Fifty-two percent of the top-performing TikTok videos about ADHD contain misinformation. That is where this conversation starts. But Dr. Judith Joseph, board-certified psychiatrist, principal investigator, and author of High Functioning, quickly moves it somewhere more complicated: what happens when a diagnosis is not a medical conclusion but a way of belonging?

Patients are arriving in the exam room already labeled because an online community offered an identity at a moment when they needed one. Dr. Judith walks through the Tourette's uptick she observed in post-pandemic adolescents, the adult women grieving years of missed ADHD diagnoses, and the stimulant shortage she sees as a downstream consequence of over-prescription driven by online self-diagnosis.

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Seventy-one percent of Americans trusted doctors and hospitals in January 2020. By January 2024, that number had fallen to forty percent. But the same data shows that eighty-five percent of patients still trust their own physician. Cardiologist Dr. Akshay Pendyal calls medicine the most complex social role in human history, and in this conversation with Dr. Aditi Nerurkar, he makes the case for why. Drawing on the placebo effect, the nocebo effect, the ORBITA trial, and decades of clinical practice, they examine the alchemy of the therapeutic encounter: what patients bring into the exam room, what doctors carry with them, and what the science says happens when those two forces meet.

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Host Dr. Aditi Nerurkar sits down with Dr. Thomas VanderMeer, surgical oncologist and interim director of the Upstate Cancer Center at SUNY Upstate Medical University, to trade notes on the real work of caring for the data-informed patient.

They start with a case. A woman with rising ctDNA, no imaging correlate, walking into Tom's office. He thought the conversation would be about the limits of detection. It wasn't. Her question, once he listened for it, was about her children, and whether the same molecular tests could tell her something about their risk. Tom uses the case to make a larger point. The question on the surface is rarely the question the patient actually came in with.

From there, the two doctors get into the practice. The teach-back method as a check on real understanding. The discipline of not looking at your watch, even when the schedule says you should. And the throughline Aditi names back to him by the end of the conversation: open-mindedness and humility, held steady against the rigor of the science.

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