YouSaid · the spoken record

Dr. Lloyd Minor

lines on the record: 76
first: 2020-03-11
most recent: 2020-03-11
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“We live All right, when we get back, we're going to talk about how you do that, how you do that, and how you spread it out to most people in this country. And we will talk a little bit about not Medicare for all, but healthcare for all and doing that when we get back. We're here with Dr. Lloyd Minor. He's the dean of the Stanford University School of Medicine. We'll be back after this.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Our genome plays a big role in determining what we're at risk of. It's not everything, though. You know, it's a sad fact in America today, the best predictor of life expectancy is not our genetic code. It's a zip code in which we live. And I think that's something we're going to have to, the social environmental behavioral determinants, and I write about them in the book, are going to be areas that we have to focus a lot more attention on in academic medicine and the U.S. healthcare delivery system than we have in the past. That being said, our genome does give us insights into our risk factors for a variety of different diseases. So that's a starting point, but it's really only a starting point as we look at the interaction between the genome and things in the environment. That's where we're going to get a much more robust picture of what our risk factors are and what we can do about it.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“All right, so let's talk about that idea. So you take a patient, a precision health, it would be to figure out I've heard of lots of these companies now and a lot of tech people are going to them what they're going to die of. They're going there to find out what they're probably going to die of based on this, this idea of what your risk factor is. Talk about how that works individually and then we can talk about it for everyone for lots of people.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Better control of blood pressure, all of those factors coming together have reduced the instance of heart disease. Shouldn't we be able to do the same thing for other types of diseases where the risk factors may be a little bit harder to deduce than they were for heart disease, but still now, particularly with data science, with the ability to aggregate large amounts of data, we should be in a much better position for each one of us to know what our likelihood of developing a disease is and how we can best prevent that disease.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“That's right. Cancer being probably the most notable one, but also in heart disease today, a lot of advances in predicting and preventing heart disease and also in treating severe heart disease. And heart disease points out how we can make progress in actually reducing the instance of a disease quite a bit in the course of the last 20, 25 years. It was a study begun now 60 years ago, the Framingham study in a suburb of Boston that defined the risk factors for heart disease, high cholesterol, high lipid levels, the relationship of high blood pressure. As a result, drugs like lipid lowering drugs were developed. And we also had a renewed attention on reducing the instance of smoking.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“That's right Right, we can continue with the example of breast cancer. There are three very important receptors that are tested in every breast cancer patient. The therapy for that patient is determined based upon whether or not the person has receptor or not. Also, the status of any nodal, any involvement of lymph nodes impacts the choice of therapy. So whereas in the past, like maybe 15 to 20 years ago, the treatment would have been mastectomy, no dissection, radiation therapy, everybody got the same thing. That's not the case today. And as a result, the outcomes are better because”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Wait how that works because I think people understand that medicine has been sort of kind of a, I don't say spray and pray, but off the shelf. Everyone gets the same thing in this testing is done. Everyone's not the same. That's right. So the idea of precision medicine is that you tailor the medicine to the individual person based on their genomics and other things.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Those terms used, then President Obama picked that up as being an overall national goal. And precision medicine is about using genomics and data science to personalize the treatment of the best example is cancer. Today, for example, our treatment outcomes in breast cancer are much better than they were a decade ago because no one with breast cancer gets off the shelf treatment. Everyone with breast cancer has a treatment protocol that's individualized to the disease.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“You're right, and really the term precision medicine began right here in San Francisco back 2013, 2014, when Sue Desmond Hellman was chancellor at UCSF. She hosted a national conference on precision medicine. It's the first time I had heard.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“That are focused on detecting cancers like pancreas cancer, ovarian cancer much earlier should have an effect on the outcomes because today those two cancers in particular, pancreas and ovarian cancer, are classically diagnosed very late in their course and therefore have a relatively poor outcome. If we detect them earlier, we should be able to treat them much more effectively.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Acute diseases we treat today like cancer and heart disease will either be prevented in the first place or there'll be less severe because we will have detected and treated them earlier. Therefore there are three components to precision health predict, prevent, and cure. But really in that order because if we're able to predict the likelihood that you or I will get a disease, we're much better equipped to prevent it from occurring in the first place. And when we can't prevent it If we diagnose it much earlier, we'll be able to treat it more effectively than if it was diagnosed at a very late stage. Cancer provides a good example knowing our risk factors is going to be increasingly important and advanced diagnostic tests.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Our strategic vision in Stanford Medicine, we describe as precision health, and we call it health rather than medicine for the following reasons. In the United States, we have a great sick care system in terms of organ transplantation, the latest treatments for cancer. And for goodness sakes, if one of our family members has a disease like severe heart disease or cancer, we want to get the very best individualized treatments. And we do relatively well with that in the United States, but shouldn't we be taking those same enablers of genomics and data science and applying them much earlier on to predict and prevent disease? Precision health, therefore, is about health care. It's about learning how to keep us healthy. If we get sick, we want precision medicine, which is about sick care, which we for sure do at Stanford. But the way we know we'll be successful a decade, we've been successful a decade from now in our vision for precision health, is that a lot of the”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“All right, this gives a good segue into talking about your book, Discovering Precision Medicine. The idea that tech can help us in this way, I mean, I wrote a column about it recently about the things, obviously working from home and things, there's a lot of technologies now that prevent people from”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“In recent years, there are lots of reasons for that in terms of the business model, in terms of the amount of RD costs required to develop new vaccines. But we need to rethink that, and we need to learn a lot more about human immunology and how it is that we form vaccines, how it is that we can mobilize the immune system in each of us to fight off infections like the infection from coronavirus. Our knowledge of human immunology and the human vaccine response is still fairly primitive. That's an area we focused on a lot at Stanford and will continue to focus on in addition to the work that's going to go on in industry, I hope, to develop a vaccine for COVID-19 and also better vaccines for the flu and other related viral illnesses.