The Healthcare Liberty Lab Podcast Titelbild

The Healthcare Liberty Lab Podcast

The Healthcare Liberty Lab Podcast

Von: Tiffany Ryder
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 Healthcare without the propaganda. Pro-evidence. Anti-bullsh*t.

signalandnoise.onlineTiffany Ryder Hygiene & gesundes Leben
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  • What If The Healthcare Revolution is Already Here?

    What If The Healthcare Revolution is Already Here?
    Aug 8 2025
    I just had a conversation that made me genuinely excited about the future of healthcare.It also reminded me that there’s a lot of work that still needs to be done. My guest Brian Reid, health policy expert and former science writer for Bloomberg Health spent years covering the FDA, followed by 20 years of PR, and now runs his own consultancy while writing the Cost Curve newsletter- a fascinating publication covering the technical bits of the business of healthcare - which is how I found his work and decided I had to invite him on. What he shared wasn't just another doom-and-gloom take on our "broken" system.It was something much more complex: including proof that we're already fixing it, even as entrenched interests are actively working against us.Let me show you what I mean.The $60 Billion Shell GameThere's a program called 340B that perfectly captures everything wrong with healthcare today.Created in 1992 to help vulnerable patients get cheaper drugs, it now generates $60 billion annually for hospitals.Here's the scam:* Hospitals buy drugs at massive discounts (i.e. a $50 drug for 10 cents)* They give those drugs to insured patients * Then bill the insurance the full $50 (or maybe $500 since they make it up as they go along)* They pocket the $40+ difference* And there’s zero oversight on where the money goesYou might be thinking… well, okay, but at least it’s helping uninsured or more vulnerable patients, right? Well, no actually. Brian shared that there’s no evidence of that. Uninsured and lower income patients often still pay “full price.”So you also might be wondering why am I telling you this awful story and pretending it’s good news, but here’s the exciting part… You are reading about it right now. Instead of it flying under the radar as it has for the past 30 years, people are talking about it. A lot. It’s not just me. Even better, solutions are being highlighted.And not just for 340B. We’re beginning to pay attention to corrupt practices in many areas of healthcare that previously would have gone completely unnoticed.Brian put it perfectly: "Complexity has been weaponized. Complexity is a barrier to access."It isn't incompetence. It's intentional.Every confusing form, every price you can't comparison shop, every procedure that mysteriously costs different amounts at different places – it's all designed to extract maximum profit while keeping you confused and compliant - but the scheme is cracking as more and more of us are waking up. The Beautiful Counter-RevolutionBut here's where it gets exciting.While the old guard plays their shell games, entrepreneurs are building the future.Mark Cuban looked at the pharmaceutical pricing mess and said "screw this" – then launched Cost Plus Drug Company to sell medications at transparent prices.Pharmacists are leaving the corporate chains to start consulting practices, giving families the medication guidance they actually need.Direct Primary Care doctors are cutting out insurance middlemen entirely, offering unlimited access for monthly fees.Telehealth platforms are connecting patients directly with specialists, bypassing geographic gatekeepers.And it’s not theory. It’s happening right now. The Information WarComplexity isn't just annoying – it's expensive and hurtful.When you don't understand the system, you make worse decisions. When you can't comparison shop, you pay more. When the system is opaque, you get ripped off.But here's the thing: You can fight back with information.Every term you learn arms you against exploitation. Every price you comparison shop is a vote against the old system. Every time you choose transparency over complexity, you're funding the companies leading the revolution.The Trade-Offs They Don't Want You to SeeBrian dropped this truth bomb: "There's no tooth fairy."Every healthcare solution involves trade-offs. Want cheaper care? You'll have to do more work to find it. Want unlimited access? You might pay premium prices. Want government-controlled costs? You'll get fewer innovations.The establishment pretends these trade-offs don't exist. Politicians promise more for less. Insurance companies claim better coverage at lower costs. It's all BS.The entrepreneurs building the new system? They're honest about the trade-offs:* Direct Primary Care: Lower cost and more access, but you still need something to help with catastrophic events.* Transparent drug pricing: Better prices, but fewer locations or you wait for shipping.* Telemedicine: Convenient access, but there’s no real physical examination. Honesty about trade-offs is how you know who's actually trying to help you.The Innovation Explosion (Despite the Resistance)Here's what makes me optimistic: The medical breakthroughs are so good that even the broken system can't stop them.Gene therapies are curing "incurable" diseases. AI is revolutionizing drug discovery. The free market is fixing access and pricing. Yes, the old system tries to gatekeep ...
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    55 Min.
  • The Real Problem with Private Practice Isn't What You Think

