Podcasts about uncaring how

Few people are better at demystifying the byzantine complexities of the American healthcare system than the former CEO of Kaiser Permanente, Robert Pearl, MD. So what does Pearl make of Trump's nomination of RFK Jr for Secretary of Health and Human Services? Is this a thinly veiled excuse to go to war with the current American healthcare system? Or does RFK Jr really have the acuity to responsibly reform a system in desperate need of reinvention?For 18 years, ROBERT PEARL, MD served as CEO of The Permanente Medical Group (Kaiser Permanente). He is also former president of The Mid-Atlantic Permanente Medical Group. In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. He is a clinical professor of plastic surgery at Stanford University School of Medicine and on the faculty at the Stanford Graduate School of Business, where he teaches courses on healthcare strategy, technology, and leadership. Pearl is board certified in plastic and reconstructive surgery, receiving his medical degree from Yale, followed by a residency in plastic and reconstructive surgery at Stanford University. He's the author of three books: Mistreated: Why We Think We're Getting Good Healthcare—And Why We're Usually Wrong, a Washington Post bestseller (2017); Uncaring: How the Culture of Medicine Kills Doctors & Patients, a Kirkus star recipient (2021); and his newest book ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine (April 2024). All profits from sales of his books go to Doctors Without Borders. Dr. Pearl is a LinkedIn “Top Voice” in healthcare and host of the popular podcasts Fixing Healthcare and Medicine: The Truth. He publishes two monthly healthcare newsletters reaching 50,000+ combined subscribers. A frequent keynote speaker, Pearl has presented at The World Healthcare Congress, the Commonwealth Club, TEDx, HLTH, NCQA Quality Talks, the National Primary Care Transformation Summit, American Society of Plastic Surgeons, and international conferences in Brazil, Australia, India, and beyond. Pearl's insights on generative AI in healthcare have been featured in Associated Press, USA Today, MSN, FOX Business, Forbes, Fast Company, WIRED, Global News, Modern Healthcare, Medscape, Medpage Today, AI in Healthcare, Doximity, Becker's Hospital Review, the Advisory Board, the Journal of AHIMA, and more.Named as one of the "100 most connected men" by GQ magazine, Andrew Keen is amongst the world's best known broadcasters and commentators. In addition to presenting KEEN ON, he is the host of the long-running How To Fix Democracy show. He is also the author of four prescient books about digital technology: CULT OF THE AMATEUR, DIGITAL VERTIGO, THE INTERNET IS NOT THE ANSWER and HOW TO FIX THE FUTURE. Andrew lives in San Francisco, is married to Cassandra Knight, Google's VP of Litigation & Discovery, and has two grown children.Keen On is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit keenon.substack.com/subscribe

Special Guest: Dr. Robert Pearl – Physician, Clinical Professor of plastic surgery at Stanford University School of Medicine, Faculty member of the Stanford Graduate School of Business, Former CEO of The Permanente Medical Group (Kaiser Permanente), and Author   Points covered  ·       Not all AI is the same. Generative AI will save hundreds of thousands of lives and reduce medical costs. ·       The combination of a dedicated clinician, empowered patient and GenAI will be incredibly more powerful than any of the three alone.  ·       Chronic disease is overwhelming the American healthcare system leading to stagnant life-expectancy, higher costs and the epidemic of burnout.  ·       Success will require that we shift payment in healthcare from "pay-for-volume" (FFS) to "pay-for value) (capitation). Doing so will require skilled clinician leadership and a different doctor-patient relationship.  Biography Dr. Robert Pearl was the CEO of The Permanente Medical Group (Kaiser Permanente) from 1999-2017. In this role he led 12,000 physicians, 42,000 staff and was responsible for the nationally recognized medical care of over 5 million Kaiser Permanente members on the west and east coasts.    His newest book, “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” debuted as #1 on Amazon's “New Best Seller” list. All profits from the book go to Doctors Without Borders. He is also the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller and “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” published May 2021.    Pearl, named one of Modern Healthcare's 50 most influential physician leaders, serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He hosts the popular podcasts Fixing Healthcare and Medicine: The Truth,  publishes a newsletter called Monthly Musings on American Healthcare, and is a regular contributor to Forbes.  Dr. Pearl received his medical degree from the Yale University School of Medicine and completed his residency at Stanford University.    Connect with Dr. Robert Pearl on Twitter @RobertPearlMD, LinkedIn and at his website robertpearlmd.com.    Brought to you by the J.C. Cooley Foundation, "Equipping the Youth of Today for the Challenges of Tomorrow."#ItsYourLife #Talkshow #Podcast #Radio #RobertPearlMDSupport the show: http://www.cooleyfoundation.org/See omnystudio.com/listener for privacy information.

This Podcast offers a pathway to continuing education via this CMEfy link: https://earnc.me/zifQrx Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts.   Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery.  He is the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. All proceeds from the book go to Doctors Without Borders. His next book, Uncaring: How the Culture of Medicine Kills Doctors and Patients will be published spring 2021.  Connect with Dr. Robert Pearl on Twitter @RobertPearlMD, LinkedIn and at his website robertpearlmd.com.  -=+=-=+=-=+= Are you a doctor struggling to provide the best care for your patients while dealing with financial and caregiving matters out of the scope of your practice? Do you find yourself scrambling to keep up with the latest resources and wish there was an easier way? Finally, our Virtual Health and Financial Conference for Caregivers is here! This conference helps you and your patients enlist the best strategies around health care resources and the best financial steps for your patients to take while navigating care. You don't have to go home feeling frustrated and helpless because you couldn't connect your patients with the best services. In just 90 minutes, our VIP Live Roundtable will answer your questions and be the lifeline that helps your patients put together an effective caregiving plan. Find out more at Jeanniedougherty.com and click on Conference for Caregivers VIP. -+=-+=-+=-+= We at MD Coaches know that match is a stressful time. If your match results were not what you expected, you might need the time and the space to explore what's next. MD Coaches is proud to offer a comprehensive six-week virtual group coaching program that explores your unique value and possibilities beyond the match. We're offering four separate rolling cohorts, Sundays, April 7 through May 12, or May 19 through June 23. A second option is Thursdays, May 2 through June 6, or June 13 through July 25. All sessions begin at 7 p.m. Eastern Time. You can register today at https://www.mymdcoaches.com/medical-student-coaching   Join the Conversation! We want to hear from you! Do you have additional thoughts about today's topic? Do you have your own Prescription for Success? Record a message on Speakpipe   Unlock Bonus content and get the shows early on our Patreon Follow us or Subscribe: Apple Podcasts | Google Podcasts | Stitcher | Amazon  | Spotify --- There's more at https://mymdcoaches.com/podcast Music by Ryan Jones. Find Ryan on Instagram at _ryjones_, Contact Ryan at ryjonesofficial@gmail.com Production assistance by Clawson Solutions Group, find them on the web at csolgroup.com

There are few people more adept at navigating America's labyrinthine medical system than Robert Pearl. Yale medical degree, Stanford University professor, best-selling author, former CEO of the Californian insurance network Kaiser Permanente, Pearl has explored this byzantine confusion of private enterprise monopoly and government supported bureaucracy from almost every angle. And now Dr Pearl has a way of curing its profound dysfunctionality and shoving the archaic system into the 21st century. As Robbie argues in his new book, ChatGPT, MD (which he claims he “co-authored” with ChatGPT), Robbie is unfashionably bullish about AI's potential to improve both our health and our working lives. Let's hope he's right.For 18 years, ROBERT PEARL, MD served as CEO of The Permanente Medical Group (Kaiser Permanente). He is also former president of The Mid-Atlantic Permanente Medical Group. In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. He is a clinical professor of plastic surgery at Stanford University School of Medicine and on the faculty at the Stanford Graduate School of Business, where he teaches courses on healthcare strategy, technology, and leadership. Pearl is board certified in plastic and reconstructive surgery, receiving his medical degree from Yale, followed by a residency in plastic and reconstructive surgery at Stanford University. He's the author of three books: Mistreated: Why We Think We're Getting Good Healthcare—And Why We're Usually Wrong, a Washington Post bestseller (2017); Uncaring: How the Culture of Medicine Kills Doctors & Patients, a Kirkus star recipient (2021); and his newest book ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine (April 2024). All profits from sales of his books go to Doctors Without Borders. Dr. Pearl is a LinkedIn “Top Voice” in healthcare and host of the popular podcasts Fixing Healthcare and Medicine: The Truth. He publishes two monthly healthcare newsletters reaching 50,000+ combined subscribers. A frequent keynote speaker, Pearl has presented at The World Healthcare Congress, the Commonwealth Club, TEDx, HLTH, NCQA Quality Talks, the National Primary Care Transformation Summit, American Society of Plastic Surgeons, and international conferences in Brazil, Australia, India, and beyond. Pearl's insights on generative AI in healthcare have been featured in Associated Press, USA Today, MSN, FOX Business, Forbes, Fast Company, WIRED, Global News, Modern Healthcare, Medscape, Medpage Today, AI in Healthcare, Doximity, Becker's Hospital Review, the Advisory Board, the Journal of AHIMA, and more.Named as one of the "100 most connected men" by GQ magazine, Andrew Keen is amongst the world's best known broadcasters and commentators. In addition to presenting KEEN ON, he is the host of the long-running How To Fix Democracy show. He is also the author of four prescient books about digital technology: CULT OF THE AMATEUR, DIGITAL VERTIGO, THE INTERNET IS NOT THE ANSWER and HOW TO FIX THE FUTURE. Andrew lives in San Francisco, is married to Cassandra Knight, Google's VP of Litigation & Discovery, and has two grown children.Keen On is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit keenon.substack.com/subscribe

In this episode of the show, I sit down with Dr. Robert Pearl to talk about his new book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, a book he co-authored with...ChatGPT! We talk about the deep fractures and problems in American health care that Generative AI may be positioned to solve, the changing landscape of health care, and  the possibility that Amazon, Google, or OpenAI may become the nation's latest healthcare providers.   For 18 years, Dr. Robert Pearl, MD served as CEO of The Permanente Medical Group (Kaiser Permanente). He is also former president of The Mid-Atlantic Permanente Medical Group. In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts.  He is a clinical professor of plastic surgery at Stanford University School of Medicine and on the faculty at the Stanford Graduate School of Business, where he teaches courses on healthcare strategy, technology, and leadership. Pearl is board-certified in plastic and reconstructive surgery, receiving his medical degree from Yale, followed by a residency in plastic and reconstructive surgery at Stanford University. He's the author of three books: Mistreated: Why We Think We're Getting Good Healthcare—And Why We're Usually Wrong, a Washington Post bestseller (2017); Uncaring: How the Culture of Medicine Kills Doctors & Patients, a Kirkus star recipient (2021); and his newest book ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine (April 2024). All profits from sales of his books go to Doctors Without Borders. Dr. Pearl is a LinkedIn “Top Voice” in healthcare and host of the popular podcasts Fixing Healthcare and Medicine: The Truth. He publishes two monthly healthcare newsletters reaching 50,000+ combined subscribers. A frequent keynote speaker, Pearl has presented at The World Healthcare Congress, the Commonwealth Club, TEDx, HLTH, NCQA Quality Talks, the National Primary Care Transformation Summit, American Society of Plastic Surgeons, and international conferences in Brazil, Australia, India, and beyond. Pearl's insights on generative AI in healthcare have been featured in Associated Press, USA Today, MSN, FOX Business, Forbes, Fast Company, WIRED, Global News, Modern Healthcare, Medscape, Medpage Today, AI in Healthcare, Doximity, Becker's Hospital Review, the Advisory Board, the Journal of AHIMA, and more.

