Fixing Healthcare: Recent Episodes
Robert Pearl and Jeremy Corr
In this Unfiltered episode of Fixing Healthcare, cardiologist and well-being advocate Dr. Jonathan Fisher joins healthcare leader Dr. Robert Pearl and host Jeremy Corr to explore how healthcare professionals handle stress and what can be learned from other high-stakes fields like athletics.
The trio delves into various aspects of pressure in medical practice, comparing it to the intensity athletes experience in major sporting events. Drawing on their own medical experiences, they discuss how clinicians can find the right balance to achieve peak performance while maintaining their mental and physical health.
The show’s primary topics include:
- Understanding pressure in healthcare. Dr. Fisher explains the concept of “good” vs. “bad” pressure, citing research that shows the impact of too much stress on cognitive function and patient care. He draws parallels to the “Yerkes-Dodson” curve, which suggests an optimal level of stress for peak performance.
- Impact of external pressures. Drs. Pearl and Fisher talk about the variety of pressures doctors face today, from financial and administrative burdens to life-and-death decisions that impact patient care. They consider how these pressures affect different medical specialties and the importance of balancing professional demands with personal well-being.
- Lessons from athletics. Dr. Fisher reflects on how athletes manage social and performance pressures, comparing it to the scrutiny doctors face in healthcare settings. He emphasizes that, like athletes, healthcare professionals need to understand and manage both internal and external expectations to prevent burnout and sustain their careers.
- Leadership and support in high-stakes environments. Dr. Pearl shares insights from his experience leading Kaiser Permanente, highlighting the role of supportive leadership in helping clinicians manage pressure effectively. The discussion also addresses the importance of team dynamics and creating a culture where medical professionals feel empowered and defended in their roles.
To hear more about how to manage pressure in the workplace, listen to the full episode and check out these helpful links:
- ‘Just One Heart’ (Jonathan Fisher’s newest book)
- ‘ChatGPT, MD’ (Robert Pearl’s newest book)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #154: Handling pressure in medicine with tips for doctors, leaders appeared first on Fixing Healthcare.
In the latest episode of Fixing Healthcare, hosts Dr. Robert Pearl and Jeremy Corr welcome back Vinod Khosla, legendary investor and co-founder of Sun Microsystems, to discuss the transformative impact of artificial intelligence on healthcare. As the head of Khosla Ventures and an early investor in OpenAI, Khosla brings a unique perspective to the potential and challenges AI presents in medicine.
This interview is part of the show’s tenth season, which focuses on the future of technology in healthcare—the central focus of Dr. Pearl’s newest book ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, with all profits going to Doctors Without Borders.
Khosla, known for his bold, often disruptive views on tech, shares a vision for AI-driven solutions that have the potential to reshape medical practice. Here are three key insights from the episode:
1. AI as an amplifier of physician capabilities
Khosla envisions a future where every physician could work with multiple “AI interns” to handle routine tasks, analyze data and assist in diagnostics. He argues that AI has the potential to vastly expand physician capacity, allowing doctors to provide more preventive and personalized care.
2. Continuous, AI-driven patient monitoringWith AI-enabled systems, Khosla sees healthcare shifting from reactive, episodic care to proactive, continuous monitoring. He believes wearable devices and AI models will enable real-time patient data analysis, catching health issues early and reducing the need for costly interventions.
3. The power of startups in driving healthcare innovationKhosla emphasizes that true innovation often comes from entrepreneurial startups rather than established companies. He advocates for partnerships between startups and large healthcare organizations to scale transformative technologies, noting that small, agile teams can push boundaries more effectively.
Tune in to hear Khosla’s bold predictions for the future of medicine, along with his advice for physicians, healthcare leader, and entrepreneurs seeking to navigate the chaos of American healthcare.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #153: Vinod Khosla on AI, disruption & the future of medicine appeared first on Fixing Healthcare.
In the latest episode of Diving Deep, hosts Dr. Robert Pearl and Jeremy Corr explore three timely healthcare topics that are shaping the future of medicine. This episode focuses on denial in public health, the rise of patient consumerism and a potential fix for U.S. healthcare’s cost crisis.
The episode begins with an in-depth discussion about how denial functions as an unconscious defense mechanism that prevents patients, clinicians and health officials from acknowledging and reacting to health threats. Dr. Pearl highlights how denial not only hampered the response to COVID-19 and HIV/AIDS, but also to emerging health crises like mpox, along with chronic illnesses such as hypertension and diabetes.
Next, the conversation shifts to the growing trend of patient empowerment through consumerism. The hosts examine how advances in generative AI and at-home diagnostics are transforming the doctor-patient dynamic. Pearl notes that patients increasingly prefer convenience over traditional in-person visits, and with AI becoming more accurate and empathetic, the doctor’s role is evolving.
Finally, the hosts tackle the financial challenges plaguing the U.S. healthcare system. Pearl explains how capitation—a payment model that rewards doctors for keeping patients healthy—would flip the traditional fee-for-service model on its head. He draws on game theory principles to illustrate how trust and cooperation between payers and providers could lead to better patient outcomes and lower costs. A win-win for both sides.
Join the conversation as Dr. Pearl and Jeremy Corr dive deep into the most critical issues in American healthcare today.
HELPFUL LINKS
- Denial: The Hidden Link Connecting Mpox, COVID-19, HIV/AIDS
- The Consumer Revolution In Medicine Is (Finally) Here. What Comes Next?
- A Strange Way To Fix American Medicine: Game Theory
Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Diving Deep is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #152: Tackling healthcare denial, consumerism & the cost crisis appeared first on Fixing Healthcare.
In the latest episode of Medicine: The Truth, Dr. Robert Pearl and Jeremy Corr return with timely insights on some of the most pressing issues in healthcare today.
From the chilling implications of abortion restrictions on women’s health to the opaque and controversial role of pharmacy benefit managers (PBMs) in driving up drug prices, the episode covers a lot of ground.
The conversation kicks off with an update on COVID-19 and the flu season, emphasizing that while hospitalizations remain stable, low vaccination rates may raise concerns in the months ahead. Dr. Pearl also delves into the new abortion laws sweeping the nation, shedding light on tragic cases where legal fears prevent doctors from acting swiftly, endangering women’s lives.
The hosts then dive into the murky world of PBMs, where just three companies control nearly 80% of drug sales in the United States. Pearl explains how PBMs manipulate prices to favor expensive drugs while profiting off hidden rebates, all at the expense of patients and insurers. As legal battles between PBMs and the Federal Trade Commission (FTC) unfold, the episode highlights the growing outrage over pharmaceutical price gouging.
Here’s a snapshot of just some topics covered in this episode of Medicine: The Truth:
- COVID-19 and flu season updates
- The dangers posed to women’s health by restrictive abortion laws
- A deep dive into the role of PBMs in the U.S. healthcare system
- Why healthcare costs are projected to rise by 8% next year
- The troubling future of drug pricing in America
- Why more parents aren’t vaccinating their kids
- A surge in at-home diagnostic testing
- The Nobel Prize in chemistry goes to …
- Why 98.6 isn’t the average body temperature
- Superbugs are coming
Join Dr. Pearl and Jeremy Corr as they unravel these complex healthcare challenges and offer insight into the future of medical care in America.
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #88: Abortion restrictions, PBMs and the rising cost of care appeared first on Fixing Healthcare.
Six years ago, Fixing Healthcare launched as a “podcast with a plan to fix American healthcare.” After more than 150 episodes—spanning three election cycles—the show has explored countless ideas for reform. Still, American healthcare remains plagued by high costs, uneven quality and limited access.
One of our earliest guests left us with some of the most provocative solutions to these problems: Dr. Don Berwick, a name synonymous with medicine’s “Triple Aim.” With the November elections less than a month away, we thought listeners would find value in revisting Berwick’s groundbreaking vision for healthcare reform.
As Berwick explained, “We need a system of three goals: better care for people when they’re in the care system, better health for populations, and lower per capita cost through improvement, not through rationing or withholding.”
Supporting the Triple Aim, Berwick called for healthcare to be recognized as a human right and advocated for a shift toward global, population-based budgets—moving away from the inflationary fee-for-service model that dominates today.
Cohosts Dr. Robert Pearl and Jeremy Corr were intrigued by the clarity and cohesiveness of Berwick’s plan.
“We have a highly fragmented system in which people are trying to solve problems separately,” Berwick said. “That is just not going to work … we’re going to have to fix healthcare together.”
Berwick is clinical professor of pediatrics at the Harvard Medical School and professor of health policy and management at the Harvard School of Public Health. He is the former head of the Centers for Medicare and Medicaid (CMS), the co-founder of the Institute for Healthcare Improvement (IHI) and leader of the organization’s 100,000 Lives Campaign.
Helpful links:
Season 1 explainer: ‘Welcome to the toughest interview in healthcare’
Episode 5 recap: ‘Don Berwick brings a global perspective to fixing US healthcare’
The full transcript of this episode with Don Berwick
Don Berwick: Profiles in leadership
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #151: Six years later, Don Berwick’s vision for healthcare remains unfulfilled appeared first on Fixing Healthcare.
In this Unfiltered episode of Fixing Healthcare, cardiologist and physician well-being advocate Dr. Jonathan Fisher joins healthcare leader Dr. Robert Pearl and Jeremy Corr, CEO of Executive Podcast Solutions, for a candid discussion about the evolving role of physicians in modern medicine.
The trio explores how systemic challenges—such as burnout, the loss of physician autonomy and the growing influence of private equity—are reshaping the trajectory of medical careers.
Today’s topics include:
- The burnout epidemic. Dr. Fisher reflects on how increasing administrative burdens, declining autonomy and career dissatisfaction have led many physicians to leave the field or seek non-clinical roles. He emphasizes the need for healthcare organizations to support doctors across different career stages, from early-career residents to seasoned clinicians.
- Restoring meaning and fulfillment. Drs. Pearl and Fisher discuss the importance of restoring meaning to physicians’ work by offering leadership opportunities and emphasizing the creative, humanistic aspects of medicine. They argue that physicians need more than just financial incentives. They also need a sense of purpose and the ability to make meaningful changes in patient care.
- The role of leadership in medicine. Drawing from his experience as CEO at Kaiser Permanente for 18 years, Dr. Pearl highlights how leadership training can empower doctors to take control of their practice environments, improve health outcomes and reduce medical errors.
- Balancing career and personal life. Both Fisher and Pearl emphasize the difficulty of balancing the demands of a medical career with personal fulfillment. They call for a broader cultural shift in healthcare, one that allows doctors to find meaning not just in their work, but in their lives outside the clinic as well.
To hear more about how these experts believe we can bring meaning back to medicine, listen to the full episode and check out these helpful links:
New book: ‘Just One Heart’ (Jonathan Fisher)
New book: ‘ChatGPT, MD’ (Robert Pearl)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #150: Restoring meaning in medicine—burnout and the physician career arc appeared first on Fixing Healthcare.
In the second episode of Fixing Healthcare’s 10th season, cohosts Dr. Robert Pearl and Jeremy Corr welcome back Dr. David Feinberg, chairman of Oracle Health, for a discussion centered on the future of technology in medicine.
Given the season’s focus on transformative technologies in medicine, Dr. Feinberg brings a wealth of experience as the former CEO of Cerner, VP of Google Health, and CEO of Geisinger Health.
As Dr. Pearl has highlighted throughout the season, technology—including artificial intelligence—is becoming a pivotal force in healthcare. His own book on the subject, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, explores this theme in great detail, and it debuted on the list of Amazon’s Top New Releases. All profits from Pearl’s book benefit Doctors Without Borders.
During the interview, Dr. Feinberg shares his thoughts on the three most important technological developments in healthcare over the next five to 10 years:
1. Technology stepping aside: Dr. Feinberg says one of the most critical advances in healthcare will involve technology getting “out of the way” of the doctor-patient relationship. He notes that while innovations have advanced healthcare, they often interfere with the time and connection between clinicians and their patients. Feinberg envisions a future where technology is present but not disruptive, allowing physicians to focus on their patients rather than on navigating electronic systems.
2. AI’s role in anticipatory medicine: Like many healthcare leaders, Feinberg identifies artificial intelligence as a major player in the future of healthcare. However, he offers a unique perspective by discussing AI’s potential beyond current applications like diagnostics and documentation. He predicts that AI will develop anticipatory abilities, allowing clinicians to foresee medical issues and prevent serious health problems. This could allow doctors to say to patients, “If we don’t get this [health issues] in order, the computer is telling us you won’t make it to your grandchild’s college graduation,” helping patients take critical action before it’s too late.
3. The power of the cloud: Here, Feinberg highlights the immense potential of cloud technology. He explains how the cloud can significantly enhance healthcare, particularly in terms of cybersecurity and data management. By leveraging cloud systems, hospitals can not only protect sensitive patient data but also streamline operations, enabling more effective analysis and use of healthcare information across platforms.
Tune in for the full interview and join the conversation on social media.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #149: Tech needs to get out of the way of healthcare, says Feinberg appeared first on Fixing Healthcare.
In this month’s Diving Deep episode, part of the Fixing Healthcare podcast series, Dr. Robert Pearl and Jeremy Corr dive into two vital topics in healthcare: lessons learned from experts on end-of-life care and innovative solutions to address chronic disease in underserved communities.
The episode begins with an exploration of end-of-life care, revisiting Season 9 of the podcast series, which focused exclusively on this emotionally charged topic. Dr. Pearl reflects on his conversations with guests like Dr. Atul Gawande, author of Being Mortal, and the powerful lesson that “people have goals besides living longer.” The hosts discuss how clinicians need to respect patient autonomy, particularly when the choices revolve around what makes life worth living versus prolonging survival at all costs.
Next, the conversation shifts to the topic of chronic disease management in underserved communities. Dr. Pearl references his recent Forbes article, which outlines how social determinants of health (SDOH) contribute to health inequities in the U.S. He introduces a practical solution: GenAI-driven health hubs, designed to combat chronic disease in low-income areas.
The hosts discuss the implementation of these hubs, explaining how they could provide affordable, targeted and technologically advanced support to individuals in areas where healthcare resources are limited. By leveraging generative AI tools, the hubs would help manage chronic diseases, reduce the burden on overworked doctors and prevent life-threatening complications. With a small investment, Dr. Pearl argues, these hubs could yield significant cost savings by preventing just one major health event, such as a heart attack or stroke.
Click play to hear these insights and more, and explore how healthcare leaders can improve care for patients at all stages of life.
HELPFUL LINKS
- 9 Powerful Lessons On Life You Can Learn From Experts On Death (Forbes)
- GenAI-Driven Health Hubs Can Combat Chronic Disease In Underserved Areas (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #148: End-of-life lessons and combatting health disparities appeared first on Fixing Healthcare.
In today’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl dive into timely and significant medical topics, focusing on the resurgence of COVID-19, rising healthcare costs and a growing shift toward patient empowerment through at-home testing solutions.
The episode kicks off with an update on the recent summertime surge of COVID-19, particularly in the Western and Southern parts of the country. Despite rising case numbers, researchers have noted that hospitalizations and deaths remain stable. The hosts discuss the release of new COVID-19 boosters, which are tailored to emerging variants. This comes at a time when skepticism about vaccinations persists, still fueled by misinformation and politics.
Shifting gears, the conversation moves to healthcare costs, particularly the burden on small businesses. Rising inflation and the increased use of costly GLP-1 (weight loss) medications are driving up medical costs, with premiums projected to rise sharply in the coming year.
Here’s a snapshot of the topics covered on this episode of Medicine: The Truth:
- COVID-19 resurgence
- Rising healthcare costs
- Long COVID updates
- Climate change and public health
- Mpox (formerly monkeypox)
- Medicare drug price negotiations
- At-home testing revolution
- Uterine transplants and advances in reproductive medicine
Throughout the episode, the hosts touch on the transformative potential of generative AI and other technological advances, arguing that patient empowerment and consumerism will continue to shape the future of healthcare.
Join the conversation as Dr. Pearl and Jeremy Corr tackle the latest medical news and discuss the implications of these trends for the future of healthcare.
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #87: COVID-19 resurgence, soaring healthcare costs and the push for patient empowerment appeared first on Fixing Healthcare.
This Unfiltered episode of Fixing Healthcare features Dr. Jonathan Fisher, a respected cardiologist and advocate for physician well-being, and Dr. Robert Pearl, healthcare leader and author of ChatGPT, MD. Jeremy Corr, CEO of Executive Podcast Solutions, adds the patient’s perspective, as always.
In this episode, the trio takes a deep dive into the intriguing applications of Game Theory in healthcare. Dr. Pearl introduces Game Theory—a concept that analyzes how individuals or groups make decisions in competitive situations—drawing from its use in business to better understand interactions between physicians, insurers and healthcare organizations.
Today’s topics include:
- Game theory and healthcare economics: Dr. Pearl explains how Game Theory can help reframe the often adversarial relationships between doctors and insurers, exploring ways to move from lose-lose situations to more collaborative, win-win outcomes.
- The role of autonomy: Dr. Fisher explores the inherent conflict between physician autonomy and collective decision-making, noting how the fragmented nature of healthcare impacts both patient outcomes and physician satisfaction.
- Collaboration vs. competition: The group discusses the need for healthcare professionals to shift from tribalism and competition within and between specialties to a more cooperative approach that benefits patients.
- The prisoner’s dilemma: Dr. Pearl introduces this classic Game Theory scenario to illustrate the difficult choices doctors face when limited healthcare resources force tough decisions about patient care.
To discover more, press play and check out these helpful links:
New book: ‘Just One Heart’ (Jonathan Fisher)
New book: ‘ChatGPT, MD’ (Robert Pearl)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #147: Game theory and healthcare—the complex relationship between doctors, payers and patients appeared first on Fixing Healthcare.
In the first episode of Fixing Healthcare’s 10th season, cohosts Dr. Robert Pearl and Jeremy Corr speak with Dr. Eric Topol, a healthcare visionary and global technology leader.
This season focuses on the future of technology in healthcare, a topic close to Dr. Pearl’s heart. His newest book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, debuted as an Amazon top new release. All profits from the book go to Doctors Without Borders.
Dr. Topol is a renowned cardiologist and founder of the Scripps Research Translational Institute. He has been a pioneer in predicting how technology will shape the future of medicine. His bestselling book, Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again, explores the transformative power of AI in healthcare. During the interview, Dr. Topol highlights three ways technology will break the traditional rules of medicine:
- Precision Preventive Care: Dr. Topol emphasizes that AI will revolutionize preventive care by moving beyond the outdated practice of relying solely on age and sex to determine who needs screening. Instead, generative AI will analyze vast datasets, including polygenic risk scores, biomarkers and proteomic data, to identify individuals at the highest risk of developing life-threatening diseases like cancer or heart disease. This proactive approach will allow for targeted prevention, significantly improving outcomes.
- Reducing Misdiagnoses: The conversation turns to the persistent issue of diagnostic errors, a leading cause of preventable harm in healthcare. Dr. Topol discusses how AI can alleviate this problem by giving clinicians more time to think critically, providing deep analysis of patient data and interpreting medical images with unparalleled accuracy. This would dramatically reduce the current rate of misdiagnoses, which remains a significant life ending failure in healthcare.
- Transforming Clinical Documentation: Dr. Topol also explores how generative AI is already freeing from the burden of administrative tasks, particularly documentation. By automating the creation of high-quality electronic health records from conversations between doctors and patients, AI will allow clinicians to focus more on patient care, improving both efficiency and the patient experience.
Throughout the episode, Drs. Topol and Pearl discuss the broader implications of these technologies, including the potential to revolutionize medical research, the challenges of data security and the cultural shift required in healthcare to fully embrace these innovations.
Tune in for the full interview and join the conversation on social media.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #146: Dr. Eric Topol on how AI is changing healthcare appeared first on Fixing Healthcare.
In the final episode of season nine, Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr sit down with Brad Stulberg, a renowned author and public health expert, to discuss the keys to living (and eventually dying) well. The interview concludes a season-long focus on ways to improve end-of-life care in the United States.
The hosts start with Stulberg’s recent New York Times recent op-ed, “The Key to Longevity Is Boring.” Stulberg, known for his work on human performance and well-being, emphasizes the power of simple, evidence-based habits for achieving a long and healthy life.
The conversation covers the importance of regular exercise, a nutritious diet, avoiding smoking, limiting alcohol consumption, and nurturing meaningful relationships. While these practices might seem mundane compared to the latest health fads and biohacks, Stulberg argues that they are the true keys to a life well lived.
He highlights research demonstrating that people who consistently follow these five principles live seven years longer on average, with six of those years spent in good health.
Key topics explored in this episode include:
- The myth of biohacking: Stulberg critiques the growing trend of biohacking, emphasizing that many popular supplements and extreme health practices are not supported by science and can detract from the joy of living.
- Exercise as a movement practice: Stulberg encourages a shift from viewing exercise as a chore to seeing it as a sustainable movement practice, whether it’s through sports, walking or other enjoyable activities.
- Nutrition without obsession: The discussion moves to the challenges of maintaining a nutritious diet amidst a culture obsessed with quick fixes and fad diets. Stulberg advises focusing on whole foods and avoiding ultra-processed products.
- Social connections: The episode delves into the vital role that relationships play in both mental and physical health, drawing on findings from the Harvard Study of Adult Development, which identified strong social connections as the most important factor for a long and healthy life.
- Debunking health anxiety: Stulberg touches on the rise of health anxiety fueled by the wellness industry and social media, urging listeners to focus on the basics rather than getting caught up in the latest trends.
Throughout the episode, Stulberg’s insights remind us that the path to longevity doesn’t require radical change or cutting-edge science. Instead, it’s about mastering the fundamentals—habits that are accessible to everyone.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #145: The boring secrets to longevity with Brad Stulberg appeared first on Fixing Healthcare.
In this month’s Diving Deep episode, part of the Fixing Healthcare podcast series, Dr. Robert Pearl and Jeremy Corr tackle two crucial issues in American healthcare: the need for radical reform in medical education and the growing crisis surrounding Medicare’s payment model.
The episode opens with a critical examination of medical education in the United States. Dr. Pearl discusses how current medical training is rooted in outdated practices that fail to prepare future doctors for the challenges of modern medicine. He emphasizes the need for integrating generative AI into medical school curricula—not just as an add-on but as a core component—in order to improve chronic disease management, diagnostic accuracy and clinical research.
Next up in the episode, the hosts turn their attention to Medicare’s payment model, comparing it to the “cobra effect” where well-intentioned policies inadvertently worsen the problem they aim to solve. Dr. Pearl outlines the flaws in the current system, particularly how today’s fee-for-service model incentivizes volume over value, driving up healthcare costs while compromising patient care. He calls for a shift to a capitated payment model that rewards quality care and preventive medicine.
Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- Medical Education Needs Radical Reform: AI, Alone, Isn’t The Answer
- Why Congress Should Change How Medicare Pays Physicians
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #144: Medical education reform and Medicare’s payment crisis appeared first on Fixing Healthcare.
In today’s episode of Medicine: The Truth (MTT), hosts Jeremy Corr and Dr. Robert Pearl explore the latest developments in Alzheimer’s disease, colon cancer detection, COVID-19’s resurgence and other significant news.
The episode begins with a discussion on the surge of new COVID-19 cases, particularly in the western and southern U.S., where wastewater surveillance data indicates high virus levels. The hosts emphasize the importance of continued vaccination, especially with new variants emerging.
The conversation then shifts to advancements in cancer detection, highlighting a new blood test for colon cancer that shows promise in identifying early-stage cancers but falls short in detecting precancerous growths. This test, though not yet a replacement for colonoscopy or the fecal Immunochemical test (FIT), could encourage more people to undergo further screening when necessary.
In Alzheimer’s research, a new blood test offers a less invasive alternative as a first step in diagnosing the disease. While it represents a significant advance, the test is not yet a gamechanger due to the lack of effective treatments for Alzheimer’s.
Other topics covered in this episode include:
- COVID-19 updates and the impact of vaccination on long COVID
- Advances in genetic research for rare diseases like progeria
- The rise of new weight-loss medications and market competition
- The continued influence of pharmaceutical payments to physicians
- The potential of drones in cardiac arrest response
- Climate change’s impact on children’s health and education
- Increasing cancer rates among Gen X and millennials
- The rise of sexually transmitted diseases in older adults
- Mental health challenges and access to care
- Insights into the potential impact of the upcoming presidential election on healthcare policy
Join us for this insightful episode as we delve into these critical healthcare issues and explore the future of medicine.
