Fixing Healthcare Podcast

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl dig for the facts beneath healthcare’s biggest headlines. Today’s show opens with the issue most likely to shape how Americans think about healthcare heading into the midterm elections: affordability.

Dr. Pearl explains that medical costs have now reached $5.7 trillion, rising more than 7% for the third consecutive year. Federal actuaries project that healthcare spending could approach $9 trillion by 2034, accounting for more than 20% of the U.S. GDP. For voters, employers, patients and families, those numbers aren’t just an endless string of zeroes. They’re impacting everyday life.

Premiums, deductibles, copays and prescription drug costs are forcing people with private insurance, Medicare and exchange coverage to delay care, take on debt or choose worse coverage. Two major drivers stand out: hospital spending and drug costs. Hospital care remains the largest share of national healthcare expenses, while drug spending is rising fastest, driven in part by the growing use of GLP-1 medications. Pearl sees enormous potential in these drugs to improve health and reduce complications over time, but only if prices fall low enough for the long-term savings to justify the near-term expense.

That tension becomes clearer in the discussion of Medicare’s new GLP-1 pilot program for weight loss. Under the “bridge program,” eligible Medicare enrollees will be able to obtain GLP-1 medications for $50 a month, far below current retail prices. Pearl calls the program an important experiment, but also notes its limitations: coverage is not automatic, eligibility is restricted, administrative hurdles remain and the pilot may end after 18 months. If patients lose access and regain weight, the program could fail despite the promise of the medication.

The episode then moves into several unusual and important stories, including new research into the origins of life, the medical risks of cannibalism, the promise and limitations of wearable health data, a large cyclosporiasis outbreak, rising e-bike injuries among children and adolescents, a new cholesterol-lowering pill, CDC leadership and measles.

Here are the major storylines from episode 109:

Researchers studying the origin of life made progress by taking a counterintuitive approach: building a synthetic cell from simple inorganic materials rather than stripping existing life forms down to their minimum parts.

“Spud cell” research could eventually help scientists understand which genes are essential and create engineered cells capable of producing new medical treatments.

A new study suggests cannibalism may have disappeared in part because of medical consequences, including infections and prion diseases that harmed tribes practicing it.

Wearable devices are generating valuable health data, but most doctors lack the time, reimbursement and regulatory pathways needed to integrate that information into clinical care.

A large cyclosporiasis outbreak has raised concerns about foodborne illness surveillance, produce safety and the difficulty of identifying contamination sources when symptoms appear one to two weeks after exposure.

E-bike injuries are rising, especially among children and adolescents, with head, face and neck injuries posing particular concern.

The FDA has approved a new pill that can lower LDL cholesterol to very low levels, though Pearl emphasizes that most average-risk patients should still rely on low-cost generic statins.

The nomination hearing for Dr. Erica Schwartz as CDC director highlighted the continuing tension between science and politics, especially around vaccines, RFK Jr. and public trust in federal health agencies.

Measles cases continue to rise, with nearly all occurring among unvaccinated people and with serious risks for those whose immunity has waned.

Generative AI may reduce costs and accelerate parts of drug development, but no AI-generated medication has yet obtained FDA approval.

The episode closes with a broader reflection on Season 11 of Fixing Healthcare. Pearl notes that the concerns raised by guests with large public followings are often different from the priorities emphasized by clinicians and national medical societies. Most Americans are not asking for unreasonable things. They want healthcare that is easier to access, affordable for their families and personalized to their circumstances. That gap, Pearl argues, may change how patients use technology. Large language models such as ChatGPT, Claude and Gemini are available 24/7, provide information at no additional cost and become more personalized as patients share more details. While many doctors worry that hospitals or insurers will replace them with AI, Pearl sees a different threat emerging: patients at home, frustrated by delays, high costs and feeling unheard, turning to generative AI because the healthcare system has not met their needs.

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 #109: Healthcare affordability, GLP-1s and the patient revolt ahead appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher explore what medicine can learn from positive psychology, elite sports teams and the daily pressures facing clinicians, leaders and patients.

The conversation begins with Fisher’s recent trip to Ireland, where he spoke at a conference on positive psychology, organizational well-being and leadership. Fisher explains that positive psychology is not simply about optimism or self-help. At its best, the field asks a more useful question: What can we learn from people, teams and organizations that are already flourishing?

