Howard Harrell

speaker

1,260 appearances 4 recordings 1 series first heard May 2026 last heard 23 Jul

Howard Harrell’s voice in public audio — every appearance, attributed to the second.

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recordings per month · last 12 months

Recordings per month over the last 12 months — 4 in all, peaking in Jul 2026 with 2.

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Thinking About Ob/Gyn · Episode 11.12 The Malpractice Crisis Is Real And Blaming Evidence-Based Care Makes It Worse · 10 Jun 2026 podcast

Or where are we?

But then this placental grading

got extrapolated to the idea of hypermature placentas that could be associated with fetal growth restriction or hypertensive disorders or other problems that we might lump under the term placental insufficiency.

So then the idea here was that if we saw grade three maybe earlier on, like at 32 weeks, then we'd think the placenta's aging too quickly, there might be an increased risk of stillbirth.

It may be that the pathophysiology that leads to those changes that are visible on ultrasound in the placenta

Could be accurate.

But the predictive and prognostic value of that numerical grade score is just such poor

quality that it it doesn't have any true clinical utility.

And that particular

grading system is subject to a lot of interobserver variability.

And that could be one of the things that makes it so unreliable.

All right.

Well, let's move on.

So we've talked offline several times about an obstetrician out there who is on Substack.

The it's like people that don't know it's basically a blog, uh social media kind of thing.

And his articles get shared quite a bit on the OBGYN version of doximity.

And so

I will open up Doximidi and frequently see these articles.

And this guy makes a lot of arguments that we take issue with quite strongly.

So we we wanted to talk about that in relating to the topic of malpractice.

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