Fixing Healthcare Podcast

Latest Episodes:

MTT #88: Abortion restrictions, PBMs and the rising cost of care Oct 23, 2024

Show notes

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.

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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.

FHC #151: Six years later, Don Berwick’s vision for healthcare remains unfulfilled Oct 15, 2024

Show notes

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

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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.

FHC #150: Restoring meaning in medicine—burnout and the physician career arc Oct 08, 2024

Show notes

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)

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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.

FHC #149: Tech needs to get out of the way of healthcare, says Feinberg Oct 01, 2024

Show notes

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.

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The post FHC #149: Tech needs to get out of the way of healthcare, says Feinberg appeared first on Fixing Healthcare.

FHC #148: End-of-life lessons and combatting health disparities Sep 24, 2024

Show notes

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)

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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.

The post FHC #148: End-of-life lessons and combatting health disparities appeared first on Fixing Healthcare.

MTT #87: COVID-19 resurgence, soaring healthcare costs and the push for patient empowerment Sep 18, 2024

Show notes

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.

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The post MTT #87: COVID-19 resurgence, soaring healthcare costs and the push for patient empowerment appeared first on Fixing Healthcare.

FHC #147: Game theory and healthcare—the complex relationship between doctors, payers and patients Sep 11, 2024

Show notes

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)

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The post FHC #147: Game theory and healthcare—the complex relationship between doctors, payers and patients appeared first on Fixing Healthcare.

FHC #146: Dr. Eric Topol on how AI is changing healthcare Sep 03, 2024

Show notes

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.

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The post FHC #146: Dr. Eric Topol on how AI is changing healthcare appeared first on Fixing Healthcare.

FHC #145: The boring secrets to longevity with Brad Stulberg Aug 27, 2024

Show notes

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.

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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.

The post FHC #145: The boring secrets to longevity with Brad Stulberg appeared first on Fixing Healthcare.

FHC #144: Medical education reform and Medicare’s payment crisis Aug 21, 2024

Show notes

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