EPISODE 1921: In this KEEN ON show, Andrew talks to Dr Robert Pearl, author of UNCARING, about how the American healthcare system is rigged against ethical doctors and poor patients and what needs to change in 2024Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. His new book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” is available now. All proceeds from these books go to Doctors Without Borders. Dr. Pearl hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in medical journals and contributed to numerous books. A frequent keynote speaker at healthcare and medical technology conferences. Pearl has addressed the Commonwealth Club, the World Healthcare Congress, the Institute for Healthcare Improvement's National Quality Forum and the National Committee for Quality Improvement (NCQA) Board certified in plastic and reconstructive surgery, Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, Pearl served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, D.C.Named as one of the "100 most connected men" by GQ magazine, Andrew Keen is amongst the world's best known broadcasters and commentators. In addition to presenting KEEN ON, he is the host of the long-running How To Fix Democracy show. He is also the author of four prescient books about digital technology: CULT OF THE AMATEUR, DIGITAL VERTIGO, THE INTERNET IS NOT THE ANSWER and HOW TO FIX THE FUTURE. Andrew lives in San Francisco, is married to Cassandra Knight, Google's VP of Litigation & Discovery, and has two grown children.

More than 75,000 Kaiser Permanente healthcare workers in five states —including 22,000 in the Bay Area — went on strike Wednesday after the company and unions failed to resolve a dispute over wages and staffing levels. The union says the strike, set to last three days, is the largest in the healthcare sector in U.S. history. We'll look at how the walkout is affecting patient care and how it fits into the recent trend of labor actions targeting a range of industries across the country. Guests: Jeannifer Key, licensed clinical social worker at Kaiser Oakland; member, SEIU-UHW Ken Jacobs, chair, Center for Labor Research and Education at UC Berkeley Farida Jhabvala Romero, reporter, KQED Dr. Robert Pearl, former CEO, The Permanente Medical Group; author, "Uncaring: How the Culture of Medicine Kills Doctors and Patients"

One of the questions I often get asked is this (actually, it's more of a comment usually than a question): Someone says, “Seems like this whole transformative primary care thing is pretty much just, let's go back to the old country doctor. Let's just have a single doctor out there taking care of patients like a Norman Rockwell painting.” To which I reply (and I'm channeling many experts, including my guest Robert Pearl, MD, when I do), “Yeah … except no.” In the golden olden days of the “ye olde country doctor,” there was a lot of art in medicine and a lot less science. If someone got cancer or even heart disease, what was required, fairly exclusively, was comfort and compassion. Now, first and foremost so there's no confusion, am I dismissing the importance of bedside manner and of providing comfort and compassion? Hell no. Would rather have that any day of the week than deal with a “drive-by PCP” or “drive-by specialist” with the throughput of a freeway who has no idea what I may befall the second I step out of his or her exam room. But in the olden days, medicine was fundamentally art with a lot less science … because there wasn't much science. For the most part, we didn't have data. Or MRIs. This was before the whole pharma industry for the most part. We had weird heroin-infused tinctures, but we didn't have oncology meds or biomarkers or even statins for Pete's sake. Consider all the new diabetes meds and biologics and artificial joints and sub-subspecialists who have, through data and advanced analytics by looking at patients across the country, proven out some best practices that might be fairly unintuitive—or disproven some conventional wisdom. It's a different and much more complicated world today, and what's required now is a healthy appreciation for not only the art of medicine but also the science. And science inherently means that, yeah, there are standards of care to be adhered to. That's what science means. There are rules and better ways to do things as proven by looking at the data and not relying primarily on personal recollections of what may or may not have worked in the past. Listen to the shows with Bob Matthews (EP315) or Alex Akers (EP154) for more on this topic, but this all leads me to the interview with Dr. Robert Pearl in this healthcare podcast where we get into some concepts that he covers in his new book, Uncaring. In this episode, we're talking about some how-tos for being a leader of doctors, going about that against the backdrop of this evolving art and science of medicine dynamic, and the impact of this evolving art and science dynamic on physician culture and self-esteem. Because (spoiler alert) if a doc is following evidence-based guidelines, not relying solely on their own personal experience, does that make said doc feel like they are being devalued and that they are but a cog in the wheel and practicing so-called “cookie cutter” medicine? So many nuances, so little time. But, yeah, there's a lot going on which, at its core, is this tension that can play out in some big bad ways. I asked Dr Pearl for some advice for today's healthcare leaders, and he did not disappoint. He suggested using a model that he calls the A to G model, and, in short, you've got to have: A: an aspirational vision B: behaviors C: context D: data E: engagement (throughout the organization and also with the patient) F: faculty G: governance You'll have to listen to the episode for the why and how of each of these. My guest today, as aforementioned, is Dr. Robert Pearl. I am sure that most of our Relentless Tribe who are listening to the show today already know Dr. Pearl, but in short, he was the CEO of Kaiser Permanente for 18 years. Now he hosts a podcast called Fixing Healthcare. He teaches at the Stanford Graduate School of Medicine and Business. He writes articles for Forbes and elsewhere. He's also an author. He wrote a great book called Mistreated, and now there's a new one called Uncaring. I would recommend both. Also mentioned in this episode is Zeev Neuwirth, MD.   You can learn more at robertpearlmd.com.   Robert Pearl, MD, is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led over 10,000 physicians and 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Named one of Modern Healthcare's 50 most influential physician leaders, Dr. Pearl is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led healthcare delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership and lectures on information technology and healthcare policy. He is the author of Mistreated: Why We Think We're Getting Good Health Care—And Why We're Usually Wrong, a Washington Post bestseller that offers a roadmap for transforming American healthcare. All proceeds from the book go to Doctors Without Borders. His most recent book, Uncaring: How the Culture of Medicine Kills Doctors and Patients, was published May 2021. Dr. Pearl hosts the popular podcasts Fixing Healthcare and Medicine: The Truth (formerly Coronavirus: The Truth). He publishes a newsletter with over 13,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, and NPR, and in TIME, USA Today, and Bloomberg News. He has published more than 100 articles in medical journals and contributed to numerous books. A frequent keynote speaker at healthcare and medical technology conferences, Dr. Pearl has addressed the Commonwealth Club, the World Healthcare Congress, the Institute for Healthcare Improvement's National Quality Forum, and the National Committee for Quality Improvement (NCQA). Board certified in plastic and reconstructive surgery, Dr. Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, Dr. Pearl served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC.   04:50 What is the idea of the art of medicine? 09:29 EP407 with Vivek Garg, MD, MBA. 09:32 Why has the intrinsic motivation of doctors plummeted? 09:48 Patient perspective versus doctor subjective response. 12:36 Why is there a fundamental change in what doctors and medical professionals can take pride in? 14:38 What did change management look like in the past? 15:24 “What does a patient really want? They'd like not to have a stroke, a heart attack … in the first place.” 20:23 “How do leaders achieve evolution?” 23:57 “Incentives always work … the problem in medicine is, they rarely work the way you planned.” 24:20 What's the way to make change happen, and why doesn't it involve financial incentives? 28:10 What do leaders in organizations today consistently underestimate? 29:11 What are the three parts of leadership? 29:25 What is the hardest part about leadership? 31:31 Dr. Pearl's two books, Mistreated and Uncaring.   You can learn more at robertpearlmd.com.   @RobertPearlMD discusses art vs science and leadership in #medicine on our #healthcarepodcast. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Larry Bauer (Summer Shorts 8), Secretary Dr David Shulkin and Erin Mistry, Keith Passwater and JR Clark (Summer Shorts 7), Lauren Vela (Summer Shorts 6), Dr Jacob Asher (Summer Shorts 5), Eric Gallagher (Summer Shorts 4), Dan Serrano, Larry Bauer, Dr Vivek Garg (Summer Shorts 3), Dr Scott Conard (Summer Shorts 2)  

EPISODE 1393: In this KEEN ON episode, Andrew talks to Robert Pearl, MD, about how generative AI represents a Gutenberg moment in the history of medicine and offers five ways that it will revolutionize healthcare in the next few years Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. His new book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” is available now. All proceeds from these books go to Doctors Without Borders. Dr. Pearl hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in medical journals and contributed to numerous books. A frequent keynote speaker at healthcare and medical technology conferences. Pearl has addressed the Commonwealth Club, the World Healthcare Congress, the Institute for Healthcare Improvement's National Quality Forum and the National Committee for Quality Improvement (NCQA). Board certified in plastic and reconstructive surgery, Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, Pearl served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, D.C. Named as one of the "100 most connected men" by GQ magazine, Andrew Keen is amongst the world's best known broadcasters and commentators. In addition to presenting KEEN ON, he is the host of the long-running How To Fix Democracy show. He is also the author of four prescient books about digital technology: CULT OF THE AMATEUR, DIGITAL VERTIGO, THE INTERNET IS NOT THE ANSWER and HOW TO FIX THE FUTURE. Andrew lives in San Francisco, is married to Cassandra Knight, Google's VP of Litigation & Discovery, and has two grown children. Learn more about your ad choices. Visit megaphone.fm/adchoices

On this KEEN ON episode, Andrew talks with Dr Robert Pearl MD about why the U.S. Medical System is now so deeply resistant to All innovation. Pearl also explains why American healthcare is about to be taken over by Amazon, Walmart and CVS and how ChatGPT will revolutionize the doctor/patient relationship. ABOUT ROBERT PEARL Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. He is the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. His new book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” is available now. All proceeds from these books go to Doctors Without Borders. ABOUT ANDREW KEEN: Name as one of the "100 most connected men" by GQ magazine, Andrew Keen is amongst the world's best known broadcasters and commentators. In addition to presenting KEEN ON, he is the host of the long-running How To Fix Democracy show. He is also the author of four prescient books: CULT OF THE AMATEUR, DIGITAL VERTIGO, THE INTERNET IS NOT THE ANSWER and HOW TO FIX THE FUTURE. Andrew lives in San Francisco, is married to Cassandra Knight, Google's VP of Litigation & Discovery, and has two grown children. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of "Technically Human," I give my mic over to two guest hosts, David Geitner and Roman Rosser, to interview Dr. Robert Pearl about the intersection between tech, medicine, and our health. Dr. Pearl answers questions about the way that technologies are radically reshaping health care; the hosts ask questions about bias in medicine; and the group discusses the ways in which our current system fails to treat us, well, well. Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong, a Washington Post bestseller that offers a roadmap for transforming American healthcare. His new book, Uncaring: How the Culture of Medicine Kills Doctors & Patients is available now. All proceeds from these books go to Doctors Without Borders.  Dr. Pearl hosts the popular podcasts "Fixing Healthcare" and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called  HYPERLINK "https://robertpearlmd.com/newsletter/" Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News.  David Geitner is a third-year Biological Sciences major and Frost Scholar at California Polytechnic State University. He grew up in Yuba City California where he learned to love science, sports, community service, and the outdoors. He works in an on-campus research lab working with protein phosphomimetics for protein-to-protein interactions. David aspires to be a dentist as quality dental care is a necessity for society. David hopes to go into the military as a dentist and provide a service to his country. Roman Rosser is a student studying Aerospace Engineering at Cal Poly, San Luis Obispo. He recently joined the PROVE team which is building a long-distance electric car. Roman hopes to work on designing or building new vehicles and has a particular passion for orbital rockets. His hobbies include lifting, backpacking, surfing and reading. A special thank you to David Geitner and Roman Rosser for hosting this week's episode, and to Dr. Pearl for joining us for the show. We'll be back next week with another episode of the “22 Lessons in Ethical Technology special series,” so stay tuned! You can find more information about the 22 Lessons series and the Technically Human Podcast, on our website, www.etcalpoly.org.  And don't forget to subscribe to the show! You can find us on Apple Podcasts, Google Podcasts, Spotify, or wherever you get your podcasts.  

