Who’s Steering the $50B? Doctors, Dollars & the Media Machine

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🎯 Why Listen

A 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-Hosts

Dutch Rojas – Founder, Bliksem Health

Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher

Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator

Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice

Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

The crew dissects a new $50B rural health initiative that appears to route funds around independent and physician-owned facilities—prioritizing large systems, pricey EHRs, and even retail partners. They debate Sen. Bill Cassidy and vaccine policy rhetoric, explain how public-choice incentives drive misallocation, and compare U.S. access with Canada’s waitlists (and the medical-tourism pull). They also pick apart Walmart/Dollar General clinic models, why scale struggles without physician workflow design, and how media incentives skew clinical stories—especially around presidential health.

💬 Notable Quotes

• “There’s a lot of money being thrown at them to tell them what to think.” (00:12:58)
• “If a doctor can ace organic chemistry, you can learn HR and build a clinic.” (00:35:58)
• “This is a misallocation of $50 billion.” (00:18:15)
• “Business thinks pull and scale; medicine runs on relationships.” (00:32:00)
• “Truth doesn’t scale if your audience wants rage-clicks.” (00:56:15)

📚 What You’ll Learn

• How funding criteria (affiliations, Epic mandates, retail tie-ins) push out independents.
• Why public-choice theory explains hospital lobbying advantage.
• Where Walmart/Dollar General clinic plays fell short—and what physician design would fix.
• Practical clinic-flow lessons: blueprinting around patient movement and staff placement.
• The difference between population-level policies and individualized bedside decisions.
• How media incentives distort clinical narratives about public figures.
• Why medical tourism grows when domestic access shrinks.

⏱ The Episode (Timestamps)

00:00 Cold open: lobbying, misallocated capital

03:36 Housekeeping + PHA conference preview (19 interviews)

05:06 Senator Cassidy, vaccine takes, and pharma donations discourse

12:59 Why lawmakers misunderstand delivery & finance

15:27 Rural funds, EHR mandates (Epic), and retail partners (Dollar General)

23:07 Canada wait times, border medical tourism, cash-pay joints

28:00 Walmart clinic lessons: price points, demand, and execution

32:00 Scale vs. relationships: designing clinics that actually work

38:00 Presidential health narratives, COVID memory, media speculation

56:15 Ratings, advertisers, and why “truth” often loses to clicks

1:06:20 Next up: 340B and payer–provider “dance”; wr

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X