Dr. Sreedhar Potarazu
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WASHINGTON, DC—As one of the preeminent professionals in his field, Dr. Sreedhar Potarazu is often called upon by major media outlets to offer his opinion on various medical matters. He was termed by The Washington Post as a “distinguished” expert, for which he writes a weekly column on the national healthcare debate, and he frequently appears on national television news programming, including the Fox Business Channel’s “Your World with Neil Cavuto,” “Bulls & Bears,” and “Stuart Varney.”
Dr. Potarazu received his medical degree from George Washington University where he subsequently completed his internship in surgery as well as his residency. He then completed fellowships in neuro-ophthalmology and glaucoma at the Bascom Palmer Eye Institute at the University of Miami in Florida, followed by an MBA from Johns Hopkins that he earned while practicing medicine.
His focus on health information technology led to his current position as one of today’s most widely recognized and knowledgeable industry leaders in health care and health care technology, according to Dr. Potarazu’s own professional website, and his expertise in the fields of health care cost control and reform has led to collaborations with gargantuan companies such as McDonalds, Kodak, and Microsoft.
In a phone interview to The American Bazaar, Dr. Potarazu gave insights into topics ranging from the proliferation of medical cannabis, to the onset of stem cell research. Excerpts from the interview:
If you had to boil it down, why is the United States’ healthcare system so far behind those of other developed nations? For example, infant mortality rates in Nordic nations are always among the best in the world, while the U.S. slots in at 33.
Infant mortality rates are clearly a measure as far as the overall efficiency of a healthcare system. But I think that the reality is that as one looks at the challenges every healthcare system has, there is no utopia that exists today in terms of how we’ve been able to provide unlimited resources. There is no market where that exists today as sort of a blank check. There’s this notion that in single-payer systems where the government is funding everything is running perfectly. Every healthcare system has the same challenges in terms of where to apportion their resources in order to ensure the right groups of individuals are getting the right care, and that cost and quality are being balanced at any given moment. That’s a hard thing to do because most healthcare systems lack the right infrastructure in terms of their ability to analyze the data necessary to make those kind of changes.
When you say infrastructure, what specifically are you referring to?
Data is a big part of it. Data is a key component of any infrastructure in a healthcare system where understanding all of the key metrics around healthcare cost utilization in its entirety becomes critical in terms of optimizing strategy. That is often fundamentally, especially in the United States, a limitation in terms of the ability to create sustainable change.
However, it is an extremely broad statement, and for me to generalize about an extremely complex system and use a very generic term like “ahead” or “behind” without getting very specific would do it no justice. But there are millions of layers and comparisons that can be made that are more quantitative and objective rather than subjective. We should never make it a subjective comparison.
There’s been talk of the U.S. benefiting from its re-burgeoning relationship with Cuba by way of bio-tech research proliferation. Do you think our geopolitical neighbors could affect the dynamics of healthcare over here given time?
I think it’s premature to be commenting on Cuba, I don’t think anybody knows enough about the efficiency of that system and whether it’s working or not. I’d be shocked if Cuba themselves knew that much. But I think that the United States can certainly benefit from observations from many countries in terms of things that work. But perhaps things that are not working become triggers for the kinds of mistakes that can be made. There’s often been discussion about looking at either the Canadian or the British system for healthcare delivery in terms of coverage. But the mistake that’s often made is that coverage is not a synonym for care; they’re different words. So just because somebody gets coverage it doesn’t automatically mean that they’re getting the right care. Even the U.K. and Canada are having their own challenges in terms of what they’re able to do or not to do, so it’s in that context that we have to be judicious in what can be done.
Do you view president Obama’s health care reform as a success or failure?
The idea of providing and enhancing coverage for those who didn’t have it — that has been successful. I think in terms of looking at the financial solvency of the Affordable Care Act in achieving the savings that were scored by the CBO [Congressional budget Office] have yet to be recognized in its totality and I think it faces challenges because the adequate infrastructure in terms of being able to measure the true impact of coverage and its impact on getting the right care — the right infrastructure is not there. And the cost for that has not been adequately factored in. Anything we report on in terms of economic benefits in terms of Obamacare is suspect until those things are in place.
The lines that are drawn between medicine and business, plus medicine and politics grow ever finer. How do you define them?