Fixing the healthcare system in America is a lofty goal but Dr. Robert Pearl, a clinical professor of surgery at Stanford and author of "Uncaring: How the Culture of Medicine Kills Doctors and Patients", tells the Morning Show with Nikki Medoro how Amazon and Apple are both using their efficient business models to improve the health care system.See omnystudio.com/listener for privacy information.

Fixing the healthcare system in America is a lofty goal but Dr. Robert Pearl, a clinical professor of surgery at Stanford and author of "Uncaring: How the Culture of Medicine Kills Doctors and Patients", tells the Morning Show with Nikki Medoro how Amazon and Apple are both using their efficient business models to improve the health care system.See omnystudio.com/listener for privacy information.

As former CEO of the Permanente Medical Group, Dr. Robert Pearl was responsible for the work of 50,000 healthcare workers and the medical care of 5 million Americans through Kaiser Permanente hospitals across the country. A leading expert on healthcare management and strategy, Dr. Pearl is the author of two bestselling books, “Mistreated: Why We Think We're Getting Good Healthcare–And Why We're Usually Wrong” and “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” a regular contributor to Forbes, and the host of several popular medical podcasts. He is a board-certified plastic and reconstructive surgeon, clinical professor at Stanford Medicine, and lecturer at the Stanford Graduate School of Business. In this episode, Dr. Pearl shares his thoughts on why American healthcare is failing not only patients but also physicians, and what we can do to address inherent problems in the culture of medicine.In this episode, you will hear about:Dr. Pearl's journey to a career in plastic surgery - 2:13Grappling with complications that arise during surgery - 9:40Dr. Pearl's transition from surgeon to CEO of the Permanente Medical Group - 12:49The mission that Dr. Pearl brought to his role as CEO and how he implemented that mission - 17:21How Dr. Pearl paved a path for increasing both the quality of care and physician satisfaction, while keeping costs low, and why so often these goals seem at odds with each other - 20:32The toxic culture of denial in medicine and why it is killing doctors and patients - 27:45How status and compensation disparity contributes to physician burnout, and what to do about it - 35:47Dr. Pearl's administrative strategy that led Kaiser Permanente to much success during his tenure as CEO - 43:08Dr. Pearl's advice to physicians on how to stay connected and empowered in their careers - 46:38Dr. Robert Pearl is:Author of two books: Mistreated: Why We Think We're Getting Good Healthcare - And Why We're Usually Wrong; and Uncaring: How the Culture of Medicine Kills Doctors & Patients, with all proceeds going to Doctors Without BordersA frequent contributor to Forbes Magazine The host of two podcasts: Fixing Healthcare and Coronavirus: The TruthFind more information at RobertPearlMD.com or follow Dr. Pearl on Twitter @RobertPearlMDVisit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.Copyright The Doctor's Art Podcast 2022

Hosted by Andrew Keen, Keen On features conversations with some of the world's leading thinkers and writers about the economic, political, and technological issues being discussed in the news, right now. In this episode, Andrew is joined by Robert Pearl, author of Uncaring: How the Culture of Medicine Kills Doctors and Patients. Dr. Robert Pearl is the former CEO of The Permanente Medical Group. Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of the Washington Post bestseller Mistreated, hosts the popular podcast Fixing Healthcare, publishes a newsletter with over 10,000 subscribers, and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today, and Bloomberg News, and is a frequent keynote speaker at healthcare and medical technology conferences. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, we have as your guest the legendary Dr. Robert Pearl, a Stanford University professor, Forbes contributor, bestselling author and former CEO of The Permanente Medical Group.  Coming off of his bestselling book, “Uncaring: How the Culture of Medicine Kills Doctors and Patients” and a series of articles in Forbes about “Breaking the Rules of Healthcare”, Dr. Pearl describes the key economic and cultural forces that will reshape healthcare in the post-pandemic era. He highlights the flawed system design of our fragmented industry and how that has perpetuated economic status quo in the decades preceding the pandemic.  Dr. Pearl describes a better future for our healthcare system once we move from fee-for-service to capitation. In this podcast he provides thought leadership and sets a bold direction for a better tomorrow, while sharing lessons learned from his leadership experience at Kaiser Permanente and how COVID-19 will serve as a strategic inflection point to bring scalability to value-based care. Episode Bookmarks: 01:45 Introduction to Robert Pearl, M.D. 03:50 COVID-19 as a strategic inflection point and how rules of industry (and society) are changing 05:40 System vs. Culture in medicine and the impossibility of separation 06:00 The consequences of cottage industry design and fee-for-service incentives in American healthcare 08:00 The trajectory of rising healthcare costs over the next decade and missed opportunities for social investment 09:45 How COVID-19 will change the rules of physician culture 11:00 A medical history lesson (ex: Ignaz Semmelweis and the pioneering of antiseptics) and how it relates to lack of progress in the modern-day 14:00 Why medical culture is holding back innovations that improve care outcomes (and how COVID-19 has exposed cultural flaws in the profession) 16:45 The positive aspects of physician culture and the heroism of physicians during COVID-19 19:30 The need to value primary care and prevention (over specialty care and intervention) and the impact on primary care on life expectancy 20:00 Why were Black patients 2-3X more likely to die from COVID-19 than White patients? 21:00 How physician culture tolerates low value care and the high frequency of personal bankruptcies of patients seeking care 23:00 How COVID-19 accelerated the adoption of virtual care (and why the culture of medicine continues to oppose it) 26:00 Why capitation is a better economic model to improve care outcomes 27:00 The impact of Private Equity on value-based care and digital transformation 29:00 How post-pandemic economic pressures will reshape care delivery and support VBC adoption (i.e. virtual systems of care, employer-led initiatives) 32:00 Dr. Pearl reflects on the Haven venture and future steps to be taken in healthcare by Amazon 33:00 The anger, denial, bargaining, and depression that will be experienced during the process of reshaping American healthcare 34:00 “Acceptance of change will be the opportunity to make American healthcare once again the best in the world.” 36:00 How digital transformation, AI and interoperability can eliminate friction in the healthcare value chain and create a new era of patient consumerism 39:00 The advancement of medical devices and wearables that will support advanced analytical capabilities in diagnostics 43:00 “The key step to reshaping healthcare will be moving from fee-for-service to capitation.” 50:00 Lessons from Kaiser Permanente's success and why their full-risk model hasn't shown scalability at a national level 52:30 How post-pandemic disruptions and virtual care models will bring scale to value-based care 53:30 Dr. Pearl explains how the government push towards value-based care actually began in 1932! (and how the AMA quashed the move to capitation)

Welcome to the final episode of Season 1 of Techtopia! I thought it would be appropriate to end the year as we began it, talking about Covid-19 and its pernicious impact on our lives, psyche, and the healthcare system at large. Hard as it may seem to imagine, we're now entering year three of COVID-19 with a new variant, Omicron, upending lives globally. Two great guests join me in this episode to discuss our year in health or lack thereof and looking ahead to 2022. They are Dr. Robert Pearl and Jeremy Corr, co-hosts of two great podcasts: Fixing Healthcare, and Coronavirus: The Truth. Jeremy Corr is also the CEO of Executive Podcast Solutions and as many of you know, produces both my podcasts, Techtopia and When It Mattered. And Dr. Pearl is the former CEO of Kaiser Permanente Medical Group. He is currently both practicing and teaching at the Stanford University School of Medicine. His new book is, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” and all proceeds from his books go to Doctors Without Borders. 

Dr. Robert Pearl, MD is the author of the book Uncaring: How the Culture of Medicine Kills Doctors and Patients https://robertpearlmd.com/uncaring/

Welcome to Difficult Conversations with Dr. Anthony Orsini. As I was driving from my home in Florida to New Jersey, I was listening to an audiobook called, Uncaring: How the Culture of Medicine Kills Doctors and Patients, which in my opinion is the best analysis and synopsis of the state of healthcare today that I have ever read . Today, I am so honored to have the author of this book, Robert Pearl, MD as my guest. Robert is the former CEO of the Permanente Medical Group,.  Being one of modern healthcare's 50 most influential physician leaders, Dr. Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led health care delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business,   Dr. Pearl is the author of Mistreated: Why We Think We're Getting Good Healthcare-- and Why We're Usually Wrong, and his new book, Uncaring:  How the Culture of Medicine Kills Doctors and Patients, which we'll be discussing today. He is also a fellow podcaster and  publishes a newsletter called “Monthly Musings on American Healthcare.”  He has published more than 100 articles in medical journals and is a frequent keynote speaker at healthcare and medical technology conferences.Robert describes his success story behind becoming a surgeon, the CEO of Kaiser and author as serendipitous . In his book, Uncaring:  How the Culture of Medicine Kills Doctors and Patients, Robert first defines physician culture and how it's helped  and hurt medicine.. Dr. Orsini discusses how change is often hard for physicians, and one of the best thing that's happened is the elevation of the patient experience  Robert tells us why walking the line as an administrator and physician has helped him. and goes more in depth about the biggest problems with  physician culture. He shares a  phenomenal fact that will shock you. They discuss the importance of  preventative care better and building relationships with patients. Robert shares his thoughts on what we can do about professional burnout and how we can make it better to get doctors to enjoy their work even more.    If you enjoyed this podcast, please hit follow, and download all the previous episodes to find out more about what we do and how we teach communication.  Host: Dr. Anthony OrsiniGuest:Robert Pearl, M.D. For More Information:The Orsini WayThe Orsini Way-FacebookThe Orsini Way-LinkedinThe Orsini Way-InstagramThe Orsini Way-TwitterIt's All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony OrsiniResources Mentioned:Robert Pearl, MD WebsiteRobert Pearl, M.D. TwitterRobert Pearl, M.D. LinkedinUncaring:  How the Culture of Medicine Kills Doctors and Patients by Robert Pearl, MDMonthly Musings on American Healthcare by Robert Pearl, MD

"Physicians have had a rough century, so far. In addition to battling COVID-19, doctors have spent the past two decades fighting the health care industry's fiercest players and losing, badly. Power in the industry now belongs to health insurance companies, major drugmakers, and hospital tycoons. Physicians feel beaten up, burned out, and abused by a system so overrun with regulations that clinicians now spend more time filling out paperwork than helping patients. Doctors long for the last century. Back then, they were paid well, revered by everyone, and largely left alone to practice as they please. As the war against COVID-19 winds down, doctors believe now is the time to demand a return to the glory days when physicians ruled medicine. To get there, doctors want more money, respect, and autonomy. They'll get none of that because our nation can't afford to give it to them." Robert Pearl is a plastic surgeon and author of Uncaring: How the Culture of Medicine Kills Doctors and Patients. He can be reached on Twitter @RobertPearlMD. He shares his story and discusses his KevinMD article, "Doctors and the 5 stages of grief." (https://www.kevinmd.com/blog/2021/07/doctors-and-the-5-stages-of-grief.html)

This episode features Dr. Robert Pearl, Former Ceo of The Permanente Group, Co-Host of Fixing Healthcare, and Author of Uncaring: How the Culture of Medicine Kills Doctors and Patients. Here, he discusses what is happening with the delta variant and his thoughts on handling the pandemic.

