthcare Plan,' which aims to lower dr
The ACA Subsidies, New Vaccine Schedules, Ezekiel Emmanuel, AI in Medicine
Send us Fan MailSend us a textKeywordshealthcare, ACA subsidies, vaccine schedule, AI in healthcare, concierge medicine, food pyramid, healthcare policy, public health, physician autonomy, healthcare costsSummaryIn this episode, the hosts delve into the complexities of healthcare, discussing the ongoing saga of ACA subsidies, recent changes to vaccine schedules, and the implications of AI in healt
TDL Year End Review: the BBB Vindicated,First Principles in Health Policy and Popular 2025 Tweets
Send us Fan MailSend us a textKeywordshealthcare policy, Medicaid, ACA, fraud, social media, bureaucracy, primary care, immigration, healthcare reform, insuranceTakeawaysThe One Big Beautiful Bill aimed to reform Medicaid and tighten eligibility checks.Fraud in Medicaid has been highlighted by recent cases, particularly in Minnesota.Work requirements for Medicaid recipients are seen as a reasonabl
The Failure of the Electronic Medical Record in Medicine & the Impact of DEI in Medicine
Send us Fan MailSend us a textKeywordselectronic medical records, healthcare technology, EHR challenges, physician experience, digital health, healthcare regulations, EMR usability, healthcare innovation, patient care, medical technology, EHR, healthcare efficiency, physician ownership, diversity in medicine, medical education, healthcare bureaucracy, DEI, patient care, healthcare systems, physici
Diving Deeper into The Canadian MAID Program and GOP Healthcare Solutions
Send us Fan MailSend us a textKeywordshealthcare, MAID, patient autonomy, economic implications, GOP healthcare proposals, health savings accounts, dynamic pricing, Instacart, ethical dilemmas, healthcare systemsSummaryIn this episode, the hosts discuss pressing issues in healthcare, focusing on the Canadian MAID program, the implications of patient autonomy, economic factors influencing healthcar
Side Table with Christopher Habig: Turning Medicaid into a Trampoline, Not a Trap
Send us Fan MailSend us a textKeywordshealthcare, primary care, ER, cost reduction, pharmacy reform, 340B program, healthcare access, bureaucratic reformSummaryThe conversation focuses on the need to shift healthcare from emergency rooms to primary care, emphasizing cost reduction and improved access through reforms in pharmacy practices and bureaucratic processes.TakeawaysShifting healthcare to p
Medicaid Fraud, COVID Vaccine Deaths, Eli Lilly PBM Moves, Health Care Economics
Send us Fan MailSend us a textKeywordshealthcare, Medicaid fraud, DEI, vaccine safety, Eli Lilly, ACA, healthcare policy, trust in medicine, social determinants of health, healthcare reformSummaryIn this episode, the hosts discuss various pressing issues in healthcare, including Medicaid fraud, the impact of fraud on legitimate healthcare needs, and the ongoing debate about healthcare as a human r
Side Table with Dr. Anahita Dua : Women's Health, Women in Medicine and the Challenges of Research Funding in Academia
Send us Fan MailSend us a textSummaryDr. Anahita Dua is a vascular surgeon at Massachusetts General Hospital who joins Dutch Rojas, Anish Koka, and Anthony Digiorgio to discuss her views on women's health and cardiovascular disease, the need for a broader understanding of women's health issues beyond reproductive health, and the problems female physicians face in medicine. We discuss the
Office Surgeries, Insurance Games, and Giving Thanks
Send us Fan MailSend us a textSummaryIn this episode of the Doctors' Lounge, the hosts discuss a range of topics centered around healthcare, including personal experiences with medical procedures, the importance of trust in healthcare providers, the economics of office-based surgeries, and the role of insurance companies in driving up costs. They reflect on the need for a more patient-centere
Free Market or Central Control? Physicians Debate the Real Future of Healthcare
Send us Fan MailSend us a text 🎯 Why Listen:Dive into a heated discussion on the future of healthcare, where leading physicians debate the merits of free market principles versus centralized healthcare planning. Discover why the current system may be failing and what can be done to steer it in a better direction.👥 Co-Hosts:Dutch Rojas – Founder, Bliksem HealthAnthony DiGiorgio, DO, MHA – Neurosurg
The Hidden Costs of Coverage: Why Subsidies Can’t Fix Healthcare
Send us Fan MailSend us a text📌 Episode Overview:In this episode, the co-hosts dive into the complexities of healthcare policy, discussing the impact of ACA subsidies, the role of insurance companies, and the potential for HSAs to empower patients. They explore the challenges of healthcare costs, the influence of government subsidies, and the need for a competitive marketplace.👥 Co-Hosts:Anthony D
The Healthcare Fallacy: How Big Systems Broke the Market
Send us Fan MailSend us a textShow Link: https://www.acpjournals.org/doi/10.7326/0003-4819-153-8-201010190-00274Why Listen 👥In this episode, the hosts delve into the complexities of the healthcare system, discussing the impact of large hospital systems as major employers, the broken window fallacy in healthcare, and the challenges of high premiums. They explore the historical context of certificat
Behind the Bill: What’s Really Driving Healthcare Costs
Send us Fan MailSend us a textWhy Listen 👥In this episode, the hosts delve into the complexities of healthcare costs, the impact of policy decisions, and the role of market forces in shaping the healthcare landscape. They discuss the consolidation of healthcare providers, the influence of insurance companies, and the challenges faced by independent practices. The conversation also touches on the C
Side Table: The 340B Dilemma: Who Really Benefits?
