Fixing Healthcare Podcast

In this episode of Fixing Healthcare, Dr. Robert Pearl and Jeremy Corr welcome back Dr. Rod Rohrich, an internationally recognized plastic surgeon, former editor-in-chief of Plastic and Reconstructive Surgery and national leader in the application and safety of social media for medical advancement.

Dr. Rohrich, a returning guest (FHC #57), focuses now on the healthcare concerns most affecting Americans today. Drawing on his experience with patients, physicians and a massive social media audience, Rohrich identifies three questions he hears most often:

Can I trust my doctor?

Is this information true or merely popular?

And can AI really help me understand my health and make it better?

These questions frame a conversation about generative AI, patient empowerment, medical misinformation, physician compassion and the future of clinical practice.

Can I trust my doctor?

Rohrich says patients want the speed of AI and the accessibility of social media, but they still want the compassion and judgment of a trusted physician. He and Pearl agree that AI will not replace doctors, but it can help patients ask better questions, understand their conditions more quickly and arrive at appointments better prepared. Rohrich sees this already in plastic surgery, where patients bring questions, research and even AI-generated summaries into consultations. Used well, he says, AI can streamline the visit, clarify patient goals and help physicians focus faster on what the patient needs.

Is this information true or merely popular?

Rohrich’s social media experience gives him a clear view of the problem. Patients are bombarded with claims about longevity, sleep, fitness, supplements and medical treatments, often from influencers with no healthcare background. His practical advice is to use generative AI as a filter: ask tools like ChatGPT or Claude to evaluate claims based on peer-reviewed, evidence-based research and supporting references. Pearl connects the point to peptides, noting that enthusiasm is not the same as evidence. Both physicians argue that patients need better ways to distinguish science from marketing.

Can AI really help me understand my health and make it better?

Pearl and Rohrich see AI’s greatest promise in making care faster, more personalized and more humane. Rohrich shares how AI helped identify a postoperative infection from a patient photo and generate clearer instructions for home care. He also describes using AI to write more empathetic responses to anxious patients. Pearl adds that ambient AI tools can free doctors from computer screens, while future applications could help patients understand hospital care, test results and next steps. The goal, both agree, is not to remove humanity from medicine but to use technology to restore it.

Jeremy closes the show with a patient-centered concern: What happens when people receive lab, MRI or CT results through an online portal late at night, without a physician available to explain them? Rohrich says AI is already better than Google at providing context, but it must be used carefully because partial information can produce partial answers. Pearl argues that the answer is not to fear the technology, but to make secure, private AI tools more complete, accurate and useful for patients.

The episode ends with Drs. Pearl and Rohrich laying out a shared vision. Generative AI should not replace physicians. It should take work off their plates so they can focus on what only people can do: solve complex problems, communicate compassion and guide patients through frightening moments. For Rohrich and Pearl, AI offers a chance to make medicine faster, smarter and more human, but only if doctors and patients learn to use it well and keep evidence at the center.

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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 X and LinkedIn.

The post FHC #227: Dr. Rod Rohrich on social media, science and AI-powered care appeared first on Fixing Healthcare.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr examine two very different healthcare debates that share a common problem: when medicine lacks good evidence and aligned incentives, patients and doctors are left with bad choices.

The conversation begins with experimental peptides, a fast-growing topic on social media and in wellness circles. Dr. Pearl reviews the FDA’s ongoing debate over whether six experimental peptides should be made available to licensed compounding pharmacies. Supporters argue that Americans are already buying these substances through the gray market, often from overseas suppliers, and that regulated access would be safer. Critics argue that expanded access would encourage far more people to use products whose benefits, risks, purity and long-term safety remain uncertain.

For Pearl, both sides are partly right, which is why a simple yes or no is the wrong answer.

Saying no would not eliminate demand. It would leave many Americans buying peptides online without reliable quality control. Saying yes without conditions would create the impression of FDA approval without the scientific evidence normally required to prove safety and efficacy. Instead, Pearl argues for a third path: pair regulated access with federally coordinated research, safety reporting and controlled studies so patients, doctors and regulators can learn whether these peptides actually work and whether they are safe.

The second half of the episode turns to primary care, a specialty Pearl says is in serious trouble.

Primary care physicians are overburdened, under-resourced and underpaid compared with specialists. They face growing patient panels, administrative demands, declining autonomy and less interest from medical students entering the field.

Pearl acknowledges that primary care leaders are right to ask for more respect, more support and better compensation. But he argues that payers are unlikely to invest substantially more unless primary care can demonstrate better outcomes and lower total costs. That has not happened consistently under traditional fee-for-service or pay-for-performance programs, which reward isolated steps in care rather than overall clinical impact.