Ever since the disease was recognized more than 100 years ago, patients with Alzheimer's, and their families and caregivers, have longed for an effective drug for this brutal and tragic disease. But last month, when the Food and Drug Administration finally approved a drug named Aduhelm for use as the first Alzheimer's drug in 18 years, there was little rejoicing. Instead — a big uproar from critics both outside and inside the FDA who say that there's no clear evidence that Aduhelm has any benefits. And, that it could actually have serious side effects including brain bleeding. And at $56,000 a year per patient and counting, they say it not only will break patients and their families but also stress Medicare — federal health care for the elderly and disabled — to the utmost. Today, I have invited two wonderful guests to help us understand what just happened at the FDA, the implications, the fallout, and what happens next. Dr. Robert Pearl is the former CEO of the nation's largest medical group, Kaiser Permanente. A Forbes Health Contributor, Dr. Pearl's latest book is titled, “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” the proceeds of which go to Doctors without Borders. Dr. Pearl also co-hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. Also joining me is my very dear friend and former NPR colleague, the award-winning health and science writer, Joanne Silberner.  She's currently a freelance journalist living in Seattle. Silberner has covered the FDA for decades while at US News & World Report and at NPR — where she worked for 18 years. Joanne has written a piece on how Aduhelm came to be approved — published last week in the online media outlet STAT+ — and it's a fascinating look at how the FDA responds to pressure from drug companies and patient groups, very relevant for this story. Read the Transcript Download the PDF Chitra Ragavan: Ever since the disease was recognized more than 100 years ago, patients with Alzheimer's, and their families and caregivers have longed for an effective drug for this brutal, and tragic disease. But last month when the FDA finally approved a drug named Aduhelm, for use as the first Alzheimer's drug in 18 years, there was little rejoicing. Chitra Ragavan: Instead, a big uproar from critics both outside and inside the FDA, who say that there's no clear evidence that the drug has any benefits, and that it could actually have serious side effects, including brain bleeding. And at $56,000 a year per patient and counting, they say, "It not only will break patients and their families, but stress Medicare to the brink." That's the federal health care for the elderly and disabled. Chitra Ragavan: Hello, everyone. I'm Chitra Ragavan, and this is Techtopia. Today I've invited two wonderful guests to help us understand what just happened at the FDA, the implications, the fallout, and what happens next. Dr. Robert Pearl is the former CEO of the nation's largest Medical Group, Kaiser Permanente. Chitra Ragavan: His latest book is called, Uncaring: How the Culture of Medicine Kills Doctors and Patient, the proceeds of the book go to Doctors Without Borders. Dr. Pearl also co-hosts with Jeremy Corr, who happens to be my wonderful executive producer, the popular podcasts, Fixing Healthcare and Coronavirus, The truth. Chitra Ragavan: Also joining me is my very dear friend and former colleague, the award winning health and science writer, Joanne Silberner, she is currently a freelance journalist living in Seattle. Silberner has covered the FDA for decades while at the US News and World Report, and an NPR where she worked for 18 years. Chitra Ragavan: Joanne has written a piece on how Aduhelm came to be approved, published today in the online media outlet, STAT+, and it's a fascinating look at how the FDA responds to pressure from drug companies and patient groups, very relevant for this story. Dr.

To read a full transcript of this episode or to comment please visit: https://wwww.medscape.com/viewarticle/953633 The culture of medicine is an invisible force with the strength of gravity that keeps the profession stuck, Robert Pearl says. To move forward, physicians have to own their role and drive change. Uncaring: How the Culture of Medicine Kills Doctors & Patients https://www.publicaffairsbooks.com/titles/robert-pearl-md/uncaring/9781541758254/ You may also like: Medscape's Chief Cardiology Correspondent Dr John M. Mandrola's This Week In Cardiology https://www.medscape.com/twic Discussions on topics at the core of cardiology and the practice of medicine with Dr. Robert A. Harrington and guests on The Bob Harrington Show https://www.medscape.com/author/bob-harrington For questions or feedback, please email: news@medscape.net

Daniel sits down with Dr. Robert Pearl, former surgeon and CEO at Permanente Medical Group for 18 years, about the culture of medicine and his new book Uncaring: How the Culture of Medicine Kills Doctors & Patients (proceeds go to Doctors Without Borders). Dr. Pearl provides an unflinching diagnosis of “physician culture” dating back to Dr. Ignaz Semmelweis' battered leather apron in 1844; second, he details the escalating costs of healthcare; and third, he addresses the danger of implicit bias in healthcare with some truly stunning examples that can only come through the lens a former physician turned health care executive.

Dangers Modern Medicine with Dr. Robert Pearl -------------------- How much would you spend to feel healthy and energized? If you were truly sick, you'd probably spend everything you had to feel well again. The USA currently spends about 20% of GDP on healthcare, and if that meant we were all glowing with health and living our best lives, the price would be a bargain. But that's not what's happening. Our reactive healthcare system offers the most expensive, worst-performance outcomes of any system in the world. It's bad for doctors, patients, and the economy. I'm not in any way qualified to offer solutions to this medical-industrial complex, but my guest on this week's show is. Meet Dr. Robert Pearl, medical doctor and former HMO executive.   Listen & Learn How individual incentives are messed up in the medical system Why primary care physicians outperform specialists in terms of absolute impact  Why culture and the system are to blame, no one person Countries and cultures to model  Links & Resources Robert's Books & Site ABOUT OUR GUEST Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017). He was named one of Modern Healthcare's 50 most influential physician leaders. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is the author of two books, his latest: UnCaring: How the Culture of Medicine Kills Doctors & Patients. Nutritional Tip of the Week BCAA Got Questions? Submit your question: yogabody.com/asklucas/ Like the Show? Leave us a Review on iTunes

In this episode of "Keen On", Andrew is joined by Robert Pearl, the author of "Uncaring", to discuss the state of the American healthcare system -- and how we can save it. Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts.  Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. He is the author of “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. All proceeds from the book go to Doctors Without Borders. His next book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients” will be published spring 2021.  Dr. Pearl hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in medical journals and contributed to numerous books. A frequent keynote speaker at healthcare and medical technology conferences. Pearl has addressed the Commonwealth Club, the World Healthcare Congress, the Institute for Healthcare Improvement's National Quality Forum and the National Committee for Quality Improvement (NCQA). Board certified in plastic and reconstructive surgery, Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University.  From 2012 to 2017, Pearl served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, D.C. Learn more about your ad choices. Visit megaphone.fm/adchoices

You've been asking and we heard you! By popular demand, we are hosting our very first Faisel & Friends Book Club. We've all been reading Dr. Robbie Pearl's new book, “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” and we can't wait to discuss it with you. To help us discuss and answer your questions, we'll be joined by Dr. Gordon Chen and the author himself, Dr. Robbie Pearl.Being a doctor is your calling because you couldn't imagine doing anything else. Let's talk about your career goals in medicine. Connect with us and tell us how you dream of practicing medicine. Want to learn more about how we do healthcare? Visit our resource center and check out how we are transforming healthcare. Don't forget subscribe to ChenMed Rx to receive the latest news and articles from ChenMed.

Dr. Robert Pearl, the former CEO of the Kaiser Permanente Medical Group, Professor of Plastic Surgery at the Stanford School of Medicine and Faculty at the Stanford Graduate School of Business, joins for a discussion on becoming the CEO of the nation's largest medical group and reforming the culture of medicine. Discussing his recent book Uncaring: How the Culture of Medicine Kills Doctors & Patients, Robert provides a deep analysis of physician culture, both its beauty and dark underbelly. Join for an engaging conversation with one of the key leaders in healthcare on how to navigate the culture of medicine, and what it means for innovation and reform in healthcare. --- Send in a voice message: https://anchor.fm/tdio/message

In his new book “Uncaring: How the Culture of Medicine Kills Doctors and Patients,” Dr. Robert Pearl offers an indictment of physician culture -- a culture he argues leads to doctor burnout and bad patient outcomes. For 18 years, Pearl served as the CEO of the Permanente Medical Group, the largest medical group in the country, and that experience led him to realize that to improve care for patients, doctors needed to re-evaluate the cultural norms they had been trained to accept. We'll talk to Pearl about how fixing healthcare in America means also fixing its doctors.

Dr. Robert Pearl is the former CEO of The Permanente Medical Group and former president of The Mid-Atlantic Permanente Medical Group. In these roles was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Named one of Modern Healthcare’s 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced and physician-led healthcare delivery.He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy.He is the author of “Mistreated: Why We think We’re Getting Good Healthcare—And Why We’re Usually Wrong,” a Washington Post bestseller that offers a roadmap for transforming American healthcare. His most recent book, Uncaring: How the Culture of Medicine Kills Doctors and Patients was published May 2021.  John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz., with a satellite office in Princeton, N.J.