    The Real Problem with Private Practice Isn't What You Think
    Jul 25 2025
    I had a fascinating conversation with Dr. Dan Neissany, a former physical therapist turned practice optimization consultant, that reframed how I think about the challenges facing private practice clinicians today. What emerged wasn't the typical "doctors are bad at business" narrative we hear so often, but something far more nuanced and actionable.The Rules Changed Mid-GameIt's not that physicians can't run businesses. It's that someone went around back and changed all the rules after they started.The system that once worked- where you could see a reasonable number of patients and keep the lights on- has been systematically undermined. Reimbursements are declining, denials are increasing and the result is physicians having to see 20%+ more patients just to make the same income they made before.Which creates, essentially, a “burnout” trap. A doctor seeing 52 patients in one day with 10 surgical cases the next day might technically be capable of handling that load, but as Dan asked: "Do you want to do it? And how long can you do it for?"The real issue isn't capability- it's sustainability. When your passion for medicine starts to fade because you're drowning in volume, what then? By the time most physicians realize they need help, it's often too late.What Actually Needs MeasuringHere's where the conversation got really practical. Most private practices are flying blind when it comes to basic metrics that could dramatically improve their operations. Dan highlighted several key areas:Daily Metrics:* Cancellation and no-show rates (many practices don't calculate this)* Schedule fill rates* Patient flow efficiencyWeekly/Monthly Metrics:* First-pass claim acceptance rates* Denial reasons and patterns* Patient retention rates* Revenue per visitThe shocking reality? Many established practices have been around for 10-15 years but have only a handful of online reviews. They have no social media presence. They're essentially invisible to potential patients making decisions in 2025.The Missing InfrastructureWhat struck me most was Dan's point about getting outside help. Unlike other business leaders who surround themselves with experts in different areas, many physicians feel they need to master everything themselves."You take the CEO of any company, they're not expected to be the expert at web design and cybersecurity... The skill set that they need is the ability to listen to the people who are experts at those things and then make the best decisions."Clinicians are smart and well educated. They have these executive functioning skills. What they often lack is knowing there's a framework of trusted experts they can build around their practice - and using them. The Opportunity Hidden in the CrisisRather than just complaining about everything wrong with the system, Dan advocates for a different approach: Instead of focusing on everything that's going wrong... let's look at the opportunity here.But it isn’t about accepting a broken system- it's about building resilience while working toward systemic change. The practices that thrive are those that:* Build systems early rather than waiting until they're overwhelmed* Use data to identify revenue leakage they didn't know existed* Create authentic connections with patients through modern channels* Develop leadership teams that can handle business operations while physicians focus on patient careThe Social Media Blind SpotOne of the biggest missed opportunities Dan identified is social media presence. Not silly dancing videos, but authentic content that shows the personality and culture of the practice.When patients are choosing between five similar practices with similar reviews, the one with an active, authentic social media presence often wins. It's free marketing that builds trust before patients even walk through the door.The Bottom LineThe narrative that "doctors are bad at business" is not only wrong- it's harmful. Physicians are dealing with a system that's been deliberately stacked against private practice success. The solution isn't to become MBAs; it's to build the right support systems and focus on what actually moves the needle.As Dan said: Healthcare is still business. If you're not making money, nobody's staying open... It's like you don't want to treat it as business but newsflash if you're not making money you're closing down or you're going to be forced to sell.The physicians who will thrive are those who acknowledge this reality while staying true to their mission of excellent patient care. They're not selling out- they're building sustainable practices that can weather whatever changes come next.This conversation reminded me that the best solutions often come from stepping outside our industry silos and learning from unexpected places. Sometimes the insights we need are hiding in plain sight- we just need the right lens to see them.Want to connect with Dan Neissany?* Podcast: "All Things LOCS" (Leadership, Operations, Culture & Strategies)* ...
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    42 Min.
  • Your Eyes Are Screaming

