Fixing Healthcare Podcast

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.

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

In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher join cohost Jeremy Corr for a fascinating conversation about the physician’s mind, the promise and limits of generative AI, and what medicine risks losing when technology advances faster than humans can tolerate.

In this episode, Pearl turns to a realization he had during a recent hiking trip in Portugal: his brain felt different while walking through the woods than it does while solving analytical problems.

That observation leads to a deeper discussion of “left brain” and “right brain” thinking in medicine. Fisher explains that while the popular labels are oversimplified, the underlying challenge is real. Doctors must integrate structured reasoning with emotional awareness, diagnosis with relationship, and technical expertise with the human experience of illness.

The discussion then moves into one of the episode’s most provocative questions: Can generative AI be taught to express empathy and relational intelligence as well as humans? Pearl points to studies showing that AI-generated responses to patient questions can be rated as highly empathetic, comprehensive and accurate. Fisher pushes back, arguing that there is a difference between perceived empathy in written answers and the embodied presence of a physician sitting with a fearful patient and family in a vulnerable moment.

What follows is a thoughtful disagreement about the future of medicine. Pearl sees generative AI as a way to fill dangerous gaps in American healthcare, including lack of access after hours, rural shortages, diagnostic errors, preventable medical mistakes and poorly controlled chronic disease. Fisher worries that if AI begins taking over both analytical and relational parts of care, physicians may feel even more threatened in a profession already marked by burnout and uncertainty.

This leads to the debate’s central question: Will generative AI become the enslaver of clinicians or the liberator? Pearl argues that AI could help physicians escape the growing corporatization of medicine by taking on routine work, expanding access and enabling doctors to practice with more autonomy. Fisher agrees that this future is possible but cautions that in a fee-for-service system, efficiency gains may simply become an excuse to increase volume, billing and pressure on clinicians.

Finally, Jeremy brings the conversation back to everyday life by asking whether heavy reliance on technology and AI could weaken the mind the same way physical inactivity weakens the body. Fisher warns that when people offload too much thinking, emotion and relationship-building to devices, they risk losing cognitive sharpness and emotional attunement. Pearl agrees that every technology carries benefits and harms, arguing that the goal should be balance: using AI to learn, understand and solve problems without letting it flatten life’s richer, more meaningful experiences.

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 Twitter and LinkedIn.

The post FHC #219: Can AI help doctors think without losing medicine’s humanity? appeared first on Fixing Healthcare.

Dr. Anthony “Mazz” Mazzarelli brings a rare combination of perspectives to American healthcare: physician, executive, lawyer, bioethicist, author and media voice.

As co-president and CEO of Cooper University Health Care and associate dean of clinical affairs at Cooper Medical School, Mazzarelli leads a major safety-net health system while continuing to see patients himself. He is also co-author of Compassionomics, a book that makes the evidence-based case that compassion in medicine improves outcomes, lowers costs and reduces clinician burnout.

That combination makes him an ideal guest for 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 the public right now.

For Mazzarelli, three themes rise to the top:

Growing concern over Medicaid cuts and rising uninsurance

Excitement about generative AI and other new technologies

Awe at the speed of change healthcare leaders will need to manage

Key episode highlights include:

Medicaid cuts will hit safety-net patients hardest. At Cooper, roughly one-third of patients are covered by Medicaid or are self-pay. Mazzarelli explains that many of these patients live paycheck to paycheck or depend on coverage to manage chronic disease. When they lose access, prevention disappears and patients often delay care until they show up sicker in emergency departments and hospitals.

Generative AI is a promising tool for rethinking how care is delivered. Ambient listening and automated notes are helpful, he says, but the larger opportunity lies in decision support, preventive outreach, chronic disease management, medication adherence and giving clinicians more time to connect with patients.

Fraud prevention should not become a barrier to legitimate care. Mazzarelli supports catching fraud and abuse in Medicaid and Medicare, but argues that AI should be used to identify bad actors more precisely so the system can reduce unnecessary checkboxes.

Employer-based healthcare has hidden the true cost crisis. Employers and government programs have absorbed much of the rising cost of care, preventing individuals from feeling the full impact. That delay has reduced pressure for major reform, even as the system becomes increasingly unaffordable.

Payment reform remains the real lever for change. While Mazzarelli supports incremental improvements, he says the biggest changes will require addressing the way care is paid for, including the misaligned incentives that shape nearly every part of American healthcare.

AI can help clinicians reconnect with patients. Compassion is not a soft concept. Stronger patient connection has been linked to better outcomes, lower costs, fewer unnecessary tests and less burnout among clinicians.

Technology should redesign care, not automate bad workflows. Mazzarelli cautions that healthcare does not simply need better AI models. It needs leaders willing to redesign workflows in an “AI-native” way rather than layering technology on top of broken processes.

Convenience must be balanced with human connection. Jeremy raises concerns about the broader health consequences of modern convenience, including loneliness and isolation. Mazzarelli agrees, noting that loneliness is a major public health risk and that healthcare organizations have a responsibility to address it.

Burnout requires more than wellness programs. Mazzarelli argues that yoga, walks and wellness initiatives are not enough if clinicians feel disconnected from the work itself. The real antidote, he says, is restoring meaning at the point of care by helping clinicians connect with patients and see the difference they make.

There’s much more in this conversation, including Cooper’s co-president model, the impact of private equity on physician practice, the future of 24/7 access and how policymakers should think about AI safety without slowing progress.

Tune in to hear what one of healthcare’s most thoughtful physician-executives believes patients, clinicians and leaders should expect from the next era of medicine.

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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 #218: Dr. Anthony Mazzarelli on healthcare’s next burning platform appeared first on Fixing Healthcare.