Podcast
They Did What?
Hosted by Dr. Anand Lalaji · EN
Did you ever get a medical bill or denial and think, ‘Who the hell approved this?’ If you have, you’ve come to the right place.
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.
Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.
Subscribe to They Did What? New episodes every week.
Welcome to They Did What? The podcast where we examine one real-life decision in medicine, insurance, or policy, explaining what happened and why it matters.
Hosted by Dr. Anand Lalaji, better known as Dr. A, a physician and critic at The Radiology Group, we’ll talk about algorithms that reject care in seconds, prior authorizations that slow treatment, ‘networks’ with no available doctors, and surprise bills that arrive months later. Clear stories, plain language, practical takeaways.
Subscribe to They Did What? New episodes every week.
13episodes
Episodes
Newest firstAll episodes
The Broken Economics of Saving Lives
Nov 400:19:10Tap to summarizeA surgeon saves your life by cutting out your inflamed gallbladder and gets paid less than the price of a MacBook. A heart transplant surgeon trains for 17 years, spends 10 hours in the OR, and takes home just $1,250, sometimes less than what’s paid to fix a spider vein. This is not rumor, it’s the official Medicare fee schedule.In this episode, Dr. A digs into the upside-down math of physician reimbursement. We walk through how lobbying tilts the playing field, why elective procedures outpay life-saving ones, and what this means for patients, doctors, and the future of medicine. Behind every hospital bill is a simple but devastating question: when the people who save lives are the ones most underpaid, how long can the system hold?We Also CoverFor patients: Why knowing procedure reimbursement rates helps you understand access and hidden incentives.For clinicians: How distorted pay scales drive burnout and career flight from life-saving specialties.System takeaway: Lobbying and fee schedules (not clinical need) set the value of life-saving care.
Transcribe →Inside the Broken World of Medical Licensing
Oct 2100:23:58Tap to summarizeA single complaint (true or not) can unravel a physician’s entire career. Once a state licensing board gets involved, the process can move like a runaway train: opaque, insulated, and nearly impossible to appeal. The boards were built to protect patients, but in practice they often operate more like monarchies than fair courts.In this episode, Dr. A takes us inside the hidden world of medical licensing boards. We look at how one board member was convicted of illegally distributing opioids while simultaneously judging other doctors, how lawsuits in states like Oklahoma reveal backroom deals and conflicts of interest, and why even honest physicians are afraid to come forward. At stake? Not just careers, but patient access and the worsening doctor shortage.If the people overseeing doctors are themselves unchecked, who’s really protecting patients and what can be done about it?We Also Cover:For patients: Why physician shortages and licensing board abuse could limit your access to care.For clinicians: How even minor complaints can spiral, and the importance of knowing your state board’s culture.For the system: How legal immunity shields boards and fuels calls for reform.
Transcribe →The AI That Decides If You Get Care
Oct 700:16:46Tap to summarizeWhen an algorithm can deny your care in seconds, who’s really making the call on your health?In this episode, Dr. A unpacks how a major insurer deployed an AI tool that automatically rejected claims without a physician review, despite laws requiring it. What looks like efficiency on paper could mean millions of patients face roadblocks to life-saving treatments.Dr. A breaks down why medicine’s complexity can’t be reduced to code, how profit-driven incentives shape these systems, and the long shadow cast by the HMO Act of 1973. If insurers hide behind AI, what happens when the denials pile up faster than appeals can ever catch?We Also CoverHow to request a human review of any AI-driven denial.Why documenting medical necessity in plain terms is more critical than ever.How regulatory gaps let insurers build and run their own decision-making algorithms.
Transcribe →