Fixing Healthcare Podcast

Jaksot

• 
  Revisiting Vinod Khosla’s vision for AI-powered healthcare 16.09.2026 51min

  With all the turmoil surrounding healthcare and artificial intelligence, the Fixing Healthcare team is revisiting one of its most provocative conversations: an interview with entrepreneur, investor and technology visionary Vinod Khosla. When Khosla appeared on the show in November 2024, he made a claim that drew immediate criticism from many in medicine: “The most expensive part of the healthcare system is expertise. And expertise can be tamed with AI.” At the time, many listeners and social media commenters saw the statement as overly optimistic, even dismissive of the complexity of clinical care. Today, it sounds less like provocation and more like a prediction medicine is still struggling to absorb. In this rerun episode, co-hosts Dr. Robert Pearl and Jeremy Corr invite listeners to hear Khosla’s remarks again in light of today’s rapidly changing AI landscape. He does not argue that technology should replace the human elements of medicine. Rather, he argues that AI can expand access to expertise, reduce the cost of routine clinical knowledge and make high-quality guidance available to more people in more places. For rural communities, patients with chronic disease and individuals waiting weeks or months for care, that possibility remains deeply consequential. The episode also asks a larger question: What happens if healthcare moves too slowly? Listen again to this timely conversation with Vinod Khosla, and decide for yourself: Was he too optimistic about AI in medicine, or too cautious? Helpful links: Vinod Khosla: How venture-backed tech is transforming U.S. healthcare (FHC #153) ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine (Pearl’s newest book) Khosla Ventures (Official Site) * * * 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 Revisiting Vinod Khosla’s vision for AI-powered healthcare appeared first on Fixing Healthcare.
• 
  FHC #227: Dr. Rod Rohrich on social media, science and AI-powered care 09.09.2026 51min

  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. * * * 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.
• 
  FHC #226: Peptides, primary care & the false choices in American medicine 01.09.2026 39min

  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) * * * 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.
• 
  MTT #110: Peptides, politics & the perils of medicine without evidence 26.08.2026 39min

  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. * * * 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.
• 
  FHC #225: Kindness, burnout and the limits of medical leadership 18.08.2026 49min

  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) * * * 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.
• 
  FHC #224: Austin Chiang on burnout, misinformation and the future of med-tech 13.08.2026 53min

  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. * * * 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.
• 
  FHC #223: How GenAI & World Cup strategy can help fix healthcare 06.08.2026 41min

  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) * * * 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.
• 
  MTT #109: Healthcare affordability, GLP-1s and the patient revolt ahead 29.07.2026 40min

  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. * * * 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.
• 
  FHC #222: From burnout to leadership: how physicians can flourish 22.07.2026 51min

  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) * * * 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.
• 
  FHC #221: What 440 medical groups are saying about healthcare today 15.07.2026 55min

  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. * * * 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.
• 
  FHC #220: How AI is challenging old assumptions in medicine 08.07.2026 42min

  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) * * * 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.
• 
  MTT #108: Designer babies, chronic disease & AI-powered care 01.07.2026 42min

  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.
• 
  FHC #219: Can AI help doctors think without losing medicine’s humanity? 23.06.2026 45min

  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) * * * 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.
• 
  FHC #218: Dr. Anthony Mazzarelli on healthcare’s next burning platform 16.06.2026 47min

  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. * * * 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.
• 
  FHC #217: GenAI, physician fulfillment & the future of medical practice 10.06.2026 41min