The COVID-19 global pandemic has shined a bright light on our medical system unlike perhaps any other time in this country's history. For more than a year now, we have seen how the daily work of making important, even life-and-death decisions is frequently made harder by factors and variables outside the control of an individual doctor and patient. Meanwhile, even before the pandemic, hospitals and medical offices faced tremendous budget problems, and big pharmaceutical and insurance companies continued to shape the delivery of medical care in all corners of the country; the pandemic only exacerbated these trends. In a new book, Uncaring, Dr. Robert Pearl—former CEO of The Permanente Medical Group and a Stanford professor—shows how all these stresses have led to a toxic culture in medicine, particularly for physicians. He says doctors resist change, leading to important clerical mistakes. They don't offer equal treatment to all patients. Their competitive work ethic leads to burnout and bad decisions. All these mistakes, he warns, can be and frequently are matters of life and death. As we emerge from the pandemic and engage in a public debate about the appropriate role of government, technology, big pharmaceutical and insurance companies in our health-care system, Pearl believes we have paid little attention to what it actually feels like to be a doctor. If we want to improve medical outcomes for doctors and patients alike, Pearl believes we need to start seeing health-care professionals as the real and flawed human beings they actually are, and real issues they face every day in their professional lives. We look forward to welcoming Dr. Pearl back to The Commonwealth Club for an important conversation on how we can have a safer and healthier health-care system. Moderator Julie Kliger is the digital health transformation leader of the Health Solutions practice at FTI Consulting. She has expertise working with health-care delivery systems, platform-telehealth and bio/med-tech companies to design, optimize and implement new approaches to care delivery, with the goal of improving quality, value and experience of care. Kliger currently serves as a member of the board of directors for a $3 billion health system and chairs the Enterprise-Wide Committee on Quality, Safety and Patient Experience, and is vice chair of the Executive Compensation Committee.​ The views expressed by the moderator are not necessarily the views of FTI Consulting, Inc., its management, its subsidiaries, its affiliates or its other professionals. SPEAKERS Dr. Robert Pearl M.D., Clinical Professor of Plastic Surgery, Stanford University School of Medicine; Author, Uncaring: How the Culture of Medicine Kills Doctors and Patients Julie Kliger MPA, BSN, Senior Managing Director, Health Solutions, FTI Consulting—Moderator In response to the COVID-19 pandemic, we are currently hosting all of our live programming via YouTube live stream. This program was recorded via video conference on May 26th, 2021 by the Commonwealth Club of California. Learn more about your ad choices. Visit megaphone.fm/adchoices

The COVID-19 global pandemic has shined a bright light on our medical system unlike perhaps any other time in this country's history. For more than a year now, we have seen how the daily work of making important, even life-and-death decisions is frequently made harder by factors and variables outside the control of an individual doctor and patient. Meanwhile, even before the pandemic, hospitals and medical offices faced tremendous budget problems, and big pharmaceutical and insurance companies continued to shape the delivery of medical care in all corners of the country; the pandemic only exacerbated these trends. In a new book, Uncaring, Dr. Robert Pearl—former CEO of The Permanente Medical Group and a Stanford professor—shows how all these stresses have led to a toxic culture in medicine, particularly for physicians. He says doctors resist change, leading to important clerical mistakes. They don't offer equal treatment to all patients. Their competitive work ethic leads to burnout and bad decisions. All these mistakes, he warns, can be and frequently are matters of life and death. As we emerge from the pandemic and engage in a public debate about the appropriate role of government, technology, big pharmaceutical and insurance companies in our health-care system, Pearl believes we have paid little attention to what it actually feels like to be a doctor. If we want to improve medical outcomes for doctors and patients alike, Pearl believes we need to start seeing health-care professionals as the real and flawed human beings they actually are, and real issues they face every day in their professional lives. We look forward to welcoming Dr. Pearl back to The Commonwealth Club for an important conversation on how we can have a safer and healthier health-care system. Moderator Julie Kliger is the digital health transformation leader of the Health Solutions practice at FTI Consulting. She has expertise working with health-care delivery systems, platform-telehealth and bio/med-tech companies to design, optimize and implement new approaches to care delivery, with the goal of improving quality, value and experience of care. Kliger currently serves as a member of the board of directors for a $3 billion health system and chairs the Enterprise-Wide Committee on Quality, Safety and Patient Experience, and is vice chair of the Executive Compensation Committee.​ The views expressed by the moderator are not necessarily the views of FTI Consulting, Inc., its management, its subsidiaries, its affiliates or its other professionals. SPEAKERS Dr. Robert Pearl M.D., Clinical Professor of Plastic Surgery, Stanford University School of Medicine; Author, Uncaring: How the Culture of Medicine Kills Doctors and Patients Julie Kliger MPA, BSN, Senior Managing Director, Health Solutions, FTI Consulting—Moderator In response to the COVID-19 pandemic, we are currently hosting all of our live programming via YouTube live stream. This program was recorded via video conference on May 26th, 2021 by the Commonwealth Club of California. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Robert Pearl joins Shireen to discuss physician culture, improvements that can be made to it, and questions to ask your doctor. Dr. Pearl is a Forbes healthcare contributor, the former CEO of The Permanente Medical Group, a best-selling author, and a Stanford Medical School and Business School professor. He is also the host of two healthcare podcasts: "Fixing Healthcare" and "Coronavirus: The Truth." His new book "Uncaring: How the Culture of Medicine Kills Doctors & Patients” is available for presale. "My belief is that together we can once again make American medicine great again." - Dr. Robert Pearl In this episode you will learn: Physician Culture The Application and Improvement of Physician Culture Questions to Ask Your Doctor Key Notes: [1:20] How Dr. Pearl Came to the Medical Field [2:27] Physician Culture [6:59] Application of Physician Culture [8:20] Ways to Improve Physician Culture [18:47] Questions to Ask Your Doctor [23:47] Connect with Dr. Pearl Connect with Dr. Pearl! Facebook https://www.facebook.com/RobertPearl.MD/ LinkedIn https://www.linkedin.com/in/robert-pearl-m-d-32427b98/ Twitter https://twitter.com/RobertPearlMD Connect with Yumlish! Instagram https://www.instagram.com/yumlish_/ Twitter https://twitter.com/yumlish_ Facebook https://www.facebook.com/yumlish/ LinkedIn https://www.linkedin.com/company/yumlish/ --- Send in a voice message: https://anchor.fm/yumlish/message

Dr. Robert Pearl is the former CEO of Kaiser Permanente, host of the podcast, "Fixing Healthcare," and a clinical professor of plastic surgery at Stanford. He joins me to talk about his new book, "Uncaring: How the Culture of Medicine Kills Doctors and Patients" — you know, an uplifting story — which is tackling head-on issues well beyond physician burnout and the flawed culture that guides medical professionals in their practice. He's also one of the more vocal and outspoken expatriates from our fabulously broken healthcare ecosystem who is fueled by, among other things, having had family members die unnecessarily due to hospital errors. This is Hippocrates Shrugged if there ever were such a metaphor. Enjoy the show.

Purchase links for Uncaring- How the Culture of Medicine Kills Doctors and Patients: Audible, Barnes and Noble, Amazon All profits from the book go to Doctor's Without Borders Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation’s largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles he led 10,000 physicians, 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Dr. Pearl hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in medical journals and contributed to numerous books. A frequent keynote speaker at healthcare and medical technology conferences. Pearl has addressed the Commonwealth Club, the World Healthcare Congress, the Institute for Healthcare Improvement’s National Quality Forum and the National Committee for Quality Improvement (NCQA). Dr. Robert Pearl's Personal Website Sunny's Instagram, Twitter (GIVEAWAY SOON)

https://www.alainguillot.com/robert-pearl/ Robert Pearl is a practicing physician, Stanford professor, Forbes.com contributor, and former medical group CEO. His latest book is Uncaring: How the Culture of Medicine Kills Doctors and Patients. Get the book here: https://amzn.to/3wlBvRB