Send us Fan MailSend us a text📌 Why ListenExplore the complexities of the 340B program, its impact on healthcare systems, and the implications for both hospitals and independent clinicians. Understand the need for transparency and potential reforms to align the program with its original goals.👥 Co-HostsAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcherAnish Koka, MD – Cardio
When Politics Masquerades as Healthcare: A Deep Dive into Schumer’s Claims
Send us Fan MailSend us a text🎯 Why ListenWhen Senator Chuck Schumer joined Dr. Mike’s podcast to discuss “The Truth About the Government Shutdown,” the talk quickly became a lesson in political spin. In this episode, the co-hosts of The Rojas Report dissect Schumer’s claims, challenge Dr. Mike’s deference, and unpack the policy mechanics behind Medicaid, ACA subsidies, and America’s trillion-doll
Admit Defeat: How Hospitals Stripped Doctors of Control
Send us Fan MailSend us a text🎯 Why ListenThis episode is a no-holds-barred takedown of how hospitals manipulate billing codes, exploit DRG loopholes, and increase patient risk—all while squeezing out independent physicians. Whether you’re a patient, policymaker, or healthcare insider, you’ll walk away questioning everything you thought you knew about how hospitals operate behind the scenes.👥 Co-H
The Government Shutdown: When Healthcare Policy Becomes Hostage Negotiation
Send us Fan MailSend us a text🎯 Why ListenIn this fiery and insightful episode, the doctors dissect the political and economic fault lines behind the Affordable Care Act (ACA), the looming government shutdown, and the multi-billion-dollar subsidies keeping America’s healthcare afloat. From insurance distortions and Medicaid loopholes to why the system rewards bureaucracy over care, this is an unfi
The ACA Bubble: How Insurance Giants Hijacked American Healthcare
Send us Fan MailSend us a text🎯 Why ListenThis episode of The Doctor’s Lounge cuts straight into one of the most polarizing questions in U.S. healthcare: Did the Affordable Care Act (ACA) fix the system—or hand it to corporate interests? The doctors debate how government mandates, corporate lobbying, and political theater have created a bloated insurance economy that benefits everyone but patients
Private Equity in Medicine: Profit, Patients, and the Fight for Independent Practice
Send us Fan MailSend us a text🎯 Why ListenWhat happens when private equity buys hospitals? Do staffing cuts and profit motives compromise patient safety? This episode of The Doctor’s Lounge dives into the controversial world of private equity in healthcare, the role of RVUs and the RUC, and why physicians are losing control over their profession. Expect an unfiltered discussion on power, profit, a
Side Table: Who Really Decides What Doctors Get Paid? Inside the RUC
Send us Fan MailSend us a text🎯 Why ListenEver wonder who actually decides how much doctors earn for surgeries, visits, or procedures? This episode takes you inside the mysterious but powerful Relative Value Scale Update Committee (RUC) — the body that determines physician payments for Medicare and beyond. If you care about fairness in healthcare, innovation, or why a complex surgery can pay the s
Side Table: Monkeypox, Public Health Messaging, and the CDC’s Trust Problem
Send us Fan MailSend us a text🎯 Why ListenJournalist Ben Ryan joins the panel to unpack what really happened during the 2022 monkeypox outbreak, how public health messaging shaped public perception, and why institutions like the CDC are facing a crisis of trust. With decades of experience covering HIV and infectious disease, Ryan shares his perspective on risk communication, stigma, and the politi
Who’s Steering the $50B? Doctors, Dollars & the Media Machine
Send us Fan MailSend us a text🎯 Why ListenA spicy, inside-baseball roundtable on why rural healthcare dollars keep missing physicians, how enterprise EHRs and retail chains distort priorities, and why media narratives around leaders’ health go off the rails. Practical, provocative, and very quotable.👥 Co-HostsDutch Rojas – Founder, Bliksem HealthAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; hea
Patients, Politics, and the FDA: Who Decides What’s Enough Evidence?
