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Episode 172
Duration 39:04
Joel Bervell

Joel Bervell: The Healthcare Communicator

Howie and Harlan are joined by Joel Bervell, a recent medical school graduate who uses social media platforms to combat misinformation and explain racial biases in healthcare. Harlan discusses his new Wall Street Journal commentary highlighting the link between viral infections and chronic diseases; Howie reports on powerful new evidence for the effectiveness of the HPV vaccine and warns of the dangers of a vaccine-skeptical presidential administration.

Links:

Viral Infection and Chronic Disease

Harlan Krumholz: “How to Lead a Chronic Disease Revolution”

“A natural experiment on the effect of herpes zoster vaccination on dementia”

“Unexplained post-acute infection syndromes”

Joel Bervell

Joel Bervell

Joel Bervell on TikTok

Joel Bervell on Instagram

“TikTok's 'Medical Mythbuster' Helps Save Lives By Tackling Racial & Gender Disparities In Healthcare”

“How the pulse oximeter became infamous on TikTok”

“Racial Bias in Pulse Oximetry Measurement”

Joel Bervell’s TikTok on the pulse oximeter

Joel Bervell: “The eGFR Equation”

“Race Correction and the X-Ray Machine: The Controversy over Increased Radiation Doses for Black Americans in 1968”

Joel Bervell: “For over 50 years, X-ray technicians were taught to administer higher radiation doses to Black patients”

Joel Bervell’s Instagram reel on bias in the measurement of lung capacity

Made to Stick: Why Some Ideas Survive and Others Die

Joel Bervell on LinkedIn

Joel Bervell on YouTube: The Doctor Is In

Kickstarter: The Doctor Is In

“Medical mythbuster Joel Bervell, MD, on how to teach kids about medicine and address misinformation”

Cleveland Clinic: Amyloidosis

Joel Bervel’s Instagram reel on the GFR equation

“Abandoning a Race-biased Tool for Kidney Diagnosis”

“OPTN Board approves elimination of race-based calculation for transplant candidate listing”

“America’s News Influencers”

“85th Annual Peabody Awards Announce Nominees for the Arts, Children’s/Youth, Entertainment, and Interactive & Immersive Categories

Vaccines and the Federal Healthcare Agencies

Health & Veritas Episode 165: “Aging in Bursts and Other News”

“U.S. government researchers present ‘phenomenal’ new data on HPV vaccines”

“Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: a population-based observational study of age at immunization, dose, and deprivation”

“Kennedy played key role in Gardasil vaccine case against Merck”

“RFK Jr. suggests some vaccines are risky or ineffective, downplays measles threat”

“FDA chief says they're looking at whether to approve COVID shots for next winter”

“How Marty Makary’s FDA is embracing a more skeptical view of vaccines”


Learn more about the MBA for Executives program at Yale SOM.

Email Howie and Harlan comments or questions.

Transcript

Harlan Krumholz: Welcome to Health & Veritas. I’m Harlan Krumholz.‌

Howard Forman: And I’m Howie Forman. And we’re physicians and professors at Yale University. We’re trying to get closer to the truth about health and healthcare. Our guest today is Dr. Joel Bervell. But first, we like to check in on current hot topics in health and healthcare. What do you got today, Harlan?‌

Harlan Krumholz: Hey, Howie, as you know, it’s a good day, because today we had a piece published in The Wall Street Journal, Akiko Iwasaki and I, focusing on this idea about maybe we can do something a little different to prevent and treat chronic diseases and what people are usually thinking about.‌

As you know, she’s one of the world’s leading immunologists and someone I’ve learned a lot from over the time I’ve spent focusing on the pandemic stuff along COVID. This piece makes the case that we may need to completely rethink how we view chronic disease. And I’ve come to this topic more recently.‌

She, of course, has been in it for a long time. Together we argue that many diseases we think of as non-infectious might actually be the consequences of infection, sometimes delayed—‌

Howard Forman: Sure.‌

Harlan Krumholz: ... sometimes subtle, maybe potentially preventable. This is building off of the momentum from long COVID but saying that this is actually something much bigger than that, this idea of post-infectious chronic condition. So, you might think about chronic fatigue, which is often linked to Epstein-Barr virus, that... inflammatory bowel syndrome, like Crohn’s.‌

Howard Forman: But you’ve also explained to me that patients who even get pneumonia have a higher inflammatory marker that can lead to cardiovascular disease. So, there’s so much more.‌

Harlan Krumholz: There’s a thing about infections triggering things, like they can trigger the heart attacks. But there’s something also about maybe it starts to rev up the immune system in ways that creates this chronic condition that where the body, like type 1 diabetes following a viral infection, people may not have known that. Multiple sclerosis. Thinking about that following a viral infection. Somehow the body’s response to the initial infection begins a cascade of things that occurs that may lead to a lifelong condition.‌

