Joseph A. Ladapo, MD, PhD, is a physician and health policy researcher whose primary research interests include assessing the cost-effectiveness of diagnostic technologies and reducing the population burden of cardiovascular disease. He is Associate Professor-in-Residence at the David Geffen School of Medicine and cares for hospitalized patients. Previously, he served as a faculty member in the Department of Population Health at NYU School of Medicine and as a Staff Fellow at the Food and Drug Administration.<\/p>\n\n\n\n
Dr. Ladapo’s research program, funded by the NHLBI, NIMHD, and the Robert Wood Johnson Foundation, focuses on (1) patient-centered approaches to improving the health of individuals evaluated for coronary artery disease, and (2) behavioral economic interventions to promote sustainable cardiovascular health, including among adults with HIV. He also leads the health economic and quality of life evaluation of multiple NIH-funded randomized trials focused on cardiovascular disease and tobacco cessation. His national honors include the Daniel Ford Award for health services and outcomes research, and he was also a regular columnist for the Harvard Focus during medical school and residency, where he discussed his experiences on the medical wards and perspectives on health policy issues.<\/p>\n\n\n\n
Dr. Ladapo graduated from Wake Forest University and received his MD from Harvard Medical School and his PhD in Health Policy from Harvard Graduate School of Arts and Sciences. He completed his clinical training in internal medicine at the Beth Israel Deaconess Medical Center.<\/p>\n","protected":false},"excerpt":{"rendered":"Joseph A. Ladapo, MD, PhD, is a physician and health policy researcher whose primary research interests include assessing the cost-effectiveness of diagnostic technologies and reducing the population burden of cardiovascular disease. He is Associate Professor-in-Residence at the David Geffen School of Medicine and cares for hospitalized patients. Previously, he served as a faculty member in the Department of Population Health at NYU School of Medicine and as a Staff Fellow at the Food and Drug Administration.","protected":false},"author":13,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","episode_type":"audio","audio_file":"http:\/\/podcasts.la.utexas.edu\/cepa\/wp-content\/uploads\/sites\/21\/2020\/06\/Policy-at-McCombs-Summer-2020-Joseph-Ladapo.mp3","podmotor_file_id":"","podmotor_episode_id":"","cover_image":"","cover_image_id":"","duration":"","filesize":"23.38M","filesize_raw":"24515264","date_recorded":"25-06-2020","explicit":"","block":"","itunes_episode_number":"","itunes_title":"","itunes_season_number":"","itunes_episode_type":""},"tags":[90,68,89,91],"categories":[],"series":[2],"class_list":{"0":"post-543","1":"podcast","2":"type-podcast","3":"status-publish","5":"tag-fda","6":"tag-health","7":"tag-health-politics","8":"tag-joseph-ladapo","9":"series-policymccombs","10":"entry"},"acf":{"related_episodes":"","hosts":[{"ID":693,"post_author":"38","post_date":"2020-10-29 17:58:44","post_date_gmt":"2020-10-29 17:58:44","post_content":"\n
Carlos M. Carvalho is an associate professor of statistics at McCombs. Dr. Carvalho received his Ph.D. in Statistics from Duke University in 2006. His research focuses on Bayesian statistics in complex, high-dimensional problems with applications ranging from finance to genetics. Some of his current projects include work on large-scale factor models, graphical models, Bayesian model selection, particle filtering and stochastic volatility models.<\/p>\n\n\n\n
Before moving to Texas Dr. Carvalho was part of the faculty at The University of Chicago Booth School of Business and, in 2009, he was awarded The Donald D. Harrington Fellowship by The University of Texas, Austin.<\/p>\n\n\n\n
Dr. Carvalho is from Rio de Janeiro, Brazil and before coming to the U.S. he received his Bachelor's degree in Economics from IBMEC Business School (Rio de Janeiro) followed by a Masters's degree in Statistics from the Federal University of Rio de Janeiro (UFRJ).<\/p>\n","post_title":"Carlos Carvalho","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"carlos-carvalho","to_ping":"","pinged":"","post_modified":"2020-10-29 17:59:59","post_modified_gmt":"2020-10-29 17:59:59","post_content_filtered":"","post_parent":0,"guid":"http:\/\/podcasts.la.utexas.edu\/cepa\/?post_type=speaker&p=693","menu_order":0,"post_type":"speaker","post_mime_type":"","comment_count":"0","filter":"raw"}],"guests":[{"ID":616,"post_author":"42","post_date":"2020-07-03 20:17:06","post_date_gmt":"2020-07-03 20:17:06","post_content":"\n