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #86: New hope for Alzheimer’s, colon cancer and mental health appeared first on Fixing Healthcare.
Fixing Healthcare welcomes Dr. Atul Gawande, a renowned surgeon, writer and public health researcher who currently serves as the Assistant Administrator for Global Health at USAID.
He has a rich background as both a medical professional and a compassionate individual. Ten years ago, Dr. Gawande published the bestselling book “Being Mortal: Medicine and What Matters in the End,” which explored the intersection of medicine, aging, and the end-of-life journey. His father’s battle with a spinal tumor profoundly influenced the book, serving as a catalyst for Gawande to confront the limitations of medical interventions and the importance of addressing patients’ individual goals and fears as they approach the end of their lives.
This episode explores:
- Gawande’s personal story as he reflects on his father’s battle with a spinal tumor, highlighting the complexities and emotional challenges of dealing with serious health issues within a family.
- His father’s journey from being a vibrant individual and a dedicated surgeon to facing the limitations imposed by his illness provides; a profound context for the discussion on end-of-life care.
- Difficult decisions that families and patients face when confronted with terminal illnesses, along with the nuances of choosing between aggressive treatments and palliative care.
- Approaches to end-of-life care that respect the patient’s wishes and focus on enhancing the quality of life rather than merely extending it.
- The significance of having open and honest conversations about end-of-life preferences and the limitations of medical interventions.
This episode is part of the ninth season of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC#143: Navigating life’s final chapter with Atul Gawande appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare features Dr. Jonathan Fisher, a respected cardiologist and advocate for physician well-being; Dr. Robert Pearl, healthcare leader and author of the new book “ChatGPT, MD”; and Jeremy Corr, CEO of Executive Podcast Solutions, who adds the patient’s perspective.
On the show today, the trio delves into the intriguing concept of luck and its impact on medicine and life, exploring how perceptions of luck influence happiness, health outcomes and success.
Today’s topics include:
- Luck vs. serendipity: The distinction between luck and serendipity and the importance of recognizing and seizing opportunities.
- Optimism and mindset: The significance of optimism and a growth mindset, with references to Carol Dweck’s and Martin Seligman’s research.
- Privilege and social inequities: The role of privilege in perceived luck and how systemic factors contribute to opportunities and outcomes.
- Autonomy in medicine: The balance between autonomy and standardization in healthcare, and the conflict between individual clinician intuition and best practices.
- Community and accountability: The tension between personal autonomy and community responsibility, particularly in healthcare behaviors that impact public health and finances.
To discover more, press play and check out these helpful links:
New book: ‘Just One Heart’ (Jonathan Fisher)
New book: ‘ChatGPT, MD’ (Robert Pearl)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #142: The role of luck in medicine and life appeared first on Fixing Healthcare.
In this poignant episode of Fixing Healthcare, cohosts Dr. Robert Pearl and Jeremy Corr engage in a deep and heartfelt conversation with Lucy Kalanithi, MD.
Dr. Kalanithi, a clinical assistant professor of medicine at Stanford University, reflects on the enduring impact of her late husband Paul Kalanithi’s memoir, When Breath Becomes Air, and her experiences navigating life, loss and love.
Dr. Pearl begins by acknowledging the profound influence of the memoir and commends Kalanithi for her beautifully written epilogue. The discussion delves into various aspects of her journey, highlighting the personal and philosophical reflections that have shaped her understanding of life and death.
This episode explores:
- Paul’s legacy. Kalanithi shares insights into Paul’s life as a neurosurgeon and writer, his philosophical interests, and how his terminal diagnosis profoundly influenced their lives and his writing.
- The decision to have a child. The episode explores the couple’s choice to have a child despite Paul’s terminal illness and the impact it has had on Kalanithi and their daughter, Cady.
- Coping with loss. Kalanithi discusses the challenges of facing Paul’s death, the physical and emotional toll it took, and how she found ways to process her grief.
- Legacy and memory. Paul’s memoir has helped keep his memory alive for friends, family and, most importantly, for Lucy and Cady. Kalanithi explains the importance of maintaining connections with the deceased while moving forward in life.
- Finding new love. Finally, she explains the complexities and nuances of falling in love again after such a significant loss, and how it does not diminish the love and memory of the deceased.
Throughout the episode, Kalanithi offers valuable advice for those navigating similar experiences, emphasizing the importance of palliative care, finding support, and allowing oneself to grieve fully. Her reflections on balancing the pain of loss with the beauty of new beginnings provide a deeply human perspective on end-of-life issues.
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #141: Reflections on life after loss with Lucy Kalanithi appeared first on Fixing Healthcare.
In this special episode of Fixing Healthcare, co-hosts Dr. Robert Pearl and Jeremy Corr dive into surprising insights and lessons drawn from Dr. Pearl’s literary works. Focusing on his 2017 book “Mistreated: Why We Think We’re Getting Good Healthcare—and Why We’re Usually Wrong,” and his new release, “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine,” Pearl compares the world healthcare, now and then.
The episode opens with Corr asking Pearl about the motivation behind his newest book and how it connects to his previous works. Dr. Pearl recounts his journey, starting with the revelations from his time as CEO of Kaiser Permanente, where he realized the systemic flaws in American healthcare. His first book, “Mistreated,” was written to highlight these issues, comparing healthcare to a 19th century cottage industry that was stuck in the past.
Despite the optimism following the publication “Mistreated,” Dr. Pearl observed that little had changed in the following years. This led him to explore the deep-seated cultural issues in medicine in his second book, “Uncaring: How the Culture of Medicine Kills Doctors and Patients.” Yet again, change remained elusive.
Pearl’s newest book, “ChatGPT, MD” emerged from the realization that a powerful tool like generative AI could finally catalyze the much-needed transformation in healthcare. This book, co-authored with ChatGPT itself, delves into the potential of AI to enhance diagnoses, manage chronic diseases and streamline patient care, making healthcare more efficient and equitable.
To illustrate the ongoing challenges and the potential impact of AI, Dr. Pearl reads excerpts from the first and last chapters of “Mistreated,” recounting the harrowing story of his father, Jack Pearl. Through this personal narrative, he highlights the tragic consequences of medical errors and systemic failures that led to his father’s untimely death.
Dr. Pearl then discusses three significant ways his father’s care could have been improved with the advent of generative AI. And he expresses optimism that the introduction of generative AI into healthcare can finally drive the changes he has long advocated for, making the system more effective, compassionate and patient-centered.
Tune in to this compelling episode to hear Dr. Pearl’s reflections and visions for the future of healthcare, and join the conversation on social media.
HELPFUL LINKS
- Buy “ChatGPT, MD” with all profits going to Doctors Without Borders (Amazon)
- Learn more about “Mistreated” and “Uncaring” (RobertPearlMD.com)
- Monthly Musings on American Healthcare (monthly digital newsletter)
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #137: How generative AI could have saved my father appeared first on Fixing Healthcare.
This episode of Fixing Healthcare continues the ninth season’s focus on end-of-life issues by exploring the often overlooked topics of love and sexuality during this critical time.
Cohosts Dr. Robert Pearl and Jeremy Corr welcome Dr. Pebble Kranz, a sexual medicine specialist and medical director at the Rochester Center for Sexual Wellness.
In a recent Medscape column titled “Physicians: Don’t Ignore Sexuality in Your Dying Patients,” Dr. Kranz wrote: “I have a long history of being interested in conversations that others avoid. In medical school, I felt that we didn’t talk enough about death, so I organized a lecture series on end-of-life care for my fellow students. Now, as a sexual medicine specialist, I have other conversations from which many medical providers shy away.”
She brings a unique perspective to the podcast, highlighting the importance of addressing sexual concerns for patients nearing the end of their lives. She discusses the need for healthcare providers to have open, honest conversations about sexuality, noting that patients often want to discuss these issues, but clinicians are frequently uncomfortable or unprepared to do so.
Throughout the interview, Dr. Kranz emphasizes that sexuality is a vital part of human identity and well-being, extending from young adulthood through old age, and even in illness. She shares insights from her work, including the story of a 75-year-old patient with cancer who sought to maintain her sexual health despite her illness.
The episode addresses several key points:
- The cultural and medical taboos surrounding discussions of sexuality, especially for patients at the end of life.
- The importance of medical education in preparing clinicians to handle sexual health concerns.
- Strategies for expanding the concept of sexual play and intimacy to accommodate the changing needs and capabilities of patients.
- The role of healthcare providers in facilitating conversations about sexual health and providing appropriate treatments.
Dr. Kranz also touches on the emotional and existential dimensions of sexuality, explaining how physical intimacy can help patients feel more connected to themselves and others, even as they face terminal illness. She advocates for more privacy and support in hospital settings to allow patients to express their sexuality and maintain close relationships.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #136: Love and sexuality at the end of life with Dr. Pebble Kranz appeared first on Fixing Healthcare.
This month’s “Diving Deep” episode, part of the Fixing Healthcare podcast series, delves into a pair of stories that will have a significant impact on the U.S. healthcare workforce. Cohosts Dr. Robert Pearl and Jeremy Corr explore the intricate legalities surrounding medical malpractice in the age of AI, as well as the Federal Trade Commission’s (FTC) recent rule to ban non-compete clauses.
The episode begins with an in-depth look at a new set of liability issues in medicine: What happens when AI harms a patient? Dr. Pearl discusses how concerns among clinicians are shifting—from AI reliability to liability. Highlighting insights from Michelle Mello, a professor of law and health policy at Stanford University, the segment addresses the complexities of determining liability when AI tools are involved in patient care. Dr. Pearl outlines key considerations for healthcare professionals, emphasizing the importance of understanding AI’s limitations, negotiating terms of use with AI developers, and staying informed about the legal landscape.
Next, the conversation transitions to the FTC’s groundbreaking decision to ban non-compete agreements. This ruling, set to take effect in September, is anticipated to have a profound impact on the medical profession by boosting career mobility, increasing competition and potentially reducing healthcare costs. Dr. Pearl and Jeremy Corr discuss the winners and losers of this new regulation, focusing on how the ban will benefit newly trained clinicians and patients in competitive healthcare markets while posing challenges for large health systems and hospital administrators.
Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- If AI Harms A Patient, Who Gets Sued? (Forbes)
- Healthcare Winners And Losers After FTC Bans Noncompete Agreements (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #135: Diving Deep into AI-medical malpractice & FTC’s non-compete ban appeared first on Fixing Healthcare.
Today’s episode of Medicine: The Truth examines important updates in women’s health, focusing on mammograms and hormone replacement therapy (HRT), among other pressing news topics in medicine.
The U.S. Preventive Task Force has updated its mammogram guidelines, now recommending that screenings start at age 40 instead of 50 and occur every two years. This adjustment responds to data showing that breast cancer is occurring earlier, potentially due to changes in pregnancy timing and related hormonal impacts. By starting screenings a decade earlier, the Task Force projects a 19% reduction in breast cancer deaths in the U.S.
The hosts discussion then revisits the use of hormone replacement therapy. After concerns in the early 2000s about its link to increased cancer risks, new studies indicate HRT is safe for younger post-menopausal women under 60. These studies correct earlier misconceptions, showing no increase in heart risk or mortality and a lower risk of breast cancer with estrogen-only treatments. Dr. Pearl highlights the necessity of data-driven medical practices to prevent the overreactions of the past.
The episode advocates for informed healthcare decisions, particularly in how women are treated during menopause. Join us to explore these critical issues and more. Here’s a snapshot of all the topics covered on this episode of Medicine: The Truth.
- Medical debt now affects more than 100 million Americans
- Seniors have seen the biggest rise in mental health diagnoses
- Why drug ODs are down for the time since the onset of Covid-19
- New recommendations for mammogram screenings
- New data on hormone medications for menopause
- Hospitals now demanding patients pay in advance
- The mystery of Beethoven’s deafness finally solved
- 320,000 children lost a parent to a drug overdose from 2011-2021
- A new program to attract more people to mental health counseling
- The newest research on Alzheimer’s Disease treatments
- Why half of rural hospitals are losing money
- Status of the pig-kidney transplant recipient?
- AI vs. clinician’s diagnostic accuracy in the emergency room
- Does H5N1 have what it takes to become a viral pandemic?
- Longevity vs. “healthy life expectancy”
- The death of Walmart Health and what it means for other retailers
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #84: The latest research on mammograms, hormone (HRT) medications appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare features Dr. Jonathan Fisher, a respected cardiologist and advocate for physician well-being; Dr. Robert Pearl, healthcare leader and author of the new book “ChatGPT, MD”; and Jeremy Corr, CEO of Executive Podcast Solution, who adds the patient’s perspective.
Today, the trio dives deep into why lifestyle medicine improvements—such as diet, weight loss, mental health, and relaxation—are so challenging for people. Dr. Fisher discusses the psychological and motivational factors that create barriers to change, while Dr. Pearl explores how generative AI could assist in overcoming these hurdles. Jeremy Corr brings the patient’s viewpoint, emphasizing the real-world difficulties and potential solutions from a non-clinician’s perspective.
Join the panel as they explore the complexities of human behavior, the role of healthcare professionals in coaching patients, and the innovative technologies that could revolutionize how we approach health and well-being. This episode provides insightful strategies and compassionate advice for anyone looking to make lasting, positive change in their life.
To discover more, press play and check out these helpful links:
New book: ‘Just One Heart’ (Jonathan Fisher)
New book: ‘ChatGPT, MD’ (Robert Pearl)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #134: An unfiltered look at the challenges of lifestyle medicine appeared first on Fixing Healthcare.
This episode of Fixing Healthcare dives into the essential yet often misunderstood world of palliative and hospice care—part of this ninth season’s continued focus on end-of-life issues.
Our guest today, Dr. Monique Danielle Schaulis, MD, MPH, is a board-certified physician in both Emergency Medicine and Hospice and Palliative Medicine. She is currently practicing at Kaiser Permanente San Francisco. With extensive experience and a compassionate approach, Dr. Schaulis sheds light on the critical role of palliative care in modern healthcare.
Alongside cohosts Dr. Robert Pearl and Jeremy Corr, Schaulis tackles common myths and misunderstandings surrounding palliative care. She explains why palliative care is not just for end-of-life situations, and how it can be integrated with curative treatments at any stage of a serious illness. She emphasizes that palliative care is a holistic medical specialty focused on improving the quality of life for patients of all ages by addressing physical, psychosocial, spiritual, and existential distress.
This episode also explores why American culture struggles with the acceptance of death and palliative care. Dr. Schaulis reflects on how historical developments in medical technology and a lack of training for physicians on end-of-life conversations contribute to this issue. Tune in to learn more about the transformative potential of palliative care and how it can enhance quality of life for patients—and their families.
Dr. Robert Pearl is the author of the book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #133: The many misconceptions of palliative care appeared first on Fixing Healthcare.
This month’s “Diving Deep” episode, part of the Fixing Healthcare podcast series, takes a close look at two transformative AI developments in healthcare. Cohosts Dr. Robert Pearl and Jeremy Corr explore the profound medical potential of ChatGPT’s new “memory” and Nvidia’s new AI bots, which the company claims can outperform nurses in some tasks.
The episode begins with a spotlight on ChatGPT’s enhanced memory capabilities. This breakthrough could revolutionize healthcare by making interactions more contextual and patient-specific, potentially leading to more accurate diagnoses and personalized care. Dr. Pearl discusses how this new AI feature could integrate vast amounts of medical data, dramatically improving clinical outcomes by overcoming the current limitations of electronic health records and knowledge accessibility.
Next, the conversation shifts to Nvidia’s latest innovation: AI bots that have shown promising results in performing certain nursing tasks more accurately than humans. This segment examines the implications of such technology in healthcare, discussing both the efficiency gains and the ethical considerations of integrating AI at this level of care.
Throughout the episode, Corr quizzes Pearl on these advancements, unpacking their medical relevance and vast potential. The discussion is not only a deep dive into the current capabilities of AI in medicine but also a thoughtful exploration of its future trajectory and the ethical landscape that accompanies it.
Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- 3 Ways ChatGPT’s ‘Memory’ Can Spark Breakthroughs In Healthcare (Forbes)
- Nvidia’s AI Bot Outperforms Nurses, Study Finds. Here’s What It Means. (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #132: Diving deep into ChatGPT’s ‘memory’ and Nvidia’s AI bot appeared first on Fixing Healthcare.
Medicine: The Truth covers the latest news and most pressing issues in medicine today. The headline story for this episode focuses on the FTC’s vote to ban non-compete agreements.
Co-host Dr. Robert Pearl explains how these clauses were originally designed to protect trade secrets, but have been used in healthcare to prevent doctors from taking new positions—and taking their patients with them.
Non-compete policies not only disrupt the doctor-patient relationship but also contribute to higher healthcare costs. As Pearl has written about in Forbes and other outlets, hospital consolidation has long been a strategic move to control market share, leading to increased medical bills and facility fees. Non-compete clauses have been central to maintaining this monopoly. It’s no surprise the ban is being fiercely opposed by the American Hospital Association and U.S. Chamber of Commerce.
Alongside cohost Jeremy Corr, Pearl unpacks this issue and the following topics in this episode of Medicine: The Truth.
- Care organizations led by primary care physicians are most effective, efficient
- 263,000 docs have become employees since 2012
- The FTC ban on non-compete clauses
- Research finds weight-loss drugs also treat sleep apnea
- Patient receives a pig’s kidney in experimental transplant
- S. doctors accepted $12.1 billion from drug companies over the past 10 years
- Paxlovid ineffective for vaccinated individuals with Covid-19
- Why financial breaks didn’t spur insulin usage among diabetics
- The impact of Covid-19 on child development
- HHS mandates attending doctors get permission for pelvic, prostate exams
- ChatGPT becoming more reliable and accurate in diagnosing disease
- Unnecessary inpatient care cost $6 billion last year
- Republicans reported 25% more severe reactions to Covid-19 vaccine
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #83: How will the FTC’s non-compete ban affect healthcare workers? appeared first on Fixing Healthcare.
Today’s episode of Fixing Healthcare is a true sign of the times in medicine. Not only is generative AI the topic of today’s podcast, it’s also an active participant. Co-host Jeremy Corr used ChatGPT to come up with questions for fellow co-host Dr. Robert Pearl about “ChatGPT, MD,” a new book that Pearl co-authored with ChatGPT.
Still following? This unique setup underscores the dynamic relationship between artificial intelligence, medicine and healthcare leadership.
ChatGPT, with questions voiced by Jeremy Corr, delves into Dr. Pearl’s decision to write “ChatGPT, MD,” a book that aims to demystify the potential and practicalities of AI in healthcare. The discussion moves through a series of insightful questions, thoughtfully generated by AI, to probe the nuances of integrating large language models like ChatGPT into the medical field. These questions explore the opportunities AI presents for improving diagnostic accuracy, personalizing patient care, and streamlining administrative processes in healthcare settings.
As the conversation unfolds, it becomes clear that AI’s integration into healthcare promises significant advancements, but it also raises important ethical, legal and operational considerations.
Note to listeners: all profits from Dr. Pearl’s book go to Doctors Without Borders.
HELPFUL LINKS
- Buy “ChatGPT, MD” with all profits going to Doctors Without Borders (Amazon)
- Empowering patients: Navigating medical information with AI (KevinMD)
- My journey with AI and medicine: ‘ChatGPT, MD’ is here (RobertPearlMD.com)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the coauthor of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #131: ChatGPT interviews Dr. Pearl about their new book, ‘ChatGPT, MD’ appeared first on Fixing Healthcare.
In this “Unfiltered” episode of Fixing Healthcare, the conversation dives deep into the role of AI in medicine with Dr. Jonathan Fisher, a respected cardiologist and advocate for physician well-being; Dr. Robert Pearl, author of the new book “ChatGPT, MD”; and Jeremy Corr, CEO of Executive Podcast Solution, who adds the patient’s perspective.
The panel examines the current applications of AI in the medical field, highlighting early successes and the challenges of integrating a technology that isn’t quite ready for widespread adoption.
Recent studies indicate that 40% of doctors feel comfortable using AI for specific clinical and administrative tasks. However, many patients express concerns about physicians becoming overly dependent on AI for diagnoses and treatments. Fisher, Pearl and Corr cut through the noise to focus on the facts, helping listeners understand what AI can currently achieve, its potential in the near future, and the issues to watch as technology firms and healthcare leaders smooth out the rough edges.
As always, Corr voices a critical patient-oriented question – this one about the potential risks of AI in healthcare and how to mitigate patient concerns.
To discover more, press play and check out these helpful links:
Buy now: ‘Just One Heart’ (Jonathan Fisher’s new book)
Buy now: ‘ChatGPT, MD’ (Robert Pearl’s new book)
3 Ways ChatGPT’s ‘Memory’ Can Spark Breakthroughs In Healthcare (Forbes)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #130: An unfiltered look at AI’s current, future uses in medicine appeared first on Fixing Healthcare.
In a special episode of the Fixing Healthcare podcast, co-host Dr. Robert Pearl, former CEO of The Permanente Medical Group and a respected voice in healthcare, shares two chapters from his latest work, “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine,” which he co-authored with the generative AI model ChatGPT.
Listener note: All profits from the book go to Doctors Without Borders
Celebrating the book’s release, which has already clinched the #1 new release spot on Amazon, Dr. Pearl chose to read excerpts from two pivotal chapters, providing listeners a unique glimpse into the collaborative process between a human author and generative AI.
Dr. Pearl reads from chapter five, a section primarily penned by him, followed by chapter six, where ChatGPT took the lead, crafting 90% of the content. The exercise offered an intriguing comparison, allowing listeners to discern the nuances between human and AI contributions.
Throughout, Dr. Pearl emphasized the collaborative nature of the book, underscoring the potential of generative AI to revolutionize healthcare by enhancing the partnership between patients and doctors.
HELPFUL LINKS
- Empowering patients: Navigating medical information with AI (KevinMD)
- My journey with AI and medicine: ‘ChatGPT, MD’ is here (RobertPearlMD.com)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #129: A reading from Dr. Pearl’s newest book, ‘ChatGPT, MD’ appeared first on Fixing Healthcare.
Today’s episode of Medicine: The Truth delves into the lasting impact of adverse childhood events (ACEs) on mental and physical health in adulthood. A groundbreaking study involving over 25,000 Swedish twins has shed new light on the significant role the environment plays in shaping mental health outcomes, revealing that individuals who experienced major childhood traumas were substantially more likely to develop psychiatric illnesses compared to their non-traumatized twin counterparts.
Podcast cohosts Dr. Robert Pearl and Jeremy Corr unpack these findings, exploring the intricate relationship between childhood adversity and later life health challenges, including depression, anxiety disorders, substance abuse, and even physical ailments like heart disease and cancer. The discussion extends to the influence of genetics versus environment on mental health and the transformative potential of nurturing healthier environments for children to mitigate these long-term impacts.
Are we underestimating the power of our childhood experiences on our adult well-being? Join us to explore this critical question and more in today’s thought-provoking episode. Here’s a snapshot of all the topics covered on this episode of Medicine: The Truth.
- The latest on birth control availability
- The link between COVID vaccination and political affiliation
- The Alabama Supreme Court’s decision on IVF embryos
- New twin study about mental health and childhood trauma
- How to close the “empathy gap” in medicine
- New data on fentanyl deaths
- Voters’ top healthcare concerns in 2024
- ER visits up for kids taking parents’ sleep medications
- Price of new drugs defy White House actions
- Healthcare held hostage by ransomware attack
- Generative AI’s latest medical advance
- Consumers growing more comfortable with AI in medicine
- How the Dobbs ruling affected abortion rates
Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine“ about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #82: How do childhood traumas shape our health as adults? appeared first on Fixing Healthcare.
Late last year, Fixing Healthcare cohost Dr. Robert Pearl read a remarkable essay in the New York Times titled, “I Promised My Sister I Would Write About How She Chose to Die.” In that essay, Steven Petrow offers a deeply personal account of his sister Julie’s choice to use Medical Aid in Dying (MAID) in New Jersey.
Her journey, marked by advanced ovarian cancer and the exhaustion of treatment options, illustrates the importance of MAID as a means of taking control at life’s end. The piece advocates for wider awareness and accessibility of such options, emphasizing the dignity in making a profound and personal choice.
Petrow, a contributing columnist at The Washington Post and the author, most recently, of “Stupid Things I Won’t Do When I Get Old,” joins the podcast today to discuss a panoply of end of life issues, which is the focus of this ninth season of Fixing Healthcare.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #128: ‘I Promised My Sister I Would Write About How She Chose to Die’ appeared first on Fixing Healthcare.