That shift applies greatly in healthcare. Fisher argues that physician burnout cannot be solved by treating it only as an individual failure or by focusing only on what’s broken.

Pearl connects that idea to leadership. In business and medicine, he says, leaders often try to motivate people through fear, urgency and the “burning platform.” But both he and Fisher question whether threat-based leadership can produce the creativity, teamwork and judgment healthcare needs. Fisher points to research showing that when people feel threatened, their attention narrows. When they feel supported, curious and connected to a larger purpose, they can see more possibilities and make better decisions.

The conversation then turns to the World Cup. Pearl uses the tournament as a metaphor for medical practice, asking whether some doctors, like great athletes, are simply better performers than others. Fisher says yes, although the answer depends on what is being measured. Technical excellence matters, but so do teamwork, emotional regulation, communication and the experience of patients and colleagues.

That leads to one of the episode’s most important questions: What should healthcare do with brilliant clinicians who deliver exceptional technical results but damage the teams around them? Fisher argues that leaders must widen the definition of performance. Safety and volume matter, but so do turnover, culture, communication and the psychological impact one physician has on the rest of the team. A doctor can care deeply about patients and still harm the people required to care for them.

The final portion of the conversation returns to medical training. Fisher describes his work with new residents, where he teaches self-awareness, self-regulation, compassion and the ability to reset between difficult patient encounters. Pearl pushes the idea further, arguing that future physicians will also need strategic training: how to lead through others, apply technology, redesign care delivery and help medicine shift from disease reversal to health creation.

Cohost Jeremy Corr closes with a patient-centered question that extends the conversation beyond medicine: What should people do when work consumes their lives and leaves no space for health, relationships or meaning? Fisher cautions against simple hacks, arguing that people often need courage, help and boundaries to step off the hamster wheel. Pearl adds that for many Americans, the pace and expectations of modern life have become unsustainable. Strategy, he says, is not only about what people choose to do. It is also about what they are willing not to do.

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 #222: From burnout to leadership: how physicians can flourish appeared first on Fixing Healthcare.

Dr. Jerry Penso leads one of the most influential organizations in American healthcare. As president and CEO of AMGA, the American Medical Group Association, Penso represents 440 medical groups and health systems that care for nearly 100 million Americans.

That vantage point makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr.

This season’s guests are being asked what they are hearing from patients, clinicians and healthcare leaders right now. For Penso, three concerns rise above the rest:

A payment system that is fundamentally broken.

Worsening access to care.

A workforce under severe strain.

Penso begins with payment, especially Medicare and Medicaid. He explains that Medicare’s physician fee schedule has failed to keep up with inflation, leaving medical groups paid less in real terms while the cost of running a practice continues to rise. Medicaid cuts, he warns, will add further financial strain, especially for hospitals and medical groups that cannot choose which patients come through the emergency department or clinic doors.

The second major concern is access. Penso describes emergency rooms backed up across the country, patients waiting weeks to see specialists and primary care practices unable to accept new patients. He shares the story of his own mother, who spent five days in an emergency department before a hospital bed became available. For Penso, this is a symptom of a system in which demand is rising, the population is aging, chronic disease is growing and clinicians cannot simply “turn the hamster wheel” any faster.

That leads to the third issue: workforce. Physicians, nurses, advanced practice clinicians, pharmacists and staff are being asked to operate inside a system not designed for today’s volume, complexity or patient needs. Penso notes that most physicians are now employed by hospitals, health systems, insurers or private equity-backed organizations, a shift that has changed the psychology and day-to-day experience of medical practice. Loss of autonomy, bureaucracy and poor integration across systems all contribute to frustration and burnout.

There’s much more in this conversation, including the role of employer-sponsored health benefits, the limits of government reform, the promise and risk of generative AI, the future of physician autonomy and how AMGA is helping medical groups learn from one another.

Tune in to hear one of healthcare’s most experienced physician-executives explain what medical groups are seeing now, what must change next and why he remains optimistic that American healthcare can still move toward better payment, easier access and a more sustainable workforce.