Joseph A. Ladapo, MD, PhD, is a physician and health policy researcher whose primary research interests include assessing the cost-effectiveness of diagnostic technologies and reducing the population burden of cardiovascular disease. He is Associate Professor-in-Residence at the David Geffen School of Medicine and cares for hospitalized patients. Previously, he served as a faculty member in the Department of Population Health at NYU School of Medicine and as a Staff Fellow at the Food and Drug Administration.<\/p>\n\n\n\n
Dr. Ladapo's research program, funded by the NHLBI, NIMHD, and the Robert Wood Johnson Foundation, focuses on (1) patient-centered approaches to improving the health of individuals evaluated for coronary artery disease, and (2) behavioral economic interventions to promote sustainable cardiovascular health, including among adults with HIV. He also leads the health economic and quality of life evaluation of multiple NIH-funded randomized trials focused on cardiovascular disease and tobacco cessation. His national honors include the Daniel Ford Award for health services and outcomes research, and he was also a regular columnist for the Harvard Focus during medical school and residency, where he discussed his experiences on the medical wards and perspectives on health policy issues.<\/p>\n\n\n\n
Dr. Ladapo graduated from Wake Forest University and received his MD from Harvard Medical School and his PhD in Health Policy from Harvard Graduate School of Arts and Sciences. He completed his clinical training in internal medicine at the Beth Israel Deaconess Medical Center.<\/p>\n","post_title":"Joseph Ladapo, MD","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"joseph-ladapo-md","to_ping":"","pinged":"","post_modified":"2020-07-03 20:17:06","post_modified_gmt":"2020-07-03 20:17:06","post_content_filtered":"","post_parent":0,"guid":"http:\/\/podcasts.la.utexas.edu\/cepa\/?post_type=speaker&p=616","menu_order":0,"post_type":"speaker","post_mime_type":"","comment_count":"0","filter":"raw"}],"transcript":"
Welcome to policy, Emma. A data focused conversation on tradeoffs.
\n\ue5d4
\nI’m Kalev Core Value from the Saban Center for Policy at the University of Texas at Austin.
\nAll right. So it’s a pleasure to have with us today dr. Joseph LaRocco from UCLA, professor
\nof medicine and also health policy. Thanks for joining me. And I
\nthink I want to start like I’m asking a lot of our guests to go back to March
\nto the beginning of and perhaps even March. These were really happening on your end, given that you are in the house to see
\nbases and so on. But for a lot of us, that’s when we started really thinking hard about, okay, this is serious.
\nWhat do we need to do here? And and one of the first things I read from from from you
\nwas already really facing very clearly the tradeoffs that we’re we’re facing
\nthat point in time and put it in a way that I didn’t see coming from from
\na lot of health officials in particular at that point. So I try to go back there. And that was where you think.
\nWhat was your sort of what what evidence you’re looking at, where the models are looking at and how you react to that point in time?
\nYeah. Yeah. Well, thank you for that. And then in terms
\nof what I was thinking, what models, I think the big model at that
\ntime that most people were citing versus the one out of out of England,
\nI forget the name the group right now. College. Yeah, exactly. Exactly. Yeah. And
\nyou know, they did. I completely commend the job that they did. They got some things
\nwrong, which is like, you know, but it was still useful and it
\nwas important to do something to give us some place to start. So
\nso that model did some things that were pretty dire based on the data
\nthat they were using. And now we know that they overestimated mortality,
\nfor example, they overestimated disease morbidity, which is totally
\nfine. You know, we know more now than we did then. And and
\nusing that information, it painted a pretty dire picture,
\nbut it’s really important to think about. About what we
\nare doing. You know why we’re doing it and where we’re headed with what we’re doing. And,
\nyou know, I spend a lot I spend a lot of time, obviously, I spend a lot of time taking care of patients.