Send us Fan MailSend us a text🎯 Why ListenDive into one of the most consequential debates in medicine: how should the FDA balance speed, safety, and patient need in approving new drugs and gene therapies? Dr. Bob Goldberg, joins the Doctors Lounge to unpack regulatory science, RCTs, accelerated approvals, and the controversies around muscular dystrophy treatments.👥 Co-HostsDutch Rojas – Founder, B
Futile Care, Dignity at the End of Life, and Physician-Owned Hospitals
Send us Fan MailSend us a text🎯 Why ListenWhen an 88-year-old with dementia lands in the hospital, should we implant a device simply “because we can”? The panel examines futile care, ICU economics, malpractice fears, and the cultural bias to always “do something.” With special guest JP Kolcun, a seventh-year neurosurgery resident, they also debate whether physician-owned hospitals could restore di
Side Table: Declaring Death — Cutting Through the Noise on Organ Donation
Send us Fan MailSend us a text🎯 Why ListenOrgan donation is one of the most emotional and misunderstood processes in modern medicine. In this minisode, the hosts tackle the ethics, procedures, and misconceptions around declaring death and procuring organs. Whether you’re a healthcare professional, patient advocate, or simply someone who has “organ donor” on your driver’s license, this conversation
Licensing Loopholes, Wage Pressures, and the Fight for Physician Standards
Send us Fan MailSend us a text🎯 Why ListenNorth Carolina approved a bill letting some international medical grads practice without U.S. residency. Smart fix for shortages—or a back door for cheaper labor that risks quality? We break down patient impact, wages, malpractice, and what it means for the profession. Plus: Vinay Prasad’s surprise return to the FDA, catastrophic insurance, and why prices
Physician Shortage, Visas, and Why Doctors Are Leaving Medicine
Send us Fan MailSend us a text🎯 Why ListenIs there really a physician shortage—or just bad incentives driving doctors out of practice? In this episode, the crew unpacks Representative Greg Murphy’s call for more foreign-trained doctors, the real barriers U.S. medical students face, the role of residency caps, gender dynamics in the physician workforce, and why private practice may hold the key to
Hope vs. Power: Gene Therapy, FDA Shake-Up, and Truth in Medicine
Send us Fan MailSend us a textOriginal Substack Release: Aug 23, 2025🎯 Why ListenWhen hope collides with billion-dollar incentives, who protects patients? We unpack Vinay Prasad’s FDA resignation, Sarepta’s $3.2M Duchenne gene therapy, and how accelerated approvals can leave families without the long-term data they deserve.👥 Co-HostsDutch Rojas – Founder, Bliksem HealthAnthony DiGiorgio, DO, MHA –
Enforcement, Arbitration, and the Fight to Keep Independent Medicine Alive
Send us Fan MailSend us a textOriginal Substack Release Date: August 29, 2025🎯 Why ListenHeard “surprise billing” blamed on doctors? This episode shows how insurers shaped the narrative, how the No Surprises Act (NSA) was meant to protect patients, why weak enforcement broke it, and what Rep. Greg Murphy’s No Surprises Enforcement Act could fix.👥 Co-HostsDutch Rojas – Founder, Bliksem HealthAntho
38% of Doctors Gone in 5 Years? Inside the Battle for Independence
Send us Fan MailSend us a textOriginal Substack Release Date: August 9, 2025🎯 Why ListenThis episode pulls no punches on the future of physician independence. From the looming physician shortage to the retaliatory tactics of insurers, you’ll hear an unscripted conversation about the raw realities inside American healthcare—and the strategies physicians can use to fight back.👥 Co-HostsDutch Rojas –
Prior Auth: The AI Arms Race, Medicare’s Cliff, and the Boomer Trade-Off
Send us Fan MailSend us a textOriginal Substack Release Date: July 20,2025🎯 Why ListenPrior authorization is the bureaucratic chokehold strangling American healthcare. But this episode isn’t just venting — it’s a masterclass in how the system got built, why it persists, and where leverage actually lies. From AI-driven denials to Medicare’s looming funding cliff, we break down the forces shaping ca
ACIP Bloodbath, AMA Meltdown: Who Really Speaks for Doctors
Send us Fan MailSend us a textOriginal Substack Release Date: Jun 18th, 2025🎯 Why ListenThis week’s episode takes you inside the chaos rocking organized medicine: ACIP’s sudden purge, the AMA’s meltdown, and the war over who really speaks for America’s doctors. If you’ve ever wondered how medical “consensus” is manufactured—and who benefits—this is the episode to hear.👥 Co-HostsDutch Rojas – Found
Is Healthcare a Right or a Rigged System?
Send us Fan MailSend us a textOriginal Substack Release Date: June 14th, 2025🎯 Why ListenWhen the New England Journal of Medicine claims that direct primary care threatens the “common good,” four practicing physicians step into the ring. This episode isn’t just a rebuttal, it’s a full-throated defense of medical freedom, patient choice, and the future of primary care. If you want to understand ho
Medicare: Promise, Politics, and Patient Care – Are Doctors Just a Nuisance Now?
Send us Fan MailSend us a textOriginal Substack Release Date: June 7th, 2025🎯 Why Listen:“Shut up and enjoy your salary.”—What passes for health policy debate in 2025.Does the government actually listen to doctors anymore? Or do they just think we’re a nuisance — good for photo ops, useless in policymaking?In this episode of The Doctor’s Lounge, Dutch and Anthony pull no punches on Medicare:Why M
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