The solution is capitation. Under this model, primary care doctors would receive a prospective payment to care for a defined population rather than being paid for each visit or service. If chronic diseases are controlled, emergency department use falls and complications decline, both patients and clinicians benefit. But capitation also requires doctors to accept financial risk, organize into larger groups, adopt common clinical standards, coordinate care and empower effective physician leaders.

The episode closes with a call for national primary care societies to lead. Pearl says they can help doctors form groups, negotiate capitated contracts, purchase stop-loss protection, implement generative AI, build clinical infrastructure and spread best practices from early demonstration programs.

Across both topics, Pearl returns to the same point. Whether the issue is experimental peptides or the future of primary care, patients need evidence, doctors need accountability and the system needs incentives that reward better health.

For more, tune into this month’s episode and check out the link below.

Helpful links:

The Best FDA Decision On Peptide Authorization Isn’t Yes Or No (Forbes)

Monthly Musings on American Healthcare (RobertPearlMD.com)

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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.

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 X and LinkedIn.

The post FHC #226: Peptides, primary care & the false choices in American medicine appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl go in search of the facts beneath healthcare’s biggest headlines. Today’s show opens with one of the hottest and least understood medical topics: experimental peptides.

Pearl explains that an FDA advisory committee narrowly recommended allowing compounding pharmacies to provide six experimental peptides to patients. This is not the same as traditional FDA approval. Rather than reviewing a drug through the usual three-phase clinical trial process, the recommendation would allow suppliers to provide peptide ingredients that compounding pharmacies could use to fill prescriptions.

Pearl then explains why this distinction matters. If the FDA follows the committee’s recommendation, many patients may assume the peptides have been vetted like other approved medications. He warns that this could leave the nation in a medical gray zone, with broad access but little rigorous evidence on safety, effectiveness, dosing or long-term risk.

The episode then turns to several follow-up stories and new medical developments, including the cyclospora outbreak, CDC leadership, pediatric e-bike injuries, AI-designed viruses, Ebola, mRNA flu vaccines and the continuing politicization of vaccine policy:

The cyclospora outbreak appears to be slowing, but the total case count remains high and the exact source has not been fully confirmed.

Erica Schwartz has been confirmed as CDC director, becoming the agency’s first full-time leader in a year. Pearl says Schwartz has strong credentials but will face major challenges, including depleted agency staffing, infectious disease outbreaks and political pressure around vaccines.

Pediatric e-scooter and e-bike injuries surpassed 2,000 incidents from 2020 to 2024, according to data from Johns Hopkins researchers. Pearl warns that more states may need to restrict use among young children.

AI can design viruses that do not currently exist in nature, a new Stanford study showed. This opens possibilities for new treatments but also raising biosecurity concerns. Pearl says the technology could one day help fight antibiotic-resistant bacterial infections, but it also raises concerns about bad actors.

Ebola is spreading rapidly in the Democratic Republic of Congo, with more than 1,500 deaths and a mortality rate estimated at 40% to 50%.

The FDA approved the first mRNA flu vaccine, developed by Moderna, for adults 50 and older. Pearl explains that mRNA technology could improve flu vaccination by allowing scientists to update vaccines closer to the arrival of each year’s viral strain.

The episode closes with Pearl’s strongest warning: medical decisions made on politics rather than science lead to harm. He points to President Trump’s executive order changing childhood vaccine recommendations and encouraging separation of the MMR vaccine into individual measles, mumps and rubella shots.

Pearl says there is no scientific evidence supporting the president’s claim that the combined MMR vaccine may be dangerous, while numerous studies show it is safe, effective and lifesaving. His conclusion: when scientific evidence is overwhelming, leaders need a compelling scientific reason to deviate from it. Whether the subject is experimental peptides, AI-designed viruses, mRNA vaccines or childhood immunization, medicine cannot protect patients if politics replaces data.

Tune in to hear the full discussion and subscribe to Medicine: The Truth for more fact-based analysis of the medical, scientific and policy stories shaping American healthcare.

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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” about the impact of AI on the future of medicine.

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 X and LinkedIn.

The post MTT #110: Peptides, politics & the perils of medicine without evidence appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher join cohost Jeremy Corr for a wide-ranging conversation about burnout, kindness, leadership, medical errors and what American healthcare can learn from other nations.

The episode begins with Fisher’s recent trip to Australia, where he joined physicians and other healthcare professionals for a program focused on individual well-being, organizational well-being and burnout. Held near Uluru, on sacred Aboriginal land, the gathering included conversations with tribal elders about the connection between land, culture, traditional remedies and healing.

Fisher explains that some Australian hospitals have incorporated Aboriginal traditions alongside Western medicine, not as a replacement for modern care, but as a way to build trust and honor patients’ cultural identity. That approach, he says, has helped Indigenous patients feel more respected by the healthcare system.

