A show dedicated to solving medicine's hardest problems — one big question at a time. Hosted by Dr. Ilana Yurkiewicz, Stanford physician, professor, and journalist. <br/><br/><a href="https://ilanayurkiewiczmd.substack.com?utm_medium=podcast">ilanayurkiewiczmd.substack.com</a>
Hard Medicine
Claim This Podcastby Ilana Yurkiewicz, MD
5.0(1 reviews)
6 episodes
Updated Daily
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Podcast Overview
A show dedicated to solving medicine's hardest problems — one big question at a time. Hosted by Dr. Ilana Yurkiewicz, Stanford physician, professor, and journalist. <br/><br/><a href="https://ilanayurkiewiczmd.substack.com?utm_medium=podcast">ilanayurkiewiczmd.substack.com</a>
Language
🇺🇲
Publishing Since
12/29/2025
1 verified contact email on file for Hard Medicine
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Recent Episodes
May 24, 2026
Is Cancer Preventable?
<p>Cancer care still mostly revolves around one goal: chasing cure. But what if that approach is costing us thousands of lives and untold suffering?</p><p>In this episode of Hard Medicine, Dr. Yurkiewicz speaks with Dr. Azra Raza, oncologist and author of <a target="_blank" href="https://azraraza.com/books/the-first-cell/">The First Cell</a>, about why cancer medicine still prioritizes treatment over prevention — and the paradigm shift needed to change that. They discuss what stands in the way: massive disparities in research funding, a health care system that flattens prevention into one-size-fits-all, and a medical culture favoring incremental advances over radical change. They also explore solutions, from targeting cancer precursors in the bloodstream to tailored screening for people at high risk.</p><p>This is a conversation about cancer that is both deeply critical and optimistic.</p><p>0:06 Opening Monologue: From Treatment to Prevention — Cancer Needs a Paradigm Shift</p><p>2:49 Why Focus on Prevention?</p><p>8:33 Cancer Is Too Complex to Cure</p><p>14:45 95% of Cancer Drug Research Fails</p><p>18:47 What’s Wrong With Mouse Models?</p><p>27:40 Building Biobanks From Human Samples</p><p>30:18 The “Stentinel”</p><p>37:21 The Limits of One-Size-Fits-All Screening</p><p>44:43 Rapid Fire Q&A: Blood Tests for Early Detection, Full-Body MRIs, and Rising Cancers in Young Adults</p><p>50:31 Is Cancer Preventable?</p> <br/><br/>Get full access to Hard Medicine at <a href="https://ilanayurkiewiczmd.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4">ilanayurkiewiczmd.substack.com/subscribe</a>
April 27, 2026
How Can We Get Doctors Where They’re Needed Most?
<p>The U.S. has doctors, but they’re not distributed where the needs are greatest. We are in short supply of primary care physicians, especially in rural communities. In this episode, Dr. Yurkiewicz speaks with policy analyst Lawson Mansell about the incentives — largely from the government — that influence what doctors choose to practice and where. These incentives systematically steer doctors away from the medicine patients need most.</p><p>They dissect several sources: payment that rewards episodic care over long-term relationships, outdated residency funding that favors hospitals over clinics, and underutilizing internationally trained physicians already living in the U.S. They also discuss hopeful initiatives, such as a bipartisan bill that would let Medicaid support a model known as direct primary care.</p><p>How can policymakers rewrite incentives to reflect workforce needs? How can we help more doctors choose to practice where they’re needed most? </p><p>0:06 Opening Monologue: Where Doctors Go Is a Policy Choice</p><p>1:52 Why Are Primary Doctors Paid Less Than Specialists?</p><p>19:20 Lobbying from the AMA and Unintended Consequences</p><p>24:18 The Pipeline In: Residency Funding Is Outdated</p><p>39:39 Wasting International Physicians’ Time</p><p>45:26 Bipartisan Support for Direct Primary Care</p><p>51:04 How Do We Get Doctors Where They’re Needed Most?</p> <br/><br/>Get full access to Hard Medicine at <a href="https://ilanayurkiewiczmd.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4">ilanayurkiewiczmd.substack.com/subscribe</a>
March 23, 2026
Can Medicine Make Peace With Dependence?
<p>What is dependence, and is medicine built to handle it? That’s the question at the center of this conversation between Dr. Yurkiewicz and Leah Libresco Sargeant, a writer and thinker. Sargeant’s latest book, <a target="_blank" href="https://undpress.nd.edu/9780268210335/the-dignity-of-dependence/">The Dignity of Dependence</a>, argues that society treats autonomy as the default, when in reality our lives are shaped by need. Does healthcare, of all places, fully accept this? </p><p>They discuss the vulnerabilities that even healthcare struggles to hold — chronic illness, pregnancy, end-of-life — and the costs of treating these as exceptions: financial loss, employment discrimination, and compassion fatigue. What would it take for medicine to meet real human need?</p><p>0:06 Opening Monologue: Healthcare’s Blind Spots on Dependence</p><p>1:22 What Is Dependence?</p><p>2:29 Does Medicine Overlook Need?</p><p>7:22 What Economics Misses About Caregiving</p><p>10:14 Workplaces Don’t Accommodate Being Human</p><p>17:57 Nine Months of Illness: Failing to Account for Pregnancy</p><p>23:21 The Myth of the Invincible Clinician</p><p>29:02 The Range of Human Experience and Tradeoffs</p><p>36:45 The Dignity of End of Life</p><p>39:16 What Is Our Obligation When Quality of Life Is Irreversibly Lost?</p><p>44:08 Compassion Fatigue</p><p>46:25 Is Physician Aid in Dying Dignified?</p><p>55:30 Can Medicine Make Peace With Dependence?</p> <br/><br/>Get full access to Hard Medicine at <a href="https://ilanayurkiewiczmd.substack.com/subscribe?utm_medium=podcast&utm_campaign=CTA_4">ilanayurkiewiczmd.substack.com/subscribe</a>
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Frequently asked questions
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- What is Hard Medicine?
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This podcast updates daily.
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