Fixing Healthcare co-host Dr. Robert Pearl recently returned from a surgical mission in the Philippines. The trip not only reignited his passion for global surgery, but it also provided three key lessons about American healthcare.
That’s the first topic of this week’s “Diving Deep” program. The second takes a different look at the state of American healthcare, this time through the lens of human evolution.
Pearl notes, “In a world where change is the only constant, the swift currents of modern life contrast starkly with the sluggish pace of genetic evolution—and of American healthcare, too.”
He and co-host Jeremy Corr discuss whether our nation’s healthcare system can evolve as fast as our DNA. Two relatively recent biological events offer profound insights into American medicine—along with a warning about what happens when healthcare systems fail to change.
Learn more about these two topics in today’s episode of Fixing Healthcare. Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- 3 Surprising Lessons U.S. Medicine Can Learn From Around The World (Forbes)
- How Genetic Insights Can Reshape American Medicine (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #127: Diving deep into the state of American healthcare appeared first on Fixing Healthcare.
As Dr. Robert Pearl puts the finisihing touches on his upcoming book “ChatGPT, MD,” the cohost thought it would be a fitting time to read a chapter from his previous book “Uncaring: How the Culture of Medicine Kills Doctors & Patients.” All profits from sales of Pearl’s books go to Doctors Without Borders.
What you’re about to hear is the story of Judy, a colleague of Dr. Pearl’s at Kaiser Permanente, and Judy’s spouse. It’s a story about acceptance and kindness, about love without labels, about honoring commitments in good times and bad, and about the enduring power of hope in life’s most challenging moments.
Tune in and join the conversation on social media. You can also learn more about this topic and the book of Uncaring via the links below.
HELPFUL LINKS
- The story of Judy at Kaiser Permanente (San Francisco Chronicle)
- Learn more about the book ‘Uncaring’ (RobertPearlMD.com)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #126: On finding peace with who you are appeared first on Fixing Healthcare.
Today’s episode of Medicine: The Truth takes a look at the mental and physical health of America’s youth.
More than ever before, kids 17 and under are getting their medical care at drug stores and retail clinics, signaling a further decline in traditional doctor-patient relationships. Meanwhile, new data show that young people, especially adolescent girls, experienced a massive increase in antidepressant medication usage during the pandemic—trends that continue today at an alarming rate.
Podcast cohosts Dr. Robert Pearl and Jeremy Corr discuss what’s happening with America’s young people. Are the kids going to be alright? Find out on today’s show.
Here’s a snapshot of all the topics covered on this episode of Medicine: The Truth.
- The effectiveness of the latest COVID-19 vaccines
- In-person vs. virtual visits following medical abortion
- The impact of COVID-19 on babies and their mothers
- The rise of cervical cancer among low-income women
- Why younger patients are getting their care at retail clinics
- Antidepressant prescriptions boomed among adolescent girls
- Unpaid medical bills are also on the rise
- Ransomware attacks are preventing Rx refills
- Insurers are cracking down on popular weight-loss drugs
- Alabama’s courts rule against IVF treatments
- How Jimmy Carter has survived a year in hospice
- An unprecedented donation to a medical school is sparking hope
- The importance of healthcare in this year’s election
- The impact of running on prostate cancer
- The residual impact of Long COVID
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #81: Are the kids alright, medically? appeared first on Fixing Healthcare.
This ninth season of Fixing Healthcare continues its focus on complex end-of-life issues. In this episode, hosts Dr. Robert Pearl and Jeremy Corr venture outside the traditional walls of medicine for help understanding the spiritual and communal aspects of end-of-life decision making. Joining today’s show is Rabbi Melanie Aron. As a Jewish scholar and expert in Reform Judaism with a rich history of spiritual leadership and personal compassion, she brings a unique perspective to this important topic.
Serving Congregation Shir Hadash of Los Gatos for over three decades, and now as Rabbi Emerita, her involvement with diverse, interfaith organizations reflects her commitment to community and open dialogue. Rabbi Aron’s experiences offer invaluable insights into how different traditions and communities navigate end-of-life decisions.
This episode explores:
- Religious traditions and their influence over the medical decisions of people who are nearing the end of their lives.
- The difference between legal restrictions on end-of-life medical care and the moral/ethical considerations that still confront people of faith.
- What religion can teach clinicians about providing more compassionate medical care at the end of life.
- Situations where religions institutions and medical institutions agree and disagree on end-of-life treatments.
- Brain death, Alzheimer’s, hospice care, assisted dying—seen through the lens of religious texts and teachings.
- Whether mental and physical health be treated similarly when making moral and ethical decisions around a person’s death.
- Advice for families struggling with the reality that a loved one has a terminal disease.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #125: Beyond medicine—a Rabbi’s insights on end-of-life issues appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being. This February, what more appropriate topic to discuss with a heart doctor than love?
Dr. Fisher, whose upcoming book “Just One Heart” dedicates an entire chapter to the topic, says that love is a skill that requires practice, work and considered thought. The elevated amount of dedication and commitment needed to find and foster love is not unlike the journey toward becoming a doctor. Dr. Fisher recalls some of the obstacles he faced in both arenas: his study of cardiology and of love.
“In medical school and residency training, I did not value love,” said Dr. Fisher. “I valued success and becoming a great doctor. And, actually, that was part of the reason I became burned out. I under-valued and under-indexed love and over-indexed success, at least the way that it was modeled to me by my teachers.”
Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr help Dr. Fisher explore the importance of love in all aspects of life. Dr. Fisher offers tips and techniques for mastering the “skill” of love. Dr. Pearl describes the medical and psychological consequences tied to the lack of love in one’s life and how recently he elevated his love of medicine during a surgical mission to the Philippines. They share statistical evidence of love’s impact on happiness, professional satisfaction and even longevity. And, as always, Jeremy Corr chimes in with a question on behalf of patients.
To discover more, press play and check out these helpful links:
Presale: ‘Just One Heart’ (Jonathan Fisher’s new book)
Rediscovering The Mission, Purpose Of Medicine (Forbes)
Monthly Musings on American Healthcare (RobertPearlMD.com)
Breaking The Rules Of Healthcare (LinkedIn)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #124: An unfiltered look at the science & skill of love appeared first on Fixing Healthcare.
Healthcare used to be a “country club competition,” in the words of past Fixing Healthcare guest Dr. Robert Burgelman. By this, he meant that doctors, insurers, drug makers and others worked well together and stayed out of each other’s respective lanes, trusting each other to keep the wheels of medicine churning slowly forward. Disputes, if any, were resolved quietly and kept behind the scenes.
Those days are gone and, in 2024, three major healthcare conflicts are set to erupt. In this episode of Diving Deep, Dr. Robert Pearl and Jeremy Corr discuss this year’s cutthroat competitions and intense disputes, each of them being played out in public.
Later in the episode, Dr. Pearl dives deep into the OpenAI saga involving its CEO (turned ex-CEO turned CEO again) Sam Altman and his very public feud with the company’s board of directors. Setting the dramatics aside, Pearl examines the important lessons that healthcare leaders should take from this dispute and from Altman’s leadership style.
Learn more about these two topics in today’s episode of Fixing Healthcare. Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- 3 Huge Healthcare Battles Set To Erupt In 2024 (Forbes)
- Sam Altman’s Wild Year Offers 3 Critical Lessons for Healthcare Leaders (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #123: Diving deep into healthcare’s biggest battles of 2024 appeared first on Fixing Healthcare.
Fixing Healthcare welcomes Dr. Atul Gawande, a renowned surgeon, writer and public health researcher who currently serves as the Assistant Administrator for Global Health at USAID.
He has a rich background as both a medical professional and a compassionate individual. Ten years ago, Dr. Gawande published the bestselling book “Being Mortal: Medicine and What Matters in the End,” which explored the intersection of medicine, aging, and the end-of-life journey. His father’s battle with a spinal tumor profoundly influenced the book, serving as a catalyst for Gawande to confront the limitations of medical interventions and the importance of addressing patients’ individual goals and fears as they approach the end of their lives.
This episode explores:
- Gawande’s personal story as he reflects on his father’s battle with a spinal tumor, highlighting the complexities and emotional challenges of dealing with serious health issues within a family.
- His father’s journey from being a vibrant individual and a dedicated surgeon to facing the limitations imposed by his illness provides; a profound context for the discussion on end-of-life care.
- Difficult decisions that families and patients face when confronted with terminal illnesses, along with the nuances of choosing between aggressive treatments and palliative care.
- Approaches to end-of-life care that respect the patient’s wishes and focus on enhancing the quality of life rather than merely extending it.
- The significance of having open and honest conversations about end-of-life preferences and the limitations of medical interventions.
This episode is part of the ninth season of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #122: Navigating life’s final chapter with Atul Gawande appeared first on Fixing Healthcare.
Today’s episode of Medicine: The Truth looks at the latest in new drug approvals and new drug pricing, topics that have become inseparable in our nation’s healthcare conversation.
One study found that the average “launch price” of new drugs has increased from $2,115 per year in 2008 to $180,007 per year in 2021. And there’s no sign drug makers are slowing down. Already in 2024, pharma companies have raised prices on 775 new medications.
Podcast cohosts Dr. Robert Pearl and Jeremy Corr discuss the cost of new drugs and their relative value. Are Americans getting what they’re paying for? For that answer and more, here’s a snapshot of topics covered on today’s show:
- As many as 2 million new cases per day of Covid, RSV and flu
- FDA approves a new sickle cell disease treatment
- The latest Covid variant, JN.1, and its impact on Americans
- A morning-sickness hormone discovered by Cambridge researchers
- Drug rebates coming this year for Medicare patients?
- The link between drug makers and non-profit patient advocacy groups
- Congress mulling price transparency laws despite intense lobbying
- The latest on GLP-1 weight-loss medications
- Infected Americans no longer isolating, masking
- What now for 10 million Americans who lost Medicaid coverage?
- Venture capital firm buys one of largest health systems in Ohio
- Should you turn to YouTube for emergency medical advice?
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #80: What’s new in drug discovery and pricing? appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being.
Last Wednesday, January 17, was “Quit Day,” when most people give up on their New Year’s resolutions to get fit, eat better and try new things. Today’s show leads with an up-close look at the annual ritual of making (and breaking) resolutions.
“I have a little bit of skepticism about resolutions in general,” says Dr. Fisher, adding, “I certainly make resolutions for myself, especially around fitness, around relationships, around nutrition. But I want to ask, what does it actually mean to have a resolution? If you resolve to do something, doesn’t that mean you’re going to do it once and for all, and you don’t have to keep making these things every year?”
Fixing Healthcare cohost Dr. Robert Pearl notes that there’s very little in healthcare that we do once and that’s it. “Maybe get our appendix taken out,” he says, but the point is that these promises we make to ourselves don’t come with an annual (or 17-day) stopping point. Perhaps it is the gravity of these resolutions that makes it all the more difficult to keep them.
Today’s show explores why it’s so hard to get resolutions to stick, and what people can do to live happier, healthier lives without the pressure of this oft-failed tradition. Later in the episode, Dr. Fisher discusses the “placebo effect” and its impact on medicine. The group concludes with a discussion of “flow” and the positive psychological principle of being in the zone. As always, cohost Jeremy Corr chimes in with a question on behalf of patients.
To discover more, press play and check out these helpful links:
Presale: ‘Just One Heart’ (Jonathan Fisher’s new book)
5 New Year’s Resolutions That Can Save Your Life (Forbes)
3 Beneficial Healthcare Laws The 118th Congress Could (Actually) Pass (Forbes)
Breaking The Rules Of Healthcare (LinkedIn)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #121: An unfiltered look at resolutions, kept and unkept appeared first on Fixing Healthcare.
This week, cohost Dr. Robert Pearl is on a plastic surgery mission trip to the Philippines where he will be repairing the cleft lips and palates of children. While he’s away, we’re revisiting one of the most popular episodes from 2023 featuring Dr. Zubin Damania, known to many as ZDoggMD.
Zubin Damania is a UCSF- and Stanford-trained internist and founder of Turntable Health, an innovative primary care clinic and model for Health 3.0. As a way to address his own burnout and find his voice, he started producing videos and live shows under the pseudonym “ZDoggMD.” His persona became a grassroots movement, reaching more than 1 billion people across a wide array of different media.
In this episode, Drs. Pearl and Z discuss the hero’s journey in healthcare. The concept of the “hero’s journey” was popularized by the American writer Joseph Cambell, and it applies aptly to American healthcare. In every medical professional’s career, there is a calling, a fear of failure and people along the way who provide support (or pose additional challenges). Listen to find who are healthcare’s heroes today, what are the dragons that need slaying, how doctors will overcome their fear of failure and what journeys still lie ahead.
For more, press play.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #120: Revisiting the hero’s journey with Dr. Zubin Damania (ZDoggMD) appeared first on Fixing Healthcare.
Clinician burnout is a major problem in the United States. But as cohosts Dr. Robert Pearl and Jeremy Corr discuss in today’s episode of Diving Deep, burnout is not a distinctly American problem.
Recent data from The Commonwealth Fund indicates that primary care doctors in the United States are as satisfied as their peers in the UK, Germany, Canada, Australia and New Zealand. This seems surprising given the unique challenges and frustrations posed by the American healthcare system. But if the system isn’t the sole cause of doctor dissatisfaction, then what else is there?
Dr. Pearl offers a surprising take on the global origins of clinician burnout and, in the second half of today’s show, he offers a technology-based solution to reverse our nation’s surge in chronic illnesses and the clinician burnout crisis. Finally, Pearl acknowledges and addresses the likely skepticism of doctors, especially considering the longstanding failure of heavily hyped tech when it comes to improving medical outcomes or professional satisfaction.
Learn more about these two topics in today’s episode of Fixing Healthcare. Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- Burnout In US Healthcare: New Data, Surprising Insights (Forbes)
- ChatGPT Will Reduce Clinician Burnout, If Doctors Embrace It (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #119: Diving deep into clinician burnout and ChatGPT as a solution appeared first on Fixing Healthcare.
What a year it was for American healthcare. Generative AI exploded onto the scene and scored in the top echelon of test takers on the U.S. medical licensing exam. America’s largest retailers made several multibillion-dollar acquisitions in the primary care, telemedicine and home-health arenas. Diabetes drugs stunned researchers with their ability to help patients lose weight.
These are just a few of the biggest stories from 2023 that cohosts Dr. Robert Pearl and Jeremy Corr discuss on today’s episode of Fixing Healthcare, which also takes a bold look ahead at 2024. Which healthcare issues will matter most in this election year? Which technologies are set to make on impact on America’s health? Will the physician burnout crisis get better or worse in the year to come?
Here’s a snapshot of the topics covered on today’s show:
- The explosion of generative AI (ChatGPT)
- The rise of the ‘retail giants’ in healthcare
- Ozempic and other weight-loss drugs
- Medicare Advantage saw enrollment surge in 2023
- The tech breakthrough to fight sickle cell disease
- Overdoses, suicides and other healthcare failures of the last year
- The threat of rationing in 2024
- The Roe v. Wade fallout
- Addressing physician burnout in the U.S.
- The most promising medical technologies coming in 2024
- Which healthcare issues will matter most at the polls?
- How to contain drug and care-delivery costs going forward
- Healthcare staffing shortages: causes and solutions
- A telehealth comeback in 2024?
- America needs a mental health check
- Who was Dr. Pearl’s greatest career influence?
Click play to learn more or check out the various links below for additional information.
MUST-READ ARTICLES FROM 2023
- The AI-Empowered Patient Is Coming: Are Doctors Ready? (Forbes)
- 15 Innovative Ideas For Fixing Healthcare From 15 Brilliant Minds (Forbes)
- American healthcare: The good, bad, ugly, future (LinkedIn)
- How The U.S. Government Can Solve The Obesity Epidemic (Forbes)
- Burnout In Medicine: New Data, Surprising Insights (Forbes)
- Subscribe: Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #118: 2023 in review plus 2024 preview and predictions appeared first on Fixing Healthcare.
Bubbly and precocious, Hunter was every parent’s dream child and every teacher’s ideal student. By age 14, she had already enrolled in classes at a local college to augment her course schedule. She played soccer, softball, basketball and ran track in high school. She was on the swim team. She even tried cheerleading, though that wasn’t her cup of tea, said Maria, Hunter’s mom.
Maria describes her daughter with words like “amazing” and “beautiful” and “unstoppable.” But to truly appreciate the power of this mother-daughter duo, you have to understand what the two of them went through together. Theirs is a story of medical trials and tribulations, of heartbreaking diagnoses and difficult medical decisions. Their story challenges both conventional wisdom and the doctor-patient relationship.
In today’s episode, Dr. Robert Pearl’s reads a chapter from his critically acclaimed book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients.” All profits from sales of the book go to Doctors Without Borders. This episode is part of season nine of Fixing Healthcare, which tackles the difficult topic of death, examining end-of-life issues from multiple angles.
Tune in and join the conversation on social media. You can also learn more about this topic and the book of Uncaring via the links below.
HELPFUL LINKS
- Kirkus starred review: ‘Uncaring’ (Kirkus Reviews)
- Learn more about the book ‘Uncaring’ (RobertPearlMD.com)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #117: The Young and the Breathless appeared first on Fixing Healthcare.
Welcome to season nine of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr. This season tackles the difficult topic of death, examining end-of-life issues from multiple angles.
Today’s episode features a reading from Dr. Robert Pearl’s most recent book “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” which is available in audio book, eBook and hardcover. All profits from sales go to Doctors Without Borders.
What you’re about to hear is the story of David, a colleague and friend of Dr. Pearl’s at Kaiser Permanente. David lived a beautiful life that was cut short by illness. In his final years, he and his family faced a difficult decision, one that raises important questions for all of us about ethics, morality, the law and the choices we make at the end of life.
Tune in and join the conversation on social media. You can also learn more about this topic and the book of Uncaring via the links below.
HELPFUL LINKS
- Life’s most difficult decision: An excerpt from ‘Uncaring’ (RobertPearlMD.com)
- Learn more about the book ‘Uncaring’ (RobertPearlMD.com)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #116: Death of a Surgeon appeared first on Fixing Healthcare.
As it was this time last year, ‘tis the season for sneezing once again. While carolers are coughing and shoppers are sniffling, podcast cohosts Dr. Robert Pearl and Jeremy Corr are tracking the seasonal surge in Covid-19, influenza and RSV.
Half a year has passed since the federal government declared an end to the public health emergency for Covid-19. But public health experts are worried that the lack of masking and social distancing this year could send tens of thousands of Americans to the hospital before winter’s end.
On today’s episode of Medicine: The Truth, listeners will uncover critical insights about this season’s most important health trends.
Here’s a snapshot of topics covered on today’s show:
- Tracking the ‘triple-demic’ this holiday
- The major downtick in vaccine boosters for Covid-19
- A major uptick in another vaccine-preventable disease
- A scary new statistic concerning a mental health crisis
- The risk of viral spread in nursing homes
- New poll suggests most Americans know someone with long-Covid
- A (very small) rebound in life expectancy after the pandemic
- America’s ongoing struggles to rein in healthcare costs
- The latest news with weight-loss drugs
- A new technology to empower patients like never before
- A big breakthrough in the battle against sickle-cell disease
- The biggest health story affecting kids and parents today
- Training more primary care doctors
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #79: Why do viruses love the holidays? appeared first on Fixing Healthcare.
The 21st century has granted humanity incredible access to medications and procedures that can extend life almost indefinitely. Ventilators can breathe for us, intravenous tubes and pumps can nourish us, and hemodialysis machines can filter waste and excess water from our blood, all but replacing healthy kidneys.
The fact that medicine can extend human lives almost indefinitely is considered by many to be a great scientific achievement. Still, many doctors feel beset by the gifts they’ve been given. In the ever-distressing, noise-polluted, sick-care environment of today’s hospital, it’s not clear whether patients nearing the end of their lives are being treated or tortured. So, how should our nation define “life?”
Welcome to season nine of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr. Things are about to get emotional and philosophical. In this and future episodes, guests will tackle the difficult topic of death. Although it is a complex and uncomfortable subject, listeners will have the opportunity to learn from world experts regarding the ethical, legal and medical decisions that surround end-of-life care.
This season’s first guest is Dorothee Caminiti, the director of the bioethics program at the Makkula Center for Applied Ethics at Santa Clara University. She works at the intersection of digital ethics in healthcare and law, and focuses on the ethical problems associated with personalized medicine and the processing of health-related data. She received her master’s degree in bioethics from Harvard University.
In this episode, Caminiti discusses:
- Whether doctors should “save a life at any cost”
- How the Terri Schiavo case influenced our nation’s views on end of life
- What are the rights of patients in terms of the “right to die”
- The purpose of advanced directives in medicine
- How ethics committees define “life” in medical disputes
- Weighing the input of doctors, patients and families
- The ethics of medical aid in dying laws
- Lessons from around the world about end-of-life care
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #115: The bioethical dilemma of saving life ‘at any cost’ appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being. Today’s show leads with an up-close look at a subject near and dear to Dr. Fisher’s heart, literally.
“Empathy resides in the emotional heart, and it also has impacts on the physical heart and the physiologic heart, as well,” says Dr. Fisher adding that, “empathy helps steady the heart, lower heart rate, lower stress and, in the exam room, can even lower blood pressure.”
As part of the conversation, Fixing Healthcare cohost Dr. Robert Pearl introduced a study published in the Journal of the American Medical Association over the summer that got many in medical profession talking. Here’s how Dr. Pearl described it in a recent Forbes article:
“Researchers compared doctor and AI responses to nearly 200 medical questions submitted by patients via social media. The answers were read by a team of healthcare professionals who didn’t know whether the author was a doctor or a bot. The team concluded that 80% of the AI-generated responses as more nuanced, accurate and detailed than those shared by physicians. But most surprising was ChatGPT’s bedside manner. While less than 5% of doctor responses were judged to be ‘empathetic’ or ‘very empathetic,’ that figure shot up to 45% for answers provided by AI.”
Today’s show explores the importance of empathy and how healthcare professionals—many of whom suffer an erosion of empathy due to high stress and burnout—can better express their emotions with others, including their colleagues and patients.
To discover more, press play and check out these helpful links:
Presale: ‘Just One Heart’ (Jonathan Fisher’s new book)
Doctors Vs. ChatGPT: Which Is More Empathetic? (Forbes)
Do you have the emotional intelligence it takes to be a great hospital leader? (Becker’s Hospital Review)
How AI, Empathy, & Capitation Can Transform Healthcare (Speaking Of Podcast)
Breaking The Rules Of Healthcare (LinkedIn)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #114: An unfiltered look at empathy in medicine appeared first on Fixing Healthcare.
Listeners of Fixing Healthcare keep writing in and reaching out with questions about two hot-button healthcare topics: the high price of healthcare and the impact generative AI (like ChatGPT) will have on the future of medicine.
This episode of Diving Deep begins with a look at “skimping,” which refers to the many ways in which healthcare prices are constrained, but at the expense of American patients. It’s equivalent to consumers purchasing a box of cereal at the regular price only to find 25% fewer flakes inside. Of course, the difference is that skimping on medical care as a means to flatten healthcare inflation proves destructive to our nation’s health.
Cohosts Dr. Robert Pearl and Jeremy Corr then focus on the future of generative artificial intelligence (GenAI). Tools like OpenAI’s ChatGPT, Google’s Bard and Microsoft’s Bing are poised to give people significantly more power and control—not just over their personal lives and professional tasks, but over their own medical health, as well. What will this mean for the doctor-patient relationship going forward?
Pearl explains that, if used correctly, GenAI “offers the opportunity to make the doctor-patient relationship more collaborative and create empowered patients who will improve their health.”
Learn more about these two topics in today’s episode of Fixing Healthcare. Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- How America Skimps On Healthcare (Forbes)
- How Generative AI Will Upend The Doctor-Patient Relationship (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #113: Diving deep into Dr. ChatGPT and healthcare ‘skimping’ appeared first on Fixing Healthcare.
Season eight of the Fixing Healthcare podcast continues its focus on the role of leadership in driving change. Our guest today is an expert in this area.
Jenny Chatman is Acting Dean at the Haas School of Business and the Paul Cortese Professor of Management at UC Berkeley. She’s a world-renowned researcher, teacher and consultant on leveraging organizational culture to boost team performance. Chatman is also editor-in-chief for the journal “Research in Organizational Behavior” (2019-2022) and co-director of the Berkeley Haas Center for Workplace Culture and Innovation.