Part 2 - Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD. Tune into Swift Healthcare Podcast to hear Robert Pearl, MD discuss his new book which has already become a #1 New Release in multiple Amazon categories and is soon to be a NY Times Bestseller! Ranked a Top 60 Healthcare Leadership podcast by Feedspot. In his new book, Dr. Pearl shines a light on the unseen and often toxic culture of medicine. Today's physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us. Robert Pearl, MD Links: https://robertpearlmd.com https://robertpearlmd.com/books/ https://www.linkedin.com/in/robert-pearl-m-d-32427b98/ Music Credit: Jason Shaw from www.Audionautix.com THE IMPERFECT SHOW NOTES To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we'd love to offer polished show notes. However, Swift Healthcare is in its first year.  What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it's close enough - even with the errors - to give those who aren't able or inclined to audio interviews a way to participate.  Please enjoy! Transcript Patrick Swift, PhD, MBA, FACHE: [00:00:00] [00:00:00] Welcome folks to another episode of the Swift healthcare video podcast. I'm delighted that you're here and I have an amazing guest for our episode to Dr. Robert Pearl. Welcome back to the Swift healthcare video podcast, Dr. Pearl. [00:00:13] Robert Pearl, MD: [00:00:13] It is a privilege to be back, Patrick , looking forward to it all week long. [00:00:17] Patrick Swift, PhD, MBA, FACHE: [00:00:17] I'm glad, I'm glad. I'm glad. And we are talking about your book that is coming out Uncaring: How the culture of medicine is killing doctors and patients. I'm going to say that title again. It is packed Uncaring: How  the culture of medicine is killing doctors and patients. And in this episode, last episode, hopefully you've dialed in and heard that one. [00:00:40] This episode, we're going to be talking about doctors. We're going to be talking about providers and it wouldn't do justice without giving  a little intro for Dr. Pearl here. So Dr. Pearl bear with me and for listeners, please take this in who you're listening to. This is Dr. Robert Pearl. He's the former CEO of the Permanente medical group, [00:01:00] the nation's largest medical group. [00:01:01] At the time he was there in 99 to 2017, former president of the Mid-Atlantic Permanente medical group, 2009 to 17. He's led 10,000 physicians, 38,000 staff. These are people that get up in the morning and report to work. We're looking at 50,000 plus that he supported, uh, 5 million Kaiser Permanente members. [00:01:20] He's been listen to this named one of modern healthcare's 50 most , influential physician leaders. And you're listening to him right now. He has a. Authored several books I'm gonna  touch on that, but he's also hosting podcasts, fixing healthcare, another one, Coronavirus, the truth. And then he has a newsletter Monthly Musings on American healthcare. [00:01:42] He's a regular contributor to Forbes. And the first book I'm sure we'll touch on one was Mistreated: why we think we're getting good healthcare and why we're usually wrong. Holy crap. That is just a great title. Uh, and then this new book coming out, uncaring, how the culture of medicine kills doctors and patients.  With that [00:02:00] said the intro, Dr. Pearl, let's just jump right into it. And, , you have done some amazing things. I want to ask you number one, thanks for being on the show [00:02:10]Robert Pearl, MD: [00:02:10] Thank you. [00:02:11] Patrick Swift, PhD, MBA, FACHE: [00:02:11] Two , uh, we're talking about providers, folks, This book that's coming out is supporting doctors without borders, all the , all the proceeds of the goes to the doctors, to the borders. He's done some really cool stuff involving Ebola response to tsunamis, and I've got to pick his brain, uh, just because, um, share some insight being there. We're talking about providers, we're talking about professionals, we're talking about physicians. Um, what was your experience supporting providers, physicians, um, particularly, um, but supporting providers in response to Ebola and, uh, the tsunami [00:02:45] The tsunami was fascinating because it was a lot more than just physicians. A lot of psychologists actually participated because the mental health issues of the people in Sri Lanka, which is where we went along with doctors without borders, [00:03:00] uh, was tremendous. So this happened, people may remember a little over a decade ago, a tsunami hit the area. Uh, it was the day after Christmas, but we knew that there were a lot of people who were killed, harmed and about to be harmed because the upcoming diseases with the communicable diseases and the contaminated water or the malaria then invariably would come. And so we worked with doctors without borders, uh, to figure out how we could send teams of volunteers there. I sent a secure email out to my physicians. Uh, they 10,000 of them. And I said, how many of [00:03:47] day after Christmas. [00:03:49] Robert Pearl, MD: [00:03:49] The day after  Christmas? So half of them were on vacation with their family. And I said, how many of you would be willing to volunteer? And they're not going to get paid. We'll provide the [00:04:00] supplies. We'll provide the transportation, but they're, they're on vacation. [00:04:03] This is their vacation to go to Sri Lanka. And then of course I'm a physician. So I have to provide informed consent. Number one, there may not be any food. Number two, the water could easily be contaminated. And number three there's been a civil war for 20 years. I figured maybe I get five or six over 200 people volunteered that week. [00:04:26] Or we ended up sending 10 trips, saving tens of thousands of lives, providing the psychological support to them, avoiding malnutrition, avoiding death from diarrhea, avoiding malaria, all the different pieces, depending upon how the epidemic happened. And then we said teams to Guatemala. After the earthquake struck there, we sent teams to the South. [00:04:55] After hurricane Katrina to Louisiana, we sent them [00:05:00] a great story. They arrived there and the police have a barricade up. So no one can come into the area where Katrina has been. So what do they do? They rent a car at night and they go around the police barricade so they can get in there and provide care to these people who were in tremendous need. [00:05:17] And then the Ebola comes, uh, Liberia and the physicians there. And they're all physicians in this case because you need infectious disease, expertise and emergency expertise. They actually have to have IVs going into their arms while they're providing care, because they're wearing the protective suits that are so hot. [00:05:36] It's 120 degrees inside the suit. [00:05:39] Patrick Swift, PhD, MBA, FACHE: [00:05:39] Oh my God. [00:05:39] Robert Pearl, MD: [00:05:39] are alive unless they're receiving IVs. [00:05:43] Patrick Swift, PhD, MBA, FACHE: [00:05:43] Oh my God. [00:05:44] Robert Pearl, MD: [00:05:44] And this to me is the amazing piece. Patrick, I talked to  everyone who came back. Now just try to think about what it's like to be, be there. That 120 degree suit we're sitting there in the midst of a tsunami with knowing that there's civil war around you or the [00:06:00] hurricane debris of, uh, of central America. I have never seen happier physicians. The ones who went there made me think about all the trips that I've done. I fixed kids with cleft lip and cleft pallet. I've probably done a dozen trips to central South America, to some other countries as well. You know, you go there, you work 12 hour days, the ORs are not air conditioned. [00:06:23] Food is rice and beans and everyone comes back fulfilled. Now think about in the context of burnout, what is missing? It's not the comfort, it's not the money. It's the mission and purpose. I think that we have lost that. And that's part of why I wrote on caring, how the culture of medicine kills doctors and patients, because I think some of it, much of it has been done to us, but much of it we've done to ourselves. [00:06:53] And hopefully we'll get into that in greater detail. So people can start working on ways to [00:07:00] minimize the harm that they're experiencing. [00:07:02] Patrick Swift, PhD, MBA, FACHE: [00:07:02] Yeah, your a story. It brings tears to my eyes. You're just talking about these people who are, um, volunteering. I mean, it's hope you speak about hope, Dr. Pearl. There's so much pessimism and confusion and misinformation and, and sarcasm and negativity and your story of expecting five and you get 200, um, people putting them their, their lives at risk, um, uh, giving up not only just vacation, but risking their lives, um, in Liberia and, and, and Sri Lanka. And, and these are stories of, of the reason why we go into healthcare. We all want to make that difference. Healthcare people are mission-driven people. And what you're talking about is, uh, facilitating folks, being able to follow their Dharma, follow their calling. And I know in the previous episode, we talked about you following your Dharma and your calling, and, um, it's so beautiful. [00:07:57] That's why we go into healthcare we're mission [00:08:00] driven people, and you touch on being done to us as providers and doing it to ourselves, and that leads to a conversation about culture. Um, and, um, uh, I'm curious about your thoughts in this, in light of the amazing book that you have coming out, um, your thoughts about culture and how we're doing this to ourselves. [00:08:20], in light of, , this episode, focusing on providers and physicians. [00:08:24] Robert Pearl, MD: [00:08:24] If you ask physicians, why are 44% of physicians burned out? And why do they talk about moral injury? They'll tell you it's three things. At least the three most common we don't get paid enough. We have to do so many bureaucratic tasks and the computers in the exam rooms and the offices are so slow and clunky. [00:08:52] They make a spend a huge amount of time documenting rather than providing the care. [00:08:59] Patrick Swift, PhD, MBA, FACHE: [00:08:59] that is [00:09:00] maddening. I got to tell you. [00:09:01] Robert Pearl, MD: [00:09:01] And they're all right, all those three things are there. But I wrote the book because my first book mistreated was about the systemic issues. And as I went around talking to people and I researched areas like burnout, there was still a piece missing. [00:09:21] So let me give you a couple of examples. The people who were paid the least are pediatricians, but their rate of burnout is not that high, primary care is a much higher rate of burnout than pediatrics, even though the salaries are higher. What was even more amazing to me was the specialty that had the highest rate of burnout over 50% is urology. [00:09:48] Now think about it. Urologists make almost a half million dollars a year. It's not the salary. They're making as much money now as they did in the past, when they [00:10:00] had low rates of burnout and compared to orthopedics or ophthalmology, they make just as much money, but they have 20% higher burnout rates. [00:10:12] How do you explain this? It's not a lack of salary, because they're making a lot more than primary care and just as much, and even more than the other specialties, it can't be the bureaucratic tasks that goes into the same authorization processes. They have the same restrictions, the same regulations, and they're using exactly the same computers. [00:10:31] So there's nothing different that explains it. If you look at the data over time, you start to see an interesting phenomenon, which is that urology used to have a low burnout rate, similar to some of the other surgical specialists specialties. And then what happened almost a decade ago is that the national preventive care oversight groups. [00:10:50] Decided that the PSA, the prostate specific antigen that's used to find prostate cancer was causing as much harm, as good as [00:11:00] people underwent a huge number of biopsies and other tests. And people were also discovering that lo and behold, not intervening had as good a long-term expectancy in a lot of cases without the risk of impotence and urinary incontinence. [00:11:18] And so the number of cases they did start going down a why is that important? Because in the hierarchy of medicine, it's not rational in the hierarchy of medicine, the cooler, the procedure, and this robotic prostatectomy, it's like a star Wars of surgery gave urologists this high status. And now as fewer and fewer urologists can do the procedure or have the opportunity to do the procedure. [00:11:51] All of a sudden this level of satisfaction. One that's not created from the outside, because remember I said, urologist's are  making just as much [00:12:00] money, but simply from this hierarchy of medicine, I'm sure you're familiar with the work of Sir  Michael Marmot who looked at the relative hierarchies in British society amongst workers. And he could show a clear correlation. The lower down you were, the more dissatisfied, unfulfilled, fatigued. You were the exact same symptoms as burnout. [00:12:26] Patrick Swift, PhD, MBA, FACHE: [00:12:26] beautiful point and you're not picking on urologist, obviously you're not, but I think it's worth pointing out. You're not picking on urologists. You're you're pointing out. You're shining a light on culture. And how we, we, like you said, we do to ourselves, we get caught up in this hierarchy and socially our families and culture and environment looks at us in pressure. [00:12:48] There's this whole environment. you get to the, you get to 40 and don't give a shit what people think you get to 50. You don't give a fuck what people think I'll , bleep that out. But, but the notion that as you get older, you have to recognize praise and blame weigh the [00:13:00] same. [00:13:00] All these, all this external, um, is,  Maya, this illusion , this, this farce. And so you're speaking to one is the  Occams' razor of cutting right through it. And that even saying that you breathe a little clearer of, of recognizing your own value. And that's the coaching I do as a psychologist and as an executive coach, it's about cutting through. [00:13:23] So personally, there's that decision you touch on the other is now the culture, external culture. What can we do to move that culture, Dr. Pearl? Because your voice is so powerful that it speaks to putting a light on this, but there's also organizational institutional cultural things that, that, that needs to happen in order for this to shift in medicine. [00:13:44] Right? The incentive. [00:13:46] Robert Pearl, MD: [00:13:46] So, this is the piece of the book that I think is the most important, which is the way that culture and system move together. [00:14:00] So if you're going to try to create, you're going to try to create a, a logical way to say which specialties should be near the top of the hierarchy. And I told you that adding 10 community increases longevity two and a half times more than adding 10 specialists, you would say primary care should be at the top of the hierarchy. And yet they are not now in the minds of a lot of physicians, the order is we're not paid a lot, so we're not at the top of the hierarchy. And I'm making the point in this book that some of the reason why primary care is not paid as much is because the physician hierarchy does not put them higher enough. [00:14:43] Because when you look at groups, the Mayo clinic or Kaiser Permanente, what you see as their primary care physicians are paid a lot more than in the community, because their value is seen more clearly. [00:14:56] Patrick Swift, PhD, MBA, FACHE: [00:14:56] say that again. Please say that again.  [00:15:00] did you just say, I think I heard you say this, but I want our listeners to hear this. You just said in the Kaiser Permanente group, the primary care are compensated more because they're valued for the life-saving essentially, now  I'm putting words in your mouth, but it's also impacting preventing it saving lives. [00:15:19] Is that what you said? That there's more compensation? [00:15:22] Robert Pearl, MD: [00:15:22] If you look around the United States, I was also the chairman of the accountable care organization. And we had 24 groups, including the Mayo clinic and the Kaisers and the Geisinger's ad. And every group primary care is paid more in a group practice than it is an individual. But what, so what can be done? [00:15:41] I think that physicians, [00:15:43] Patrick Swift, PhD, MBA, FACHE: [00:15:43] one is they move their right to be part of that culture. [00:15:49] Robert Pearl, MD: [00:15:49] the good part is they wouldn't have to move there [00:15:51] Patrick Swift, PhD, MBA, FACHE: [00:15:51] Okay. How [00:15:53] Robert Pearl, MD: [00:15:53] I think in the post, I think in the postcard, a virus era, there will [00:16:00] be everywhere. And what I mean by that is the following. You know, the United States will have borrowed $8 trillion that we'd have to pay back or we'll have to pay interest on by law every state in the United States has to have a balanced budget. They're going to have more unemployment claims, more Medicaid and less revenue. And small businesses that are the engine that drives employment. The people that drive the stock market are Amazon, Netflix, Apple, but the people who drive employment are this small businesses and they've been hammered a third of them saying they can't actually get through this year. [00:16:39] without  continued government support. You know, we've talked about the need to lower the cost of healthcare for decades instead of we should. We must. I'm saying now that we will, because people won't be able to afford to pay the projected five to 6% costs [00:17:00] increased year over year. And when you can't afford something, you don't do it even if you want to do it. [00:17:07] And I think that that's where our nation is going to be, and we're going to face. [00:17:11] Patrick Swift, PhD, MBA, FACHE: [00:17:11] So hang on. Are you saying then that I agree with you that people are less likely to go to the, basically they're less likely to go to doctors. Ones are likely less likely to have procedures done those less likely to get care. They're less likely to get screening. So then mortality increases and then there's death. [00:17:31] We're talking, we're talking over more mortality. So where, where is the, where's the solution here? How do we, how do we get, how do we address this before the tsunami, um, of poor care? Comes because of lack of access because of lack of resources to be able to pay for it. [00:17:51] Robert Pearl, MD: [00:17:51] Look at the options you have, where you have a budget that cannot be exceeded a fee for [00:18:00] service system, which providers can just do more and more can't work. So you're left with two options. We'll either ration care or we'll transform care. Under a single payment, the technical word is capitation. And here's where the interesting part starts, which is that the physician culture that for decades has avoided progress because it's been the interest of physicians and hospitals and others to be paid in a fee for service type way when that's no longer possible. [00:18:34] And the choice shifts into one of rationing versus capitation. I think we're going to see people start to move forward. Not everyone at once, but some people will move forward. I'm hopeful. It's going to be similar to when Roger Bannister broke the four minute mile. Once some people are doing it, as you know, with it, it was thought to be [00:19:00] impossible. [00:19:00] And there were three years, there were 10 people who had done it because now once you're in a capitated system, you see the culture start to change. And what do I mean by [00:19:09] Patrick Swift, PhD, MBA, FACHE: [00:19:09] Your lips to God's ears. [00:19:11] Robert Pearl, MD: [00:19:11] Well, what you see is that in a capitated system, prevention becomes far more important. Primary care becomes far more important. Patient safety avoids a complication for chronic disease. All of these become positive [00:19:29] Patrick Swift, PhD, MBA, FACHE: [00:19:29] and this is a provider, this is a provider of focus. Right? And so satisfaction goes up, [00:19:35] Robert Pearl, MD: [00:19:35] and exactly, [00:19:36] Patrick Swift, PhD, MBA, FACHE: [00:19:36] provider experience goes up the, the quality of life work-life balance. All of the benefits. There is a sea change for us as providers with that kind of model. [00:19:48] Robert Pearl, MD: [00:19:48] where you ha you start to have the control, but you also have the risk. And this is why I think it's the risk aversion of physicians. That's kept them out of the model, but once you have the [00:20:00] risk, you need to find ways to obviate it, which means you've got to form groups. Working together in collaborative and cooperative ways, which I think psychologically is far better than everyone out for themselves. [00:20:16] You have to find technology that's going to work. I mean, look what happened in COVID all of a sudden physicians started doing 60 to 70% telemedicine patients got better care. Everyone's talking about it as it as good. The fact that can address your problem right now, rather than telling you to come back. [00:20:36] I mean, when I was the CEO in Kaiser Permanente, we set up a system whereby if a patient was seeing a primary care physician, this was pre COVID and the physician wanted to send the referral rather than sending a referral. We created a video link with a specialist. Dermatology was a great example of this. [00:20:55] I don't know what it's like in your community. Most places in the United States, this is a six week wait, [00:21:00] the primary care physician, rather than telling the patient call. The dermatologist took a digital picture. Sent it to a dermatologist who was assigned that day to oversee this entire area for, for quite a number of physicians. [00:21:14] and , within six minutes, there was an answer. So care was started that day, not six weeks later. How can you say this inferior care to seeing a doctor in his or her own office six weeks from now that opportunity physicians will figure out and I have tremendous faith that they will do the right things for patients. Once the incentives align and the culture evolves. [00:21:43] Patrick Swift, PhD, MBA, FACHE: [00:21:43] You said something profound to me in another conversation we had in which you said, you tell me the incentives and I will tell you the behaviors. Is that what you said? Am I quoting you correctly? Or the outcomes you tell me the incentives. And you said, you tell me a sentence and I can [00:22:00] tell you what's gonna happen. [00:22:01] Robert Pearl, MD: [00:22:01] I can tell you how people are going to behave. [00:22:02] Patrick Swift, PhD, MBA, FACHE: [00:22:02] Yeah, yeah, yeah. [00:22:04] Robert Pearl, MD: [00:22:04] commonly used business school phrase that somehow it in the culture of medicine, we don't think it's true. We don't think that the 30% of procedures that we do that have been shown to add no value. And I'm talking about by the Mayo clinic and a new England journal of medicine summaries of this that's somehow that's the right thing to do because the culture of medicine tells us somehow that it's okay. [00:22:30] The reality says that is money, we could be better investing whether we want to invest it in prevention, whether we want to invest it in more primary care, whether we want to invest it in better education to make up for what's happened in COVID. Whether you want to invest in development of cities, I can come up with a lot of reasons why it is wasted. [00:22:51] It makes us overlook things like surprise billing. I mean, the fact that we not only give people bills when they come to [00:23:00] get care, because we're battling an insurance company and we put the patient in the middle and then the hospitals that employ us Sue the patient when they can't pay. And we talk about moral injury, talk about inflicting  harm the culture. Doesn't let us see it. You're the psychologist. But to me, it's like a fine grain sieve. It seeps out. And I believe that it erodes the purpose and the mission. And I think that it contributes to the 400 suicides of physicians a year. [00:23:33] Patrick Swift, PhD, MBA, FACHE: [00:23:33] Yeah. Grossly underestimated too. [00:23:35] Robert Pearl, MD: [00:23:35] both doctors and patients. [00:23:37] Patrick Swift, PhD, MBA, FACHE: [00:23:37] Yeah. Yeah. Ah, yeah, incredible. And this episode is your message is one of hope in the face of, you know, full circle in the face of acknowledging, , physician suicide, , the degree of suicide, , in providers and quite frankly, in the country and on a global scale, , providers around the planet right now, moral distress, everything we're going through, , to [00:24:00] the scope of this conversation about the culture of the self-inflicted wound and this wound we're born into, , , in medicine in a previous episode, we taped together, Dr. Pearl, you acknowledged a culture from the 18 hundreds. , and so the environment we're working in and beginning this episode, when you brought tears to my eyes, talking about Liberians, the tsunami, , this is there's such sacrifice on the part of our, our patients. And on the part of our providers, , there is such sacrifice in that his heart, , and what you speak of your message here is one of courage. , the, the courage, , to do something about this and your book is about that. Is it not [00:24:41] Robert Pearl, MD: [00:24:41] Uncaring other culture, medicine kills docs and patients. It is. And I point out in one last thing and again, colleges, so you're more of an expert than I am to this, but the five stages of loss or grief, the Kubler Ross has the fond. And my understanding is they really can't be avoided. [00:25:00] And so the viewers should understand that they may not feel it's going to be necessary. [00:25:06] They're going to deny the change is going to be there. And I hope that they're right, but I don't think they will be for the reasons that we said, and then what's going to happen. They're going to get angry because they feel like something's being done to them. I think some of that's already started [00:25:21] Patrick Swift, PhD, MBA, FACHE: [00:25:21] Oh yeah. [00:25:21] Robert Pearl, MD: [00:25:21] looked at the issue of moral injury as an example of burnout. Then what happens? Third, they start to bargain. Okay, I'll do it Tuesday and Thursday, but not Monday, Wednesday and Friday. I'll do it for some patients and not others. And then they get depressed. And I'm worried about that phase. And I'm hoping that they're going to get through that phase to acceptance, which is not the same thing as saying, it's what I want the saying under the circumstances, it's the best option that's there. [00:25:49] And I'd be a miss to not also mention the article I'll be publishing in Forbes next week, about the impact of COVID-19 [00:26:00] on physicians, particularly in critical care and in infectious disease, the newest Medscape's study has shown that actually urology is now number four with critical care and ID above because of the experience. I think these physicians are having, I talked to one doctor who said he lost four patients in one day. I talked to another one. She was a resident and she said that on day one of the rotation, she inherited six patients. By the end of the month later, they were all dead. I talked to people who are a woman, who's a double boarded physician, probably the grittiest smartest person. I know. And she said she can't go to sleep at night. And she wakes up before sunrise and sweats, sweating in bed. Uh, I think that we have got to understand that PTSD doesn't happen in the midst of the war. It happens afterwards. And I'm hoping [00:27:00] that if listening in are people who run residencies who run hospitals, this is the time to make sure that the psychological resources are there as a conversations can happen. If not, we're going to see as you call it a tsunami of problems with these individuals who have dedicated their life. And risked their life to take care of people infected with this horrible Corona virus pandemic experience. [00:27:30] Patrick Swift, PhD, MBA, FACHE: [00:27:30] Absolutely. And, and I really want to encourage folks to take a look at Dr. Pearl's book, because it is a message of truth, recognizing what is going on here, but it's also a message of hope. There's the question of what can we do? And Dr. Pearl earlier you touched on, um, I, I wanted to bring up, , seeing the stages of grief, , and getting to that acceptance and that not being just, okay, I'm going to just take it, but it's about personal [00:28:00] leadership. [00:28:00] I'd add personal leadership and professional leadership. That's the work I do with, with people is the personal professional leadership is about seeing things as they are not worse than they are. Not better than they are, but seeing things as they are. And then what do we do? And I know they're going to be QANON and wing nuts and people with propagating all kinds of garbage, um, as we have to adjust. [00:28:23], but the vast majority of us are reasonable people, , who bring heart to what we do in caring for our patients and caring for our system. , and, and I couldn't think of a more, , global voice, um, to bring, , courage, compassion, joy, and hope, in the work we do. So it's my prayer that this episode may lift uplift people. And I, and I get to ask you my favorite question at the end of the show here, which is if you had the attention of all the healthcare professionals around the whole planet for a brief moment, what would you tell them? Dr. Pearl. [00:28:55] Robert Pearl, MD: [00:28:55] First thing I would tell them is that the [00:29:00] culture of medicine is getting in the way of fulfilling the reason they chose medicine in the first place that the systematic problems around us they're real. But you know, the people in generations before us. They didn't have effective treatments or they didn't have necessarily the right procedures to perform . There's always difficulties that need to be overcome. And in this particular situation, I think the physician culture and again I  called the physician culture is really a clinician culture. It's just that I'm more knowledgeable. A lot of physicians is getting in the way, you know, the fact that, um, hypertension, the number one cause of strokes and kidney failure is controlled 55 to 60% of the time across , the country. And there are groups, large medical groups that control at 90%. That's not [00:30:00] a criticism. It's just the fact as you point out the question is what are we going to do about it? In the last episode, we talked about racism and the fact that black patients don't receive the same care as white patients, there's systemic issues as well. But the things that we can control. Again, you're the psychologist, but my sense is start with what you can do rather than starting with what you can't do and what you often will find that as you start to do the things that you can to raise quality, to provide care, that's more convenient, that's  more compassionate to be able to make care more affordable, low and behold. [00:30:42] You're going to discover that the happiness and fulfillment that you experience, whether it's a combination of gratitude or there's a combination of being generous is going to come back and have people become more satisfied. I go [00:31:00] back to the tsunami experience, international experience, the happiest people I ever saw were clinicians who went over there and were able to do the right thing. Despite the fact that as you say that you volunteered, despite the risks that were out there, despite the hours, we need to work to change the system, but we also need to work to change the culture. [00:31:25] Patrick Swift, PhD, MBA, FACHE: [00:31:25] incredible, incredible, Dr. Pearl , if folks are interested in following up with you learning more about your podcasts, your newsletters, the book, uh, where can they go? [00:31:34] Robert Pearl, MD: [00:31:34] Best place to go is the website, RobertPearlmd.com. RobertPearlmd.com. They can order the book, pre-order the book. And if they pre-order the book, they'll get the signed book plate to discussion guide. They'll get the bibliography and they'll get the book delivered to their home. On the first day it's available. [00:31:53] Uh, they could also get a lot of other information on the monthly musings on the articles that are being [00:32:00] written, the opportunity to broaden the knowledge and in all of my monthly musings, I always ask for reader feedback. And when it comes to this book, I'm encouraging people. Please read it if you love it, or you hate it. If you agree with it or disagree, let me know. That's how I learned. And I want to learn from all of your viewers and from all of the people who already are following the things that I get a chance to write and say, it's just a privilege to be able to work to transform medicine on behalf of people. And I appreciate all of you viewers who are going to come along on this journey, [00:32:35] Patrick Swift, PhD, MBA, FACHE: [00:32:35] I pray they do. And he does read his email folks and, and the proceeds of the book goes to [00:32:41] Robert Pearl, MD: [00:32:41] Doctors without borders, a tremendous organization that is running healthcare for those who can't contain it around the globe. [00:32:51] Patrick Swift, PhD, MBA, FACHE: [00:32:51] Love them, love them. Outstanding, Dr. Pearl. It is a pleasure and an honor. Thank you so much for being on the Swift  healthcare podcast. Thank you so much for the heart and courage and [00:33:00] joy  and compassion that you bring to the show. [00:33:02] Robert Pearl, MD: [00:33:02] Thank you, Patrick. I've had a lot of fun and I really appreciate you taking the time and educating your viewers. I can't wait to hear their feedback. Thanks so much.

