Fixing Healthcare Podcast

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.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr examine two big questions facing American medicine: how generative AI can make healthcare more affordable and what the World Cup can teach doctors about strategy, teamwork and leadership.

The conversation begins with a counterintuitive point: In other industries, technology often lowers costs by allowing companies to produce the same output with fewer workers. But Dr. Pearl knows medicine is different. In healthcare, the biggest costs arise when preventable and controllable conditions turn into life-threatening complications. Therefore, he does not believe GenAI’s greatest financial value in healthcare will come from replacing doctors and nurses.

Pearl argues that the surest way to lower healthcare spending is by keeping people healthier. Poorly controlled hypertension, diabetes, heart failure and kidney disease drive many of the nation’s most expensive complications, including heart attacks, strokes, kidney failure, hospitalizations and surgeries. GenAI can help prevent those outcomes, and the savings could far exceed anything gained by reducing clinician headcount.

From there, Pearl identifies three major opportunities for GenAI-driven improvements:

Control chronic diseases by helping patients understand their conditions, track data from home devices and get medication adjustments sooner (rather than waiting months between office visits).

Expand access to medical expertise after hours and on weekends.

Improve care coordination and medication safety, especially for older adults with multiple chronic conditions.

But technology alone will not be enough. So, the second half of the episode turns to entrepreneurship and leadership. Pearl discusses new research comparing expensive physician-facing AI tools with general-purpose large language models such as ChatGPT, Claude and Gemini.

His takeaway for entrepreneurs is clear: the biggest opportunity may not be building costly tools for hospitals, but helping patients use the AI tools already available on their computers and smartphones to manage their health more effectively.

That point leads into a broader lesson from the recent World Cup. Pearl argues that American medicine, like many talented teams that failed to win soccer’s biggest prize, has extraordinary resources but lacks a shared strategy. The United States has exceptional doctors, world-class hospitals and more healthcare spending than any nation, yet outcomes remain inconsistent, access unreliable and costs unaffordable.

The episode closes with a warning and a challenge. American medicine already has the talent, technology and financial resources to succeed. What it lacks is a clear strategy, coordinated teamwork and effective clinician leadership. If doctors want to improve care for patients and preserve the profession’s values, Pearl argues, they will need to embrace new technology, work together differently and take responsibility for the system’s performance.

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

Helpful links:

Entrepreneurs Beware: Inexpensive AI Is The Future Of Medicine (Forbes)

GenAI Won’t Lower Medical Costs By Replacing Doctors And Nurses (Forbes)

47 World Cup Teams Fell Short. US Medicine Should Learn From Them (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 #223: How GenAI & World Cup strategy can help fix healthcare appeared first on Fixing Healthcare.

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.