And so, what we’re trying to do is say this has really been marginalized for too long, and many of the people who are suffering from things have been dismissed because we don’t really understand it. And then there was this remarkable study in nature, I think that we’re really anchoring on. So, I don’t know if you’ve seen this, Howie, but it is amazing. This is about whether Shingrix can prevent dementia.‌

So, people may think Shingrix is this vaccine that’s intended to prevent shingles, which is herpes zoster. We all have it, most of us, within our bodies, and it reactivates over time. And shingles is something that goes down a dermatome, it shows up in a certain part of the skin, can be very painful if it goes on the face, it can even cause blindness. And so, a vaccine was developed, which is highly effective in reducing the risk. It doesn’t eliminate it; it reduces the risk.‌

And researchers took advantage of the fact that in Wales, there was this quirk in 2013, eligibility for the shingles vaccine was determined by your exact date of birth. If you were born just before September 2nd, 1933, you didn’t qualify; if you were born just after, you did. And that arbitrary cutoff created an opportunity for a natural experiment, essentially mimicking a randomized trial.‌

And they ended up studying over hundreds of thousands of older adults and followed them for seven years. And over that period of time, about 35,000 were diagnosed with dementia. And here’s what they found. Those who got the vaccine... now remember, it was just a quirk. So, people were a little bit older, a little bit younger, but in essence, not that different in age, but those who got the vaccine were 20% less likely to develop dementia. That’s a massive effect.‌

Nobody has ever identified anything with an effect that large. And what’s really interesting is this is about preventing an infection or diminishing an infection. And the idea that it would be linked with the onset of dementia chronic condition is really wild. And not only should it get our listeners to think if you qualify for the Shingrix vaccine—like you should go get it—but also to start reinforcing this idea about these post-infectious relationships.‌

So, it’s not that the Shingrix vaccine is a cure for dementia, but that chronic diseases may be preventable in ways we haven’t always been thinking about. And that may include everything including cardiovascular disease. How these things go, which, and we know, by the way, inflammation is related to cardiovascular disease, but how are infections related? This is something that’s going to be, I think a very fruitful—‌

Howard Forman: We keep learning a lot. And this is the opportunity to learn tremendously from the COVID era because we have a large cohort that we can learn from.‌

Harlan Krumholz: Well, and if we have a federal government and a head of HHS who continues to say that chronic disease is going to be a focus of research in the future, we’re just suggesting that this might be a good place to focus attention and funding. Hey, let’s get on to our guest. He’s a real rock star. I know everyone’s going to enjoy him. Let’s not delay another minute.‌

Howard Forman: Dr. Joel Bervell is a Ghanaian American medical doctor, a social media medical educator, and the host of the Dose podcast with the Commonwealth Fund, known online as “the Medical Mythbuster.” His videos focus on highlighting and educating his followers about racial disparities and biases in healthcare. He’s built a following of over 1.3 million people across his TikTok and Instagram and other social media platforms.‌

Harlan Krumholz: Wait, a minute. You said 1.3 million?‌

Howard Forman: 1.3 million, which is a little more than you, Harlan.‌

Harlan Krumholz: What? What?‌

Howard Forman: He’s got it. He’s got it. And his platforms have generated more than 300 million impressions. I’m sure it’s way more than our last estimate.‌

Harlan Krumholz: That’s platinum or more, I don’t know, whatever that is.‌

Howard Forman: That’s right. And reached more than 10 million people monthly. He was named a 2025 Forbes “30 under 30” in social media, a 2024 TED Fellow, and is a recipient of TikTok’s Changemaker Award.‌

Harlan Krumholz: And, importantly, as a former student of yours.‌

Howard Forman: Well, we’ll get to that. He was the youngest participant invited to the White House Office of Public Engagement: Healthcare Leaders in Social Media Roundtable and has collaborated with the World Health Organization’s Digital Communications Team to combat health misinformation on social media. Dr. Bervell received his BA in molecular cellular and developmental biology at Yale in 2017.‌

I had met him just a few years before completing a master’s degree at Boston University in medical science and then a medical degree just this past year at Washington State University. And this June, he will begin his internal medicine residency at Virginia Mason Medical Center in Seattle, Washington. So, it really is an absolute pleasure to have you on the podcast. You and I have known each other now for 11 years.‌

As Harlan said, you did take my class, and despite that, you have continued to be a successful person. But I want to start off because your path is an unusual one. You are a trained physician now, you’re going to go do internal medicine, and you have a social media platform.‌

So, that doesn’t make you necessarily unique, but you have targeted some of the most egregious examples of systemic bias and disparities in both health and healthcare and healthcare delivery over these last several years, really taking off during the pandemic. And I want to start off and let you tell the narrative about how that came to be. How did you get to know Kelly Clarkson and Oprah Winfrey and the Surgeon General and President Biden and so on?‌