In this interview, Chatman shares lessons in leadership and cultural change with Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr.
Throughout today’s episode, she discusses:
- Organizational culture: what it is and isn’t
- How doctors learn “the unwritten rules” of medical culture
- How norms form and what control leaders have over them
- Why handwashing isn’t as normal in medicine as you might think
- Auditing and assessing norms as part of the culture-change process
- The power of subcultures within a healthcare organization
- How new leaders should approach cultural change in medicine
- What to do if you find yourself in a toxic culture
- Creating collectivist (vs. individualistic) goals in healthcare
- More powerful: a common purpose or a common enemy?
- Why gratitude goes a long way
- How generative AI (like ChatGPT) will change medical culture
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #112: How the culture of medicine can change appeared first on Fixing Healthcare.
This year, the cost of health insurance for a working family of four exceeded $24,000 for the first time ever. That’s up 7% from last year (the largest rate increase since 2011). But increased spending has not equated to happier patients. New research has uncovered an “unprecedented decline” in patient satisfaction throughout United States.
In today’s episode of Medicine: The Truth, podcast cohost Dr. Robert Pearl discusses the rise of medical costs alongside the rise in patient displeasure.
But the bad news doesn’t stop there. New data suggest that infant morality and maternal mortality are on the rise in America. At the same time, doctors, nurses and medical staff are exiting the profession by the hundreds of thousands.
However, listeners looking for good news will find some in today’s show, too. Here’s a snapshot of the topics covered:
- AI is making massive inroads in predicting next Covid-19 strains
- Paxlovid prices are going up: why and by how much?
- The link between Long Covid and inflammation
- Average family health premiums topped $24,000
- Why are patients less satisfied with hospital care?
- Telemedicine usage continues to dip following pandemic highs
- The results of 49 pilot programs since 2011 to reduce medical costs
- Study: daily exercise vs. anti-depressive medications
- How social determinants of health affect pre-teens
- The U.S. infant mortality rate is getting worse: Why?
- Hundreds of thousands exited healthcare profession in 2020-21
- Efficacy updates on the Covid-19, flu vaccines
- How rural areas are affected by hospital closures
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #78: How high will premiums rise? How low will patient satisfaction go? appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being.
Today’s show leads with an in-depth look at bias. In particular, the kind of cognitive biases studied by Nobel Prize researchers Daniel Kahneman and Richard Thaler, who identified the many reasons why the human brain makes illogical and irrational choices. The two then talk about how doctors view technologies like ChatGPT through the lens of their own preconceived notions about the world around them.
Later in the episode, Dr. Robert Pearl introduces some surprising data on physician burnout. In August, an independent research group, the Commonwealth Fund, published a global report on satisfaction among primary care physicians.
According to the data, a paltry 47% of America’s primary care doctors are satisfied with their medical practices overall. Most surprisingly, however, is that the UK, Germany, Australia, New Zealand and Canada all claim less-satisfied doctors, despite working in countries that consistently and considerably outperform the United States in clinical outcomes.
With all the talk around America’s dysfunctional healthcare system as the main driver of physician burnout, how is it that the U.S. sits squarely in the middle of 10 other developed countries in rankings of professional satisfaction (especially when doctors elsewhere work in government-funded healthcare systems and don’t have to deal with things like prior authorization and computer systems designed around fee-for-service payments)?
Today’s show provides some answers and offers new ways the burnout crisis can be remedied.
To discover more, press play and check out these helpful links:
Presale: ‘Just One Heart’ (Jonathan Fisher’s ucpoming book)
Overworked and Undervalued: Unmasking Primary Care Physicians’ Dissatisfaction in 10 High-Income Countries (The Commonwealth Fund)
The Healthcare Burnout Symposium featuring Dr. Fisher (Event: November 2-3, 2023)
Who has the power to end clinician burnout? (RobertPearlMD.com)
Breaking The Rules Of Healthcare (LinkedIn)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #111: Among wealthy nations, U.S. docs rank average for burnout appeared first on Fixing Healthcare.
Like magicians, the U.S. biopharmaceutical industry has used diversion to distract the public’s attention away from where the real action is really happening. This Fixing Healthcare episode of Diving Deep begins with a look at three illusions drug companies have crafted to maintain massive profitability and keep Americans from seeing important truths about pharma pricing, innovation and regulation.
Cohosts Dr. Robert Pearl and Jeremy Corr then focus on the future of generative artificial intelligence (GenAI). Despite 20-plus years of hype, AI’s impact on medical practice has been negligible thus far. But Pearl believes the next generation of AI is unlike any technology that has come before. The launch of ChatGPT in late 2022 marked the dawn of a new era in medicine. Pearl says that, in time, generative AI tools will “radically change healthcare, empower patients and redefine the doctor-patient relationship.”
Learn more about these two topics in today’s episode of Fixing Healthcare. Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- The AI-Empowered Patient Is Coming: Are Doctors Ready? (Forbes)
- Dark Magic: Drug Companies And The Art Of Deception (Forbes)
- Monthly Musings on American Healthcare (Robert Pearl’s newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #110: Diving deep into drug-pricing wizardry and deep learning (AI) appeared first on Fixing Healthcare.
Dan Ariely is an expert in irrational behavior. He has extensively researched it, mulled it over and, more often than not, produced brilliant insights into what it means to be a human. His studies and observations have resulted in three New York Times bestsellers on human psychology.
During the Coronavirus pandemic, he was attacked for his efforts to save lives through vaccination and mandatory masking. His newest book, “Misbelief: What Makes Rational People Believe Irrational Things,” recalls his travails during Covid-19 era and the blowback he received as the “chief consciousness engineer” of the “covid-19 fraud” (in the words of his skeptics).
In this interview, Ariely discusses the highlights of his decades-long research into psychology and behavioral economics and their applications toward U.S. medicine with Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr.
In this episode, Ariely discusses:
- Irrationality and “anchoring,” the use of prior decisions to make future ones
- The pitfalls confronting the consumers and producers of healthcare
- Why, in health, we need to celebrate the idea of “nothing bad happens”
- His work helping the Israeli government with its Covid-19 strategy
- How stress leads to a misbelief in doctors, the government, etc.
- Whether misbelief can be a positive for patients
- Much, much more
Ariely is an is a leading behavioral economist, author, entrepreneur and the James B. Duke Professor of Psychology and Behavioral Economics at Duke University.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #109: Dan Ariely on irrationality and misbelief in medicine appeared first on Fixing Healthcare.
Last year, around this time, the CDC alerted physicians about the triple threat of Covid-19, seasonal influenza and RSV (respiratory syncytial virus). The result was one of the worst flu seasons in more than a decade.
In today’s episode of Medicine: The Truth, podcast cohost Dr. Robert Pearl discusses the return of the “triple-demic” this winter and what listeners should do about it.
According to forecasts, researchers expect a total of 1.15 million hospitalizations from these three viruses. How do those numbers stack up against last year? And will the newest vaccines prove more or less efficacious?
Also featured on today’s program:
- Data on the new vaccine and its efficacy against the newer variants
- The surprising reason Americans won’t get the new shot
- Why the CDC is recommending this antibiotic after unprotected sex
- The reason healthcare costs will rise 6.5% in 2024
- How health benefits affect entrepreneurship, employee wages and prices
- An unexpected development in government negotiations of drug prices
- The return of the free Covid-19 testing kit program
- Results of a genetically engineered pig heart transplant
- Why innovative medical researchers struggle to get due recognition
- KP’s massive labor strike and the reasons behind it
- A new entrant among the retail giants trying to disrupt healthcare
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #77: Is the ‘tripledemic’ returning? Will new vaccines help? appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being.
On today’s show, Dr. Fisher serves up a question for Dr. Robert Pearl.
He recalls the classic Harrison’s Principles of Internal Medicine, a medical school textbook that now comprises more than 3,000 pages of vital information. And yet, despite the book’s exhaustive and comprehensive nature, Dr. Fisher remembers one thing that was notably absent from its pages:
“Something was missing in that book that has come back to bite me on more than one occasion in my clinic, relating to patient care and also working with my colleagues. It has to do with the role of trust in healthcare.”
Fisher recalls, in his early years of practice, assuming that patients would come to his office, heed his medical wisdom, dutifully follow his recommendations and return later for a follow-up visit having benefited greatly. But he quickly learned that this paternalistic approach to medical treatment had fallen out of favor some time ago. Now that today’s patients aren’t so quick to defer to the physician’s expertise, what is the state of trust in healthcare and how can physicians earn more of it from increasingly skeptical patients?
Today’s show explores the role of trust and distrust in medicine. The doctors, alongside cohost Jeremy Corr, dive into the relationship between patients and doctors, physicians and their colleagues and clinicians and those in leadership roles.
To discover more, press play and check out these helpful links:
Presale: ‘Just One Heart’ (Jonathan Fisher’s new book)
Healing Healthcare: Repairing The Last 5 Years Of Damage (LinkedIn)
To End Burnout, Doctors Must Change the Culture of Medicine (Medscape)
Transforming Leadership & Well-Being From The Heart (About My Brain)
Breaking The Rules Of Healthcare (LinkedIn)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #108: An unfiltered look at distrust between patients and doctors appeared first on Fixing Healthcare.
It’s no secret that doctors hold themselves to incredibly high standards, driven by a dedication to patients and a desire to save lives. It’s also understood that, in medicine, self-imposed high standards are fully reinforced by colleagues, administrators and an endless chain of performance metrics.
However, less commonly understood (and almost never discussed) is how the pursuit of 24/7 perfection creates an environment where people are afraid to admit their wrongdoings, failures and limitations. The fear of making mistakes or acknowledging uncertainties frequently deters healthcare professionals from voicing concerns or proposing innovative solutions.
This kind of psychological safety vacuum has adverse consequences, says Amy C. Edmonson, the Novartis Professor of Leadership and Management at the Harvard Business School and a nationally recognized expert in leadership. She is the author of the new book “Right Kind of Wrong: The Science of Failing Well.”
In this episode of Fixing Healthcare, Edmondson discusses:
- The two situations in medicine where it’s both okay and desirable to fail.
- How inclusive leaders can make medicine a journey of continuous learning.
- The need to create environments of psychological safety.
- The failure of the medical education system to create a ‘teaming’ mindset.
- The benefits of hierarchy in medicine and the conditions necessary for it to succeed.
- Much, much more.
Tune in for the full interview and join the conversation on social media.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #107: Amy C. Edmonson on ‘failing well’ in medicine appeared first on Fixing Healthcare.
He’s back! Dr. Zubin Damania (aka ZDoggMD), one of the show’s most popular returning guests, rejoins Fixing Healthcare hosts Dr. Robert Pearl and Jeremy Corr for a heartfelt look at the ugly, imperfect and oh-so human side of medicine.
In this episode, the trio discusses:
- The roots of our anxiety as patients and as clinicians
- Why so many Americans put off preventive screenings and treatment for chronic diseases
- The fear that haunts so many doctors and nurses: making a mistake
- Taking shame out of unconscious bias so that we can honestly discuss solutions for inequitable care
- And, as an extension of all these difficult emotions, the men share their thoughts on the hit movie of the summer, Barbie
Dr. Z is a UCSF- and Stanford-trained internist and founder of Turntable Health, an innovative primary care clinic and model for Health 3.0. His persona, ZDoggMD, amassed an army of followers—owing to his clever healthcare parody videos and cutting take on modern medicine.
Hit the play button to start the episode or check out more background about our guest via the links below.
Helpful links:
- The Incident Report: ZDoggMD’s Live Show
- ZDoggMD’s website: Health 3.0
- ZDoggMD diagnoses the culture of medicine (on Fixing Healthcare)
- ZDoggMD has a plan to fix American healthcare (on Fixing Healthcare)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #106: ZDoggMD on patient anxiety, medical bias & the Barbie movie appeared first on Fixing Healthcare.
Albert Einstein pointed out that time is relative. And when it comes to healthcare, five years can feel like a long and short amount of time. That’s certainly true of ...
The post FHC #105: Diving deep into the good, bad and ugly of U.S. healthcare appeared first on Fixing Healthcare.
The weight-loss drug Wegovy reduces serious heart disease, the nation’s No. 1 cause of death, according to a new clinical trial.
Proponents of the drug describe this finding as an added bonus to the drug’s prescribed purpose: shedding excess pounds.
In a nation where 60% of the population is obese or overweight and where 600,000+ die from cardiovascular events each year, the question is how can we afford not to prescribe more of these lifesaving medications?
The answer is complicated, says podcast cohost Dr. Robert Pearl, who explains that the cost of drugs in the U.S. remains disproportionately higher than in all other nations. The price of Ozempic (another drug known to assist with weight-loss) costs five times more in the United States than in Japan and 10 times more than in most European nations.
When it comes to paying for drugs that could make a huge difference in our nation’s health, who’s on the hook? That question and many others are answered on this episode of “Medicine: The Truth.”
Also featured on today’s program:
- The newest coronavirus variant: the most-transmissible yet?
- A newly approved medication for post-partum depression
- Why middleclass families have the nation’s highest medical debt
- Measuring the medical performance of AI vs. doctors
- Striking the right balance when regulating drugmakers
- The folly of BMI (body mass index) calculations
- Right arm or left: Does it matter when getting Covid vaccinations?
- Using pig kidneys for humans in need of a transplant
- The new leading cause of death for America’s kids
- The cost imbalance of weight-loss drugs in U.S. vs. elsewhere
- Reflecting on Robert Burgelman’s appearance on FHC
- The unending debate over physician autonomy
- Biden places 10 drugs on discount list for Medicare negotiations
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #76: Can Rx weight-loss drugs help prevent heart attacks, too? appeared first on Fixing Healthcare.
Dr. Robert Burgelman is the Edmund W. Littlefield Professor of Management and the Director of the Executive Program at the Stanford Graduate School of Business. As a worldwide expert on ...
The post FHC #104: Robert Burgelman on strategic leadership in healthcare appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being, for a fascinating debate about American healthcare. Alongside cohost Jeremy ...
The post FHC #103: Too much or not enough in American healthcare? appeared first on Fixing Healthcare.
Time and again, researchers have confirmed that the American healthcare system is ineffective, too expensive and falling further behind its international peers in critical measures of performance. In this episode ...
The post FHC #102: Diving deep into value-based care and the need for ‘system-ness’ appeared first on Fixing Healthcare.
Dr. Sachin Jain joins the podcast for the first time to talk about leadership in American healthcare. And his diagnosis is grim. “In American healthcare, we’ve lost our ethical and ...
The post FHC #101: Sachin Jain on the leadership crisis in American healthcare appeared first on Fixing Healthcare.
More Americans over the age of 65 are now selecting Medicare Advantage over traditional Medicare for their health insurance coverage, according to the U.S. Congressional Budget Office (CBO). What’s more, ...
The post MTT #75: Original Medicare or Medicare Advantage? appeared first on Fixing Healthcare.
Welcome to the 100th episode of Fixing Healthcare. To kick things off, hosts Dr. Robert Pearl and Jeremy Corr are taking the opportunity to examine what has improved (and, notably, hasn’t ...
The post FHC #100: Diving deep into weight-loss drugs + toxic leadership appeared first on Fixing Healthcare.
This “Unfiltered” episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being. Alongside cohost Jeremy Corr, Dr. Robert Pearl kicks off the ...
The post FHC #99: Why is healthcare so expensive and who will fix it? appeared first on Fixing Healthcare.
Returning to the Fixing Healthcare podcast for a third time is Dr. Don Berwick, here to talk about the dire need for leadership to address our nation’s many healthcare crises. ...
The post FHC #98: Don Berwick on leadership, greed + a promising youth movement appeared first on Fixing Healthcare.
As Americans everywhere gather around their BBQ grills and gaze up at fireworks, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl revisit an important episode from the show’s current ...
The post FHC #97: Fixing Healthcare flashback with Malcolm Gladwell appeared first on Fixing Healthcare.
The FDA moved forward this month with a recommendation to change the composition of Covid-19 boosters in time for fall. Whereas the current vaxx, a cocktail designed to target the ...
The post MTT #74: A change in the Covid-19 booster? A new Alzheimer’s drug? appeared first on Fixing Healthcare.
U.S. healthcare is in financial crisis. Patients are feeling the pain, acutely. Nearly 90 million Americans are enrolled in Medicaid at a time when medical bills have become the leading ...
The post FHC #96: Diving deep into the financial crisis of U.S. healthcare appeared first on Fixing Healthcare.
This Unfiltered episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being. He joins cohosts Jeremy Corr and Dr. Robert Pearl to ...
The post FHC #95: This cardiologist took care of 20,000 hearts before taking care of his own appeared first on Fixing Healthcare.
Abraham Verghese is an American physician and Professor of the Theory and Practice of Medicine and Vice Chair of Education at Stanford University Medical School. He is also the author ...
The post FHC #94: Abraham Verghese on ‘The Covenant of Water’ and the practice of medicine appeared first on Fixing Healthcare.
Dr. Zeev Neuwirth, Clinical Chief of Care Transformation for Atrium Health, returns to the Fixing Healthcare podcast for a tell-all talk about leadership in healthcare: the good, the bad and ...
The post FHC #93: Zeev Neuwirth on the future of healthcare appeared first on Fixing Healthcare.
Today’s episode of “Medicine: The Truth” (formerly “Coronavirus: The Truth”) looks at the end of the Covid-19 pandemic on the same day that the Twitter hashtag #CovidIsNotOver is trending.
This month, both the U.S. government and the World Health Organization made decisive statements on the transition out of a global crisis.
“It is time for countries to transition from emergency mode to managing Covid-19 alongside other infectious diseases,” said WHO Director-General Tedros Adhanom Ghebreyesus. In support of that statement, Covid-19 deaths continue to fall and may soon dip below 1,000 weekly mortalities, which would put the virus’ annual mortality in the same range as seasonal flu and traffic accidents.
Still, more than 1.1 million Americans have died from the virus while many more live with comprised immune systems and, therefore, remain at heightened risk from infection. These troubling figures leave us with difficult questions.
How many Covid-19 deaths could have been avoided? Why did Black and Hispanic individuals die from Covid-19 more frequently than white and Asian people? Are we any safer or better prepared for the next pandemic?
Hosts Dr. Robert Pearl and Jeremy Corr discuss these questions and several other pressing healthcare topics, including: a major change in the recommended age for mammogram screenings, the DEA’s plan to reduce deaths from opioid addiction and overdose, and new about FDA advisors backing over-the-counter birth control pills.
Tune in for the full conversation around Covid-19 and a host of healthcare topics. As always, Dr. Pearl and Jeremy eagerly follow the facts, uncover the truth, and help listeners understand how the world’s biggest healthcare stories affect us all. Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #73: #CovidIsNotOver or is it? appeared first on Fixing Healthcare.
Since ChatGPT burst onto the tech scene in November 2022, the generative AI application has become one of the hottest topics in the world—and in the world of medicine, especially.
Fixing Healthcare cohost Dr. Robert Pearl is a recognized med-tech leader whose insights and perspectives on generative AI have appeared in USA Today, MSN, Wired, Global News, MedPage Today, Modern Healthcare, Becker’s Hospital Review and on SiriusXM.
In this episode of ‘Diving Deep,’ Pearl tackles your questions about ChatGPT and its potential uses in medical care. He responds to dozens of listeners who have asked about the safety, security and potential risks of ChatGPT and other generative AI in healthcare.
Among the questions answered on today’s show: Will generative AI be HIPAA compliant and secure? Will it help with home health? How will it impact the doctor-patient relationship? Click play to learn more or check out the various links below for additional information.
HELPFUL LINKS
- ChatGPT’s Use In Medicine Raises Questions Of Security, Privacy, Bias (Forbes)
- Will Generative AI Wreck Or Rekindle The Doctor-Patient Relationship? (Forbes)
- ChatGPT is poised to upend medical information. For better and worse. (USA Today)
- ChatGPT Can Help Doctors—and Hurt Patients (WIRED)
- How ChatGPT may change the role of physicians (MSN via Global News)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #92: Diving deep into the future of AI in medicine appeared first on Fixing Healthcare.
This Unfiltered episode of Fixing Healthcare welcomes back Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being.
He joins cohosts Jeremy Corr and Dr. Robert Pearl to discuss the lines between human and machine.
ChatGPT is constantly challenging our understanding of what generative AI can accomplish. From acing medical-licensing tests to coding entire websites from simple prompts and even simulating talented musicians like Drake and Weeknd, the question now is: what can’t AI do?
Dr. Pearl posits that the singularity—a once-hypothetical future point at which technological growth becomes uncontrollable—may be nearing. Dr. Fisher points out that humans tend to overestimate their abilities and, therefore, are overlooking the many limitations of the human mind.
These observations dovetail with humanity’s existing anti-tech biases. Take self-driving cars, for example. Pearl notes that humans are often outraged when an autonomous vehicle kills a pedestrian and, yet, rarely is our outrage targeted at the 50,000 human-generated auto deaths that occur each year.
How will this thinking, and our very human biases, apply to medicine—both for patients and doctors?
To discover more, press play and check out these helpful links:
When you realize your favorite new song was performed by … AI (NPR)
AI has better ‘bedside manner’ than some doctors, study finds (The Guardian)
Will generative AI wreck or rekindle the doctor-patient relationship? (LinkedIn)
ChatGPT can help doctors—and hurt patients (Wired)
ChatGPT’s raises questions of medical security, privacy, bias (Forbes)
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #91: An unfiltered look at what AI can (and cannot) do appeared first on Fixing Healthcare.
Malcolm Gladwell—author of “Outliers: The Story Of Success” and “David and Goliath: Underdogs, Misfits, and the Art of Battling Giants”—knows a thing or two about good leaders and bad ones. His insights on leadership blanket his popular books, articles and speeches.
He also knows a thing or two about navigating the American healthcare system. As a relatively new father and the son of a woman in her 90s, Gladwell says, “Observing people at those ends of life, you realize that what you really want from the healthcare system is reassurance as much as anything … You want someone you can call on the phone or email, and who will respond really quickly and tell you it’s going to be okay.”
In this episode of Fixing Healthcare, Gladwell combines his passion for codifying and analyzing effective leadership with his healthcare experiences to prescribe a new path forward.
He joins Robert Pearl, a longtime physician leader and healthcare CEO, and Jeremy Corr, CEO of Executive Podcast Solutions, for a sprawling discussion about blazing new trails in medicine—from hospital C-suites to physician offices to the AI systems that will undoubtedly impact the future of medical care.
Helpful links: Revisionist History (A Malcolm Gladwell podcast) * Malcolm Gladwell on breaking the rules of healthcare (FHC #43) * Outliers (book) * David and Goliath (book) * The ordinary greatness of Roger Bannister (The New Yorker) * Was Jack Welch the greatest CEO of his day—or the worst? (The New Yorker)*
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #90: Malcolm Gladwell on a new kind of healthcare leader appeared first on Fixing Healthcare.
On today’s episode of “Medicine: The Truth” (formerly “Coronavirus: The Truth”), hosts Dr. Robert Pearl and Jeremy Corr tackle more of healthcare’s hottest issues and biggest problems.
Today’s show begins with the “end” of the Covid-19 pandemic. This month, the Biden administration signed a bipartisan congressional resolution to end the Public Health Emergency (PHE) declaration that began in March 2020 under then-president Trump. Pearl points out that the official White House notice brought the pandemic to a rather anticlimactic conclusion. After more than 1,000 days of “emergency,” there were no fireworks, no parades, nothing to celebrate a moment for which our nation waited years.
Pearl and Corr then take a step-back look at our nation’s Covid-19 response, offering perspective by comparing it with other high-level government failures.
“When I think of conflicts that ended poorly for the U.S., like Vietnam or Iraq, the conclusions of those wars were treated similarly to how the end of the Covid-19 emergency declaration was handled,” observed Pearl who then asks his cohost, “Do you think the lack of enthusiasm shown by how the government managed the official conclusion to the pandemic reflected a sense of failure or just an acknowledgement that Americans put the pandemic in the rearview mirror months earlier?”
Tune in for the full conversation around Covid-19 and a host pressing healthcare topics. As always, Dr. Pearl and Jeremy eagerly follow the facts, uncover the truth, and help listeners understand how the world’s biggest healthcare stories affect us all. Click here for more info: https://www.fixinghealthcarepodcast.com/.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #72: The Covid-19 pandemic is over! Did anyone notice? appeared first on Fixing Healthcare.