  In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr examine the rapid advance of generative AI, along with the growing conflict between medicine’s mission to heal and doctors’ need for financial security. The conversation begins with a question now echoing across every profession: Will AI replace highly trained workers? In medicine, Dr. Pearl argues, the answer is less about replacement than redefinition. Drawing on recent changes in software development, he explains how “vibe coding” has allowed programmers to stop writing much of the code themselves and instead use generative AI to build, test and refine applications from plain-language instructions. Rather than feeling diminished, many coders report greater satisfaction because AI has taken over the repetitive, error-prone work and left them more time for problem-solving. Pearl sees a similar possibility in healthcare. Like coding, medicine relies on years of training, structured reasoning and repeatable processes. Chronic disease management offers the clearest example. Hypertension, diabetes and high cholesterol are leading causes of heart attacks, strokes and kidney failure, yet proven treatments often fail because doctors lack the time to monitor patients continuously and adjust medications quickly. With home devices, physician-set targets and generative AI support, care could shift from occasional office visits to ongoing management, helping more patients achieve control while freeing physicians to focus on complex cases. The second half of the episode turns from technology to mission. Using Tim Cook’s legacy at Apple as a case study, Pearl examines what happens when values and financial incentives collide. Cook’s tenure produced extraordinary business results, but critics have questioned whether some of his choices conflicted with his own values and Apple’s public statements around privacy, dignity and human-centered technology. Pearl uses that as background for a similar question about medicine: What happens when doctors, who train to help and heal others above all else, feel increasingly forced to make career decisions shaped by money? For generations, medicine was understood as a calling. Today, most physicians no longer own their practices. Many now work for hospitals, health systems, insurers or private equity-backed groups, while others have moved into concierge or direct primary care models. Pearl stresses that these choices are rational. But the financial upside comes with psychological and moral consequences that are rarely discussed — and that may shape the future of physician fulfillment. For more, tune into this month’s episode and check out the links below. Helpful links The AI Revolution In Coding Offers A Preview Of Medicine’s Future (Forbes) What Tim Cook’s Legacy Teaches Doctors About Money And Mission (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * 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 #217: GenAI, physician fulfillment & the future of medical practice appeared first on Fixing Healthcare.
• 
  MTT #107: How politics is weakening America’s public health defenses 03.06.2026 38min

  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 examines the accelerating progress of generative AI, the political turmoil inside America’s leading health agencies and the infectious disease threats testing the nation’s public health readiness. The conversation opens with a listener question about how close generative AI is to matching clinicians. Dr. Pearl explains that the technology is advancing faster than he predicted in ChatGPT, MD, with recent research showing an OpenAI model outperforming experienced physicians on emergency room triage and management in text-based clinical cases. He cautions that medicine is more complicated than written scenarios but argues that the trajectory is clear: before today’s incoming medical students finish training, generative AI tools are likely to be used in emergency rooms across the country From there, the episode turns to the resignation of former FDA commissioner and Dr. Marty Makary, a two-time Fixing Healthcare guest. Pearl describes Makary as a respected clinician and patient-safety expert who found himself caught between scientific rigor, political pressure, industry opposition and public health critics. His departure, along with other leadership upheaval at FDA, CDC, NIH and HHS, raises a larger concern about whether America’s once-trusted scientific agencies can regain their independence and credibility. Here are the other major storylines from episode 107: RFK Jr. removes preventive-care leaders. Pearl criticizes the firing of two respected co-chairs of the U.S. Preventive Services Task Force, warning that prevention policy may be pushed away from scientific evidence. The surgeon general nomination moving toward confirmation. Nicole Safier appears more confirmable than Dr. Casey Means because her vaccine views are closer to the scientific mainstream. A hantavirus outbreak raises public health concerns. A cruise ship outbreak involving the Andes virus appears to have spread person-to-person, causing at least 13 cases, several severe illnesses and three deaths. The U.S. remains vulnerable to fast-moving outbreaks. Pearl says the slow federal response to hantavirus shows how weakened public health capacity could become dangerous if a highly lethal virus were also easily transmissible. Tick bites are rising sharply. ER visits related to tick bites have climbed well above typical levels, driven in part by warmer temperatures and the spread of deer ticks into the Midwest and South. Ebola exposes the cost of global health cuts. A new Ebola strain in the Democratic Republic of Congo has no vaccine or effective treatment, and the outbreak was recognized only after spreading for weeks. USAID and WHO cuts increase risk to Americans. Pearl argues that reducing global public health support does not put “America first” because viruses ignore national borders. Patients should be more concerned when doctors avoid AI entirely. Pearl says he would worry more about clinicians who refuse to use reliable generative AI tools than those who consult them regularly. Opioid overdose deaths are falling but remain devastating. New CDC data show overdose deaths down for the third straight year, but annual fatalities still total roughly 70,000, with overdoses remaining the leading cause of death among adults ages 18 to 44. Vaccine safety data are being suppressed. Pearl closes by describing blocked FDA and CDC research showing COVID and shingles vaccines to be safe and effective, warning that political censorship undermines trust and harms patients. Tune in for more fact-based analysis and practical perspective on the healthcare policies, technologies and trends shaping medicine today. * * * 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 #107: How politics is weakening America’s public health defenses appeared first on Fixing Healthcare.
• 
  FHC #216: An unfiltered look at what legacy means in medicine 26.05.2026 43min