I don’t think that there is an economic component that is inseparable from healthcare delivery, if that’s what you’re labeling as business. So it is not ethical to introduce — unfortunately — economic parameters in the context of healthcare delivery. But, unfortunately, in certain circumstances it has to be done — from my previous statement that there are not abundant resources where everyone can have everything all the time, whenever they need it. But as physicians, we are taught that the economic components are secondary. The primary focus should always be in terms of patient outcomes — there’s no question about that. But clearly there is a tremendous business aspect to healthcare delivery which is important. In any situation, being able to understand health risk and how it impacts financial risk. That has bearing to an employer, an insurance company, a pharmaceutical company, a provider system — anybody. Although it sounds simple, the ability to get that kind of perspective in terms of how health risk and consumption impact over a financial incentive is a challenge, and that is a function of the depth of information that is required to be able to get the information one needs to understand the balance between that. As far as politics, there’s always going to be legislative issues based on funding and other otherwise that will become a challenge between who should be paying for what — that battle will always be there in any system. You’re going to have political implications drawn around that because it’s a shared responsibility in any situation. There’s politics; it creates politics.
What is your professional opinion of medical marijuana as the movement gains momentum across the U.S., especially considering some big names have come out in support of it, such as Dr. Sanjay Gupta?
There are certainly indications where cannabis has applicability in terms of a treatment perspective. I do believe that requires further study and adequate funding to see whether — in isolated circumstances perhaps — other treatments may not have worked or situations where the symptoms become intractable — that there might be clear indications of when cannabis could help. I use that term specifically because I don’t there to be one word used in two different scenarios. “Cannabis” should be the name of the substance that is used in a medical context, treating medical conditions, and that is what needs to be studied. “Pot,” should not be used synonymously with cannabis. Pot is a recreational use of cannabis and that is a different discussion. The problem is that when you call it medical marijuana the public doesn’t hear the medical part. What the public hears is whether marijuana should be legalized. So you should conduct a survey to look at what the response is when you call it cannabis versus pot, or medical marijuana versus marijuana — “medical” doesn’t do anything. The whole legalization issue has unfortunately created confusion, especially amongst those who may not know better and who are turning the conversation toward the legalization of marijuana independent of the conversation regarding whether cannabis should be used for medical purposes. Those are two completely different debates. But when you call it “weed,” weed is the interpretation of marijuana that is used in a recreational context. Weed should not be called marijuana that is used in a therapeutic context, ever.
So you believe there needs to be a much stricter separation between medical cannabis and “pot” or “weed” for recreational use, essentially?
There are plenty of kids who abuse over-the-counter decongestants, and on the street it’s called another name. We don’t use that name when treating a cold. So they have completely different implications. Advil, today, or a nasal decongestant is abused and it’s got a street name, but I’m not prescribing to you the street name; I’m not telling you that you ought to use the drug with the street name to treat your cold. Calling it weed and saying we need to legalize weed is the wrong discussion because it is confusing the public on two different debates and those debates should be kept separate.
In the same context, do you believe lawmaking goes hand-in-hand or are they also completely separate?
Of course, lawmaking goes hand-in-hand with that. Medical cannabis should be regulated differently from the regulations of recreational use.
Stem-cell therapy is another treatment that we are learning more about with each passing day, but is dogged by controversy. Are the ethical concerns viable, in your opinion?
They are viable; I think there’s a lot of good work that’s being done with stem cells that should not be written off and I think there will be clear applicability in research areas, so I think it’s important. I know it’s a controversial debate about where the stem cells come from and so it certainly needs to be addressed. I think that any science needs to be done in the context of controlled clinical trials in terms of testing efficacy — that’s the golden standard — and this should be no less.
Do you think the science is progressing in such a way that the public will have to be accepting of it based off of the sheer medical breakthroughs that could be made possible due to stem-cell research in the future, or will it continue to be an uphill battle for the foreseeable future?
I don’t think see it being as much of a battle in the evolving future as more progress is made.
What is the next frontier, be it innovative or detrimental — for healthcare?
The use of big data to drive innovation is going to be the biggest area of growth in healthcare. It already is, but it will continue to grow in leaps and bounds. And then of course medical devices, wearables, robotics in terms of automation, and then personalized medicine in terms of genetic engineering and specifying treatments. I think that these will be some of the key areas that we’ll see a lot of innovation in.
Do you think that privacy concerns will enter the picture when it comes to big data and personal profiles of people’s health?
No question about it, but in that lies the sophistication of the understanding of governance around privacy that enables one to maintain the sanctity of those boundaries and not violate them while still delivering value. That’s a delicate balance and it takes a lot of experience in terms of understanding that balance.
This story originally appeared on The American Bazaar.