\nAnd I spent I fortunately have a background, a quantitative background, and
\nand took some extra years in med school to get a p._h._d. You know, in health
\npolicy and mostly economics and statistics and decision analysis. So that
\nthat was that was very helpful for me in sort of thinking through the problem and thinking.
\nAnd it also helped me, I think, think about the tradeoffs. So kind of
\naltogether, that’s what led me to my suggestion. And it was really clear that
\nour leaders had no idea what they were doing. I mean, if you remember, it’s kind of been almost
\nlaughable. Like it was first, you know, groups no more than like hundred
\nand fifty then and this and that. And it’s just like when people are changing their
\nminds like that, they really. They don’t know what they
\ndon’t know what they’re doing. Ultimate. That’s the bottom line. Which is fine. You know there was a certain
\npoint in time. Yeah there was, there was. But I would say that
\ndespite the challenge of the circumstances, there was a lot of information, too. We had a lot of
\ninformation from from China. And we also knew what the consequences of shutdowns would
\nbe. I mean, you don’t need to talk to my three little wonderful boys and I
\ncan talk to my oldest six. And and you can you can think through what the consequences
\nof, you know, school and, you know, and people not being able to work.
\nAnd so fear and hysteria and all that, all that that
\ncan produce could be it’s not complicated concepts. And we don’t need to know anything about Cova
\nto be able to to be able to think about the consequences of some of our decisions.
\nSo so so I you know, clearly it was it was difficult, clearly for a lot of people
\nto sort of see through and see through sort of the fog and the
\nhaze and all that was happening. But it was still very clear what was
\nlikely to happen with our decisions. So and so.
\nSo that’s sort of what led me to write. So you I think that the main point
\nyou were making that at that point in time was to say keep you walking down short, to give us time to prepare.
\nOur health capacity is going to come. And there’s too much already. Communities spread for us to stop
\nthis. So I’ve seen this mercury. Right. With signs.
\nAnd what should be short looked down to perhaps even some time. But don’t make it short
\nso that people can have their lives back because otherwise I don’t you know, what’s the point? You know, we’re
\nwhere we’re heading and we live to live. That’s why we live. We don’t live to, you know,
\nto be fearful. And, you know, and not educate our kids and not be able
\nto pursue the things in life we want, which is not to say that
\npeople shouldn’t be fearful or shouldn’t take whatever precautions they want.
\nIt’s more just to say that that shouldn’t be forced on everyone. And so what was what was the
\nreaction of your colleagues, where your colleagues are? They have a similar reaction to the situation.
\nIs you or because I think unfortunately, those voices to me, at least my perception
\nthose voices were somehow not as large as the voices
\nsay stay at home, don’t dare to go out as long as it takes. Oh, man. Yeah, no question.
\nAnd that itself should give people pause. You know, over policy issues. I mean, over moral issues.
\nAre you my kids in background over moral issues? Now, we know there’s every reason to believe that,
\nyou know, we can have uniform beliefs as a society. But over policy issues, it’s
\nusually not such a good idea. Everyone is saying the same thing and not really
\nallowing dissent. And there was definitely an atmosphere that was pushing
\nout dissent or at least was more hostile to it.
\nAnd and in my my
\nperspectives and my wife and I, we’re like on the same page. We’ve been on the same page the whole time.
\nAnd in general, my colleagues have not received it
\nparticularly favorably. And that’s fine. You know,
\nalthough I struggle even then and I’m one of the things I do and I had
\nvias, other people that I work with to do is to really try and understand the opinions of other people
\nlike you understand what I’m trying to very well understand what
\nI think is as the voice, what what
\nother people thought and why. And I think I understood why.
\nI struggle because it really should just just it was very obvious to me why? Because if basically
\nit meant, you know, their goal was to like to take a page
\njust to stop. KOVEN You know, that was their goal. Yes, that it won’t.
\nWell, that’s the thing. I think the the cost heart wasn’t really internalized.
