FRIDAY, DECEMBER 20, 2024

What Elon Musk & Peter Thiel Invest In to Make Lives Longer

Billionaires who dream of extending human life, including Elon Musk, believe they will have very supportive partners in the incoming Trump administration. They’re excited that President Trump has nominated Jim O’Neill for the number two spot at the U.S. Dept. of Health and Human Services because of his history in the anti-aging movement.

David Gobel, the co-founder and CEO of the Methuselah Fund, says, “Jim O’Neill really understands the value of avoiding the suffering…of diseases that don’t actually have to happen if aging is held back. Robert F. Kennedy, Jr., and other nominees are very much in line with the idea of holding aging back by whatever means.” President Trump has nominated Kennedy to serve as HHS secretary.

But “Conversations on Health Care” recently spoke with S. Jay Olshansky, Ph.D., a professor at the University of Illinois at Chicago, who questioned private and public dollars going to such efforts. “We’ll be lucky if 5% of the age cohort makes it to 100,” he said. Olshansky and his colleagues have presented data that humans are approaching a biologically-based limit to life.

Join hosts Mark Masselli and Margaret Flinter for this look into the world of life extension and how Trump administration officials could push the country to embrace these unconventional practices. In addition, learn more about the first longevity patient protocol from Danielle Ruiz, MSN, APRN, AGNP-C, CEO and Medical Director, Everest Health.

THURSDAY, DECEMBER 12, 2024

Nurse Practitioners: A Growing Opportunity

Nurse practitioners, at 385,000 strong in the U.S., are increasingly seen as a key part of the solution to the primary care provider shortage. What are the challenges and opportunities to ensure everyone can get the care they need when they need it? Our guest is the president of the American Association of Nurse Practitioners, Stephen Ferrara, DNP. He also serves as the inaugural associate dean of artificial intelligence and a professor of nursing at the Columbia University School of Nursing.

Hosts Mark Masselli and Margaret Flinter (who has been a family nurse practitioner for many years) discuss the opportunities for Ferrara and his members as they seek to expand what’s called “scope of practice.” In fact, the percentage of medical visits handled by health care providers other than physicians nearly doubled between 2013 and 2019, with many of those patients seen by nurse practitioners.

THURSDAY, OCTOBER 17, 2024

How Groundbreaking NIH Research is Expanding to Birth-to-Four-Year-Olds

For nearly the first decade of the National Institutes of Health’s “All of Us” Research Program — aimed at increasing diversity in genetic research — a major component was missing: kids.

“Children are approximately 24% of our population in the U.S. and 100% of our future,” Dr. Sara Van Driest, director of pediatrics for NIH’s All of Us Program, told hosts Mark Masselli and Margaret Flinter. “In order to provide them with the very best care for the future and have them benefit from this resource, we need to include them.”

The journey is personal for Katrina Yamazaki, Ph.D., principal investigator for Community Health Center, Inc., in Connecticut, a partner organization in All of Us. Yamazaki and her husband adopted three boys through the foster care system.

“We don’t know a whole lot about their … biological families’ medical history,” Yamazaki said. “The idea that this program will one day be able to provide some of [that] missing information to me and my husband, in order to become health advocates for our children is really important to me.”

The NIH in August began limited enrollment in the program for children age 4 and under.

“We started with that youngest age group so we can follow them the longest,” Van Driest said.

Community Health Center, Inc., for its part, is partnering with community-based organizations such as the Hartford Public Library to build trust, raise awareness of the project and make a fun atmosphere through activities.

All of Us intends to change what might be seen as a “one-size-fits-all” approach to health care. It aims to encompass 1 million individuals of diverse backgrounds but doesn’t focus on particular diseases or conditions, Van Driest said. The diversity, too, goes beyond culture, touching geography, age and socioeconomic status.

“One of the goals of research is to connect the dots,” she said. Given the scope of the project, “there will be so many dots that we’ll be able to connect,” Van Driest said.

 “If we fail to include a group of individuals or an aspect of diversity, we miss out on that uniqueness. That limits us in what we’re able to understand about humanity in general,” she said. “It also limits research and learning about that group of individuals. And it limits downstream how clinicians can care about individuals and give them the very best possible outcomes.”

