Fixing Healthcare Podcast

Latest Episodes:

MTT #78: How high will premiums rise? How low will patient satisfaction go? Nov 07, 2023

Show notes

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/

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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.

FHC #111: Among wealthy nations, U.S. docs rank average for burnout Nov 01, 2023

Show notes

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)

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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 #111: Among wealthy nations, U.S. docs rank average for burnout appeared first on Fixing Healthcare.

FHC #110: Diving deep into drug-pricing wizardry and deep learning (AI) Oct 25, 2023

Show notes

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)

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The post FHC #110: Diving deep into drug-pricing wizardry and deep learning (AI) appeared first on Fixing Healthcare.

FHC #109: Dan Ariely on irrationality and misbelief in medicine Oct 18, 2023

Show notes

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.

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The post FHC #109: Dan Ariely on irrationality and misbelief in medicine appeared first on Fixing Healthcare.

MTT #77: Is the ‘tripledemic’ returning? Will new vaccines help? Oct 11, 2023

Show notes

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/

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The post MTT #77: Is the ‘tripledemic’ returning? Will new vaccines help? appeared first on Fixing Healthcare.

FHC #108: An unfiltered look at distrust between patients and doctors Oct 03, 2023

Show notes

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)

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The post FHC #108: An unfiltered look at distrust between patients and doctors appeared first on Fixing Healthcare.

FHC #107: Amy C. Edmonson on ‘failing well’ in medicine Sep 27, 2023

Show notes

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.

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The post FHC #107: Amy C. Edmonson on ‘failing well’ in medicine appeared first on Fixing Healthcare.

FHC #106: ZDoggMD on patient anxiety, medical bias & the Barbie movie Sep 20, 2023

Show notes

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)

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The post FHC #106: ZDoggMD on patient anxiety, medical bias & the Barbie movie appeared first on Fixing Healthcare.

FHC #105: Diving deep into the good, bad and ugly of U.S. healthcare Sep 12, 2023

Show notes

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 this podcast, which began five years ago and recently eclipsed 100 episodes. During that time, this show has welcomed dozens of world-renowned experts, both inside and outside the healthcare arena. Cohosts Dr. Robert Pearl and Jeremy Corr have engaged in difficult yet meaningful conversations with the likes of Malcolm Gladwell, Eric Topol, Don Berwick, Jen Gunter, Lisa Sanders, Zeke Emanuel and many others.

Their hope was that spotlighting big ideas and bold solutions would have a positive impact on American medicine. In this episode of Diving Deep, the hosts look back and examine how healthcare has improved (“the good”)—and how American medicine has become more problematic (“the bad” and “the ugly”).

The second half of today’s show focuses on the future. If the kinds of bold solutions featured on Fixing Healthcare are proving too big and audacious to implement, then which actions stand a reasonable chance of healing healthcare quickly (in the next five years) and affordably?

Click play to learn more or check out the various links below for additional information.

HELPFUL LINKS

American healthcare: The good, bad, ugly, future (LinkedIn Pulse)
Healing Healthcare: Repairing The Last 5 Years Of Damage (Forbes)
15 Innovative Ideas For Fixing Healthcare From 15 Brilliant Minds (Forbes)
Monthly Musings on American Healthcare (Robert Pearl’s newsletter)

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The post FHC #105: Diving deep into the good, bad and ugly of U.S. healthcare appeared first on Fixing Healthcare.

MTT #76: Can Rx weight-loss drugs help prevent heart attacks, too? Sep 06, 2023

Show notes

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/

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The post MTT #76: Can Rx weight-loss drugs help prevent heart attacks, too? appeared first on Fixing Healthcare.

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