Seventy-one percent of Americans trusted doctors and hospitals in January 2020. By January 2024, that number had fallen to forty percent. But the same data shows that eighty-five percent of patients still trust their own physician. Cardiologist Dr. Akshay Pendyal calls medicine the most complex social role in human history, and in this conversation with Dr. Aditi Nerurkar, he makes the case for why. Drawing on the placebo effect, the nocebo effect, the ORBITA trial, and decades of clinical practice, they examine the alchemy of the therapeutic encounter: what patients bring into the exam room, what doctors carry with them, and what the science says happens when those two forces meet.

Seventy-one percent of Americans trusted doctors and hospitals in January 2020. By January 2024, that number had fallen to forty percent. But the same data shows that eighty-five percent of patients still trust their own physician. Cardiologist Dr. Akshay Pendyal calls medicine the most complex social role in human history, and in this conversation with Dr. Aditi Nerurkar, he makes the case for why. Drawing on the placebo effect, the nocebo effect, the ORBITA trial, and decades of clinical practice, they examine the alchemy of the therapeutic encounter: what patients bring into the exam room, what doctors carry with them, and what the science says happens when those two forces meet.

Every misdiagnosis–or missed diagnosis–has a story. The Blind Spot goes looking for it. Each episode goes back to the beginning, as physicians revisit the cases that kept them up at night and patients recount the persistence it took to finally break through a diagnostic wall. The clues were often there. The question is why no one connected them.

From systemic biases where a woman's chronic pain is dismissed as "emotional," to conditions that present differently across diverse patient populations, to the incredible administrative pressures facing providers doing their best. 

The Blind Spot reveals what it takes to see what medicine almost missed — and what it costs when we aren’t seeing each other clearly across the exam room.

Every misdiagnosis&ndash;or missed diagnosis&ndash;has a story. The Blind Spot goes looking for it. Each episode goes back to the beginning, as physicians revisit the cases that kept them up at night and patients recount the persistence it took to finally break through a diagnostic wall. The clues were often there. The question is why no one connected them.
From systemic biases where a woman's chronic pain is dismissed as "emotional," to conditions that present differently across diverse patient populations, to the incredible administrative pressures facing providers doing their best.&nbsp;
The Blind Spot reveals what it takes to see what medicine almost missed &mdash; and what it costs when we aren&rsquo;t seeing each other clearly across the exam room.

The Blind Spot with Dr. Aditi Nerurkar

Be the Medicine: Dr. Akshay Pendyal on Placebo, Nocebo, and Trust

https://api.omny.fm/orgs/e73c998e-6e60-432f-8610-ae210140c5b1/clips/b01619de-3ed5-464e-9d5a-b47400026d70/transcript

Most physicians were trained to believe Munchausen by proxy is vanishingly rare. Andrea Dunlop has spent years talking to the clinicians, survivors, and researchers who know otherwise. In this conversation with Dr. Aditi Nerurkar, she makes the case that the condition is far more common than the medical community recognizes, and that the structural reasons physicians miss it are themselves a form of institutional blind spot.


Dunlop, creator of the award-winning podcast "Nobody Should Believe Me" and founder of the nation's only nonprofit dedicated to survivors of this abuse, walks through how the pattern actually appears in a chart, why clinicians are uniquely vulnerable to manipulation by perpetrators, and why a child aging out of pediatric care does not mean they are out of danger. The conversation keeps returning to a single orienting principle: the child is the patient, not the parent. When that distinction gets blurred, the consequences can be fatal.

Most physicians were trained to believe Munchausen by proxy is vanishingly rare. Andrea Dunlop has spent years talking to the clinicians, survivors, and researchers who know otherwise. In this conversation with Dr. Aditi Nerurkar, she makes the case that the condition is far more common than the medical community recognizes, and that the structural reasons physicians miss it are themselves a form of institutional blind spot.
 Dunlop, creator of the award-winning podcast "Nobody Should Believe Me" and founder of the nation's only nonprofit dedicated to survivors of this abuse, walks through how the pattern actually appears in a chart, why clinicians are uniquely vulnerable to manipulation by perpetrators, and why a child aging out of pediatric care does not mean they are out of danger. The conversation keeps returning to a single orienting principle: the child is the patient, not the parent. When that distinction gets blurred, the consequences can be fatal.