Healthcare regulations have played an essential role in our nation’s health and safety. The FDA has, historically, protected the public from harmful food and medications. The DEA has prevented and investigated illicit drugs. CMS, the Centers for Medicare and Medicaid, has regulated the healthcare system for seniors and people in need.
Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr discuss the role of regulators in the context of modern-day healthcare. They find that these regulatory bodies are in a position now to do more harm than good thanks to outdated thinking about technology and present-day healthcare delivery.
In this episode of Diving Deep, Pearl and Corr also return to a previous topic: the conglomerate of healthcare monopolies: hospitals, drug companies, insurer. These players wield tremendous power. But none is poised to win healthcare’s long game. The duo concludes today’s show by explaining who will control the “monopoly” board in five to 10 years.
HELPFUL LINKS
- Healthcare Regulators’ Outdated Thinking Will Cost American Lives
- In Healthcare’s Game Of Monopoly, One Player Will Control The Board
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #89: Diving deep into medical regulations and monopolies appeared first on Fixing Healthcare.
The Fixing Healthcare podcast welcomes back Ian Morrison. He is a globalist, futurist and popular returning guest who, in Season 1, taught us that “every healthcare system sucks in its own unique way.”
Now in Season 8, podcast cohosts Jeremy Corr and Dr. Robert Pearl ask Ian to focus on leadership—how doctors, government officials and others can bring about meaningful change in the U.S. healthcare system. He highlights leaders who have driven healthcare improvement and ones who have stood in the way. And he describes what our nation will need to do in order to develop the leaders of tomorrow.
- FHC episode 6: Every healthcare system sucks in its own unique way
- FHC episode 45: Drs. Alexa and Siri? A healthcare futurist weighs in.
- Large Employers Are Suiting Up to Fix Healthcare (Medpage Today)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #88: Good healthcare leaders vs. bad healthcare leaders appeared first on Fixing Healthcare.
This Unfiltered episode of Fixing Healthcare features Dr. Jonathan Fisher, a respected cardiologist and renowned advocate for physician well-being. He joins cohosts Jeremy Corr and Dr. Robert Pearl to discuss a pair of difficult topics in medicine: death and love.
To begin, Dr. Pearl asks Dr. Fisher to elaborate on why physicians find it so difficult to accept death as a natural part of life. Later, Pearl describes a patient who suffered greatly as a result of physicians continuing to provide treatments with no hope for cure or a return to normal. He wonders if patients and physicians alike would benefit from a measurement of the pain and discomfort inflicted on patients in their course of dying.
In the second half of the podcast, the two talk about the post-apocalyptic HBO series The Last Of Us. The doctors both found the show powerful and filled with high drama. But they were moved most by the love that characters demonstrated in the face of fear and desperation. They discuss how the themes apply directly to healthcare today and to the Covid-19 pandemic. Warning: minor spoiler alters.
To find out more, press play and check out these helpful links:
Dealing with grief and shame—with Dr. Jonathan Fisher
Life’s most difficult decision: An excerpt from ‘Uncaring’
The best medicine for patients: The truth
Interview: How the culture of medicine kills doctors and patients
Breaking The Rules Of Healthcare: Following The Science
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #87: An unfiltered look at death, medicine’s No. 1 villain appeared first on Fixing Healthcare.
On today’s episode of “Medicine: The Truth” (formerly “Coronavirus: The Truth”), hosts Dr. Robert Pearl and Jeremy Corr tackle more of healthcare’s hottest issues and biggest problems.
In this show, the hosts discuss the promise (and pitfalls) of generative AI and its future applications in medicine. Are patients ready to get their diagnoses and treatment plans from something (like ChatGPT) rather than someone (their doctor)?
The conversation then shifts to the monopolistic controls of drug makers and price-driving approaches that a longtime healthcare CEO and commentator Dr. Pearl says, “even I could never imagine.” Pearl describes a drug that generates $13 billion in revenue for a company that charges $200,000 per patient per year, 19-times more than it cost in 2007.
As always, Dr. Pearl and Jeremy eagerly follow the facts, uncover the truth, and help listeners understand how the world’s biggest healthcare stories affect us all. Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #71: Why is this drug 19-times more expensive than it was in 2007? appeared first on Fixing Healthcare.
Fixing Healthcare cohost Dr. Robert Pearl has long been a go-to resource on all-things AI in medicine. His recent insights and perspectives on ChatGPT have appeared in USA Today, MedPage Today, Forbes and other outlets.
In this episode of Diving Deep, Jeremy Corr asks Pearl about this new and highly controversial technology. How might it improve hospital care, medical education and patient health – and what are the potential pitfalls? That conversation is immediately followed by a familiar topic, as the hosts dive even deeper in healthcare’s conglomerate of monopolies. This time, they examine private equity-backed doctors and the health insurance industry.
As always, this show probes some of healthcare’s most complex topics and deep-seated problems, delivering thoughtful analysis and solutions. To dive in, press play and peruse the links below.
HELPFUL LINKS
- How Will ChatGPT Affect Medical Care? (USA Today)
- 5 Ways ChatGPT Will Change Healthcare Forever, For Better (Forbes)
- GPT-4 Is Here. How Can Doctors Use Generative AI Now? (MedPage Today)
- Poll: You down with ChatGPT? (RobertPearlMD.com)
- Private Equity And The Monopolization Of Medical Care (Forbes)
- Why Health Insurers Can, But Won’t, Break Up Medical Monopolies (Forbes)
- Breaking The Rules Of Healthcare (LinkedIn Newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #86: Diving deep into GPT-4 (the new ChatGPT) and medicine’s future appeared first on Fixing Healthcare.
In this episode, Dr. Robert Pearl fields questions from Fixing Healthcare co-host Jeremy Corr about Pearl’s experiences as a healthcare leader, educator, author and columnist.
This season’s focus: How better, bolder leadership can fix American healthcare.
Few know better than Pearl how to turn a struggling healthcare enterprise into a category frontrunner. Under his leadership, Pearl turned Kaiser Permanente into a leader in healthcare technology, quality and patient satisfaction—all while reducing prices. His proven track record and bold vision for the future of medicine represent the gold standard for health systems and primary care organizations across the country.
“Leadership is making things happen that otherwise would not,” says Dr. Pearl. “In broadest terms, leaders create a vision that others can see. Then they align people around that vision. And, finally, they motivate them to move forward.”
Learn more about Pearl’s path from surgeon to healthcare executive and hear his lessons on leadership in this must-hear episode.
Helpful links:
Dr. Robert Pearl and Kaiser Permanente: A Lesson in Strategic Leadership (Stanford)
Healthcare leadership: Making medicine a team sport (LinkedIn)
Brain, Heart, Spine: The Anatomy Of Healthcare Leadership (Forbes)
Becoming a Senior Physician Leader and the Power of Capitation (YouTube)
Permanente CEO shares leadership lessons learned throughout his career (Fierce Healthcare)
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #85: Dr. Robert Pearl’s leadership vision for American healthcare appeared first on Fixing Healthcare.
About 15 years ago, Dr. James Chen, a Taiwanese immigrant, was diagnosed with cancer. Throughout his treatment, he experienced the kind of fragmented, low-tech care that too many Americans accept as normal. After his recovery, Chen set out to create a new, better primary care system.
Today, his sons Christopher and Gordon Chen carry forth their father’s mission, providing underserved patients (primarily low-income seniors managing multiple chronic conditions) with a level of concierge-style care typically reserved for the wealthy. Chris, now CEO, and his brother Gordon, Chief Medical Officer, now oversee than 100 medical centers in 15 states.
This is season eight of Fixing Healthcare, which focuses on how leadership can drive transformative improvements in medicine. In this episode, the Chen brothers discuss the future of primary care, the role Medicare Advantage (and capitation) will play, and how their leadership philosophy honors the example set by their father.
HELPFUL LINKS
- Humana, ChenMed ink 5-year (Medicare Advantage) deal (Becker’s)
- Lessons on disrupting primary care (RobertPearlMD.com)
- Managing the most expensive patients (Harvard Business Review)
- The ChenMed channel (YouTube)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #84: ChenMed brothers feel ‘moral imperative’ to give seniors affordable, VIP care appeared first on Fixing Healthcare.
On today’s episode of “Medicine: The Truth” (formerly “Coronavirus: The Truth”), hosts Dr. Robert Pearl and Jeremy Corr tackle healthcare’s hottest issues and biggest problems.
The show begins with a question: Why, according to the Commonwealth Fund, is American healthcare once again in last place, lagging its global peers? For the answer, Dr. Pearl borrows from the world of sports. Whether it’s “blocking and tackling” in football or “the plays you should make” in baseball, American healthcare falls short when it comes to the fundamentals: preventing disease, managing chronic illness, and keeping patients safe and out of the hospital.
In Covid-19 news, Dr. Pearl addresses the latest data out of China. While it has long been assumed the country uncounted its Covid-19 death toll (attributing less than 100,000 fatalities to the virus), analysis of year over year mortality rates indicates the true mortality total is between 1 and 1.5 million. This, despite nearly three years of lockdowns, resulting in major economic difficulties.
As always, Dr. Pearl and Jeremy eagerly follow the facts, uncover the truth, and help listeners understand how the world’s biggest healthcare stories affect us all. Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post MTT #70: Why does U.S. healthcare rank last among wealthy countries (again)? appeared first on Fixing Healthcare.
In any industry, too much market consolidation limits competition, choice and access to goods and services, all of which drives up prices.
But there’s another—often overlooked—consequence. Market leaders that grow too powerful become complacent. And, when that happens, innovation dies. Healthcare is a prime example.
Welcome to Diving Deep. Each month, this show probes some of healthcare’s most complex topics and deep-seated problems, delivering thoughtful analysis and solutions.
Today, hosts Dr. Robert Pearl and Jeremy Corr explore the many ways healthcare has become monopolized, from hospitals and health systems to the drug industry and beyond. Whether you provide medical care or receive it, you’ll learn much from this conversation. To dive in, press play and peruse the helpful links below.
HELPFUL LINKS
- How Drug Companies Monopolize Medicine (Forbes)
- U.S. Healthcare: A Conglomerate Of Monopolies (Forbes)
- Breaking The Rules Of Healthcare (LinkedIn Newsletter)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #83: Diving deep into the many monopolies of U.S. healthcare appeared first on Fixing Healthcare.
Valentine’s Day is here—a time to celebrate the heart. In this episode, Drs. Robert Pearl and Zubin Damania (aka ZDoggMD) discuss a series of studies confirming that interpersonal relationships (with friends, family, etc.) have the biggest impact on life expectancy and overall wellness.
This raises the question: Is there a role for medicine in addressing this most vital component of health?
At Turntable Health, the primary-care venture Dr. Z founded in Las Vegas, the traditional “waiting room” was converted into a community space where patients could hang out, have conversations, participate in mindfulness classes and even form friendships (in a HIPAA-compliant way, he added).
“We are social creatures and we need others,” says ZDoggMD.
In this Unfiltered episode of Fixing Healthcare, cohosts Jeremy Corr and Dr. Pearl, along with ZDoggMD, discuss the “L” word, the importance of relationships in good health and how clinicians can set aside denial (a cultural tenet of medicine) and let emotion safely enter in to medical practice.
To find out more, press play and check out these helpful links:
Social Relationships and Health: A Flashpoint for Health Policy
Loneliness and Social Isolation Linked to Serious Health Conditions
Healthy Relationships Matter More Than We Think
Do Social Ties Affect Our Health?
ZDoggMD’s YouTube playlist on “Consciousness & Mindfulness”
How One Clinic Disrupted Primary Care, Made Patients Healthier & Failed
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #82: An unfiltered look at love and life expectancy appeared first on Fixing Healthcare.
Dr. Eric Topol, now a three-time returning guest on the Fixing Healthcare podcast, discusses 21st-century lessons in leadership.
Topol is the director of the Scripps Research Institute and a professor of molecular medicine. He has published more than 1,200 peer-reviewed articles and serves as the editor-in-chief of Medscape. He has authored three bestselling books including his most recent, “Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again.”
In this episode, Topol talks about the future of medical leadership and the role of AI (including ChatGPT), genomics research and genome editing, medical education and the retail/pharmacy giants in healthcare.
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #81: Eric Topol on the future of AI, medical education and leadership appeared first on Fixing Healthcare.
For three years, all eyes (and ears) were turned toward the Covid-19 pandemic. And since early 2020, Dr. Robert Pearl and Jeremy Corr have hosted the popular podcast “Coronavirus: The Truth.”
That show has cut through the fearmongering and misinformation circulated on social media to bring listeners the truth about the coronavirus—with informed commentary, helpful context and reporting from only the most credible sources. Over the past year, as other medical issues have rivaled this viral pandemic in threat and public interest, the duo have added broader healthcare topics to the show.
Today, “Coronavirus: The Truth” becomes “Medicine: The Truth.” Using the same format, the show will tackle healthcare’s hottest issues and biggest problems—including news and information about Covid-19 when relevant.
As always, Dr. Pearl and Jeremy will follow the facts, uncover the truth, and help listeners understand what’s holding back our nation’s health. Topics will feature the latest medical issues affecting patients and their physicians. The show will explore major public health problems, medical technologies, drug developments, and much more.
Listener note: If you’re currently subscribed to or following Coronavirus: The Truth on Apple, Spotify or any other podcast platform, you don’t have to change a thing. Just sit back and enjoy our new show Medicine: The Truth. If you’re new to the show, you can also hear it by following/subscribing to the Fixing Healthcare podcast.
Click here for more info: https://www.fixinghealthcarepodcast.com/
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post CTT #69: Welcome to our new show ‘Medicine: The Truth’ appeared first on Fixing Healthcare.
Without looking it up, how many Americans do you think are enrolled in Medicaid, the government-funded program that provides health coverage to low-income adults, children and families?
The answer is one of three shocking healthcare statistics you’ll hear about on today’s program.
Welcome back to Diving Deep, the first new episode of the new year. Each month, this show probes some of healthcare’s most complex topics and deep-seated problems.
Today, hosts Dr. Robert Pearl and Jeremy Corr dive into a topic that’s sure to surprise listeners: three shocking healthcare statistics for 2023. But first, the hosts go inside the newly sworn-in Congress to discuss three viable, beneficial healthcare laws that could (actually) pass over the next two years. To end the show, Dr. Pearl weighs in on what leaders can do, starting in 2023, to fix the mess that is American healthcare.
Whether you provide medical care or receive it, you’ll learn much from this conversation. To dive in, press play or peruse the helpful links below.
HELPFUL LINKS
- 3 Beneficial Healthcare Laws The 118th Congress Could (Actually) Pass (Forbes)
- 3 Shocking Healthcare Statistics For 2023 (Forbes)
- Brain, Heart Spine: The Anatomy Of Healthcare Leadership (Forbes)
- Breaking The Rules Of Healthcare (LinkedIn Newsletter)
- Our Real, Existential Medical Crisis? (Keen On Podcast)
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #80: 3 shocking healthcare stats + 3 beneficial healthcare laws appeared first on Fixing Healthcare.
The internet (and nearly every American industry) is abuzz with a new phenomenon called ChatGPT (Generative Pre-trained Transformer), a remarkable artificial intelligence chatbot launched in November 2022 that has an uncanny ability to generate human-like text.
Recent headlines tell of the potential havoc this AI can inflict: “ChatGPT writes medical research abstracts that can fool scientists” and “Use of ChatGPT in counseling sessions is raising ethical questions.”
Dr. Z lauded ChatGPT’s ability to write a convincing Doc Vader script—a scary thought for the nation’s No. 1 healthcare satirist. But what else can AI accomplish? In this Unfiltered episode of Fixing Healthcare, cohosts Jeremy Corr and Dr. Robert Pearl join ZDoggMD to talk about hyper-realistic AI and explore its influence on American healthcare.
Press play for a fresh take on this technology’s potential impact on medicine.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #79: An unfiltered look at ChatGPT and medicine appeared first on Fixing Healthcare.
This episode kicks off season eight of the Fixing Healthcare podcast.
The guest: Dr. David Feinberg, currently chairman of Oracle Healthcare, former CEO of Cerner (acquired by Oracle in 2022), and previous head of both Google Health and Geisinger. This is Dr. Feinberg’s third appearance on the show. He joined hosts Dr. Robert Pearl and Jeremy Corr in season one (episode 3) and season six (episode 41).
The focus of Season 8: How better, bolder leadership can fix American healthcare.
As Dr. Pearl explains at the top of the podcast: “The medical and academic leaders featured on Season 8 of Fixing Healthcare will discuss the difference that strong leadership can make, both for patients and clinicians. I know their insights will be educational and inspirational. Hopefully, 2023 will be the year that our country takes the strides needed to make American healthcare, once again, the best in the world.”
In the episode, Dr. Feinberg and the hosts discuss:
- Getting patients to prioritize healthy choices and lifestyle changes
- Advice for future physician leaders
- What Google knows about maximizing public health
- Why tech has a trust problem among patients and doctors
- The benefits of teams and teamwork
- The government’s role in helping people make healthy choices
- Why good communication improves medical outcomes
- How leaders can rebuild medical care around the patient, not the clinician
- Whether it’s possible to achieve better quality, cost and access in healthcare—all at once?
- What is “human capital management” in medicine?
- Where healthcare leadership can be most effective (be it academic medical centers, community health systems or elsewhere) and the downsides of each
Helpful links:
David Feinberg joins Fixing Healthcare season 1 (episode 3)
David Feinberg joins Fixing Healthcare season 6 (episode 41)
A retrospective on Cerner’s transition to Oracle
The man behind Larry Ellison’s health care gamble
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #78: How leadership can fix healthcare, with Dr. David Feinberg appeared first on Fixing Healthcare.
This week, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl conclude their holiday tribute to episodes past with this 2018 interview of Dr. Don Berwick.
Don is the former president and CEO of the Institute for Healthcare Improvement (IHI) and led the organization’s 100,000 Lives Campaign. He’s the former administrator of the Centers for Medicare & Medicaid Services (CMS) and has served on the faculty for Harvard Medical School and Harvard School of Public Health.
This is the third and final Fixing Healthcare flashback episode—all of which have featured ideas from season one to fix American healthcare from the nation’s top leaders.
The purpose? To quote Dr. Pearl: “My hope in replaying these ideas is to help listeners once again realize how much could be done to transform American healthcare and improve people’s lives. And simultaneously, help them recognize how far we are from delivering the excellence in healthcare Americans want, need and deserve.”
Helpful links:
Season 1 explainer: ‘Welcome to the toughest interview in healthcare’
Episode 5 recap: ‘Don Berwick brings a global perspective to fixing US healthcare’
The full transcript of this episode with Don Berwick
Don Berwick: Profiles in leadership
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #77: Fixing Healthcare flashback with Don Berwick appeared first on Fixing Healthcare.
This holiday season, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl are mixing things up with a look back in time—way back, in fact, to the season-one finale with healthcare futurist Ian Morrison.
During this 2019 interview, Morrison earned the distinction of becoming the first (and still the only) guest to propose “Medicare Advantage for All” as a solution for fixing healthcare.
He explained: “Medicare Advantage for All reconciles different (American) values with regard to competition and the role of government, but mandates that everybody is in the system and covered.”
So, is “Medicare Advantage for All” a possible fix for the future of American healthcare? Did any of Morrison’s other healthcare predictions prove true? Tune in to find out.
Helpful links:
Season 1 explainer: ‘Welcome to the toughest interview in healthcare’
Episode 1 recap: ‘Ian Morrison says every healthcare system sucks in its own unique way’
The full transcript of this episode with Ian Morrison
Ian Morrison’s website
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #76: Fixing Healthcare flashback with Ian Morrison appeared first on Fixing Healthcare.
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss the long list of viral enemies attacking Americans this winter. Chief among them: Covid-19, RSV and seasonal influenza, the latter of which has tallied 8.7 million cases and 78,000 hospitalizations so far (40 times higher than at this point last year).
How seriously should American take these viral threats as we approach the holiday gathering season? You’ll find this topic and all the other [time stamped] questions from today’s show here:
[00:52] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[02:45] Listener question: What’s the data on the new bivalent vaccine vs. the old one?
[07:48] How might researchers best communicate discrepancies in scientific data to patients? What should organizations like the CDC and WHO do?
[08:47] What’s new regarding the ‘tripledemic’ since the last episode?
[11:03] What’s happening with the flu?
[13:28] Why are Chinese citizens protesting “Zero-Covid” restrictions?
[16:28] What caused the near-global breakdown in public policy during Covid-19?
[18:53] Who are the people comprising the 300-350 deaths in the United States each day from Covid-19?
[22:50]: Kids and Covid-19: what’s new?
[25:03] What’s new in healthcare beyond Covid-19?
[26:44] How can patients help prevent the scourge of chronic disease in the United States?
[28:19] What has happened to cancer screening since the start of the pandemic?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #68: The worst flu season in over a decade? appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series “Diving Deep” probes some of healthcare’s most complex topics and deep-seated problems.
On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr discuss two imperatives for healthcare leadership in the 21st century: changing the way docs use technology and changing the way we pay for medical care.
For more information on healthcare leadership, check out Dr. Pearl’s latest columns on Forbes and LinkedIn. For listeners interested in show notes, here’s a discussion guide:
LEADERSHIP + TECHNOLOGY * What does the metaphor of the iron triangle represent in medicine? * Why is U.S. healthcare lacking effective leadership? * What is the “anatomy of healthcare leadership”? * How might a leader begin to change healthcare, locally? * What would leaders most like to change about the care patients receive today? * How do we make the ideal real in healthcare today? * What are some technologies that could transform medical care? * How could technologies change care for patients with chronic disease? * Once clinicians agree with the logic of new tech, how can leaders appeal to them on an emotional level? * How can real patient stories help persuade docs to embrace change? * In addition to the brain and heart, what is the role of the spine for leaders? * How did cohost Dr. Pearl use his spine to push technology forward at Kaiser? * What are the biggest problems a leader might experience when implementing new technological solutions?
LEADERSHIP + MONEY * Do Americans get what they pay for from healthcare today? * What are the biggest cost barriers to reforming healthcare? * What’s the problem with fee-for-service? * What is the alternative to fee for service? * How does “capitation” change the incentives for physicians? * Doesn’t capitation lead to delayed and denied care? * Why aren’t doctors jumping at pay-for-value models? * How do leaders use their brain, heart and spine differently to reform healthcare payments? * Can leaders make a case for capitation on an emotional level? * Why do leaders need a strong spine to advance capitation? * What else is needed to move away from fee-for-service as the method of reimbursement?
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #75: Diving deep into healthcare technology and capitation appeared first on Fixing Healthcare.
As a college freshman, Fixing Healthcare cohost Dr. Robert Pearl decided that rather than becoming a university professor as he had planned, he’d go into a field without politics: medicine. He laughs about how naïve he was as a 17-year-old.
“Healthcare is about life and death,” said Pearl, recalling his decision, “How could there be politics entwined inside that esteemed world?” Of course, Pearl soon learned that politics and medicine are a tangled mess.
In this episode of Unfiltered, Pearl and his cohost Jeremy Corr join ZDoggMD to look at the relationship between medicine and politics and if there’s any opportunity for logic to prevail.
To find out, press play or keep reading.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
UNFILTERED TRANSCRIPTJeremy Corr:
Hello, and welcome to Unfiltered, our newest program in our weekly healthcare podcast series. Joining us each month is Dr. Zubin Damania, known to many as ZDoggMD. For 25 minutes, he and Robbie will engage in unscripted and hard-hitting conversation about art, politics, entertainment, and much more. As nationally recognized physicians and healthcare policy experts, they’ll apply the lessons they extract to medical practice, then I’ll pose a question to the two of them based on what I’ve heard. Robbie, why don’t you kick it off?
Robert Pearl:
Hey, Zubin, how was your Thanksgiving?
Zubin Damania:
It was thankful. I really enjoyed it. My wife was on call, which meant we didn’t have to go through the full production of the meal. We went to a half meal, which was absolutely great. I had 70% less bloat and 100% more gratitude. How about you?
Robert Pearl:
I had a great time. I was over at my sisters and had a bunch of folks there. Did you do anything special to communicate your gratitude to others?
Zubin Damania:
I texted a lot of people that I had been a little out of touch with, and just to convey how important they are in my whole life and journey.
Robert Pearl:
Excellent. That sounds great. So I don’t know if I ever told you that I became a doctor to avoid politics.
Zubin Damania:
I didn’t know that.