Joel Bervell: Man, that’s a big story. But first of all, let me say thank you so much for having me here. This feels like a full circle moment having just graduated, but also now thinking back to what got it started a lot for me in terms of my undergrad career, but even the things that led me there in the first place. So, I think my story, I always have to go back to my family and where my parents are from.‌

So, both my parents are from Ghana, West Africa. They grew up there, immigrated first to Canada, where I was born, and then to the United States, Seattle, Washington, which is where I’m going to be doing residency as well, and grew up. And so, I’ve always called myself a third culture kid, meaning that I never felt like I belonged in one place, but it belonged everywhere at the same time.‌

I think it’s allowed me to see the world in a different way and to ask why to a lot of different questions just growing up. Growing up in my town of Mukilteo [Washington], I was routinely one of the only black students. And so I started thinking about what race meant very early on, what racism looks like, and what implicit biases look like. I remember in my high school classes, there was a class we had where we were talking about affirmative action, and I was the only person saying, “This is why we need it. Here’s the history behind it, X, Y, Z.” And people, of course, not understanding it, were pushing back.‌

And I had to really early on learn how to defend myself, but also how to approach other people to get them to understand issues that maybe I understood. And when I got to Yale, those conversations continued at the same time of me wanting to understand, “How do I make sure that I get other people to understand how race still plays a factor in so many aspects of our society?” It wasn’t until medical school, though, that I really began to realize how much of a way that race played into our society.‌

And so, during my first year of medical school, the COVID pandemic hit, and I was thinking a lot about what it meant to be a Black medical student at the time at my medical school, Washington State University, but myself and one other student, Josiah, we were the first two Black medical students at our school, despite there being 300 students or so that had already been started at our school.‌

And I was thinking a lot about what it meant to be one of the only in a space where there’s less than 6% of physicians that are Black, but also at a time where there was a lot of social unrest happening worldwide in the sense that George Floyd and Ahmaud Arbery and Breonna Taylor, these were stories that I was hearing as I was taking my medical school classes.‌

And I knew I didn’t want just to be a medical student that stood on the sideline, but wanted to make sure I was raising issues with the ways that maybe medicine was still complicit in racism and things that I had seen in myself. And it started off very benignly, with me talking about things like in my classes, in my dermatology classes, not seeing what skin conditions look like on darker skin tones, only on lighter skin tones.‌

Or in one of my classes where we talked about cyanosis, which is when the skin turns blue. And I kept looking at myself and saying, “I’m not going to turn blue. What’s going to happen to someone that looks like me?” And I started being more comfortable raising my hand and asking these questions, and my peers started saying, “Wow, Joel, if you hadn’t asked that question, I never would’ve known to ask it.”‌

And me realizing that if I don’t ask these questions now, the first time someone might see and recognize that it’s a problem is when they’re seeing a patient, which at that point might be too late. But I think I decided to start using TikTok and Instagram, which then led me to meet all the people you’ve talked about, Oprah and Kelly Clarkson, and all these amazing people who’ve helped amplify the platform.‌

But it was really one video that took it off, and it was about a device called a pulse oximeter. A pulse oximeter goes in your finger and it measures what’s called your blood oxygen saturation level. Essentially how much oxygen is bound to your red blood cells. And it helps us understand if you have low oxygen or you have normal oxygen. I was at home after my first year of medical school, and it was about December 2020.‌

And so, it was actually second year of medical school, winter break. And I read this article in The New England Journal of Medicine that essentially said that in Black patients, these devices, pulse oximeters, are three times as likely to lead to inaccurate overestimated oxygen saturation levels in Black patients. Now I had just finished my cardiology unit, my pulmonology unit—‌

Howard Forman: No one mentioned it?‌

Joel Bervell: ... and I remember thinking, no one mentioned it. And I was like, “How did no one mention this? This seems important.” Everyone gets this device when they go to the hospital. And so, I did what any Gen Z/Millennial, I call myself a “Zillennial,” does. And I made a thirty-second video, because that’s all you could do on TikTok at the time. And I started off the video by saying, “What does racial bias in medicine look like?”‌

And I said, “Exactly the problem that pulse oximeters don’t work. They’re more likely to read inaccurately on Black patients. And what that meant in the COVID pandemic, meaning that less Black patients would be receiving supplemental oxygen when they needed it.” That video I posted it, went to bed, woke up, and within less than 24 hours and I’d received over half a million views.‌

And most of the comments were from doctors and nurses and PAs saying, “I didn’t even know this was an issue.” And then from patients saying, “I wonder if this is what happened to me or to my loved one.” So, I’ll just leave it there for now. I know we’re talking about some of the other biases that I have unveiled, but that was the first one for me that started my “Racial Bias in Medicine” series. I remember after I posted it, I ran to my sister’s room.‌