THURSDAY, AUGUST 22, 2024

NEJM’s First AI Editor: Yes, AI is Here to Stay

Some patients are concerned about how far artificial intelligence (AI) is creeping into the exam room. But AI has been part of health care longer than most realize, according to Dr. Isaac Kohane, a groundbreaking Harvard University professor.

Kohane is the editor-in-chief of the New England Journal of Medicine’s first publication devoted to AI. He tells hosts Mark Masselli and Margaret Flinter that “In the 1980s, automated interpretation of an [echocardiogram] would have been considered AI. Now it’s the ability to look through a patient’s record and come up with a differential diagnosis, a second opinion, a therapeutic plan.”

Kohane shares a success story of a mother whose child had difficulty walking and chewing, suffered from headaches and had seen more than a dozen doctors over many years, with no diagnosis. After one doctor recommended a psychiatric course of action, the mother fed the reports from various past medical visits into a generative AI program, which suggested tethered cord syndrome.

Cases like this can represent AI’s potential, says Kohane. But the nascent technology raises issues of bias. “You can run tests on these AI programs and say, ‘Would you propose that diagnosis more often if this was an African-American or an Indian-American?’ … And you can adjust these programs,” Kohane says. The exciting part is that the adjustment would be easier than undoing even unconscious bias among hundreds of thousands of health care professionals, he explains.

THURSDAY, AUGUST 15, 2024

Nuance can help health field regain public trust: AcademyHealth CEO

Dr. Aaron Carroll raises eyebrows with statements that highlight contradictory health advice: “‘Eggs are going to kill you because of cholesterol’ — ‘oh, it actually doesn’t matter. Eat as many eggs as you like.’ ‘Red meat will kill you.’ ‘Oh no, read meat can be part of a diet.’ ‘Drink no alcohol’ … ‘Oh, no no. Drinking red wine is perfectly healthy.’”

Dr. Carroll has devoted his career to advocating for scientific and research communities need to improve how they discuss nuance, especially in health. Dr. Carroll, serving as CEO of the AcademyHealth, says “science is portrayed as binary — positive or negative — and that can breed mistrust from the public.”

“The way that we discuss nutrition and food [can] burn people’s belief in science, in that it feels like people are told one or the other,” Dr. Carroll tells “Conversations on Health Care” hosts Mark Masselli and Margaret Flinter.

For most people, ramping up or cutting out consumption of one particular food “can add a tiny bit of risk here or there. But the extremes that we are often sold, one way or the other, about what you should and should not eat are often not really well-supported by science,” he says.

It’s not that new data disproves old research, he says. But both add up to a more complex picture. “When you describe things in absolute terms … it creates a climate where people don’t trust exactly what you’re saying.”

Despite the constantly changing nature of science, nurses and doctors are still consistently held in high trust, Dr. Carroll says. One way to add nuance to public discourse is to use trusted voices to help people understand what questions to ask when they hear new information: Pre-buttal, as opposed to rebuttal, as he puts it. “[That] is much more powerful than trying to change their minds after they’ve heard things that are just not true.”

THURSDAY, AUGUST 8, 2024

Self-healing joints? Perfect surgeries? Your tax $$ could make it happen

The director of the Advanced Research Projects Agency for Health (ARPA-H) knows the eyes of the nation are on her. Renee Wegrzyn, Ph.D., leads the billion-dollar effort charged with leveraging research advances for real-world impact.

Wegrzyn talked with hosts Mark Masselli and Margaret Flinter at Aspen Ideas: Health about the agency’s initiatives, including a $100 million sprint for women’s health and creating tissue-specific delivery of therapies.

“How can we pursue some of these breakthroughs — in our case, for health — by empowering the scientists…the program managers…that have these really big ideas that are so risky that the technical sector, the private sector can’t address because there’s no proof of concept?”

She explained the process: Hire program managers with big ideas in health and give them a time frame to find solutions.

Wegrzyn said the time limit ensures they bring a sense of urgency to solving problems. In return, participants get resources to focus on technical risks.

Many of ARPA-H’s missions are cancer-centered, aimed at issues through what-if questions such as: “What if cancer surgeries were one-and-done?” “What if clinical trials evolved in the same way tumors do?”

She said, “The investments that we’ve made in cancer [include] our precision surgical interventions program. Think about reimagining the operating room suites, when a surgeon is looking into a surgical cavity and trying to remove a tumor.”