"The Child Is Your Patient": Andrea Dunlop on the Medical Abuse Hiding in Plain Sight

https://api.omny.fm/orgs/e73c998e-6e60-432f-8610-ae210140c5b1/clips/189d6e3c-9af2-4caf-9df5-b48f01376364/transcript

Fifty-two percent of the top-performing TikTok videos about ADHD contain misinformation. That is where this conversation starts. But Dr. Judith Joseph, board-certified psychiatrist, principal investigator, and author of High Functioning, quickly moves it somewhere more complicated: what happens when a diagnosis is not a medical conclusion but a way of belonging?

Patients are arriving in the exam room already labeled because an online community offered an identity at a moment when they needed one. Dr. Judith walks through the Tourette's uptick she observed in post-pandemic adolescents, the adult women grieving years of missed ADHD diagnoses, and the stimulant shortage she sees as a downstream consequence of over-prescription driven by online self-diagnosis.

Fifty-two percent of the top-performing TikTok videos about ADHD contain misinformation. That is where this conversation starts. But Dr. Judith Joseph, board-certified psychiatrist, principal investigator, and author of&nbsp;High Functioning, quickly moves it somewhere more complicated: what happens when a diagnosis is not a medical conclusion but a way of belonging?
Patients are arriving in the exam room already labeled because an online community offered an identity at a moment when they needed one. Dr. Judith walks through the Tourette's uptick she observed in post-pandemic adolescents, the adult women grieving years of missed ADHD diagnoses, and the stimulant shortage she sees as a downstream consequence of over-prescription driven by online self-diagnosis.

Diagnosis or Identity? Dr. Judith Joseph on Social Media, Self-Diagnosis, and Loneliness

https://api.omny.fm/orgs/e73c998e-6e60-432f-8610-ae210140c5b1/clips/4d0c67d2-d0d9-49c0-8f0d-b481010991be/transcript

Host Dr. Aditi Nerurkar sits down with Dr. Thomas VanderMeer, surgical oncologist and interim director of the Upstate Cancer Center at SUNY Upstate Medical University, to trade notes on the real work of caring for the data-informed patient.

They start with a case. A woman with rising ctDNA, no imaging correlate, walking into Tom's office. He thought the conversation would be about the limits of detection. It wasn't. Her question, once he listened for it, was about her children, and whether the same molecular tests could tell her something about their risk. Tom uses the case to make a larger point. The question on the surface is rarely the question the patient actually came in with.

From there, the two doctors get into the practice. The teach-back method as a check on real understanding. The discipline of not looking at your watch, even when the schedule says you should. And the throughline Aditi names back to him by the end of the conversation: open-mindedness and humility, held steady against the rigor of the science.

Pfizer is a non-editorial sponsor of this content.

Host Dr. Aditi Nerurkar sits down with Dr. Thomas VanderMeer, surgical oncologist and interim director of the Upstate Cancer Center at SUNY Upstate Medical University, to trade notes on the real work of caring for the data-informed patient.
They start with a case. A woman with rising ctDNA, no imaging correlate, walking into Tom's office. He thought the conversation would be about the limits of detection. It wasn't. Her question, once he listened for it, was about her children, and whether the same molecular tests could tell her something about their risk. Tom uses the case to make a larger point. The question on the surface is rarely the question the patient actually came in with.
From there, the two doctors get into the practice. The teach-back method as a check on real understanding. The discipline of not looking at your watch, even when the schedule says you should. And the throughline Aditi names back to him by the end of the conversation: open-mindedness and humility, held steady against the rigor of the science.
Pfizer is a non-editorial sponsor of this content.

"They Come In Curious": Dr. Thomas VanderMeer on Curiosity, Humility, and the Patient Who's Done the Reading

https://api.omny.fm/orgs/e73c998e-6e60-432f-8610-ae210140c5b1/clips/93c6a983-27a5-488b-a8a9-b45d00dd7052/transcript

Be the Medicine: Dr. Akshay Pendyal on Placebo, Nocebo, and Trust

In 1 playlist(s)

The Blind Spot with Dr. Aditi Nerurkar

Social links

Follow podcast

Recent clips