So, my sister’s a resident physician right now in psychiatry. And at the time she had just recently graduated, and I said, “Rachel, look at this. Did you know this existed? And did you know people are interested in learning about this?” And she’s like, “Awesome, but do you know about all these other disparities that exist?”‌

And so, we started creating a whole list of others that we can dive into from GFR, which is about kidney functioning, to spirometry, which is about lung functioning, to even cardiovascular health, in the ways that—or even AI. And so, we drafted a list together, and that became what started my “Racial Bias in Medicine” series, which kicked it all off.‌

Harlan Krumholz: It’s really an extraordinary path you’ve been on, and the awareness that you’ve been raising is so needed, talking straight to the public, doing so in very nuanced ways, but making it very clear and understandable. It’s a real gift that you’ve got. I just wondered, how have you channeled that? How have you been able to take technical information and then be able to convey it in ways that moves people, and it does so... Is it something you have to work at? Or is it just comes natural to you?‌

Joel Bervell: I love this question, and it actually goes back to even as a kid, I loved public speaking, so I started public speaking pretty early on when I was in seventh grade. I was my student body treasurer, and then I became student body president in eighth grade, and I loved creating speeches, doing all this stuff. I was actually student body president all four years in high school. It was really fun. And so, I actually was doing speech writing.‌

Harlan Krumholz: I feel bad for the person who ran against you.‌

Joel Bervell: Well, it was a tough campaign, though, especially my last year, because at this point people were like, “This is a dictatorship, get out.” And so, I had to be like, “No.”‌

Harlan Krumholz: They’re voting for term limits at that point in the high school.‌

Joel Bervell: Well, really funny story about that I haven’t told before. Actually, I remember my campaign slogan was “Victoria’s Real Secret. She voted Joel Bervell, Student Body President.” And I had these images from Victoria’s Secret that I put up.‌

Harlan Krumholz: Oh my gosh.‌

Joel Bervell: But they were all taken down, and I thought that administration took them down. I realized that it was the ninth-grade guys that were going and taking them, which was maybe the best way to campaign, because then they were sharing with their friends were like, “This is actually wonderful.”‌

Harlan Krumholz: They were showing up in their bedrooms on their walls.‌

Joel Bervell: Oh yeah. It was the best marketing that could have been out there. But I started thinking about this pretty early on, and even in college, I loved storytelling. I loved oratory. I took “Oratory and Statecraft,” which was one of my favorite classes where we got to meet with speechwriters and talk about how do you compel and tell a story.‌

One of my favorite books is called Made to Stick by Chip and Dan Heath, and it’s all about how you make ideas stick. And they have this acronym called SUCCES, which is “simple, unexpected, concrete, credible, emotional, and story.” And in every single video, I’m literally thinking about that to make sure that it’s simple enough that it’s at a fifth-grade level, that it’s unexpected. It’s something that I’m teaching people.‌

Is it concrete in that they can root it in their own lives, credible with a research study, emotionally that makes them want to actually make a change? Does it have a story behind it? And so, I’m very intentional about how... Especially on social media where you have 60 to 90 seconds to capture someone’s attention, and there’s hundreds of thousands of videos being posted every second from other people.‌

Howard Forman: And by the way, I want our listeners to know, and we’ll try to link it in the notes, you’re not just TikTok famous and Instagram famous. Your impact on LinkedIn, your impact on all social media is vast. But one of the things I’ve noticed...‌

Harlan Krumholz: And just to break in, Howie, on what your point is, he’s really not like he’s an influencer. Those are his instruments. He plays them, but actually that’s not his major, his major thing is something else. It’s not to be an influencer. He’s just using that.‌

Howard Forman: What I wanted to get to is, it’s not even just about communicating facts in science because the other thing that you do so effectively is be a role model for younger kids, particularly those of color who may not see themselves as potentially rising up to be a successful physician as you now are. And I want to touch on the fact, because you have coming out this summer, not that long from now, a TV series, and can you tell us... or a video series.‌

Harlan Krumholz: Wow, that’s amazing.‌

Howard Forman: Can you tell us a little about the origin of that and what you hope to achieve with that, and maybe even about the Kickstarter campaign?‌

Joel Bervell: Yeah, so I have a digital animated series coming called The Doctor Is In, it’s going to be out on YouTube in June. You can think of it like Blue’s Clues meets Bill Nye the Science Guy. So, I’m actually in it with a green screen in the background. And I have Leland, who’s a patient who loves coming to the pediatrician. I’m his pediatrician, Dr. Joel. He loves coming to the doctor and learning about science concepts.‌

And so, along with Sammy the stethoscope, Otto the handbag, and Zada the X-ray, we explained science concepts in a very easy way. And so, this was something... I love animation, I love superheroes, love Marvel, that kind of stuff. And when I was growing up, I used to watch Static Shock all the time, which in the animated series, and he was like an African American, such a Ghanaian American who would go around and super smart during the day, but then save the world at night. And I loved it so much.‌

