Vinay Prasad: COVID, the FDA, and Why Journalism Keeps Getting Medicine Wrong

Send us Fan Mail Episode Summary: Dr. Vinay Prasad joins the Doctors Lounge in a recorded in person conversation that moves from his time at the FDA to bigger questions about evidence, incentives, and trust in medicine. The discussion focuses on how regulatory agencies actually function, why public health debates have become so politicized, and whether the current healthcare funding model rewards good care or just expensive care. Timestamps: 00:16 - Why the FDA conversation matters now 02:49 - Why Vinay accepted the DC job 04:02 - What can actually change inside the FDA 05:39 - The Exondys approval and commissioner authority 07:22 - Do appointees really steer regulatory decisions? 09:48 - Should the FDA regulate safety or efficacy? 10:31 - Safety, efficacy, and the car analogy 13:04 - Could COVID vaccines have been released earlier? 14:04 - Challenge trials versus large community trials 16:32 - Rolling out vaccines by age and risk 18:05 - Why post COVID myocarditis comparisons are flawed 22:36 - The danger of elite stamped misinformation 24:06 - When medicine became political 26:24 - Why institutions may be too captured to trust 27:24 - The measles death story and missing context 30:17 - Buchanan, Tullock, and the logic of bureaucracy 33:17 - How healthcare swallows trillions with mixed value 35:02 - Why low back surgery is hard to centralize 37:27 - ICD placement and gray zone medicine 39:07 - Who should pay for marginal cancer drugs? 41:10 - Demand subsidies and distorted prices 43:34 - Innovation before large welfare programs 46:53 - Does more money always mean more innovation? 48:48 - Why journalism misses what matters at FDA 51:21 - The No Surprises Act and who really pays 55:42 - Vinay’s broader career path and what comes next 57:34 - Why active clinical practice still matters Co-Host Handles @anish\_koka and @drdigiorgio Show Handle @drsloungepod Subscribe Links Spotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrR Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658 YouTube: https://www.youtube.com/@TheDoctorsLoungePod Dr. DiGiorgio's project "Off Label Ideas" https://www.offlabelideas.com/ Dr. DiGiorgio's on Substack https://substack.com/@drdigiorgio 🔗 **Connect with the Hosts:** • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X **•** Dr. Sanat Dixit on X