  In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher explore three questions that reach across medicine, leadership and life itself: What legacy do physicians leave behind? How does mindset shape health and longevity? And can doctors still find fulfillment as medical practice shifts from independence to employment? The conversation begins with Tim Cook’s legacy at Apple, using his tenure as CEO to ask a larger question about values, mission and compromise. Pearl and Fisher examine whether legacy is something others assign after a career ends or something professionals create daily through their choices, actions and alignment with their deepest values. For physicians, the question becomes especially personal when financial, organizational or career decisions collide with the promise to put patients first. Midway through, the discussion turns to longevity and the science of mindset. Drawing on research from Yale and Fisher’s work in Just One Heart, the two physicians explore how beliefs about aging can influence physical function, cognitive health, inflammation and long-term well-being. Fisher explains why optimism is not merely a pleasant attitude but a physiologic force that can shape stress hormones, inflammatory pathways and the daily behaviors that determine health. Finally, Pearl and Fisher examine one of the biggest structural shifts in modern medicine: the movement from physician-owned practices to employment by hospitals, health systems and insurers. Fisher notes that independent doctors may report lower burnout, but autonomy is no longer guaranteed when administrative burdens, call schedules and financial pressures consume the practice of medicine. Employment offers support and stability, but often at the cost of control. By the end, the episode connects all three themes: legacy, health and professional fulfillment are rooted in purpose. Whether through family, patient care, mission trips, mentoring or the daily work of medicine, Pearl and Fisher suggest that doctors may live longer, healthier and more meaningful lives when they preserve the mission that brought them to medicine in the first place. For listeners who connected with Fisher’s reflections on burnout, autonomy and the search for renewed purpose in medicine, his upcoming ASPIRE physician retreat offers a deeper opportunity for reflection and recovery. Co-facilitated with Dr. Robyn Tiger, ASPIRE is a CME-accredited retreat designed exclusively for healthcare professionals, taking place June 12-14 at the Art of Living Retreat Center in Boone, North Carolina. Use code ASPIRE15 for 15% off registration. 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) * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn. The post FHC #216: An unfiltered look at what legacy means in medicine appeared first on Fixing Healthcare.
• 
  FHC #215: Revisiting healthcare leadership, technology & capitation 19.05.2026 38min

  Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl are revisiting a past episode of Diving Deep while Dr. Pearl travels and keynotes events around the world. And like last week’s replay, this conversation was selected for a reason. Originally recorded more than three years ago, this episode explores two issues that remain central to the future of American medicine: how healthcare leaders respond to technological change and whether the nation can finally move beyond fee-for-service reimbursement. Looking back now, the discussion feels strikingly current. Many of the opportunities Dr. Pearl identified at the time still exist today. Generative AI has advanced dramatically. Remote monitoring tools are more powerful and accessible than ever. And healthcare leaders continue to acknowledge the need for better chronic disease management, prevention and lower-cost care delivery. Yet despite these advances, many of the nation’s biggest healthcare problems remain unresolved. U.S. quality outcomes still lag peer nations. Life expectancy remains years shorter than in comparable countries. And healthcare costs continue rising at rates that far exceed inflation, wage growth and GDP. Throughout the episode, Dr. Pearl argues that these failures are not primarily technological. The tools to improve care already existed — and continue to improve rapidly today. The greater challenge is leadership itself: helping clinicians embrace change, aligning incentives around patient outcomes and building the operational systems required to make better care possible at scale. The conversation also revisits capitation and value-based care, themes that have resurfaced repeatedly in recent Fixing Healthcare episodes. Dr. Pearl explains why fee-for-service reimbursement continues to reward volume over outcomes and why meaningful progress in affordability will require shifting financial incentives toward prevention, chronic disease control and long-term patient health. Revisiting this episode now offers a useful perspective on the past several years of healthcare transformation: technology has accelerated, but the deeper structural changes required to improve affordability and outcomes have moved far more slowly. Helpful links The Anatomy Of Healthcare Leadership: A Mind For Technology (Forbes) Healthcare Leadership: Following The Money Can Lead To Positive Change (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * 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 Twitter and LinkedIn. The post FHC #215: Revisiting healthcare leadership, technology & capitation appeared first on Fixing Healthcare.
• 
  FHC #214: Revisiting GLP-1 prices and ChatGPT’s early leap forward 12.05.2026 35min