And so, I was always like, “I want to create an animated show in the future that inspires the next generation the same way Static inspired me.” So, this is my way of creating a show that hopefully will inspire the next generation. But we launched a Kickstarter last year asking for $60,000 to get it started off. At the same time, we actually launched a voice actor campaign. We had over 5,000 applications for voice actors, which was insane.‌

Howard Forman: Wow!‌

Joel Bervell: And my team went through it. Thankfully, our voice actor for Leland right now is actually a 6-year-old. And we have amazing people for all the other people as well. And we’ve met our Kickstarter goal, and then YouTube jumped on and said, “We love what you’re doing” and said, “We want to donate $50,000 as well.”‌

Harlan Krumholz: Wow.‌

Joel Bervell: So, thankfully we’re able to get enough for the first five episodes. We still need a fundraise for the rest of the season. But in April... or was it? Yeah, April, I think it was when I went out, filmed the first few. And so, now I’ve seen the first clips and it looks really exciting. It’s weird to see myself talking down to an actual animated character, but I think it’s going to be really cool and hopefully inspiring for the next generation to see themselves as potential doctors and nurses, whatever they want to be.‌

Howard Forman: Here’s another thing, which is people can talk about strategy, but there’s a famous quote about, “It’s all really about logistics.” It’s like, how you actually get stuff done. So, you’ve got a team... So, you get the idea of doing this or somebody, this idea percolates. How do you actually execute on this? Who is your team, and how did you put this together?‌

Joel Bervell: So, I will say all—in terms of social media videos and concepts, that’s all me. I decide on all that. But what my teams are really helpful for is the more administrative things, or it depends. So, for the show, I’m working with Ad Astra Media. I randomly got introduced by someone who reached out on social media and said, “You need to know this physician. His name is Dr. Jose Mori, and he has Ad Astra Media, which is a production company.”‌

And so, we connected, sat down, and he asked me, “What’s your dream project?” And I said, “To build this TV show.” And his answer was, “Let’s make it happen.” And so, it was three years in the making of us ideating and talking. But now I work with Ad Astra Media. He has a whole animation studio that works in Puerto Rico as well. And so, we came together and have been working together on it for the past three years to adapt to one of their books, which is Good Night, Little Doctor, into the show The Doctor Is In.‌

And then I also have a team for social media when it comes to pitching me for different brands to figure out how we work with nonprofits or for-profit companies. So, talk about really important ideas. And then the third different team I have is for speaking engagements. And so, you mentioned that it’s not just online, but I go to a lot of the professional societies.‌

And so, the American Medical Association. American Academy Medical Colleges, I’m here actually right now in D.C. at National Minority Quality Forum, I just spoke, and I was at APHA, the American Public Health Association, last week. And so, really trying to talk to the large companies, the big leaders who are making these changes happen is really important to me. Because you can’t just change narratives online, it has to be on-the-ground work as well.‌

Howard Forman: So, is this a sustainable business for you? Could you make a living on it?‌

Joel Bervell: Yeah, some of my friends are like, “Why are you going to residency?” But for me, none of this matters if I’m not seeing the patients. All I’m doing is taking an individual story and amplifying it to a larger level. And I graduated in December, not starting residency until June. And so, I’ve had some time off, but I’m antsy to get back into the hospital. So, I’m really excited because everything I do, it’s with the patient in mind and making sure that I’m telling those stories as best as I can.‌

Howard Forman: So, what’s your dream about how all this comes together? So, you get the clinical training, there’s still so much work to be done in the areas that you’re working in now. How do you think about splitting your time, or how’s this going to work?‌

Joel Bervell: Yeah, that’s a great question, and I ask myself that all the time, especially in residency. But I think one of my overall goals is just to storytell. And so, that might look different when I do it in residency. Maybe it’s telling more personal stories that I’m seeing to try and connect with people, or maybe it’s getting interviews with patients.‌

I actually just interviewed someone yesterday that had amyloidosis, and really trying to get those stories more out there in terms of the person individually telling their own story as opposed to me telling it for them. I think as a physician I’ll be able to get more of those stories, have more of that connection piece, and people might be asking, “What is amyloidosis?”‌

It’s when you have a protein buildup in specific organs, and unfortunately, it can impact a lot of people in different ways in terms of causing fatigue, making them really tired throughout the day. But essentially, it’s a rare disease that impacts 3 to 4% of the Black population, and many people don’t know that they have it, and it can be underdiagnosed in Black patients.‌

Howard Forman: You’ve told us a little about your origin, but I’m very curious to hear, I know you told me your father is from a more science engineering background, and your mother is more from a divinity mission-oriented background in healthcare. Do you see yourself as being this blend of their passions, and how do they see you as a product of their upbringing?‌

