Ep. 116: Anthony DiGiorgio & Anish Koka on the Rules That Undermine Independent Medicine and Misaligned Healthcare Incentives from Practitioners’ Perspectives

Niklas (0:01)

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All right, today is August 24th in 2026, and my guests are Dr. Anish Koka and Dr. Anthony DiGiorgio. Dr. Koka is cardiologist in private practice. By the way, feel free to correct my pronunciation. No, you nailed it. OK, good. And Dr. Anthony DiGiorgio is a surgeon who cares for patients with traumatic brain injuries or spinal cord injuries. Together, they've launched an excellent podcast called The Doctor's Lounge, which had fantastic guests on such as Cremieux, Martin Shkreli, Jay Bonacharja, and is quickly emerging as a key voice on X and among healthcare and policy practitioners, let's say on the more heterodox side of the political spectrum.

So I followed their work for a couple of months, especially since the FDA shakeup that led to the ouster of then FDA Commissioner Marty Makari, together with Rene Prasad and Tracy Bette-Houx, where they have been highly critical of the official narrative from mainstream outlets such as Stead News, and the New England Journal of Medicine, etc.

So I've learned a lot from them and I've had the pleasure to be featured on their podcast as well. Link to that episode will be in the show notes, and very excited to have them on here today as well. So welcome, Anish and Anthony.

Anthony DiGiorgio (1:47)

Thanks for having us.

Niklas (1:49)

Yeah, so it would be great, guys. Let's get started. What is the founding story from each of your point of view of The Doctor's Lounge? And feel free to kind of weave in also a bit your personal background, how you met and what led up to that you're doing this project now. I don't know who wants to start.

Go for it, Anish.

Anish Koka (2:07)

Dr. George is always the gentleman. So starting in about 2014, it became relatively obvious to me that as a practicing cardiologist, that the voice of the clinical practitioner existed out on the policy stage, but it was very, very muted. And there was a lot of health policy, or almost all the entirety of health policy was kind of directed from the vantage point of academics in health policy. And I was actually a devotee of that group, because I was like, look, I mean, I'm a practicing cardiologist. It's hard enough to figure out cardiology, let alone do health policy on top of that. And so, you know, whatever they said, I was like, okay, I mean, whatever, I mean, it's you guys are the experts, right? Take, you know, if you want good health policy, take a bunch of guys from Harvard and a bunch of guys from Yale. They're super smart. This is what they do all the time. They're professionals. Like let them do it themselves. You know, like I don't want to do my own plumbing.

Why should I try to do health policy? So whatever they said, you know, I was like, yeah, it sounds good. Let's do it, you know? So I was a proponent of Obamacare and thought it was great because they said it was great. And then I got in. And then, you know, of course, Obamacare was happening right around the time I was starting my practice. And very quickly, this divergence emerged between what the health policy people were saying reality was, and then the reality that I was living, like as a practicing guy running a private practice, trying to kind of make all this stuff work. And it became pretty obvious that there was this significant divide. And first, I was like, oh, this is a story. I'm going to let the journalists in Philadelphia know about this so that they will pick up the ball and run with it. Because again, I'm not a journalist, right? I mean, they're journalists and they're professionals. And I was very much establishment, you know, the establishment. I had a lot of respect for the institutions. And so I went and I sent emails to lots of journalists, these long things. And everyone was like, nobody, I got no response. I got a couple of interesting questions back and forth, but nobody would take any of the stories that I was saying about like, hey, they're saying this, but it's actually this, right?

And so at that point, I was like, all right, we need to start getting our voice out somewhat naively. I was like, you know, I started writing, I started writing a blog at the healthcareblog.com.