Cremieux on FDA Reform, Fake Data, and the Columbia Admissions Hack — The Doctors’ Lounge

Episode Summary

Drs. Anish Koka and Anthony DiGiorgio sit down with independent science writer Cremieux, the pseudonymous Substack author known for auditing primary data and calling out flawed research. The conversation ranges from FDA drug approval reform (Cremieux proposes a two-pathway system separating safety approval from insurer-facing efficacy approval), the divide between well-evidenced GLP-1s and unregulated peptides like BPC-157, and the HRT black-box warning controversy, to the Columbia and NYU admissions data leaks that made national news and implicated NYC mayor Zohran Mamdani. The back half digs into research methodology: why observational studies rarely replicate RCT findings, how Cremieux debunked a widely-cited Jonathan Haidt social media/cognition study, why the "administrator growth" chart doctors love to cite is likely exaggerated, and how publication bias correction methods work.

Chapter Markers

00:00 Introduction and guest background

02:00 Why the pseudonym "Cremieux"

03:11 How he got into primary data analysis and writing

04:46 FDA drug approval reform — a two-pathway proposal

05:57 The peptide market: GLP-1s vs. unproven peptides like BPC-157

09:39 Should drug authority come from the FDA or "bubble up" from trusted voices?

11:25 Regulatory capture and ideas for FDA reform

16:10 HRT, the black box warning, and communicating risk to patients

21:40 Decentralizing medical decision-making

22:45 DEI in medicine and the Columbia/NYU admissions data leak

34:28 Proving discrimination: causal inference standards for university admissions