Joel Bervell: Yeah, I think so. Funnily enough, I was on a podcast not too long ago, and they had me actually call my parents and ask them what I think their superpower is, and it was my first time hearing them say it out loud, but my dad’s answer was that I have a heart for everyone. And I think that really touched me, to even realize that he was like, “Joel will do whatever he needs to do in order to make sure that the person that’s the most marginalized is seen.”‌

And that was powerful. My mom didn’t pick up, which was shocking, but later on, she told me that she thought it was my tenacity to want to do anything. And she jokes that I was like, sometimes it’s so much that I’m very stubborn in not listening to her, but in a way that I want to get things done.‌

My little brother said, I run through walls, and thankfully I break through them, but that I do it to the point of delusion. And I loved that, because I think I do do things sometimes where people say, “There’s no way you can do this.” And I’m like, “Really? Let’s see how we can make it happen.”‌

Harlan Krumholz: That’s amazing. So, it just reminds me again, what residency are you going into?‌

Joel Bervell: I’ll be doing internal medicine.‌

Howard Forman: Oh yeah. That’s great. I love that.‌

Joel Bervell: I think it’s a perfect...‌

Harlan Krumholz: Come into cardiology after that.‌

Joel Bervell: Possibly. We’ll see. We’ll see.‌

Howard Forman: Before you got on, we talked about that. It’s a possibility, Harlan.‌

Harlan Krumholz: All right, we’d love to have you in the field.‌

Joel Bervell: I think there’s a lot of disparities even there to talk about still, from things like the PREVENT calculator, which had a racial adjustment that made it hard for Black patients to be able to be diagnosed with heart failure, to even the way that EKGs are read right now. I have a video coming out about that soon. So, there’s a lot of interesting topics.‌

Howard Forman: I want to point out for our listeners, though, that if they watch your videos, they’ll see that you are not judgmental; you are not pointing fingers and individuals. You are somebody who recognizes that the system as it is set up right now is lopsided and there are problems in it, and we need to fix them, but it’s not one person or one group of people that have caused these problems. Do you want to make a comment about how you’re able... You said earlier about how you meet people where they are, but this is another way that you do that.‌

Joel Bervell: I love that you point that out because that’s something I really try and do is not to place blame on individuals but on systems. Yes, systems are made up of individuals, but often it’s individuals that we never even knew in the past.‌

And so, if you look at even how race as a concept was set out in the United States, it came from scientists from actually doctors, people like Linnaeus and Blumenbach who created ideas of what race meant that was then passed on into scientific nomenclature that then became truth even though there was no biological truth to it, right?‌

And so, my goal is always to point out that these things that were built into our systems may not have been built by us, but our responsibility is to understand how they were built and dismantle them when they don’t make sense and don’t have anything that’s based in reality. I think one of the best examples of how is with the GFR equation, which I alluded to before, which stands for “Glomerular Filtration Rate.”<start – make sure you get this link to his TikTok or whatever>‌

If you have a high GFR, your kidneys work well. If you have a low GFR number, your kidneys don’t work very well. But for decades there’d been a racial correction that assumed that all Black patients had better kidney functioning because there was an assumption that all Black patients had higher muscle mass. That was a racist assumption, not built by us but by other people, that was passed down as truth.‌

Thankfully, there’s a new equation that was created in 2021 that no longer includes race. And in 2023, the Organ Procurement and Transportation Network essentially said, “Anyone that’s had this equation used we’re going to retrospectively go back and make sure that you no longer are burdened by that.”‌

And so, because of them retrospectively going back, ten to fifteen thousand Black Americans got moved up early on the kidney transplant list. And one woman, and this was someone, if you go watch The Kelly Clarkson Show, that she surprised me by a woman who had been watching my videos and because of my videos, her sister was able to be moved up five years on the kidney transplant list.‌

And so, really, like you’re saying, what I’m trying to do is to make sure that it’s not taking blame away from the individual and making sure that’re working at systems and how we can be what you would call antiracist at all times by making sure we’re pushing back against the systems that perpetuate harm.‌

Harlan Krumholz: You’re really showing also that we worry about misinformation on social media, but you’re one of the offsets. So, I’ve seen lots of people say, “I’m getting off social media, it’s toxic, there’s lots of misinformation, I don’t want to support it.”‌

But I think what you’re doing is better than that because you’re actually countering some of that information with positive programming and real, scientific-based information, and you’re doing it in an entirely positive, classy, professional way in a way that connects with people. I think it’s the way to go because if everyone retreats, “Who wants to do this?” then it really will be left with no offset, there won’t be—‌

Joel Bervell: Exactly.‌

Howard Forman: ... anything there.‌

Joel Bervell: And I always say, 1 in 10 people get their health information right now from social media. And so, if we’re not there, they’re going to be getting information, it just won’t be the correct information. And so I think especially being someone who grew up in this generation of digital media, I was seeing... and this is part of the reason why I even started posting, I was seeing the most egregious things, or things that made no sense.‌