Robert Pearl:
Yeah. So I was in college. I was a philosophy major, and my hero, who was a philosophy professor, quite an excellent one, he went on to become the chairman at Reed College, didn’t get tenure because of his political views, and I decided then that I wanted to do something that would have no politics. I mean, healthcare is about life and death. How could there be politics entwined inside that esteemed world? And so that’s truly why at the age of 17 I decided that I’d become a doctor, and I learned stuff later on. Any thoughts on that observation, and what we can do to minimize the politics in medicine?
Zubin Damania:
Well, you had me at philosophy major. I don’t remember you… You must have told me that, but that’s impressive. If I could go back in time and do it again, I would do philosophy instead of music and molecular biology, although that’s kind of philosophy in a way. Yeah, politics and medicine have been to some degree dance partners for a long time, but I think right now it actually just reflects how politicized everything is, and how everything is so kind of divided. Although, I’ll say this, Robbie, I’m sensing something in the air, and I might have said this at our last conversation, but I really think something is shifting. I feel like people are starting to wake up to the fact that we are really divided over nothing substantial in the sense that we’re all trying to find truth and goodness, and we just have a slightly different spin on it, and medicine maybe will wake up, but as usual, we’re about a decade or two behind the rest of the culture.
Robert Pearl:
Actually, I think that you’re correct, and I think we saw that in the most recent midterms that there was a lot more people I’ll say in the middle rather than the 20%, at both extremes, who were yelling the loudest and typing with all capitals and explanation points, but there’s a lot of people in the middle, and they want to know the truth. And I think in many ways, I’m not talking about the specifics of the outcome, but the election process itself, and, of course, we didn’t even have any attempt except in Nevada to just get rid of the entire voting and somehow have a different method of selecting candidates based upon maybe some sorcery or something else that could go into its place.
Zubin Damania:
Yeah.
Robert Pearl:
But one of the things… Sorry, go on.
Zubin Damania:
No, no, no. I was just going to say in Nevada we have a lot of interesting things like legalized prostitution among other things, so we are a special state.
Robert Pearl:
Oh, excellent. That’s right. You were there. Exactly. Legalized gambling, prostitution, so on. Yeah. One of the things that strikes me as I think about the politics is that you would think that the health status would drive the politics, by which I mean if a lot of people didn’t have coverage, then they would be attracted to a party that would be likely to give them the coverage, and we think about people voting their interests. If there was a lot of opioid addiction in a particular geography, you would think that that would be a very high concern, and yet we see almost the opposite. Tell me where you live, and I’ll tell you your view on a problem. Whether for you it’s a particular medical challenge or not doesn’t seem to be the driver as opposed to where you happen to own a home and in many cases grow up. This seems really strange to me.
Zubin Damania:
Yeah, it does, and again, all things seem strange if you look at humans as rational actors that work in their best interests all the time. And unfortunately I think we’re emotional, intuitive creatures that are the product of our conditioning and our moral sort of taste buds. And I think if your moral taste buds are concerned about say liberty versus oppression or government controlling things, even though you’re desperate for care, and you need it, and it would save your life or your family’s life, I think through that moral lens you’ll see any sort of government “intrusion” into healthcare is something that’s adverse, and you’ll fight tooth and nail.
There’s also a tribal component on all sides of this, like you said, where you grow up, and I think where you grow up is to some degree it conditions how you are, but to another degree you’re kind of attracted to those places that are an expression of your own sort of moral matrix. And so I think it’s a variety of those factors, and so people do not necessarily vote, or act, or think in their best interests always, if you look at their best interests from that standpoint. But if you look at their best interests as a morality play, they almost always do it in that way it seems. Yeah, that’s just my sense of this.
Robert Pearl:
I always love talking to you, because I think about things that I hadn’t contemplated before. About a decade ago, I did some research with a neurologist named George, and George and I looked at brain scans, and we looked at what happens when people get put into situations of great threat or great opportunity, and what we found, George York and myself, was that there’s actually a shift in our brain in terms of perception. In the last show you mentioned the amygdala, the source of great fear, and what you see is that the amygdala first gets stimulated, and then as you mentioned actually in the last show, how the occipital lobes change, and we see things differently, and by see it’s not just a vision. It’s all of our senses.
It’s our perception of the world, and maybe some of these pieces are that there are fears or maybe hopes that people have that actually change their perception. And when you move someplace else where there’s different fears, and different hopes, different views of the world because of circumstances, then you change that perception, and maybe that accounts for some of this great shift in how we relate to each other or fail to do so, and maybe some of it is coming together to recognize that we may share in more common fears and more common hopes than we otherwise might realize.
Zubin Damania:
This is a really interesting insight actually, Robbie, because it made me think of something. You were saying sometimes I’ll prompt you. This prompted me, because there is this idea that part of the reason where… There are many reasons why we’re so divided and politicized nowadays, but one of them might be that your local scenario kind of conditions you and vice versa, but the global village that we have with social media is that now there’s a saying, “Good fences make good neighbors.” When not much about someone else they’re actually all right. The more about them sometimes it’s like, “Hmm, I’m not sure about this.”
And when you take disparate ideas from different geographies that are evolved differently to suit that geography, and you place them adjacent to each other, that’s when the all caps starts happening on Twitter, because somebody that you never would’ve really known that well, and you still don’t know them well, but you know them in a social media way, are hitting you with ideas that seem so antithetical to that moral palette that they do generate that fear. It’s that fear of loss of identity, the fear of loss of self, that this is who I am, right? I’m this liberal, or I’m this conservative, or I’m this libertarian, and suddenly you’re met with somebody who’s giving you totally different ideas, and it becomes instantly a kind of like, “Okay, fight or flight. I must defend this,” sort of identity.
And what may be happening is we’re getting so used to social media now that we might be starting to transcend that initial shock and start to see what you’re pointing out, which is, “Hey, actually we’re all in this game.” And actually when you start to point out how divided we are, people start to wake up and go, “Yeah, we are kind of getting played by this, the news cycle, and social media, and this kind of thing.” So it is really interesting.
Robert Pearl:
So let’s try to meld the politics and the health. One of the areas that I’m increasingly concerned about is the LBGTQ population, and how in this environment they’re going to be able to get good healthcare across the nation in all 50 states. Do you have any thoughts about, first of all, the hatred that’s seems to be often directed particularly at trans individuals, and how will they get their healthcare needs met from an optimal medical perspective?
Zubin Damania:
Yeah. And this is one of those things where… Who said this? It was recently the World Cup, and the Iranian media was questioning American soccer players, and they asked a black soccer player. They said, “What’s it like living in a country where you’re discriminated against?” And obviously this was all politicized because of the whole Iran-US thing. And so this journalist was really trying to provoke this guy to say, “Yeah, we live in a super racist country where people are discriminated against because we keep accusing them of discriminated against women, which they do.” And he said, “Yeah, it is interesting, but I’ll say this, in America, one of the things I’ve noticed is we’re constantly trying to get better. There’s always some feeling that there is a kind of progress, and that makes it much easier to live here and deal with it, and I want to be part of the change.”
And I think with trans, with LGBTQ+, and all of that, I think that’s also what we see. These issues were repressed previously. Now the repression is less, and so we’re seeing them come to the fore, and it’s louder in sort of the culture, and so it’s easy to feel that there’s no progress, but I think that even that the conversations are happening is progress, so it’s a lot of it is ignorance. A lot of it is just lack of knowledge, and reactionism, and that kind of thing, and I think it is going to continue to progress. I mean, just look at the bill now that that’s going through the Senate where they’re going to codify protections on gay marriage say. That would’ve been unheard of a decade ago, and so I’m actually optimistic, but you can’t stop working for it, right? You can’t stop being part of the progress.
Robert Pearl:
Again, another interesting thought that I hadn’t had before about how as soon as you stop pushing forward, you slide back, and that it’s not a question of pushing forward always to make progress. It’s pushing forward even to hold the progress that you have, and I can think of a lot of examples where as soon as people stop pushing, what we see is that everything slides back to where it came from even though I can’t find the rationality for why it started there.
Zubin Damania:
Yeah, I think it takes a collective effort, and you’ll always get resistance and even understanding the resistance is a good thing. If you can see through other people’s eyes and go, “Okay, what is it that… What is this? Is this fear of other? Is this just misunderstanding? Is this a kind of projection where there’s something about them that they feel isn’t as mainstream, and they don’t want… They’re projecting this onto others.” You wrote your book Uncaring about medical culture, and I think what I loved about that book is that you just shined a direct light on things like emotional repression, projection, denial, the things that we do in medicine that we’re conditioned to do, that are really fundamentally quite harmful to progress, and I think it’s true in broader society as well. We have an epidemic, a pandemic of emotional repression, and avoidance, and projection as a result.
Robert Pearl:
Well, for any listeners who might not have read the book, let me point out that a part of why I focused on denial is that denial is what makes the medical culture great. How else do you go into the streets during the plague and take care of people knowing that it’s a contagious disease, even though you have no idea what contagion means, because it hasn’t been yet discovered, or how do you go into ERs and take care of patients early in the pandemic when you don’t have protective gear? You have to deny the risk to yourself in order to put the patient first, but I also note that that tendency towards denial can spill over when there are things that we don’t necessarily want to see, and I thought of that this week. I don’t know if you noticed that the Merriam Webster word of the year is gaslighting. Did you know that?
Zubin Damania:
I didn’t know that, but it doesn’t surprise me.
Robert Pearl:
Yeah, and there’s actually a lot of studies that have come out that said that it’s very frequent, and actually it’s very frequent in the LGBTQ+ population that we talked about, when they go for care. It’s actually very frequent when women go for care. I think many of the groups that have felt as though there’s a certain level of discrimination, the truth is that in the doctor’s office it’s there as well. The complaints are not taken as seriously. Problems that otherwise might be investigated are assumed to be simply psychological, and, of course, in medicine we deny that psychological is as important as physical, and you go on, and on, and on. Your thoughts on what we can do about it?
Zubin Damania:
Yeah, I mean, again, this is our culture. You’re right. I mean, and the gaslighting is an interesting thing because I think a lot of it is unconscious, right? People are doing it not intentionally. It’s a kind of pattern of behavior. You try to make people feel like they’re not right in the head because you’re either projecting or denying something about the nature of their care, and I think it doesn’t happen at a conscious level. So until you bring it into the light of awareness, and you actually make it explicit in a way that doesn’t actually threaten the identity structures of the person you’re talking with. That’s the problem is a full frontal assault, and I think this is why in the culture right now, the full frontal assault of progress on people who are more say conservative, it leads to kind of a psychological reactance, and because, again, we’re going to defend our identity structures on all sides of it.
So there’s a way to do that I think that is much more compassionate and actually effective. So we have to focus on those strategies. Those kind of alt middle strategies that I talk about I think are more effective ways to bring progress that also is inclusive of people that feel they’ve also been left behind.
Robert Pearl:
The reason I like the word denial, although I’ll have to tell you that there’s some readers who didn’t like it, but I like the word because of the point you just made. It’s subconscious. We’re not aware of it. We act in ways without being conscious that this is what we’re doing. We don’t see it, and that makes me think about all the problems that if you read the literature, it’s so clear how important they are, social determinants of health, racial disparities. You know, 10% of Americans are still uninsured. It used to be 16% before the ACA, and I don’t hear a whole lot of conversation about that. Last night, I teach in the Stanford Graduate School of Business, and last night our guest speaker was a guy named Dr. Dr. Devi Shetty, who’s been the podcast, and whom I’ve spoken about before, and it was fascinating.
What he said is that he believes that India will be the first nation in which the healthcare you receive will not be dependent upon the amount of money that you have. In his mind, in a nation of 1.4 billion people. And the podcast he did with me a couple of months ago is just so inspirational. It’s great, and this reflected it. He worries about all 1.4 billion people and asks himself, “How do we provide care to the last of that 1.4 billion that’s as good as we provide to the best?” And in our country we tell ourselves we provide the same care to everyone, but when you look at the data, there’s not a shred of truth about that, and I don’t hear it being talked about in a broader context of people.
I think people look at it very much by what do I and my family get? What do the people that I’m most close with in my community get? And that’s about as far as we look, and we don’t see all the implications. It’s mainly about the system of healthcare, but I think it’s really about the values of the nation.
Zubin Damania:
Yeah, I think what you nailed particularly explicitly there is the values of the nation, and America really was kind of founded in this kind of oppositional way where there’s almost an unwritten social contract that listen, listen, listen, listen, we all hate rich people for being rich and having everything, but secretly we want to be that rich person, and one day we want to have those things, and we want that opportunity to do that, to live at the top of the hierarchy. And I think it’s an unconscious kind of contract that has existed in the strata of American psyche for a long time, and that’s why something as egalitarian as a universal coverage, or everyone being treated equally in healthcare is something in the American psyche that reacts to that, and to be honest, I mean, my parents are from India. It is a vastly hierarchical, horrifically hierarchical.
In fact, when I first visited, I was taken aback by the servant class there that was treated almost akin to slaves. I mean, and part of this is the sort of general caste system, but it’s just all accepted there. And coming from America, it was a shock. It was like, “Wait, wait, you can’t treat other humans like this.” So it’s good to see Devi Shetty actually trying to unwind that, because on some level there’s aspects of Indian culture that are so community focused, and we’re all in this together. And so those things coexist, and so it can be a little schizophrenic at times.
Robert Pearl:
Well, I think that’s very true what you said, because I’ve been there too, and the disparities are massive, but the idea of asking, of starting with the question, “How do we provide excellent care to all,” I think is a fascinating path. It’s the one that he’s on, and interestingly enough, much of his answer is technology. And he says that because in a poor country there’s not enough resources. If I have a sack of rice, and I give half of it to you because you’re hungry, I only have a half sack left. If I have a computer program that allows me to get great care, and I give you a copy, I still have my computer program. And so it’s a resource that you can give away. It’s like gratitude. I can give you all the gratitude in the world, and I haven’t depleted myself at all. In fact, I’ve actually augmented my satisfaction, my happiness, my fulfillment.
Zubin Damania:
I think that’s a beautiful way to put it, and it’s very similar to thinking about compassion as opposed to empathy. Empathy is feeling someone’s pain, affective empathy as your own. That does exhaust you, actually, but compassion, which is love and concern in the face of suffering and an unconditional kind of love, that actually fills you with kind of an elevation, and it’s inexhaustible. And so technology, absolutely, so there was ways to scale what we do in medicine that allow the human relationship at the center to kind of still flourish while scaling, and I think you’re absolutely right. You’re absolutely right. And actually, it’s got to be central to our answer, because we have resource limitation across the globe when it comes to high quality healthcare. So how do you scale it in that kind of way? I like that software analogy. It’s actually a very good one. One piece of software can serve infinite numbers of people.
Robert Pearl:
Absolutely. So let me ask you a slightly tangential question, but it still is this split in society that it’s been bothering me ever since I read the Pew Research study on it about two weeks ago, and I’ve wanted to ask you about it. So in this study, only 41% of people, and this was 12,000 individuals they surveyed, thought that scientific experts are better than others at making policy decisions about scientific issues, and that negative view is held by both Democrats and Republicans. We’ve looked at this question of scientific expertise throughout COVID 19, and we’ve certainly come to the conclusion that those with the scientific backgrounds aren’t necessarily the ones that we should be trusting, and I wonder your thoughts. You’ve been right in the middle of this scrum, if you want to think about it in that way, over this issue of the role of the expert as we look at whether you want to talk about COVID or just healthcare policy in general.
Zubin Damania:
Yeah, this is something that really, like you said, I’ve been kind of in the middle of it, and this is the thing. I have always kind of worked hard, early pre-pandemic especially to defend the role of expertise in healthcare, because it is invaluable. When you’re talking about recommending a type of surgery, having an interaction with a patient where it’s an interpretive dance of their hopes, dreams, and fears, and goals, and your knowledge. The your knowledge component is a very important part of the equation, right? Now, I think what’s happened here though is… And the fact that Democrats and Republicans are both saying this makes you think also of China. So here you have say let’s say a scientific technocracy, autocracy ruling class that says, “You know what? We can actually literally prevent deaths by locking people in their homes, and the number of deaths that result from that will be less than the number of deaths that happen from COVID.”
And to some degree so far they’ve proven themselves correct, because they have the lowest per capita, if you believe their numbers, per capita death rate from COVID, but they’ve had to do these draconian things about policy-wise, and just now people are standing up and saying, “You know what? Enough is enough.” And I think what humans here are saying in America, are saying is, “Yeah, it’s…” or they’re not saying this explicitly, but I think this is the motivation is, “Expertise is great and wonderful, but when it comes to policy, we actually want to determine what our values say in the setting of that knowledge. So it may be that we could prevent all this COVID, but we’re actually more interested in going out to eat, seeing our friends without masks, not having our kids be out of school,” these kind of things.
And so that disjunction between values, which are what politics tries to apply, or policy, and scientific expertise I think has manifested now with people saying, “You know what? I don’t trust these guys to make policy.” And so I think that’s what’s happening. Now, I’m curious what you think, but that’s been my feeling. And the problem is they’re throwing the baby out with the bath water, so now they’re like, “Well I don’t trust these guys to tell me I should vaccinate my children against mumps, because the way they managed COVID I felt was incompatible with my values. What are they telling me about mandates for childhood vaccines?” So it’s really causing all this collateral damage to public health now.
Robert Pearl:
No, I really love that, because as you know, I’ve been focusing a lot the past year on these rules of healthcare that I believe many of which need to be broken, and we have maybe the strongest rule, which is to save a life at any cost, and at any cost means any cost. If kids lose a year of school, that’s a cost to save one life, or two lives, or three lives. Now, we could spend a lot of time debating this issue. It’s certainly been debated by Talmudic scholars across history, but I think at some point we have to accept that death is a reality that we can’t overcome, and we probably need to take a broader view of what that means. What’s the impact to people’s lives of missing a year of education? What’s it going to mean for them and their families? How many people are going to die even though we won’t know exactly who they are as a result of that because of their family’s socioeconomic situations? Those conversations never penetrate into medicine.
Zubin Damania:
Oh, you nailed it, man. And again, it gets to get to that root of what you wrote about in Uncaring. It’s our denial, which again can be an adaptive denial. It’s unconscious about that death is something that is inevitable, and that it’s not necessarily the worst enemy, and it has to do with your values. So Dr. Monica Gandhi, an infectious disease specialist at UCSF, who’s been on my show several times, is coming again on Saturday. Early in the pandemic, we started doing a series of shows where we were really trying to talk people off the ledge a little bit and talk about these issues. And she said to me, and she said this on camera eventually, but initially she told me off camera that she had lost her husband, who was roughly her age, late forties, early fifties to cancer right before the pandemic, and he was a cardiologist, worked super hard.
Who knows if it was radiation exposure or what, but he had a head and neck cancer, and he died, and she has two young sons, and she’s raising them alone now, and the pandemic hits, and she’s watching people, the medical system treating death like it is the worst possible thing in the universe relative to actually living your life. And it became a kind of passion for her to say, “Listen, we all look at risk differently. Here’s how you can look at risk here rather than just save a life at any cost.” And that was part of her motivation. And again, she was woken up by this tragedy that hit her and her family, and sometimes it takes something that horrible to pull the rug out of under your denial, and you shouldn’t have to have that, right? We ought to be cognizant of this as a society and as individuals in healthcare, but it’s not been part of our sort of process.
Robert Pearl:
Let me ask you one last question. It’s one question that I got asked. I was keynoting a large event a couple of weeks ago, and at the end you know you have the Q&A, and an individual stood up, wasn’t a physician, and asked me whether with more and more doctors becoming employees, whether we’re seeing, and he used the phrase, “Loss of motivation to drive change,” whether medicine is just similar to everyone else with quiet quitting, and burnout, and a sense that dedication to work isn’t worth the effort and the energy, or whether the traditional purpose and mission of medicine still persists. You have probably the broadest network of millions of people who follow you and communicate with you. What do you think? How would you answer that question?
Zubin Damania:
That’s a great question, and from the standpoint of say an independent physician, you might ask that question. From a standpoint of an employed physician, you might not know anything differently, but this is my take. Hey, remember when we didn’t have a lot of employed physicians? How much change, progress, innovation, and transformation did we get? Zero. It’s the same thing that they’re all conditioned by their incentives, by their training, by inertia, by fear. And the employed physicians have a different set of conditioning in inertia and fear, but I don’t think it’s vastly different than the old way of doing things in terms of generating innovation. I think if you want to find the roots of our failure to innovate or to feel invested in the change, I think it goes right to medical school, which you’ve talked about.
I mean, we’re basically trained to, we’re conditioned to memorize facts, half of which are eventually shown to be untrue, but they don’t tell you which half, because they don’t know, and then you’re conditioned to obey authority in the second two years, and you’re afraid you’re going to hurt someone, and you don’t want to rock the boat. And so it doesn’t matter. You come out with that conditioning. You’re really trained that way. So employed or not employed, at least if you’re an employed physician, you have this network of support, and you have an organization theoretically that could support you, or it could be seen to be trying to harm you or control you, but a lot of it is our own perspective until we kind of wake up to what we’re repressing, denying, projecting, and so on in our own conditioning, our system is going to be very unlikely to change, because our organizations are epiphenomenon of who we are.
Robert Pearl:
My answer was that, no, what I see is physicians are just as motivated to want to make medicine better, just as motivated to want to do the best for patients. They’re frustrated by the system. They’re frustrated by the inability to make change happen, and sometimes when you’re frustrated you lose the energy needed to try to drive change, but I still believe, and maybe I’m being too optimistic, which is why I asked you, or maybe just too idealistic, that the people who go into medicine are motivated by the right reasons, and that given the opportunity, they would push hard on the block, the cart, whatever you want to be saying it to be, to move it forward, and to make it accelerate at an ever faster rate.
Zubin Damania:
Oh, I think you’re absolutely right given the opportunity, and when they see these little cracks. We all think about our best day in medicine, and it’s always this kind of connectedness. It’s always this kind of autonomy, tools, teams, trust, and the patient. And it just kind of is a flow state, and I think if you give people more opportunities to actualize those flow states, show them bright spots where these things are working, and kind of just point directionally, because we all kind of know where we kind of generally want to be. We just don’t necessarily know how to get there. I think things will start. It’s inevitable. The change is already happening. It’s like what we said earlier in the thing. I sense the shift in the air.
I think the same thing is happening in medicine. There’s huge intractable seeming problems, but it’s always that way before the caterpillar spins the chrysalis and the transformation happens that you could never have predicted. So I think I’m with you on the optimism. I may be less of an idealist in this sense that it’s going to be a lot more brutal I think, and people will feel a certain way about it that’s very negative, but I think it’s inevitably going to go in a good place if we keep on the direction.
Robert Pearl:
I love it, because I’m more of an idealist. I think people have all the right motivation. I’m a little bit less of an optimist, because I think the hurdles are so tall that it’s going to take a massive amount of energy to make change happen, but with that, let’s turn it over to Jeremy for his question to us, and I can’t wait to have the next opportunity to be able to learn from your experience, and to have new views into the world.
Zubin Damania:
Likewise.
Jeremy Corr:
When it comes to politics, many voters on both sides of the aisle seem to think that the elected officials on their side are fighting for them when it comes to healthcare, while believing the other side is making healthcare worse for both them in society, whether it’s the issue of abortion, Medicare, drug pricing, transgender issues, et cetera, and I would say that the hot issue on everyone’s mind right now is freedom of speech versus censoring what some people consider disinformation or hateful speech on social media. What I really want to ask though is for a reality check from both of you. When there is so much money in politics via campaign financing, lobbying, et cetera, coming into both Republicans and Democrats from big pharma, health insurance companies, health tech companies, et cetera, is either side really fighting for the best interests of lower and middle class voters when it comes to healthcare issues, or are they just focusing on keeping these big and influential healthcare companies happy?
Zubin Damania:
Oh, I’d love to defer to Robbie first on this one, because I’m dying of curiosity to hear your take.
Robert Pearl:
I think, Jeremy, you’re raising two separate issues. I think the first issue is relative to the healthcare system, and a professor that I teach with, Robert Burgelman at Stanford, talks about medicine as being a super unmoving industry. Nothing changes over time, and he doesn’t understand why that is the case, and I think you’ve described the reason, which is there’s so many people in it, around it, impacted by it, making money from it for whom change is not what they want, and they have the power, and they have the money to be able to make stability be the example that sits within it. In contrast, I think that within the healthcare itself, that the politics, that the money is not the force that’s restraining change. I think that it’s within the people itself, it’s the difficulty of making that change happen, and I think it’s the amount of time that it takes, and I just think that it’s too much.