\nIt was just a psychopath, NASCAR. And and we’re seeing
\nthat the costs have been have been more
\nthan my mind can fathom. We hear the numbers about about unemployment
\nand we hear the numbers about higher rates of anxiety and depression. We
\ndon’t see, you know, what’s happening with kids in particular
\nthere. It’s ironic because they suffer they suffer the least from the disease. But there’s definitely
\nsuffering the most from from what we’ve done about the disease, our response
\nand the loss of structure. And we’re really lucky. I personally know our kids.
\nWe’ve been very careful not to sort of fill them with fear about the virus and things like that.
\nAnd they’ve been fine. They haven’t been getting a lot of great school education. We do what we can at home.
\nBut, you know, a lot of a lot of children are undoubtedly suffering
\ngreatly from the loss of the social connections and from the education. They don’t have a home just as as
\nas as good as ours home, really fortunate as ours in terms of, you know, access to things and so on.
\nRight. So you can see in some situations, student having a much harder time. And our kids are.
\nYeah, yeah, yeah. Yeah. Not to mention all the young people who’ve lost an employment.
\nI think, you know, older people have sought savings in more and more
\nmore of a nest to sort of, you know, be able to weather out the shutdowns and
\nprobably have done better. But you know, they’ve suffered also from the social isolation.
\nBut it’s it’s been it’s been quite costly. And and I think if we had
\nyou know, it’s not that I want it. It’s obviously we
\nwant to do as much as we can to prevent people from dying.
\nBut we just we’ve really gone about it. A very fair, few fueled wait.
\nThat just hasn’t served us. And it’s still here and we’ll continue
\nto be here. So let’s forward now then like to to to where we are. And
\nwe learned a lot more about the disease. We’re all wrong in the sense of how how severe right
\nin mortality disease is. And thankfully, it’s not as bad as we thought.
\nAnd we are at a stage now where we have, at least in the US, a number different states opening up, people getting back slowly
\nto their lives and and in very stages across. That’s true for other countries as well.
\nWhere do you see the state is moving forward now? What’s your sort of expectation of how this is going
\nto unfold? Yeah, I think that quite a lot. And, you know, with
\nthis with the with the terrible killing of
\nGeorge Floyd, that’s I think that’s also changed the dynamics because we’ve basically
\ngone from this environment where at least in some states, like in California,
\nthere was tremendous sort of restrictions.
\nThere’ve been tremendous restrictions from the governor in Los Angeles, from the mayor in
\nL.A. County on people’s activities and gathering all this stuff.
\nAnd to the protests of alone that opened a completely
\nblown out. And and it is a political component. You know, there are people
\nwho tried to protest the shutdowns and they only were criticized on these protests are much larger.
\nAnd and and they are not they don’t face the
\nsame criticism and they shouldn’t face the same criticism. In fact,
\nnone of the protests should have faced criticism. Right. It’s people absolutely have a God
\ngiven right to express their opinions.
\nAnd and where they could get away with restrictions, they’ve gotten
\naway with them. And these protests have just blown that open. And they can’t. It makes it
\nmuch harder to get away with restrictions. So so so I think
\nwhat we’re what we’re going to see is is like this continued
\nshift of power from leadership back to the people, which is
\ngreat. And and so. And so
\nI mean, so I think in the public space that’s there are a lot of social advantages.
\nIs that because people need other people? That’s that’s that’s
\nhow we work. That’s how we thrive. That’s how we find happiness. So. So that
\npart is good in terms of policy restrictions on workplaces
\nand, you know, gyms and, you know, whatever other locations, schools.
\nI think that, in fact, this again, this this is
\nthe how things are transitioning with the protests,
\nwith a lot of people just having a lot of fatigue from the shut downs and the restrictions.
\nYou know, I think that there may be some room to see more kids back in school,
\neven in a place like L.A. that’s tried to be, you know, sort of on the
\non the on the extreme off of really trying to cool things down and control things.
\nSo I guess. Yeah. So those are my main. So. So then that’s the good side, I suppose, off
\nof. But how about the disease? Let’s. Now, given that what we learn and what
\nhas been your experience, I guess lately in the house was, oh, wait, how are things progressing? Are you guys preparing
\nfor a big wave or do you think it’s going to come or. Or what is the evidence you’re looking out to to
\nprepare for that? Yeah. Great. That’s a great question. I mean, I think the cream pieces
\nare going to keep increasing. And, you know, there
\nare already a lot of preparation has happened in our hospital and other hospitals for capacity.