That was just like, “Why... One, why is this going viral, or why is there not more information out there?” And now it’s been cool. I get to work behind the scenes with TikTok on diversity initiatives with Instagram, with Meta. I just did one with Threads, and one of the things I often tell them is, I want them to change their business model from clicks being the way that it pushes videos out, to truth.‌

What would it look like if there was a social media platform that the more accurate your information, that is what pushed it up and drove it to the top of the feed? We don’t have any social media like that. Maybe on Twitter, there’s fact-based checking. What if they took the next step to say, “If it is correct and important information, we’re going to push that to the top”?‌

Harlan Krumholz: Well, I think yeah, except they’re going in the opposite direction.‌

Joel Bervell: Exactly.‌

Harlan Krumholz: I love that. One of the things ... Howie, I know we’re getting to the end, but let me just sneak this one in. A lot of people end up getting a lot of clicks through gimmicks. They’re able to do things, they write a script, they’re doing something funny, they got a funny dance. I don’t know. They’re doing crazy things, and people like to watch it. They can’t avert their eyes. You’re really just putting yourself out there and information and providing it in a way.‌

And how do you think you were able to cut through all the noise and have people actually listen to you without you having to be juggling and... I don’t know what, doing crazy stuff while you’re talking, you’re really just communicating in the most effective way possible. I’m just really so impressed there’s not a gimmick beyond to say, “I’m just going to tell you like it is.” And like you said, you don’t follow this. How were you able to do that, do you think?‌

Joel Bervell: It’s something I think about a lot because I’m just like... I’ll look at other videos and everyone’s like you’re saying, doing all these crazy things, doing a dance to get the information out. And I literally just will sit at the camera and say, “Here’s a new report that came out, here’s what’s happening.” But I think the way I approach it is, one, the information that I would have wanted to receive if I was not in medical school, and then thinking about it, what would I want to tell my parents?‌

And so, someone once told me, “When you’re posting on social media, figure out what you want your relationship to be with everyone that’s seeing your video.” And I decided that my relationship that I wanted to be was a younger brother or a nephew from someone who was just listening to their nephew. That’s a doctor saying, “Here’s some information that you haven’t heard about but is true and that could help save your life.” And I think everyone has someone in their life that’s been touched by the healthcare system. That’s easy.‌

And so, when you put information out there in a way that’s accessible and focused on communities who often have been overlooked, that is information they need. So, many Black Americans come up to me all the time and say, “I watch your videos religiously. And the reason why is because I’m not getting it anywhere else.” And so, I’m fighting a gap in the market of really important information that people want, but for some reason, no one thought we needed.‌

Howard Forman: And let me just say, it’s not just clicks and followers that are your measure of success because you’ve been nominated now for a Peabody Award, you won the Webby Award this year. Your star continues to shine bright and is a really guiding light for all of us.‌

Harlan Krumholz: And we really appreciate you taking the time for us. Because we know you’ve got so many different things pulling on you, so—‌

Joel Bervell: Oh, thank you.‌

Harlan Krumholz: ... it was so nice of you to take the time to share with our audience.‌

Howard Forman: Thank you so much.‌

Joel Bervell: Thank you. I can actually announce it now that... Because I think this will come out afterwards, but I actually did—‌

Howard Forman: That’s right.‌

Joel Bervell: ... win the Peabody.‌

Harlan Krumholz: Oh, wow!‌

Joel Bervell: This is the first time I’m announcing it live.‌

Harlan Krumholz: Oh, wow.‌

Howard Forman: That’s awesome. That’s terrific news.‌

Joel Bervell: I was literally like, “This is insane.”‌

Howard Forman: That’s a great week. And you’re going to walk for medical school, even though you’ve graduated medical school, you’re walking this weekend. So, congratulations as well—‌

Joel Bervell: Thank you so much.‌

Howard Forman: ... Dr. Joel Bervell.‌

Joel Bervell: Thank you so much.‌

Harlan Krumholz: Joel, it’s so nice to meet you.‌

Joel Bervell: So, great to meet you.‌

Harlan Krumholz: Well, I think I can understand why he’s got so many followers.‌

Howard Forman: He’s really great.‌

Harlan Krumholz: Yeah, he’s great. He’s terrific.‌

Howard Forman: He’s a great communicator and just a good person.‌

Harlan Krumholz: But next up is our rock star, Howie Forman. Let’s hear, what do you got this week, Howie?‌

Howard Forman: So, a little more mundane, maybe, but the Papanicolaou test or “pap smear” was introduced in the ’40s, and its increased use over the next decades led to many saved lives from cervical cancer. And our progress against this disease that kills literally hundreds of thousands of people worldwide every year accelerated with the introduction of the human papillomavirus vaccine in introduced in the United States in 2006.‌