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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 #221: What 440 medical groups are saying about healthcare today appeared first on Fixing Healthcare.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr explore what a breakthrough in mathematics can teach healthcare about generative AI, outdated assumptions and the future of medical practice.

The conversation begins with Paul Erdős, the brilliant Hungarian mathematician whose unit-distance problem stumped experts for 80 years. Generations of mathematicians tried to prove Erdős’ conjecture using the tools and assumptions of geometry. Then OpenAI announced that one of its models had found a different path, one that challenged the assumptions of humans.

For Pearl, the lesson for medicine is not about math. It is about the danger of staying trapped inside old models of thought. American healthcare faces persistent crises in quality, access and affordability, yet the proposed fixes focus on small adjustments to a system that has failed for decades. Pearl argues that generative AI will not reach its full potential if clinicians continue to use it merely for administrative tasks, documentation support or occasional diagnostic assistance.

Instead, he says, medicine must be willing to abandon three longstanding fallacies.

The second half of the episode shifts the discussion from assumptions to urgency. Pearl compares generative AI in medicine to the sudden invention of cars in a world where people could only travel by foot, bicycle or horseback. If faster transportation could save far more lives than it cost, society would not wait until cars were risk-free before building roads and teaching people to drive. He argues medicine should think similarly about GenAI: not as a finished product, but as a rapidly improving tool that could save lives if implemented wisely and quickly.

In the episode, Pearl highlights three areas where GenAI could have immediate impact. In each case, he returns to the same point: the greatest risk is not only that AI might make mistakes, but that medicine will ignore the harms already caused by today’s failures.

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

Helpful links:

What GenAI’s Math Breakthrough Means For Medicine (Forbes)

GenAI Is Ready To Change Medicine. America Isn’t Prepared (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 #220: How AI is challenging old assumptions in medicine appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl probe the facts beneath healthcare’s biggest headlines. Today’s show opens with a scientific breakthrough that could change the future of inherited disease: a new gene-editing technique that may allow researchers to correct DNA errors in human embryos with far greater precision than earlier CRISPR approaches.

Dr. Pearl explains that the advance, developed by researchers at Columbia University, uses a method called base editing. Unlike traditional CRISPR, which cuts out and replaces sections of DNA, base editing can alter individual nucleotides (the “letters” that make up genetic code). The difference, Pearl says, is comparable to moving from rewriting entire pages of text to correcting a single wrong letter inside a single word.

The promise is extraordinary. For families affected by one of the thousands of rare genetic diseases caused by single DNA errors, this technology could one day make it possible to prevent devastating inherited conditions before birth. Children who otherwise might face blindness, severe disability or premature death could instead be born free of the genetic defect.

But the ethical concerns are equally profound. The same technology that could prevent horrific disease could also be used to modify embryos for non-medical traits. Pearl warns that this possibility raises fears about “designer babies,” eugenics, private-sector incentives and the lack of federally funded oversight for embryo research in the United States.

Here are the other major storylines from episode 108:

A large study of 9 million patients found that four risk factors (high blood pressure, diabetes, high cholesterol and smoking) are associated with nearly all heart attacks and strokes.

The FDA approved a new sunscreen ingredient already used in Europe for decades, highlighting both the promise of better melanoma prevention and the slow pace of U.S. sunscreen regulation.

Employers are preparing for further increases in healthcare premiums, deductibles and copayments, with many companies limiting or eliminating GLP-1 coverage for obesity.

Preliminary data show U.S. infant mortality has reached an all-time low, but progress remains slow.

Medicaid work requirements could cause millions of eligible people to lose coverage because of paperwork errors, shifting costs to emergency rooms, hospitals and state budgets.

New rules under the No Surprises Act aim to speed dispute resolution between insurers and providers, but Pearl warns that payment disputes will continue as long as healthcare costs rise faster than people’s ability to pay.

Pearl outlines three requirements for real healthcare transformation: keeping people healthy by controlling chronic disease, moving more care into the home with generative AI support and shifting payment from fee-for-service to capitation.

The episode closes with two examples of AI already helping clinicians see what they might otherwise miss.

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.

* * *

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 #108: Designer babies, chronic disease & AI-powered care appeared first on Fixing Healthcare.