And that’s why I’m a big believer that the change will come not through the political process, because I think that will be blocked by the money forces that exist, but it’s going to come actually through the economics, and that’s why I’m a big believer that it’s going to be the retail forces that will drive it, the Amazons of the world and the CVSs of the world, the Walmarts of the world that are going to make the change happen. I think they’re going to drive it not necessarily out of some commitment to improving the health of people. They’re going to drive it out of a profit motive, but I think that it will create a more positive change for the country, at least that’s my optimism, and that I think that once physicians get behind it, and nurses get behind it, and patients get behind it, and they can see an improvement to happen, that there will be what Zubin has talked about, this very major shift suddenly, and what seemed impossible and then seemed possible now will seem inevitable.
Zubin Damania:
Yeah, and I think Upton Sinclair, I think it was, who said, “It’s impossible to make a man believe something if his salary depends on him not believing it.” And I think in medicine for many people, our salaries depend on us not believing, not changing to some degree, and that includes big legacy players like pharma, and insurance companies, and those kind of things, and politics just feeds right into that, and money is all the currency, the lifeblood of that. But once, like Robbie says, once the realities of the economics start to click in, and you do have these sort of disruptive agents like Amazon kind of pushing things like our old Turntable/Iora Health Model that’s now part of Amazon, when those are normalized, and consumers, the patients are able to vote with their feet a little bit, you’ll start to see change, and it will pull in especially the younger generation of healthcare professionals, who have been kind of hungry for this kind of change. They want to do the right thing. They are idealistic, and given an opportunity to practice in that kind of world, they’ll take it.
So it’s actually very, very, very encouraging. I think the shift will happen. Now, the last pitch I’ll give is personal, and I always say this, and I’m sure I can feel this is probably not true, but I can feel Robbie rolling his eyes at me. It is that people have to wake up too to their own transformation. They have to see that this sort of egoic striving that we’ve always been conditioned to do is a bit of an illusion, and once we see past that, we do emerge a world where that is actualized in a way that it’s very hard to predict, but it’ll definitely be better than what we’re going through now.
Jeremy Corr:
We hope you enjoyed this podcast, and we’ll tell your friends and colleagues about it. Please follow Fixing Healthcare on Apple Podcast, Spotify, or your favorite podcast app. If you like the show, please rate it five stars and leave a review. If you want information on healthcare topics, you can visit Robbie’s website at Robertpearlmd.com or visit our website at Fixinghealthcarepodcast.com. Follow us on LinkedIn, Facebook, and Twitter at Fixing HC Podcast. Thank you for listening to Fixing Healthcare’s newest series, Unfiltered, with Dr. Robert Pearl, Jeremy Corr, and Dr. Zubin Damania. Have a great day.
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Dr. Jonathan Fisher was practically born into medicine. All six of his siblings became doctors, following in their father’s professional footsteps. Jonathan, himself, became a Harvard-trained cardiologist, working in some of the nation’s leading medical institutions.
But, in the process of making his family proud, he was becoming anxious, depressed and burned out. He was losing an important part of himself. To make matters worse, when Jonathan finally sought the help of a therapist, he experienced profound shame and felt like a failure.
Nowadays, in addition to being a practicing physician, Jonathan is an advocate. He has devoted much of his career to solving clinician burnout. He is a mindfulness and resiliency expert who runs the Ending Clinician Burnout Global Community and co-hosts the annual summit of same name.
In this interview, hosts Jeremy Corr and Dr. Robert Pearl ask Dr. Fisher about the rules of American medicine that must be broken in order to free clinicians from the shame, anger, frustration and dissatisfaction that cause rampant burnout.
Interview HighlightsOn learning the ‘unwritten rules’ of medicine“I remember my surgery rotation in third year. We had a very well respected general surgeon, resident and a fellow, and I felt like I was in the military, which was a very bizarre thing … I found myself having to walk quite erect, almost like a group of ducklings following this senior surgical resident. [We had] to speak in exactly the way that he spoke, to present in a way that was expected. This was the first time I remember this jarring sense that there were certain rules that were established, rules of behavior if we were to fit in and to excel.”
On seeking professional help for the first time“I was a resident at the Brigham and I called [the therapist’s office] and I tried not to over-identify myself. And when I first went, I wore a coat so that I could cover part of my neck, and I wore a hat so that nobody in the neighborhood, other residents, would know that I was going to see a therapist. There was a lot of secrecy and there was a lot of shame that was there. I knew very little about the impacts of shame, which really literally means to cover up. That’s the origin of the word. There was so much covering up that I was doing that, eventually, I was unable to feel positive feelings.”
On burnout vs. depression“There’s an overlap between burnout and depression, but one is a workplace phenomenon, often driven by a certain set of known factors that Tait Shanafelt and others have described beautifully, whereas depression is more of a psychological diagnosis. What I find interesting is … there are overlaps there with the clinical spectrum of depression as well as anxiety … If you look at Medscape’s poll from last year … 70 to 80% of all doctors across 29 sub-specialties reported depression at some point in the last few years.”
On ‘the healthcare system’ and its role in burnout“People say, ‘Well, you have to change the system.’ I point out that a system is nothing more than a collection of individuals. If our individuals don’t have the presence of mind and the ability to impact change and influence the thoughts, feelings, and actions of other people, then we won’t have a generation of leaders who can make the changes that people so desperately want.”
On the role of clinicians in ending burnout“I think part of the problem we’re facing in healthcare is that we’re all siloed. We may be siloed in our own institution thinking that we’re doing it best. We may be siloed in our own specialty thinking that we’re better than others. And we know the jokes that the orthopedists tell about the internists and the cardiologists tell about the neurologists, and it’s funny. At the same time, these silos are what are going to keep us from healing our healthcare system. All of these divides need to be bridged. We need to begin the bridging. And so, that’s really the motivation for my work.”
On the problem with ‘moral injury’“If we use a narrow term like moral injury, it’s a focus on one person, which is the healthcare provider who is injured. I would say that there’s a connotation there, that there is an injurer. Once we have that connotation, there are elements of blame, of blaming the system. I’ve watched this for 10 years. Well-meaning doctors who have no recourse, spend hours of their time talking about us versus them, us versus the system … I think the popularity [of the term] comes from a sense of hopelessness and, frankly, bitterness, which oftentimes is appropriate, but after a while becomes dysfunctional.”
READ: Full transcript with Jonathan Fisher
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #73: The ‘rules of healthcare’ that cause burnout appeared first on Fixing Healthcare.
This holiday season, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl are mixing things up with a look back in time—way back, in fact, to the first episode of the first season with Dr. Zubin Damania (aka ZDoggMD). Since this interview in 2018, Dr. Z has become one of this show’s most popular returning guests.
Zubin Damania is a UCSF- and Stanford-trained internist and founder of Turntable Health, an innovative primary care clinic and model for Health 3.0. As a way to address his own burnout and find his voice, he started producing videos and live shows under the pseudonym “ZDoggMD.” His persona became a grassroots movement, reaching more than 1 billion people across a wide array of different media.
Today’s program will be the first of three Fixing Healthcare flashback episodes airing throughout the holidays, each featuring ideas to fix American healthcare from some of the nation’s top leaders.
The purpose? To quote Dr. Pearl: “My hope in replaying these ideas is to help listeners once again realize how much could be done to transform American healthcare and improve people’s lives. And simultaneously, help them recognize how far we are from delivering the excellence in healthcare Americans want, need and deserve.”
Helpful links:
Season 1 explainer: ‘Welcome to the toughest interview in healthcare’
Episode 1 recap: ‘ZDoggMD has a plan to fix American healthcare’
The full transcript of this episode with Zubin Damania
ZDoggMD’s website: Health 3.0
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #72: Fixing Healthcare flashback with Zubin Damana (ZDoggMD) appeared first on Fixing Healthcare.
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss the latest buzzword of the Covid-19 era: Triple-demic.
Earlier this month, the CDC alerted physicians about the triple threat of Covid, seasonal influenza and RSV (respiratory syncytial virus), warning that the threat of multiple infections (and resulting respiratory disease) was greatest among young children and the elderly. Is the triple-demic a legitimate public health threat and what should listeners do about it?
You’ll find that topic and all the other [time stamped] questions from today’s show here:
[00:52] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[05:18] Listener question: “Is the price of Covid vaccines going up next year?”
[08:50] Why do government and insurers seem willing to pay for so many complex services and facilities to treat people once they have a heart attack, stroke or cancer, but reticent to make the investments needed to reduce the incidence of these frequently avoidable problems?
[09:44] There’s still a lot of debate about myocarditis after vaccination. Any new research?
[11:00] What is a “triple-demic” and should we be worried about it?
[13:18] If everyone wore masks and washed their hands this winter, we could avoid millions of infections and thousands of deaths. So, why are Americans less likely than others to do?
[14:38] Listener question: I was recently vaccinated with the old booster and I was wondering about the new bivalent one. Is there data that says I should take it?
[16:30] What’s the latest on Long COVID (since it was featured in last month’s episode)?
[17:47] What are the risks of Covid-19 relative to kids now?
[18:59] What’s new in healthcare beyond Covid-19?
[21:52] How much risk should patients/consumers be willing to accept vs. their social obligation to keep others safe?
[23:13] Are parents of children with diabetes still cutting corners with insulin due to high prices?
[26:05] How does racial bias play a role in the care doctors provide patients?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #67: Should Americans be worried about a ‘triple-demic’? appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” probes into some of healthcare’s most complex topics and deep-seated problems.
On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr discuss the “Anatomy of Healthcare Leadership,” a new way of looking at the skills and qualities needed to transform American medicine. According to Dr. Pearl, leaders must apply logic and creativity (a function of the brain), they must show passion and express empathy (via the heart) and they must also demonstrate courage and resilience (using the proverbial strong spine). Later in the show, Corr gets Pearl to describe his leadership journey and the nationally recognized success he experienced for nearly two decades as CEO at Kaiser Permanente.
For more information on healthcare leadership, check out Dr. Pearl’s latest columns on Forbes and LinkedIn. For listeners interested in show notes, here’s a discussion guide:
THE ANATOMY OF HEALTHCARE LEADERSHIP * How can strong leadership defeat the “middleman mentality” in healthcare? * What proof is there that U.S. healthcare lacks effective leadership? * What kinds of healthcare problems will be hardest for leaders to address? * Can healthcare leaders really change how healthcare is paid? * What are the benefits of “capitation”? * If capitation is the solution, why is it so rare in healthcare today? * How does the middleman mentality slow healthcare’s financial reform? * Why would anyone who’s profiting from healthcare’s dysfunction want to drive change? * Where should aspiring healthcare leaders begin? * Why has the trio of cost, quality and access been so hard to achieve? * How can aspiring winning over the people who deliver care? * What is the “Anatomy of Healthcare Leadership” and how can it change medicine for good? * How can leaders apply logic and creativity (their brains) to the challenge? * How can leaders apply passion and empathy (their heart) to the challenge? * How can leaders demonstrate courage and persistence (the spine) to the challenge?
PEARL’S LEADERSHIP JOURNEY * What was the arc of Pearl’s journey from plastic surgeon to CEO? * How were healthcare problems similar/different early in Pearl’s career compared to today? * How did Pearl become the CEO at Kaiser Permanente in 1998? * What were his goals for the organization at the time? * What are the three biggest leadership lessons he learned as CEO?
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #71: Diving deep into healthcare leadership appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” probes into some of healthcare’s most complex topics and deep-seated problems. On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr explore how ...
The post FHC #68: Diving deep into the medicine’s middlemen & the future giants of healthcare appeared first on Fixing Healthcare.
Dr. Ezekiel Emanuel has spent a lifetime challenging the establishment. He says that tendency is very much a part of his family’s heritage. “My mother, not infrequently, would have to ...
The post FHC #67: Dr. Zeke Emanuel on the virtues of rule breaking appeared first on Fixing Healthcare.
Galileo, Darwin and Einstein: three historical figures who changed the way we view the world. Galileo broke the myth that we’re the center of the universe. Darwin proved that humans ...
The post FHC #66: Right brain vs. left brain in medicine appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” probes some of healthcare’s most complex topics and deep-seated problems. On today’s episode, Dr. Robert Pearl and Jeremy Corr talk about two of ...
The post FHC #65: Diving deep into Amazon and Apple’s healthcare ambitions appeared first on Fixing Healthcare.
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss the battle between the current Covid-19 vaccine manufacturers, the next generation of mRNA vaccines, and the ...
The post CTT #65: Why are Moderna and Pfizer going to war? appeared first on Fixing Healthcare.
American writer Joseph Campbell famously studied and diagramed the hero’s journey in folklore and literature. That journey begins with a call to adventure, prompting the hero’s reluctance—often due to a ...
The post FHC #64: The hero’s journey in healthcare appeared first on Fixing Healthcare.
Dr. Tom Lee founded Epocrates, one of the earliest tech-enabled healthcare applications for doctors, and One Medical, the primary care-first organization recently acquired by Amazon for $3.9 billion. He is ...
The post FHC #63: One Medical founder Tom Lee on Amazon, primary care, the future appeared first on Fixing Healthcare.
New data from the Annenberg Public Policy Center found that 4 in 10 Americans have returned to their normal, pre-pandemic lives. Over half of respondents say they rarely or never ...
The post CTT #64: Are Americans putting Covid-19 behind them? appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” probes into some of healthcare’s most complex topics and deep-seated problems. On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr discuss the ...
The post FHC #62: Diving deep into 3 urgent threats facing U.S. healthcare appeared first on Fixing Healthcare.
Did you catch the episode of Malcolm Gladwell’s Revisionist History about triplicates—those state-issued prescription pads that produced three copies of every painkiller script written? Many in medicine remember triplicates as ...
The post FHC #61: An unfiltered look at Rx triplicates & Amazon’s healthcare expansion appeared first on Fixing Healthcare.
Returning to the podcast this week is a household name in medicine, Dr. Don Berwick, who made his first appearance on the show in season one. Back then, Don said ...
The post FHC #60: Don Berwick on ‘breaking the rules for better patient care’ appeared first on Fixing Healthcare.
Dr. Anthony Fauci recently credited the antiviral drug Paxlovid with keeping him out of the hospital. That was after he tested positive a second time for Covid-19. Following a course ...
The post CTT #63: What causes ‘Covid-19 rebound’ after Paxlovid? appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” probes into some of healthcare’s most complex topics and deep-seated problems. On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr dive deep ...
The post FHC #59: Diving deep into SCOTUS rulings & drug-industry rules appeared first on Fixing Healthcare.
“I wish I was more authentic, more transparent, more myself from the very beginning (rather) than trying to create a character or a persona,” said Dr. Zubin Damania (aka ZDoggMD) ...
The post FHC #58: An unfiltered look at inauthenticity in medicine appeared first on Fixing Healthcare.
Dr. Rod Rohrich has broken the unwritten rules of medicine across his career. He turned a traditional paper-only, medical journal into a digitized force, full of videos and evidence-based rankings ...
The post FHC #57: Dr. Rod Rohrich on how to change the rules of medicine appeared first on Fixing Healthcare.
The New York Times surveyed 362 school counselors on the effects of the pandemic on children. The results were both predictable and troubling. Not only have kids fallen behind in ...
The post CTT #62: Has the pandemic ‘frozen’ kids emotionally, socially? appeared first on Fixing Healthcare.
This Fixing Healthcare podcast series, “Diving Deep,” features a robust and probing discussion into some of healthcare’s most complex subjects and deep-seated problems. On today’s episode, Dr. Robert Pearl and ...
The post FHC #56: Diving deep into odd pandemic behaviors and overpriced drugs appeared first on Fixing Healthcare.
Said ZDoggMD: “Oh, man, OK. You said, hey, let’s do a podcast together, Z. It’ll be fun, you said. It’ll be easy. It’ll be flow. Then you ask a question ...
The post FHC #55: Is it time for doctors to temper their career expectations? appeared first on Fixing Healthcare.
Author and historian Dr. Lindsey Fitzharris is fascinated with medicine’s grisly past and the extraordinary physicians who changed the profession by breaking the rules. One of those rule-breaking doctors of ...
The post FHC #54: The incredible rulebreakers of medicine’s past appeared first on Fixing Healthcare.
About a month ago, Dr. Anthony Fauci said that the United States is “out of the pandemic phase,” but he later clarified that the country is, “out of the full-blown ...
The post CTT #61: Is the Covid-19 pandemic over? Is a monkeypox pandemic next? appeared first on Fixing Healthcare.
Welcome back to the Fixing Healthcare series, “Diving Deep,” which features a robust and probing discussion into some of healthcare’s most complex subjects and deep-seated problems. In this episode, Dr. ...
The post FHC #53: Diving deep into physician burnout and America’s views on Covid-19 appeared first on Fixing Healthcare.
Welcome back to Unfiltered, a show that features two iconic voices in healthcare for a half hour of unscripted, hard-hitting talk. Dr. Robert Pearl has twice appeared on The ZDoggMD ...
The post FHC #52: The future of medical misinformation, education and motivation appeared first on Fixing Healthcare.
One hard part about interviewing Dr. Eric Topol is knowing where to begin. Topol wears a seemingly infinite array of hats: He is the director of Scripps Research Translational Institute. ...
The post FHC #51: Eric Topol on breaking the rules and putting patients in charge appeared first on Fixing Healthcare.
The biggest Covid-19 news of the last month came out of Florida, where a federal judge struck down the CDC’s mask mandate on planes, trains and in transportation hubs. As ...
The post CTT #60: Will mask mandates return to planes and trains? appeared first on Fixing Healthcare.
Welcome back to the Fixing Healthcare series, “Diving Deep,” which features a robust and probing discussion about some of healthcare’s most deep-seated problems. In this episode, Dr. Robert Pearl Jeremy ...
The post FHC #50: Diving deep into physician intuition and hospital prices appeared first on Fixing Healthcare.
Welcome to Unfiltered, a new show that brings together two iconic voices in healthcare for an unscripted, hard-hitting half hour of talk. Dr. Robert Pearl has twice appeared on The ...
The post FHC #49: An unfiltered chat about ‘the slap,’ emotional doctors, and more appeared first on Fixing Healthcare.
Season seven of the Fixing Healthcare podcast focuses on the unwritten and outdated rules of American healthcare—many of which Dr. Marty Makary would badly like to see broken. In this ...
The post FHC #48: Marty Makary on breaking the rules of medical education appeared first on Fixing Healthcare.
A group of researchers in the UK examined hundreds of brain scans that were taken both before and after people became infected with the coronavirus. The study, published in Nature, ...
The post CTT #59: What does Covid-19 infection do to the brain? appeared first on Fixing Healthcare.
Welcome back to the Fixing Healthcare series, “Diving Deep,” which features a robust and probing discussion about some of healthcare’s most deep-seated problems. In this episode, Dr. Robert Pearl Jeremy ...
The post FHC #47: Diving deep into primary care & health-tech appeared first on Fixing Healthcare.
Welcome to Unfiltered, a new show that brings together two iconic voices in healthcare for an unscripted, hard-hitting half hour of talk. Twice, Dr. Robert Pearl has appeared on The ...
The post FHC #46: An unfiltered look at medicine’s generational clash appeared first on Fixing Healthcare.
The Fixing Healthcare podcast welcomes back Ian Morrison, a globalist, futurist and popular returning guest who, in Season 1, taught us that “every healthcare system sucks in its own unique ...
The post FHC #45: Drs. Alexa and Siri? A healthcare futurist weighs in. appeared first on Fixing Healthcare.
After more than two years of Covid-19 restrictions, most parts of the country are dropping mask mandates per new CDC guidance. It seems government officials are more confident than ever ...
The post CTT #58: Are Covid-19 restrictions gone for good? appeared first on Fixing Healthcare.
Welcome to the new Fixing Healthcare series, “Diving Deep,” which features a robust and probing discussion about some of healthcare’s most deep-seated problems. With cohosts Dr. Robert Pearl and Jeremy Corr, this series will be hard-hitting, honest and undoubtedly controversial.
In this episode, Pearl and Corr talk about two areas of medicine where the existing “rules” seem out of date. It begins with an up-close look at how medical schools and residency programs select future doctors, a process that quickly reveals itself as obsolete in the 21st century. That’s followed by an in-depth review of the current (and outdated) rule used to determine how doctors are paid.
For more information on these topics, check out Dr. Pearl’s latest healthcare columns on Forbes and LinkedIn.
For listeners interested in show notes, each episode of this series will feature a time-stamped discussion guide (as follows):
[01:00] Before we dive deep, what are the “unwritten rules” of healthcare?
[02:01] How do these rules impact doctors and patient care?
[03:52] What’s the rule for selecting and training future physicians?
[06:10] Why is this rule now obsolete?
[07:43] How do we break this rule and bring it into the 21st century?
[10:38] Next rule: What’s wrong with paying physicians this way?
[13:27] Diving deeper, how exactly do doctors get paid?
[15:04] Does this payment rule lead to physician burnout?
[17:23] After 90+ years, is it really possible to change the rule?
[21:08] What are the pros of a relationship-based payment model?
[21:58] Can we make docs happier and lower healthcare costs?
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #44: Diving deep into how we select and pay American doctors appeared first on Fixing Healthcare.
Research on 4,000 women over six months found that Covid-19 vaccines are linked to a small increase in menstrual cycle length. Such a delay is common when a woman’s body mounts an immune response, says cohost Dr. Robert Pearl.
Other scientific studies have examined the link between vaccine status in pregnant mothers and relative immunity in their newborn children, as well as the link between vaccination and fertility in men. Jeremy Corr and Dr. Pearl dive into the data on this episode of Coronavirus: The Truth to examine those topics and the following [time stamped] questions:
[01:01] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[06:04] Australia shifted its public health measures from highly restrictive to incredibly lax. Why? And is it working?
[09:04] Is it the responsibility of U.S. elected officials to protect the unvaccinated by restricting the vaccinated?
[10:57] The courts have ruled that federal government can’t mandate vaccination for workers. How does this affect private businesses?
[13:29] Where does the FDA stand with approving vaccinations for kids 5 and younger?
[18:05] Anything new on the BA.2. variant?
[19:48] Listener question: Does the coronavirus vaccine affect my menstrual cycle?
[22:26] How many total deaths in the United States can be attributed to the pandemic?
[23:36] What’s good this week?
[25:29] Beyond Covid-19: What’s happening with healthcare technologies?
[28:29] Is AI something to fear or celebrate in healthcare?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #57: How do Covid-19 vaccines alter fertility, childbirth, menstrual cycles? appeared first on Fixing Healthcare.
Some of medicine’s greatest breakthroughs began as seemingly crazy ideas. In the 1950s, for example, Dr. Emil Freireich hypothesized that the only way to cure childhood leukemia was to take young patients to the brink of death with combination chemotherapy. At first, Freireich’s colleagues called him a madman, a monster and possibly a Nazi doctor. Decades later, he is remembered as a trailblazing oncologist: the “father of modern leukemia therapy.”
When great ideas start out looking reckless or even insane, it’s difficult to separate the brilliant rule-breakers from the fools and sociopaths. The story of Elizabeth Holmes, the disgraced inventor and former billionaire, reminds us just how blurred the lines can become.
To help us sort out the iconoclasts from the quacks is an expert on rule breaking. Malcolm Gladwell is the author of five New York Times bestsellers, including “David and Goliath: Underdogs, Misfits, and the Art of Battling Giants,” and he is the first guest on season seven of the Fixing Healthcare podcast. He joins hosts Dr. Robert Pearl and Jeremy Corr to discuss the rules of rule breaking—and how they apply to American healthcare today.
_______
Malcolm Gladwell Interview Highlights ________
On the personality of medicine’s rule breakers “In David and Goliath, I wrote about a man named Emil Freireich who was maybe the most important pioneer in combination chemotherapy and he’s a classic example of a rule breaker … People thought (treating childhood leukemia with this regimen) was heretical and nuts … I mean, he was denounced, ostracized … And my conclusion was he was able to do what he did in large part because of his personality. He was simply someone who just didn’t care if everyone else thought he was a monster. And you need to be that way if you’re a rule breaker, right?”
On what it takes to break the rules “You can’t be someone who’s too concerned about what your peers think and it’s really, really hard to find people who both have the imagination to break a rule and figure out a better way of doing things and also the strength of character to not care about the naysayers. It’s easy to find one of those traits and not the other. Very difficult to find both those traits in combination.”