\nSo so that’s good. We also know even more now. So
\nwe know the people who are really, really at risk. And that really points to people living in
\nnursing homes and skilled nursing facilities. And by the way, that doesn’t mean that they should not be
\nable to see other people. I think it just means that we need to think harder about how to
\nlive with this. So maybe we need more frequent testing among their family members to visit them
\nor maybe, you know, the visits should happen outside or other changes should be made. But we
\nknow a lot more. And in terms of a surge, I would be very
\nsurprised to see that outside of New York City. Very, very surprised. The reason is
\nbecause we know so much now and people are voluntarily, voluntarily
\ndoing stuff to reduce their risk like people are doing them. So I think
\nit’s unlikely that that we’ll see a surge. I imagine
\nI expect that pieces will continue to increase. There’s no escaping
\nthat. Right. So, yeah, I don’t think so. You know, short of. I don’t think
\nso. I certainly pray we get really lucky and it disappears,
\nbut I don’t think so. I think this is it’s here to stay at least for a while. Even after a
\nvaccine comes sales at its effect, it will continue to
\nbe here. And just to close it up, as I know you’re short on time.
\nHave you seen improvements in the way you guys are able to treat patients? Is that something that we’re
\nlearning as we go and we’re getting better at it or unfortunately, something that really
\nit is what it is and there’s not much we can do? Yeah, I think there have been improvements.
\nYou know, there’s we’ve learned about crowning a patient’s position and them to improve their
\nrespiration, to model, to cheer about the laying intubation. So
\nand some patients tolerating low levels of oxygen better than previously thought.
\nAnd, you know, and we’ve had some some favorable reports
\nin terms of drug efficacy for treatment. So that’s all pointing in the right
\ndirection. And and and I would not be surprised
\nif we see even more another favorable agent. They’re just an unbelievable
\nnumber of clinical trials ongoing right now. So, you know, I I would
\nexpect that we will find at least one or two more like robust.
\nEffective treatments for the condition, which would be great. That’s fantastic.
\nThat’s so good and good, good, good high note to to to end this. Thank you for all that you’re
\ndoing on the right as a day, I think are very, very helpful for me to read and I think to help people
\nunderstand different ways to think of this problem. And especially as people try to evaluate public policy like I do
\nand like my students in the class that I teach. And that’s always very important for us to focus on tradeoffs.
\nAnd you were you were there from the very beginning. So so thank you for that. All right. Thanks.
\nThanks for. Thanks for listening to Policy McCombs.<\/p>\n"},"episode_featured_image":false,"episode_player_image":"https:\/\/podcasts.la.utexas.edu\/cepa\/wp-content\/uploads\/sites\/21\/2021\/05\/SC_PolicyMcCombs_Art-scaled.jpg","download_link":"https:\/\/podcasts.la.utexas.edu\/cepa\/podcast-download\/543\/joseph-ladapo-covid-19-interview.mp3","player_link":"https:\/\/podcasts.la.utexas.edu\/cepa\/podcast-player\/543\/joseph-ladapo-covid-19-interview.mp3","audio_player":null,"episode_data":{"playerMode":"light","subscribeUrls":{"apple_podcasts":{"key":"apple_podcasts","url":"","label":"Apple Podcasts","class":"apple_podcasts","icon":"apple-podcasts.png"},"google_play":{"key":"google_play","url":"","label":"Google Play","class":"google_play","icon":"google-play.png"},"google_podcasts":{"key":"google_podcasts","url":"","label":"Google Podcasts","class":"google_podcasts","icon":"google-podcasts.png"},"spotify":{"key":"spotify","url":"","label":"Spotify","class":"spotify","icon":"spotify.png"},"itunes":{"key":"itunes","url":"","label":"iTunes","class":"itunes","icon":"itunes.png"}},"rssFeedUrl":"https:\/\/podcasts.la.utexas.edu\/cepa\/feed\/podcast\/policymccombs","embedCode":"
Joseph Ladapo – COVID-19 Interview<\/a><\/blockquote>