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Exactly. I think what's happened over the past month and particularly the past couple of weeks with regard to coronavirus really underscores the importance of needing to focus much more attention on infectious diseases, those that are emerging and those that are already here. There's been very little work done on new vaccine development”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Right. So the masks are used for healthcare workers and people who are sick who actually want to prevent from coughing on a table or more of that, essentially. That's what it should be used for if you're actually sick. That's correct. If you are sick, you should wear one. If you're not, you should not. Right, okay. So, do you all spend a lot of time thinking about this idea of the big one, the idea that there is a virus or a plague that's going to affect humanity? And I want to get into precision medicine because medicine's changing too at the same time.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Right. What we know so far, and this is changing by the hour. Not to mention by the day, is that this virus, like other virus-specific viruses in the family of coronaviruses, is spread by droplets. So the virus gets into particles of saliva or other bodily fluids, and then it's transmitted either through a cough or a sneeze or through close contact with a surface that has had droplets on it. A mask, although in some sense it might be effective, it's not the principal way we prevent the spread of the infection.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“The specific recommendations from the CDC and other organizations is that just wearing a mask, if you're not infected, if you're just wearing it because you're thinking it's going to prevent you from getting infected, that's not likely to be effective. And also it's likely to prevent the mass from getting to the places they need to get”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Right. And so people should not be hoarding masks. This is something that the Surgeon General said. I've heard lots of doctors talk about it, this idea that that will protect you. That's not the case, correct? That's”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“We, I think other organizations are watching carefully recommendations from the CDC, from local and county health departments with regard to how we advise our employees with regard to how we plan events. The CDC did last night issue a recommendation that educational institutions look at abroad programs and consider bringing students back from those programs so that's something we began to look at immediately as well as determining where we have students. We'll watch carefully the recommendations coming from national organizations, local organizations, and act accordingly.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Something that we do commonly That specific virus. Exactly. And then what about this cancellations, the quarantining, you know, because it's shown up now, it's in New York, I guess. This is the nature of viruses spreading. And this one seems to stealthily stay somewhere for a while.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“I think the way not to panic is to focus on the things that we know prevent the spread of the virus. Number one, we should wash our hands. 20 seconds with soap and water. Also, we should avoid touching our face, something that we do commonly, but that we know that the spread of the virus by and large is through mucous membranes on our face, nose, eyes, mouth. So those are two relatively straightforward, but require some intention in planning things that we can all do that have been shown to curtail the spread of viruses like COVID-19 and that specific virus. Exactly.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“COVID So, when you say not panic, what people are panicking, a lot of the stock markets getting affected, people are canceling things. How do things like this play out or we just don't know? Because everyone talks about this idea of the big one. I've been reading a lot of stories about someday there's going to be a big one. This may not be the big one. But talk about how do people not panic? What is the President thing to do? What is the responsible thing to do?”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“I think this is a serious public health concern, but it's not a cause for panic. Specifically to your question about Stanford, we're prepared. None of us knows the extent of the spread. We just opened two wonderful new inpatient facilities at Children's Hospital. We opened about two years ago a new adult hospital that we opened just this past November. They're equipped with private rooms, rooms that are ready to take care of patients with infectious diseases. Our staff are trained. We have supplies of personal protective equipment. So we've been in preparation for this or an event like COVID-19 since before the current problem with this virus began”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“So I'm going to start into your background and stuff like that, but let's talk about right now the coronavirus. Anyone who has any ability to talk about it intelligently, we love to talk about it. We're having tomorrow having Ron Clain, who was the Ebola czar. Under the Obama administration, talk a little bit about where you think we are and how Stanford is handling this, because I think probably every major medical center is discussing this at length”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT
“Hi, I'm Kara Swisher, editor at large of Recode. You may know me as someone who could probably be a very good neurosurgeon. I'm used to getting into people's heads, but in my spare time I'm just a reporter and you're listening to Reco to podcast about power change and the people you need to know. We're part of the Vox Media Podcast Network. Today, in the red chair is Dr. Lloyd Minor, the Dean of the Stanford University School of Medicine. He's also the author of a new book called Discovering Precision Health, Predict, Prevent, and Cure to Advance Health and Well-Being, which comes out March 20th. We'll talk about the big public health issue that's on everyone's mind right now, which is the coronavirus outbreak, as well as how tech is changing the study and practice of healthcare. Dr. Minert, welcome to Rico Decode.”
2020-03-11 · Decoder with Nilay Patel · Recode Decode: Dr. Lloyd Minor · IDENTIFIED FROM THE TRANSCRIPT