The American healthcare system is in crisis characterized by high and rising costs, fragmentation, poor access to care, administrative complexity, and workforce shortages. Costs are passed on via ever rising premiums, deductibles, and out-of-pocket expenses for insured individuals. Meanwhile, factors like administrative burden, a fee-for-service model, and limited access to primary care contribute to widespread medical debt and a fear of financial ruin for many who are underinsured or uninsured. Our once admired healthcare system is failing despite the U.S. spending much more per capita on healthcare than other wealthy nations. On this episode, we see how all this is affecting people personally.

Among the many reasons I chose the specialty of medical oncology is that cancer can present anywhere in the body, manifest any symptom, affect anyone, and its clinical course often presents conundrums for our inner Sherlock Holmes or Dr. House. “The Weekly Check-Up” radio show launched the year I retired from my clinical practice. I didn't realize how important a role it would play in my continued sanity as I navigated the next phase of my professional career. Like my cancer practice, “The Weekly Check-Up” callers cover the entirety of human anatomy and physiology, and there is always a puzzle to solve. This episode features a diverse set of topics that keep the radio show and these podcasts both entertaining and informative. - Dr. Bruce Feinberg, host of “The Weekly Check-Up Podcast.”

Medical historians endlessly debate the greatest medical advancements. Among them are vaccination credited to Jenner in 1796; anesthesia credited to Crawford-Long in 1842; antibiotics with Fleming’s discovery of penicillin in 1928; and X-rays credited to the Curies and Roentgen in 1895. Then you have organ transplantation, public health improvements, insulin, the microscope, germ theory, and the discovery of DNA by Watson and Crick. “The Weekly Check-Up Podcast’s” list concludes with computerized tomography, the fiber optic endoscope, and percutaneous coronary intervention or PCI. Together these discoveries resulted in a quantum leap in disease prevention, diagnosis, and treatment, as we'll hear on this episode.

The use of sound or acoustic energy in medicine has evolved from the ancient diagnostic method used by ⁠Hippocrates by placing his ear to the chest. However, we had to wait 2,000 years for the invention of the ⁠stethoscope⁠. Today, acoustic energy is used in diagnostic imaging called ultrasound that has revolutionized obstetrics and cardiology, while therapeutic applications of sound have resulted in shockwave lithotripsy to break up kidney stones, destroy tumors. This episode explores new uses of sound energy.

Great trauma systems do not prevent trauma; they limit the carnage, disability, and chaos that are its consequence. Preventing trauma is the work of public policy and organizations like the Georgia Trauma Foundation. Seat belt laws, helmet laws, and air bag requirements have saved literally millions of lives. But technology, policy, education, and awareness have limits. Reckless driving, driving while intoxicated, and the use of cell phones while driving are some of the root causes that speak to a crisis of personal accountability and the inherent irrationality of the human condition. Worse, they decry hubris, selfishness, and lack of civility that jeopardizes not just the driver’s life, but the passengers and bystanders who are placed at risk.

If you’ve ever gone with your gut to make a decision or felt butterflies in your stomach when nervous, you’re likely getting signals from an unexpected source: your second brain. Hidden in the walls of the digestive system, this brain in your gut is revolutionizing medicine’s understanding of the links between digestion, mood, behavior, health, and even the way you think. Add increased understanding of the influence gut bacteria has on disease and health, called our microbiome, and we may begin to grasp that our gut or gastrointestinal system has a much more complex role in human health beyond nutrition and energy, as we learn on this episode.

The hormonal chaos women experience month after month from menarche through menopause is due to natural, fluctuating levels of hormones like estrogen and progesterone that can impact mood, energy, and even physical health. These hormonal shifts affect internal chemicals called neurotransmitters that can lead to mood swings, anxiety, brain fog, and fatigue. They may be a normal part of the female life cycle that spans Menarche, Menstruation, Pregnancy, Postpartum, Perimenopause and Menopause, but they are often referred to as the “stages of chaos” as we'll hear more about on this episode.

The 2002 Verizon advertising campaign launched the slogan: Can you hear me now? The phrase resonated not only because of the universal experience of poor reception quality of cellular networks, but due to an emerging zeitgeist of disaffection with modernity, technology, impersonal communication, and isolation. Healthcare consumers embody this frustration, propelling them to call in to “The Weekly Check-Up Podcast.” The pain points are myriad: poor provider communication, confusing insurance benefits, fear, vulnerability, and feelings of being dismissed or unheard. It all results in dissatisfaction with care and a significant emotional toll.