  For the next two weeks, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl will be replaying past episodes of Diving Deep while Dr. Pearl travels and keynotes events around the world. But these aren’t random reruns. They were selected for a reason: to highlight just how quickly technology is advancing and how slowly healthcare is adapting. This week’s flashback revisits a July 2024 conversation recorded shortly after OpenAI released GPT-4o, a major leap forward in generative AI at the time. Less than two years later, the pace of change is striking. Capabilities that once felt groundbreaking now seem primitive compared to what today’s AI tools can accomplish for patients, physicians and healthcare organizations. At the same time, the episode’s broader themes remain remarkably current. Dr. Pearl and Jeremy discuss the future role of generative AI in medicine, how these tools could improve diagnosis and patient monitoring and why healthcare institutions often struggle to embrace transformative technology quickly. The episode also examines another issue that remains unresolved today: the high cost of GLP-1 medications like Wegovy and Ozempic. Dr. Pearl explains why these highly effective obesity treatments remain financially out of reach for many Americans despite growing demand and expanding clinical use. Revisiting this conversation now offers a useful reminder: technology can advance extraordinarily fast, but healthcare systems, incentives and policies often lag far behind. Helpful links:  OpenAI’s Rule-Shattering GPT-4o Update Will Be Lifesaving, Too (Forbes) Wegovy And Ozempic Are Overpriced By 400-500% — Here’s A Quick Solution (Forbes) Monthly Musings on American Healthcare (Robert Pearl’s newsletter) * * * 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 #214: Revisiting GLP-1 prices and ChatGPT’s early leap forward appeared first on Fixing Healthcare.
• 
  FHC #213: Longevity myths, healthcare costs & why medicine must subtract to improve 05.05.2026 38min

  In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr dissect two issues that are often discussed separately but are deeply intertwined: how Americans can live longer, healthier lives and how the nation can make healthcare more affordable. The conversation begins with longevity. As interest in lifespan and “healthspan” grows, Dr. Pearl challenges three widely held beliefs that, in his view, are holding Americans back. First, the idea that physical and cognitive decline is inevitable with age. New research suggests that nearly half of older adults improve over time, particularly when they maintain a positive outlook and stay physically and mentally active. Second, the belief that longevity can be “hacked” through supplements, peptides and other quick fixes. Despite a $50 billion market and widespread adoption, Pearl explains that most of these interventions lack strong clinical evidence in humans. And third, the assumption that prevention can wait until middle age. Updated cardiovascular guidelines show that earlier screening and intervention, particularly around LDL cholesterol, can dramatically reduce long-term risk. From there, the discussion shifts to the financial side of healthcare. Pearl argues that improving population health is the most effective way to reduce costs, but that meaningful change will also require a fundamental redesign of how care is delivered. Drawing on behavioral research, he introduces a central concept: healthcare leaders tend to solve problems by adding more resources (staff, beds, technology) when better outcomes often require subtraction first. The second half of the episode applies this “subtraction before addition” framework across the healthcare system. In outpatient care, Pearl describes how the traditional small physician office has become increasingly inefficient in an era dominated by chronic disease and administrative complexity. He proposes larger, integrated models that share staff, leverage generative AI and shift from calendar-based visits to continuous, need-based care. In emergency departments, he outlines how segmenting patients by clinical severity could reduce wait times, improve outcomes and lower costs by treating low-risk cases through primary care pathways. And in inpatient settings, he points to hospital-at-home programs as a way to safely care for a significant share of patients at lower cost and with better outcomes. Taken together, this episode teaches that Americans can extend both lifespan and healthspan by rejecting outdated assumptions and focusing on proven behaviors. At the same time, healthcare affordability will not improve by continuing to add more of the same. It will require eliminating inefficiencies, redesigning care delivery and replacing outdated models with ones better suited to modern medicine. For more, tune into this month’s episode and check out the links below. Helpful links New Studies Show Americans Are Thinking About Longevity All Wrong (Forbes) The More We Add To U.S. Healthcare, The Worse It Gets (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * 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 #213: Longevity myths, healthcare costs & why medicine must subtract to improve appeared first on Fixing Healthcare.