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38. Robin Hanson, PhD: Healthcare Signaling, the Conspicuous Caring Hypothesis, and Prediction Markets in Medicine

Robin Hanson

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 benefit for more medical care. They talk about the conspicuous caring hypothesis put forward in Robin’s book The Elephant in the Brain. Other topics discussed include end-of-life care, medicine as something Sacred, and prediction markets in medicine.

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Who is Robin Hanson?

Robin Hanson, PhD, is an associate professor of economics at George Mason University and a research associate at Oxford University. He is known for his wide-ranging interests, including artificial intelligence, prediction markets, and signaling. He is the author of several books, including The Age of Em and The Elephant in the Brain.

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37. Simon Whitney, MD, JD: Unethical Research, Unintended Consequences, and the Critical Need for IRB Reform

Simon Whitney

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 Service Syphilis Study (AKA Tuskegee experiment). They then discuss Peter Buxton, Henry Beecher, James Shannon, and the congressional oversight of federally funded research. Finally, they touch on the ISIS-2 study, Pronovost’s checklist, OHRP’s crackdown in the late 1990s, and discuss whether research is too safe, IRB infallibility, autonomy in the Belmont Report, and the risks and benefits of restricting research in the name of safety.

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Who is Simon Whitney?

Simon Whitney, MD, JD, is a family medicine physician and ethicist. He previously taught at Baylor College of Medicine for 22 years. He is currently retired from the practice of medicine but continues to publish and teach medical ethics. He is the author of the book “From Oversight to Overkill: Inside the Broken System That Blocks Medical Breakthroughs—And How We Can Fix It.”

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If you enjoyed this episode, be sure to check out our episode with Carl Schneider.

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36. John Ayers, PhD: ChatGPT and the Future of Medicine

John Ayers

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 recent Sensible Medicine Podcast. Finally, we discuss Dr. Ayer’s previous work on e-cigarettes, cannabis, and the sociology of suicide.

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Who is John Ayers?

John Ayers, PhD is a computational epidemiologist who uses big data to study public health. He is the Vice Chief of Innovation in the Division of Infectious Diseases and Global Public Health at UCSD.

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35. Andrew Foy, MD: Critical Appraisal, Austrian Economics, and Medical Conservatism vs Medical Liberalism

Andrew Foy

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 the medical literature, medical conservatism, and his skepticism around Coronary Computed Tomography Angiography as compared to Functional Stress Testing in patients with coronary artery disease. Finally, they touch on alternative visions of medical practice, content expertise in COVID, as well as statins as a potential cause of diabetes.

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Who is Andrew Foy?

Andrew Foy, MD is a cardiologist and Associate Professor of Medicine and Public Health Sciences at Penn State College of Medicine. His research interests include management of emergency department patients with low-risk chest pain, management of patients with benign and renovascular hypertension, as well as unnecessary and overly-aggressive medical care.

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34. Parker Rogers: How FDA Deregulation Promotes Medical Device Innovation & Safety

Parker Rogers

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 and his analysis of down-classification events (from higher to lower risk categories), which shows deregulation has a positive impact on innovation, firms producing devices, as well as product safety. They also touch on the value of regulation versus litigation, legal liability exposure of small versus large firms, and the European Medicine Agency.

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Who is Parker Rogers?

Parker Rogers is a Ph.D. Candidate in Economics at the University of California, San Diego. In the fall of 2023, he will be a Postdoctoral Fellow in Aging and Health Research at the National Bureau of Economic Research. In the fall of 2024, he will be joining the School of Business at Indiana University as an Assistant Professor.

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