So, HPV has been known as the cause of cervical cancer for at least 40 years with increasing evidence and a better understanding of the mechanisms of action being learned in later years. So, now we’re getting close to 20 years since this vaccine was widely available. And the vaccine, by the way, is preferably given to kids when they are 11 or 12 years old.‌

And now we’re beginning to see more great epidemiologic impact, and the data gets better and better. And just recently on episode 165, we touched on one such study, but we have more data to share today. So, a study out of the National Cancer Institute presented at a recent meeting relates impressive evidence that one shot rather than a series is extraordinarily effective, equally effective in fact, at preventing cervical cancer.‌

This has both major domestic and global implications because it dramatically improves the likelihood of reaching more people. This is a disease that generally afflicts younger people as well. So, the impact is even bigger than just numbers. The other bit of news is something that’s a little older, but for me, I hadn’t noticed it until just recently, is that a study came out of Scotland.... You were talking about Wales, I’m up to Scotland from January, and it showed 100%, 100% efficacy for the HPV vaccine among women who got vaccinated before the age of 14, with either one or two doses. So, again, an astonishing level of protection. So why do I bring this up today? Not just that it’s news, but it emphasizes a bigger point.‌

We have a new vaccine-skeptical, and I think that’s a generous term, administration at this moment in time. And three things are true. Our health secretary has been a major plaintiff in a lawsuit suing Merck, contesting the safety and effectiveness of the HPV vaccine manufactured by Merck.‌

We have the health secretary and our FDA commissioner, Dr. Martin Makary, who are both being less than emphatic about the public health need for measles, mumps, rubella or MMR vaccination during a time of the largest measles outbreak in more than 30 years. And then we have the same FDA commissioner, Dr. Martin Makary, and his staff making waves about approving the Novavax COVID vaccine at a time in the year when we’d like to be readying both that and the mRNA vaccines for inclusion in a fall booster.‌

Despite all the good questions from scientists and journalists, there has been no good response from either him or the FDA other than to indicate a potentially new standard for approving an annual vaccine and potentially applying this to all COVID vaccines. These are three data points. These are uncontestable issues right now, at least in the press, that raise far greater concerns than many of us hoped.‌

Our colleague Jason Schwartz in the School of Public Health here at Yale was quoted on this just a day or so ago, and I think it sums it up perfectly. So, I’ll end with this quote: “If there was a belief that the FDA would be insulated from this larger climate of skepticism toward vaccines that the new administration and the secretary brings, those hopes were probably misplaced.”‌

Harlan Krumholz: Well, I got nothing to say about it. I think that you’re raising this issue about important intervention that can potentially have a big impact, but it’s coming at a time where if many people are going to raise questions about something like measles, then it just opens the door to a whole range of other things.‌

Howard Forman: I really still hope, I know I sound naive and maybe even stupid at times. I really hope that both Dr. Makary and RFK will rethink what they’re doing right now. It’s okay to be skeptical. It’s okay to be personally skeptical and ask for more information. It’s really not okay for us to lose the progress that we’ve made and potentially set ourselves back many, many years.‌

Harlan Krumholz: And I think this just has multiple dimensions to it. There’s, one is mandates versus personal choice. Another is at least even having the vaccines available for people to use.‌

Howard Forman: And this is not about mandates. None of these issues we talked about today are about mandates. The MMR, the whole reason we have an outbreak is that there is not a mandate in Gaines County for these Mennonite children.‌

Harlan Krumholz: Well, I think we’ll just end it. You’ve been listening to Health & Veritas with Harlan Krumholz and Howie Forman. Next time, end me with a little bit of a more upbeat thing there.‌

Howard Forman: I’m going to work on that. I have to come up with an upbeat one next time.‌

Harlan Krumholz: All right, all right.‌

Howard Forman: So, how did we do? To give us your feedback or to keep the conversation going, email us at health.veritas@yale.edu, or follow us on any social media.‌

Harlan Krumholz: We want feedback, including telling Howie to be more of a glass-half-full person. And we’ll take it if you want to send it. But we enjoy hearing from you, and we always take suggestions. We want to do better every week.‌

Howard Forman: We really do. And if you have questions about the MBA for Executives program at the Yale School of Management, reach out via email for more information or check out our website at som.yale.edu/emba.‌

Harlan Krumholz: Health & Veritas is sponsored from the Yale School of Public Health and the Yale School of Management. We’re very fortunate to be working with our superstar students, who have really fully taken over now, Gloria Beck, and of course, Tobias Liu, who’s been working with us and our spectacular producer, Miranda Shafer. So, we’re very grateful to all of them. Talk to you soon, Howie.‌

Howard Forman: Thanks very much, Harlan. Talk to you soon.‌