Pearl connects the discussion to a larger economic reality. Although the United States spends far more on healthcare than other nations, many countries are facing the same underlying pressure: medical costs rising faster than wages, GDP or general inflation. For clinicians, the result is familiar across borders: more work, more bureaucracy, more isolation and growing frustration.

From there, the conversation shifts to kindness in leadership. Fisher draws an important distinction between being kind and being nice. Niceness, he argues, is often about wanting people to like us or avoiding discomfort. Kindness is different. True kindness may require difficult conversations, honest feedback and decisions that create short-term discomfort but protect patients, teams and organizations over time.

That distinction leads into one of the episode’s central leadership questions: How should medical leaders respond when a physician is struggling, underperforming or causing avoidable harm?

Pearl emphasizes that leaders must keep the patient at the center. Fisher adds that fairness matters deeply, especially in how feedback is delivered. Leaders should be prompt, clear, transparent about process and respectful of the physician’s dignity.

Finally, the discussion shifts to generative AI and diagnostic errors. Pearl raises the possibility that AI tools could help identify missed diagnoses in emergency departments before patients are discharged or admitted. Fisher agrees that AI can help prevent harm, but warns that emergency physicians are already overwhelmed. A tool that produces too many alerts, even if well intended, could worsen cognitive overload and be ignored.

Jeremy closes with a patient-centered question about what both physicians have seen in other countries that they wish existed in the United States. Fisher points to the sense, in some countries with socialized medicine, that everyone deserves a basic level of care. Pearl describes a hospital visit in Sweden, where strong social supports and clinician collaboration produced better outcomes by addressing many social determinants before they reached the medical system.

For more unfiltered conversation, listen to the full episode and explore these related resources:

‘Just One Heart’ (Jonathan Fisher’s newest book)

‘ChatGPT, MD’ (Robert Pearl’s newest book)

Monthly Musings on American Healthcare (Robert Pearl’s newsletter)

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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 X and LinkedIn.

The post FHC #225: Kindness, burnout and the limits of medical leadership appeared first on Fixing Healthcare.

Dr. Austin Chiang has built one of medicine’s most distinctive public platforms.

He is a triple board-certified gastroenterologist, Chief Medical Officer for Medtronic’s Endoscopy business and Associate Professor of Medicine at Thomas Jefferson University. He is also one of healthcare’s most influential physician voices online, with hundreds of thousands of followers across TikTok, Instagram, YouTube and LinkedIn.

That makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr. This season asks what patients, clinicians and healthcare leaders are saying now that feels meaningfully different from the past.

Chiang hears those concerns from several vantage points: as a practicing physician, medical technology leader, educator and public-facing doctor.

For Chiang, three issues stand out:

Clinician burnout and loss of autonomy

Chiang says physicians are struggling with administrative burden, documentation demands, prior authorization, staffing shortages, reimbursement pressure and a growing sense that medical decisions are no longer fully in their hands. Pearl pushes further, asking whether clinicians must take more responsibility for affordability rather than simply objecting to the oversight created in response to rising costs. Chiang agrees that physicians need a better understanding of the broader healthcare ecosystem if they want to help change it.

Medical misinformation and social media

Chiang has spent more than a decade learning how to communicate across platforms and audiences. He explains that accurate medical information must now compete with sensationalized claims from people who are not held to the same professional standards as clinicians. For doctors, the challenge is to be credible without being boring, engaging without becoming irresponsible and platform-specific without compromising the message. That tension is especially important in areas like gut health, diet, probiotics and the microbiome, where uncertainty creates space for simple but potentially misleading answers.

Clinician-led innovation

As Medtronic’s Chief Medical Officer for Endoscopy, Chiang works at the intersection of clinical practice and medical technology. He explains that innovation in medicine is slow for good reason: new tools must prove safety, clinical value, workflow fit and real-world usefulness before becoming mainstream. But he argues that clinicians need to be more involved in that process because they understand the nuances of patient care, staff experience and adoption better than outsiders can.

The conversation also explores colorectal cancer, which is rising among younger adults. Chiang explains why colonoscopy remains the gold standard for prevention, while also noting that lowering screening ages further would create major capacity challenges. He also discusses AI-assisted polyp detection, the future of endoscopy and why fully autonomous colonoscopy remains difficult given the complexity of human anatomy.

There’s much more in this conversation, including physician career paths beyond traditional practice, how doctors should respond when patients bring AI-generated information to appointments and what people with chronic GI conditions need from clinicians, platforms and online communities.

Tune in to hear one of medicine’s most visible digital physician leaders explain how doctors can help shape a future where technology, social media and medical innovation better serve patients.

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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 X and LinkedIn.

The post FHC #224: Austin Chiang on burnout, misinformation and the future of med-tech appeared first on Fixing Healthcare.