On rule breakers vs. crooks or kooks “The thing we have to keep in mind, I think, is when we make judgements of rule breakers, we may be right. There’s going to be some sociopaths mixed in there. I mean, there’s going to be the Elizabeth Holmes. She’s actually interesting … because that’s the kind of territory that she’s operating in, right? She’s selling her idea to a group of people who are aware of the fact that sometimes great ideas look crazy in the beginning … She goes to all these wise Silicon Valley people who have seen a version of this play out many times in the past and are aware of the fact that some percentage of truly brilliant, transformative, incredibly lucrative ideas look completely impossible and nuts out of the gate.”
On Elizabeth Holmes “I don’t think that those who invested with Elizabeth Holmes are irrational. I think it’s rational for someone with a lot of money in Silicon Valley to make bets on crazy ideas because there are a lot of other crazy ideas that did pay off, right? Had she been right, that company would be worth, I mean, untold billions of dollars, right? Would I have given Elizabeth Holmes $10,000 in 2005 … had she approached me? I don’t know, probably if I had $10,000 lying around. Now as it turns out, she falls into either the sociopath or the fool category … but we don’t know in the beginning, that’s the thing.”
On the importance of having a vision “[Rule breakers] tend to be people who have a vision, right? They are powered by something that’s really consequential and that motivates them. And I think there’s a version of that—that every one of these rule breakers has, which is they’re powered by a vision of whether they can make their world better.”
On defining a successful rule breaker “I don’t think you can find a rule breaker who follows any path to success other than outworking the status quo or everyone else, right? What the rule breaker is, is someone who’s willing to commit themselves to an unpopular idea at a level that exceeds that of their peers. That’s my definition of a rule breaker. It’s not holding an unpopular position, that’s just a beginning. It’s are you then willing to bet a huge chunk of your own time, energy, career, what have you, on that idea? And it is the magnitude of the bet that makes you a rule breaker.”
READ: Full transcript with Malcolm Gladwell
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #43: Malcolm Gladwell on breaking the rules of healthcare appeared first on Fixing Healthcare.
When it comes to healthcare, the digital hands of Google reach far and wide. Medical school students and residents use Google Search to find obscure case reports and make difficult diagnoses. Before surgery, many physicians now go to YouTube, the Google-owned video platform, to watch world-leading surgeons perform and narrate complex operations. Meanwhile, applications like Google Maps, along with products like HealthAI and Care Studio, are primed to play a meaningful role in the future healthcare.
Here to talk about the tools of tomorrow: Dr. Karen DeSalvo, Google’s Chief Health Officer, a role she has held since 2019. After medical school at Tulane, DeSalvo practiced as an internist (primary care) in New Orleans. Following hurricane Katrina, she served as New Orleans Health Commissioner and then as the city’s Senior Health Policy Advisor. At the federal level, DeSalvo served as National Coordinator for Health Information Technology and as an acting Assistant Health Secretary for U.S. Health and Human Services.
Karen DeSalvo Interview Highlights On her professional journey to Google “When they asked me to serve as the National Coordinator for Health IT, I declined. Because I just didn’t think I had the background and it wasn’t really how I wanted to go deep in the next part of my journey. But (former HHS secretary) Kathleen Sebelius convinced me and helped me see that technology is not the endgame but a tool to health, and also gave me the opportunity to go there at HHS and co-lead the delivery system reform strategy … I love my government service. I carry the stories of my patients, my experiences in local public service. But also, I saw it as an opportunity to apply the tools of technology in other ways to value-based care, and then eventually to public health.”
On her role as Chief Health Officer at Google “It’s a new job. I was recruited here principally to stand up a clinical team that could work across the Google Enterprise to build up authoritative health information on our ecosystems that are things like Search and Maps and YouTube, where literally billions of people are looking for health information. And we needed to have a way that we could create a framework that would provide clinically great information where we could and then address misinformation.”
On curbing Covid-19 misinformation “We have leaned on consensus bodies wherever we can. For example, the FDA or the World Health Organization, depending on the geography, and we often start with global consensus if it’s a new issue, and then localized as much as possible, yeah, in the various countries or even all the way down to the county level for recommendations on things like masking, because we think that our role is amplification of information, not creation of the content, especially on surfaces like Search. Now, there are some things though, that are clearly harmful, and is not the information that you would want to put out in the public domain. For the most part, those things have somewhat clearer to be able to define in COVID.”
On whether Google can disrupt healthcare “I didn’t come to Google to disrupt the healthcare system, or to show the healthcare system how it should be done. I came here because I believe that there’s a couple of key things that are missing in the work we’ve been doing. One, is consumers are not empowered. They don’t have a seat at the table in the way that need to. Two, we’re not taking advantage of tools that can reduce cognitive load and improve the efficiency of care to pull cost out of the system. We’ve instead only, largely, in tech been trying to find ways to add new things to the system.”
On how AI can help doctors, patients “Computers and AI are really good at reading pixels, better than humans, and they don’t get fatigued. Yes, all of those images and the pathology slides have to be put into context. I do understand that. It’s to me, again, not supplantation, but significant augmentation. Getting to a place where we expect that your prostate tissue slide is going to be read by AI and a human is so necessary. Getting there, though, is the barrier, isn’t only about the AI model. We’ve done a lot of good work in that space and have advanced imaging reads in that area.”
On the most exciting developments in health technology “Home-based diagnostic testing. I am fascinated by how hungry people are to have convenient, in-home diagnostic tests for COVID and beyond. The part that’s interesting to me about it is laboratory is something that often does require a biologic specimen. It’s not something that can be done completely virtually. There has to be some an interface with the diagnostic tool. The diagnostics in the COVID time have gotten much more sophisticated. The work of the RADx team at the NIH, this billion dollars they received to advance technology for COVID testing, they’re seeing that it’s applicable in other areas of diagnostic testing for convenient at-home tools…”
READ: Full transcript with Karen DeSalvo
Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #42: Google’s chief doctor previews the health tools of tomorrow appeared first on Fixing Healthcare.
Drug makers Pfizer and Moderna are testing a new vaccine specific to the Omicron variant—with an ETA around summer 2022 or even later. The timing is important as scientists recognize the variant should be far less prevalent by then. So, why would Pfizer and Modern even bother?
Hear the answer to that question at the 22:41 mark on this episode of Coronavirus: The Truth with Jeremy Corr and Dr. Robert Pearl. The duo will discuss all things Omicron, along with the following [time stamped] questions:
[00:56] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[07:35] Being “fully vaccinated” vs. “up to date”: what’s the difference when it comes to the threat of Omicron?
[09:40] How prevalent is Omicron infection where Dr. Pearl and Jeremy Corr live?
[11:43] What do we know about Chinese-manufactured vaccine, Sinovac?
[14:55] Are monoclonal antibodies effective against Omicron?
[16:46] What’s the latest science on “long Covid”?
[18:44] What’s going on with vaccine mandates?
[22:41] Is an Omicron-specific vaccine on the way?
[24:38] What’s good this week?
[26:10] What does it mean to “break the rules of healthcare”?
[31:37] How can patients safely break the rules of healthcare?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #56: Is an Omicron vaccine coming soon? Will it help? appeared first on Fixing Healthcare.
These days, it seems just about every decision comes with risk: Should I invite friends or family over? Should I dine out? Can I safely return to work or school?
To help people make safer, smarter decisions about their health, the federal government is now offering every American home four free at-home Covid-19 testing kits. It’s a step in the right direction, but many questions remain: Are these tests reliable? What are the chances of a false-negative result? What else can I do to protect my family?
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss the accuracy and intended uses of various Covid-19 tests, the importance of testing in the face of Omicron, along with the following [time stamped] questions:
[00:58] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[06:00] Why did the CDC shorten its quarantine recommendations from 10 days to 5 days for Omicron infection?
[12:05] How are political officials handling Omicron information transparency?
[14:10] What’s wrong with rapid at-home (antigen-based) testing kits?
[18:13] What’s the latest on vaccine mandates for workers?
[20:28] How strong is Covid-19 immunity after recovering from Omicron?
[21:50] Is a fourth vaccine shot coming soon?
[24:11] Are some nurses and other healthcare workers allowed to work after testing positive for Covid-19?
[25:40] What’s good this week?
[29:29] What is the idea behind Pearl’s new article series “Breaking The Rules Of Healthcare”?
[31:55] What’s the big news concerning out-of-network (surprise) billing?
[33:44] How important is technological savvy among doctors?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #55: Can I trust the results of at-home Covid-19 tests? appeared first on Fixing Healthcare.
Greetings and happy-ish New Year. If you’re here for the latest information on Omicron, check out episode #53 or tune in for episode #55 on January 18, 2022.
For now, this (shortly after) New Year’s episode of Coronavirus: The Truth features something slightly different. Jeremy Corr and Dr. Robert Pearl are zooming out for a more comprehensive look back at the year that was along with a look ahead at what might transpire in the year that is.
Take a deep breath and tune in for answers to the following [time stamped] questions:
[0:56] How can listeners put the past 12 months in perspective?
[02:28] What can we make of the divide in Covid-19 research based on political affiliation?
[07:27] What were the most significant Covid-19 moments of 2021?
[08:49] What can we predict will happen with Covid-19 in 2022?
[13:19] How are parents reacting to the highly transmissible Omicron variant?
[14:17] Will the new oral pills make a meaningful difference in the Covid-19 fight?
[15:21] What about the next set of vaccines?
[18:40] Predictions for how courts will rule on vaccine mandates?
[20:13] What will the next big wave of infections teach us?
[22:51] How is America’s heartland responding to Covid-19 now?
[24:30] Who is to blame for our continued Covid-19 difficulties?
[28:09] What are Dr. Pearl’s big Covid-19 predictions for 2022?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #54: What can we expect from Covid-19 in 2022? appeared first on Fixing Healthcare.
This week’s guest is Fixing Healthcare alum David Feinberg. In August 2021, Dr. Feinberg was named CEO of Cerner, a leading provider of “electronic health records” or EHRs.
Just four months after Feinberg became CEO, and a little more than 24 hours ago, Cerner was acquired by database giant Oracle for an estimated $28.3 billion.
In this interview (which took place before the Cerner-Oracle news broke), Dr. Feinberg offers insights into following: what makes Cerner so valuable, the company’s longstanding competition with Epic, the immense potential for EHRs as a healthcare solution, and the challenges that remain for doctors who want to spend more time with patients and less time on their computers.
David Feinberg Interview Highlights On Epic vs. Cerner “Well, first of all, I said this really clearly to the [Cerner] board when they called me, my competition isn’t Epic. My competition is heart disease and suicide and opiates being misused and preventable illnesses and COVID. And I’ll do whatever’s possible to beat that competition. I have tremendous respect for Epic. Look, I’ve been a customer of Cerner and Epic. I’ve used the systems. I’ve used Meditech, I’ve used Athena. And I would say none of us, including Cerner, have built a tool that was really designed for the end user … If my family gets admitted to a hospital and they’re on a different system than Cerner, I want it to work. So I want all these systems to work. And if we really care about our communities, they need to work together.”
On the troubled history of EHRs
“When we think of electronic health records, the bill of goods we were all sold was this was going to solve a lot of problems. Now I think it’s been a heroic lift to get everything digitized, but in doing so we created some new problems around usability and we certainly haven’t realized the promise of what this was supposed to be. [EHRs] are not intuitive and easy to use, they’re not adding a lot … they haven’t really fixed underlying problems of making it easier to care for patients.”
On Cerner 10 years from now
“A decade from now I hope Cerner is seen as the foundation of data that is allowing doctors, nurses and families to be able to access data to better care for themselves. And I hope that that leads to a healthcare system that is much more equitable, much more cost effective, much easier, and convenient and more dignified.”
On big-tech companies in healthcare
“I think it’s going to be some of the big tech companies and some of the incumbents in healthcare realizing they got to [fix healthcare] together because for us, for example, we have the data, we have the trusted relationships. If you combined us with, and you can go through the list of Amazon or Microsoft, Oracle, Google, whoever, they have other expertise that when you bring it together could really get to that promise of what I think we all thought the electronic health record was supposed to do.”
On how EHRs can lower healthcare costs
Well, the [dollar] figure has to lower because if we don’t, we can’t build roads and schools and people won’t get wage increases and we’ll see a further gap between those that have, and those who don’t. I think it’s been the biggest crime in healthcare that we’ve allowed us, those of us in healthcare, that we’ve allowed this to happen … Using data to make better decisions around care is the way [Cerner] can help the most. So, hey, we’re expensive to put in. We got to prove that not only are we easy to use, which we’re not yet, but not only are we easy to use by using our tools, you’re able to care for more people, you’re able to drop the cost of your care, you’re able to make sure that nurses that are so expensive and so hard to get right now are just doing nursing and not worrying about working in an EHR as a data clerk. So that’s how I think we can join this solution and we’re totally committed to it.”
On progress notes
“The progress notes in the United States for patients are twice as long as the progress notes that they are in the rest of the world, even in the developed world, right? And so it’s not like our patients are sicker, although a lot of doctors always like to say that, it just means that we’ve added documentation that I’m certain isn’t adding value to care. It actually becomes so dense you can’t even find what you’re looking for if you’re a consultant or a doc taking over a case. So we’re really looking at how we can decrease it.”
READ: Full transcript with David Feinberg
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #41: New Cerner CEO says Epic isn’t his biggest competitor appeared first on Fixing Healthcare.
CTT #53: How dangerous is Omicron, based on the latest data?
Omicron, the mysterious new variant accounting for nearly 3 of every 4 new cases in the United States, is top of mind for Americans as 2021 draws to an end. The answers scientists seek about Omicron are slowly coming into clearer view.
In this episode of Coronavirus: The Truth, hosts Jeremy Corr and Dr. Robert Pearl look at the most recent data and discuss: the known risks of Omicron compared to Delta, the effectiveness of vaccines and boosters against Omcrion, the effect of the new variant on vaccine rates and the latest on vaccine mandates. Tune in now for the latest, science-based answers to the following [time stamped] questions:
[01:00] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[05:23] What do scientists now know about Omicron risks?
[07:10] What are the current vaccine and booster rates?
[09:00] What’s the latest in public opinion on vaccine mandates?
[13:04] Listener question. Several listeners wrote to ask for an update on the effectiveness of the current vaccines against Omicron. What do we know?
[17:28] Discussion. Why aren’t people in nursing homes getting the attention or protection they need? What can be done?
[19:21] How will year three of Covid-19 affect people’s mental health?
[25:16] Where do vaccine mandates stand in the courts?
[28:35] What’s good this week?
[30:16] What’s the big non-Covid story this week?
[33:09] Discussion. Which of the following poses the biggest U.S. threat: inflation, Covid-19, business challenges and educational difficulties?
[35:28] Is Omicron both more transmissible and less lethal?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #53: How dangerous is Omicron, based on the latest data? appeared first on Fixing Healthcare.
Medical professionals and budding entrepreneurs love to talk about the technologies that will someday revolutionize patient care. Our guest on Fixing Healthcare is already funding and fashioning those technologies to meet the needs of today’s patients.
Our guest, Vinod Khosla, is an entrepreneur, investor, technologist and founder of Khosla Ventures, a firm with investments in hundreds of startups across more than a dozen industries. In healthcare, Khosla has provided venture assistance to fast risers like Forward, OSCAR, ZocDoc and many others. He was also the founding CEO of Sun Microsystems.
This show features case-studies galore: From AI-driven mental health and physical therapy services to a Covid-testing product that can also screen you for the top 20 different respiratory illnesses. You’ll hear about diagnostic tools that are delivering results five-times faster and 10-times cheaper. And you’ll learn about a $28 million primary-care startup that Khosla says could be the next big thing in rural and safety-net care.
In this episode, Khosla gives advice to aspiring entrepreneurs and gets specific about the future of medicine, detailing which technologies he believes have a chance at achieving the most difficult of missions: fixing healthcare.
Vinod Khosla Interview Highlights On tech improving global healthcare and U.S. healthcare “I’ll try and constrain it to the US healthcare system in terms of my answers, but I think it’s globally applicable and the solutions are the same, but with a different tilt and different cultural context. In the US, we have relatively better care, but it’s expensive. My personal view, the most expensive part of the system is expertise, and expertise can relatively be tamed with technology and AI. So, not everybody in the world can get an oncologist. We can capture some of that expertise, so each oncologist can do 10 times more patient care than they would on their own without that help. That applies broadly.”
On reducing healthcare costs with technology “I am pretty optimistic that the most expensive conditions, take diabetes, cardiology, musculoskeletal, will be done in verticals outside of the healthcare system. Can you use a Livongo or a Hello Heart to reduce blood pressure by 20 millimeters without drugs? Could you do weight reduction by 8% with a digital first offering? I think that’s starting to happen … That will start to reduce the cost, and then specialists will only be needed when the condition is severe or exceptional.”
On improving rural healthcare with technology “Wherever healthcare depends on deep expertise, which is generally expensive, think oncologists or a brain surgeon, and you can do it remotely, care quality will improve and care costs will decline and accessibility will improve because a patient won’t have to go from that small town in Iowa to a major medical center and travel for three days for an appointment. So, I do think that will happen and will be very, very beneficial.”
The business implications of healthcare disruption “It’ll be newer players who adapt these technologies, disrupt the price points in economics and will slowly eat into traditional systems, (which) will go bankrupt. This is the model that happened with bookstores and Amazon. The bookstores ignored Amazon for a long, long time as it slowly ate into sales with its new model. Later, they adapted this model, but mostly too late.”
On the role of venture capital in healthcare “Look, the venture business always over invests in hard categories. The characteristic of venture startups is most will lose money, but more money will be made than lost, which says a small percentage of these will win, but the winners will make more money than the losers lose. So, net-net, broadly, if somebody’s broadly invested, they’ll do well and make money on their investment. So, imagine after 89 billion, 80 billion gets lost. That money gets lost as investments, but the 9 billion turns into 900 billion, creates another Apple or Google. That’s the model of venture capital.”
READ: Full transcript with Vinod Khosla
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Google, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
The post FHC #40: How venture-backed tech is transforming U.S. healthcare appeared first on Fixing Healthcare.
This week, America has Omicron on the mind. Listeners flooded the CTT inbox with questions about the new variant. Among them: Is Omicron more transmissible or lethal than Delta? Are current vaccines effective against it? What is President Biden doing to control the new variant and what kinds of social restrictions should we expect in the months ahead?
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss all things Omicron. Tune in now for the latest, science-based answers to the following [time stamped] questions:
[01:00] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[04:13] What do scientists know about the Omicron variant so far?
[12:37] Are current vaccines/boosters effective against Omicron?
[17:48] What do researchers know about the economic impact of Covid-19 on minority communities?
[19:16] How can politicians and scientists contingency plan for Omicron?
[20:13] What’s new with the Merck pill that patients start soon after becoming symptomatic with Covid-19?
[23:35] How does Omicron affect the “endemic” scenario?
[27:15] Any good news this week?
[30:34] What is President Biden’s plan to control Omicron?
[33:28] Are patient privacy fears warranted?
[35:15] What’s the latest with international border closures due to Covid-19?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #52: What do scientists know about Omicron? appeared first on Fixing Healthcare.
Americans who’ve received two shots of Pfizer or Moderna, or the single-dose J&J vaccine, are considered “fully vaccinated” … for now. That could change, depending on the data, according to White House chief medical adviser Dr. Anthony Fauci. Already, some U.S. governors are pushing to update the definition to include boosters.
Last week, CDC officials urged all adults to get a vaccine booster six months after completing their original vaccine regimen.
In this episode of Coronavirus: The Truth, Jeremy Corr and Dr. Robert Pearl discuss vaccine booster rates in the United States, the possible definition change for “fully vaccinated,” and what the future may hold. Tune in now for the latest, science-based answers to the following [time stamped] questions:
[01:00] Each show begins with the most recent and relevant facts concerning the Covid-19 pandemic and its impact on American life. What’s happening and what does it mean?
[05:54] What can Puerto Rico teach the rest of America about vaccinations?
[08:23] Why are cases in Europe spiking despite high vaccination rates?
[11:26] Why is Moderna battling the NIH over vaccine patent rights?
[14:20] Where do labor union stand on vaccine mandates?
[16:02] What’s the status of President Biden’s vaccine plan for large employers?
[17:18] What’s the mental-health impact social distancing and isolation?
[18:53] Will booster shots change our nation’s definition of “fully vaccinated”?
[19:57] What’s good this week?
[21:48] What’s this episode’s big non-Covid story?
[28:15] How do patients feel about telehealth?
[29:30] How is Singapore’s government punishing unvaccinated citizens?
This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms.
If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.
To ensure the credibility of this program, Coronavirus: The Truth* refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.
The post CTT #51: Will the definition of ‘fully vaccinated’ change with boosters? appeared first on Fixing Healthcare.
George Halverson was CEO of Health Partners in Minnesota for 18 years and CEO of Kaiser Permanente for 12.
As a health-plan leader, he spent 30 years fixing healthcare. He was successful in large part because he rejected what most Americans believe about health insurance. Halvorson believes better and more affordable healthcare is possible when people stop blindly paying for it and start assuming the role of buyer.
“I absolutely, totally believe that we have to become better purchasers of care as a country,” said Halvorson, who worked as CEO alongside Fixing Healthcare cohost Robert Pearl from 2002 to 2014 at Kaiser Permanente. “When we function as a buyer, not a payer, we end up with much better care. We can expect quality to improve. We can expect data to flow. We can expect teams to function.”
In this interview, Halvorson talks about health plans and the role of buyers. He also touches on the brilliance of Medicare Advantage, the bleak outlook for solo-practice doctors, and ways to improve healthcare for America’s most vulnerable populations.
George Halvorson Interview Highlights On buying (rather than paying) for healthcare
“When we buy care as a package, when we buy care from plans, and when we expect the plans to deliver the care, we have a whole different leverage for purchasing. In that setting, we can expect quality to improve. We can expect data to flow. We can expect teams to function … Both Kaiser and Health Partners are care settings that deliver care in addition to insure care. And because of that and you know the results. We have half as many people with hospital admissions. We have far (fewer) people with asthma attacks. We end up with much better care because we can focus on the care and do a better job of care.”
On the solo-practice doctor “When you’re a solo-practice doctor, and you’re just trying to keep up all by yourself, that’s really hard. There (are) 1,000 medical journals out there. But when you have a Health Partners or Permanente Medical Group, that group can keep up on all of the science, can distill the science, and then can pass the best current science onto all of the people on the care team. So, it’s really problematic to try to keep up with medical science outside of a group setting. But in a group setting, because of Permanente, Health Partners, Mayo Clinic do a really good job of keeping up. So I much prefer the model. I just think it makes huge sense. And I think the whole country needs to move in that direction.”
On for-profit vs. not-for-profit health plans “Well, I think the differences between the not-for-profit and the for-profits were significantly greater a couple decades ago than they are now. As a not-for-profit health plan, we can focus on the wellbeing of the patient. I used to be chair of AHIP years ago. I was chair a couple times of the National Association of Insurance Companies and Health Plans. And one of the things, when we went down the path of improving quality in that context, we initially had some of the for-profit companies resisting going down that path. And they resisted because they had shareholder lawsuits, literally saying, ‘As shareholders, that those health plans should not be improving quality. They should be optimizing profit.’”
On Optum following the Kaiser Permanente playbook “Optum right now is trying really hard. Their self-image is that they’re going to deliver great and continuously improving care. That’s part of what they’re trying to push in their culture. And that’s also part of their market model. So, they have gone far down that road. And I know for a fact that the folks at Optum have studied Kaiser Permanente, studied stuff that you (Robert Pearl) had invented. They’re moving it into their setting. But they’re doing it with the belief that they will thrive over time by being best in care and not just best on underwriting and risk selection.”
On us vs. them in medical care “We are wired instinctively to divide the world into us and them. We figure out who’s an us, we figure out who is a them, and when someone is an us, we’re supportive, we’re enabling, we do good things for us. And when someone is a them we’re suspicious, paranoid, territorial, distrustful. In healthcare, we end up with all kinds of negative consequences, unintended consequences by many well-meaning people who diagnose differently, or treat differently, or prescribe differently, and also who literally don’t trust.”
On President Biden’s healthcare agenda “He should make the Medicaid part of his agenda really clear. And a lot of the people who are opposed to him, politically, a disproportionate number of them need Medicaid and need to have a sense of that he is helping, steering them in that direction. I think on the Medicare side, the pure classic Medicare for all model has some support with some elements in the party, but it does not have support with the vast majority of Democrats. Unions don’t like it at all, because unions actually provide healthcare in good ways for their members.”
READ: Full transcript with George Halvorson
Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”
Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Google, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.
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