    Your Eyes Are Screaming
    Jul 10 2025
    Most people think all eye doctors do is fix blurry vision with glasses.Turns out, that's totally wrong.Today I’m sharing a conversation I had with Joel Ciolek— Stanford Professor and one of only 80 ophthalmology physician associates in the world. After hundreds of rejections to work in the specialty he loves, he carved out a position that barely existed and built something remarkable.Joel has since created a professional society. He teaches at medical schools worldwide. He proved that innovation is still possible in healthcare - even when everyone tells you ‘no.’But most importantly, what he has learned about eyes will change how you think about your health.Your eyes aren't just for seeing. They're diagnostic windows into every major system in your body.Heart disease. Diabetes. Brain tumors. High blood pressure. Autoimmune disorders.All visible through your eyes- often before symptoms show up anywhere else.Joel has literally saved lives during routine eye exams.But here's the problem: If you don’t know this, you might be approaching eye care all wrong (or avoiding it all together).The Category Mistake Costing You Time and MoneyJoel points out that most people think all eye problems are "vision" problems.They're not.Here's the distinction that you need to understand:* Vision concerns = glasses, contacts, routine “read the bottom line” checkups (optical)* Medical concerns = pain, redness, infections, sudden changes (health)Have a red, painful eye? That's a ‘medical’ issue. Not a ‘vision’ issue.You benefit from knowing the difference because otherwise: * People end up with chronic disease that worsens undetected for years because they don’t understand the value of ophthalmology in preventative care.* Or they waste hours in emergency rooms because they don’t know how or when to get help for their eyes. * Others avoid care all together because they think they need "vision insurance" for what is actually a medical problem.Whether you have traditional insurance, CrowdHealth, or pay cash, understanding this distinction gets you to the right provider faster, and often cheaper."Essential Eye Health" In 3 StepsStep 1: Establish a relationship before you need itDon't wait for problems. Find an eye doctor now so you know who to call and where to go if you need it.Don't have one yet? Literally Google "ophthalmology" + your city. If it's urgent, most will see you quickly if you can get there.Here's what Joel told me: Just about every eye clinic has 24/7 on-call coverage for emergencies."If you have established care with an eye clinic, honestly, I would call them before you go to the ER because even if it's after hours, every eye clinic is going to have an on-call ophthalmologist... you're going to be able to get a hold of someone that's no different than your ER provider calling that on-call ophthalmologist."Step 2: Learn when it’s important to act quickly* Sudden vision loss* Severe or deep eye pain* Flashing lights or curtain-like vision changes* New floaters with flashesThese are "call/be seen immediately" situations. Not "wait and see."One benefit to having an established relationship with an eye doctor is that you can ask them what would constitute an ‘emergency,’ and they want you to do if that happens. Step 3: Think systemic, not just visionYour eyes reflect your entire body's health:* High blood sugar shows up in eye blood vessels* High blood pressure damages the retina* Cholesterol plaques appear in eye arteriesOnce the damage starts reaching a critical mass, these warning signs can be observed and more importantly can allow you the opportunity to do something about it - before it’s too late. Take home message:Regular eye exams aren't vanity- they're actually early warning systems for your whole body.Your eyes are talking to you.The question is… are you listening?Short and sweet this week, but I want to know: Have you had to seek emergency care for an ‘eye issue’? Did you know the difference between medical problems versus vision problems? Joel practices in California, but teaches all over the world. He can be found at: joelciolek.com Connect with him there!And of course, a BIG thank you to our sponsor CrowdHealth. If you’re ready to experience healthcare differently, visit joincrowdhealth.com and use code “Liberty Lab” for $99/month for the first 3 months.Until next week,Tiffany*Never Medical Advice This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thehealthcarelibertylab.substack.com Get full access to signal & noise at signalandnoise.online/subscribe
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    16 Min.
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