Part 1 - Uncaring: How the Culture of Medicine Kills Doctors & Patients w/ Robert Pearl, MD. Tune into Swift Healthcare Podcast to hear Robert Pearl, MD discuss his new book which has already become a #1 New Release in multiple Amazon categories and is soon to be a NY Times Bestseller! Ranked a Top 60 Healthcare Leadership podcast by Feedspot. In his new book, Dr. Pearl shines a light on the unseen and often toxic culture of medicine. Today's physicians have a surprising disdain for technology, an unhealthy obsession with status, and an increasingly complicated relationship with their patients. All of this can be traced back to their earliest experiences in medical school, where doctors inherit a set of norms, beliefs, and expectations that shape almost every decision they make, with profound consequences for the rest of us. Robert Pearl, MD Links: https://robertpearlmd.com https://robertpearlmd.com/books/ https://www.linkedin.com/in/robert-pearl-m-d-32427b98/ Music Credit: Jason Shaw from www.Audionautix.com THE IMPERFECT SHOW NOTES To help make this podcast more accessible to those who are hearing impaired or those who like to read rather than listen to podcasts, we'd love to offer polished show notes. However, Swift Healthcare is in its first year.  What we can offer currently are these imperfect show notes. The transcription is far from perfect. But hopefully it's close enough - even with the errors - to give those who aren't able or inclined to audio interviews a way to participate.  Please enjoy! Transcript: [00:00:00] Patrick Swift, PhD, MBA, FACHE: [00:00:00] Welcome  folks to another episode  of the Swift healthcare video podcast, I am delighted that you're here welcome to our listeners in Latin America and Eastern Europe and the United States and all over the planet because I have an amazing guest. [00:00:12] I'm so excited about Dr. Robert Pearl, Dr. Pearl. Welcome to the show. [00:00:17] Robert Pearl, MD: [00:00:17] Thank you, Patrick. It's an honor. And a privilege to be here. [00:00:20] Patrick Swift, PhD, MBA, FACHE: [00:00:20] Well, delighted you're here. And folks, I want you to take a seat, get comfortable. You're about to experience a masterclass. And, um, I could not ask for, uh, a better guest for a show. That's looking at the intersection of healthcare and leadership. Pop the hood. Look at the engine of healthcare. Talk about it from a, from a, uh, heart and head, an understanding perspective and someone who can see the big picture. [00:00:47] Uh, Dr. Robert Pearl, I have this bio, I've got to read you a portion of his bio. Dr. Robert Pearl is the listen to all this, the former CEO of the Permanente medical group, the nation's [00:01:00] largest medical group former president of The Mid-Atlantic Permanente Medical Group in these roles, he led 10,000 physicians, 38,000 staff, healthcare professionals, responsible, nationally recognized medical care and 5 million Kaiser Permanente members. [00:01:15] That's one. Two: one  of the nation's Modern Healthcare's 50  most influential. Physician leaders. I know Robert is going to try to stop me, but hang on there. I want to share this with listeners. He's the author of mistreated, why we think we're getting good healthcare and why we're usually wrong. Can you not resonate with that? [00:01:33] Uh, his next book coming out, which I'm so excited about uncaring, how the culture of medicine kills doctors and patients, ah, such a great title. He hosts multiple podcasts, fixing healthcare, coronavirus the truth. We got to hear the truth about coronavirus God, uh, publishes a newsletter with over 12,000 subscribers. [00:01:52] If you're not subscribed, please subscribe a monthly musings on health American healthcare. He's a regular contributor to Forbes. Um, [00:02:00] the man is a dynamo, um, leading with heart and, uh, let's start with the book uncaring, how the culture of medicine is killing doctors and patients at the top of the show. [00:02:12] We're going to end on this, but at the top of the show, uh, Robert, please just share with folks, um, the book and how folks can get it and who it's helping. This is listen to this. Who's helping. [00:02:24] Robert Pearl, MD: [00:02:24] Well, thank you so much, Patrick. When I wrote the book mistreated, I was talking about the systemic problems, how healthcare is paid for how healthcare is organized, how it's technologically or not technologically supported. And as I travel around the country and I talked about this in patients, it was clear to me there was something else missing. [00:02:49] And I researched trying to figure out what it was. And I wrote the book about what I believe it to be, which is the physician culture. I don't know. I call it the physician culture is really the [00:03:00] culture of all people provide care. I just know the physician side, having been the head of the medical group far better than I know all the other pieces, but it equally applies. [00:03:10] And for those of your viewers who do pre-order the book. They go to my website, Robert Pearl md.com, where they can find access to a lot of providers, all the profits go to doctors without borders, if five Oh one C3 charity providing healthcare around the globe as did the profits from Mistreated  and anyone who pre-orders, the book will get some freebies, including a signed book plates, including the discussion guide, a bibliography of other books on the same topic and a chance to pre-read the introductory chapter. [00:03:48] And it will be delivered to your home on May 18th, the official pub date. [00:03:53] Patrick Swift, PhD, MBA, FACHE: [00:03:53] love it. I love it. I love it. And again, folks that the proceeds of this book are going for doctors without borders, Medecines [00:04:00] Sans Frontieres. Uh, this is for good. Um, and it encapsulates some wisdom and love and compassion and courage. and joy  that Dr. Pearl was compelled in that composing that book. So this up number one. [00:04:13] Thank you. And two. This episode, we're going to do the show in two segments. The book is titled uncaring, how the culture of medicine is killing doctors and patients and being providers. We were talking who who's, who we going to focus on first. And we agreed the patients were going to start with an episode on the patients. [00:04:29] And so we're going to touch on, um, the elements of the book, but from the patient perspective. And, um, part of this is a conversation about culture. And I want to start with your why you became a physician, because I know this influences your perspective on culture and, and your parent experience and, and how all this comes together. [00:04:51] So, so where does this passion come from? Dr. Pearl? [00:04:55] Robert Pearl, MD: [00:04:55] So as a naive 17 year old, I headed off to college [00:05:00] and I wanted to be a university professor. I wanted to teach philosophy and my hero who ultimately became the chairman of Reed college. He was brilliant. Didn't get tenure because of his political views. And I decided I wanted to go with this, something that would have no politics and that would Medicine. We're talking about life and death, Patrick, how could you be? [00:05:30] How could there be politics? So I went to medical school and then I went on to Stanford to become a heart surgeon. And guess what? I found the best physicians didn't always get the referrals. Yeah, it was politics who you knew the club you belong to. And I, I almost dropped out of medicine, [00:05:53] Patrick Swift, PhD, MBA, FACHE: [00:05:53] Yeah. Wow. Wow. [00:05:55] Robert Pearl, MD: [00:05:55] and then I have a chance to go to Mexico on a volunteer [00:06:00] trip and fix children with cleft lip and cleft palette. And I fell in love with that opportunity, the mission and the purpose. And that's how I became what I do today, which is a reconstructive plastic surgeon. [00:06:16] Patrick Swift, PhD, MBA, FACHE: [00:06:16] I love that. I love that story. And in your bio, your, you serve as a clinical professor of plastic surgery at Stanford university school of medicine and your faculty of Stanford graduate school of business, where you teach courses on strategy and leadership in lectures on informational tech and healthcare policy. And so you're taking the wisdom and the heart of your calling and the love for caring for patients that cleft lip surgeries, you, you, you it's, it's tangible how you can transform lives. Um, with, uh, medicine and how you've, you've brought that into the work you're doing here. So let's talk about patients and, and culture. [00:06:53] And so, you know, from that perspective of, of, uh, which that just made me laugh, it's, it's, uh, you know, didn't want to go [00:07:00] into a career that involved politics that you went in medicine, and here we are, who am I? God, talk about politicized. Um, let's put the lid and let's put the politics aside. If we, if we put the heart of healthcare to this conversation and kick the politics to the curb, um, let's talk about the culture, um, of medicine and how it's impacting patients. [00:07:22] Robert Pearl, MD: [00:07:22] Culture represents beliefs, the values, the norms that we as clinicians learn medical school residency, or we carry the with us throughout our entire career. It's not written down in any textbook. It's not giving a lecture, but it's through the stories through the language that people use. When I try to explain to people about culture, I start in the 1850s with Ignaz Semmelweis. [00:07:57] He's a physician in [00:08:00] Austria, in Vienna at the leading hospital, and he's appointed the head of the delivery service and he's appalled. He's embarrassed. 18% mortality rate. What's really irksome is that the adjacent facility one run by nurse midwives has two thirds lower mortality. Now at the time when patients died from was puerperal fever, overwhelming infection of the uterus spread throughout the body and the cause was felt to be miasmas . Foul smelling particles that wafted up from the streets below, but he said, why should my patients be dying 18% when the nurse midwives' (patients)  are dying, two thirds lower. Now, as you know, Patrick, we often make our best discoveries through serendipity. And that's what happened. A colleague doing an autopsy  on a woman who died from puerperal [00:09:00] fever, nicks, his finger develops a local infection and goes on to have a clinical course identical to these women who will die so  he hypothesizes ,  maybe there's something being carried from the autopsy room into the delivery room, either on the hands or the leather aprons. These physicians wore the days they had underlying three piece suits that's being  given to women in labor. So he decides that every doctor before they go into the delivery area will change that leather apron. [00:09:34] Dip their hands in chlorinated, water and low and behold mortality drops from 18 % to 2% 90% reduction. He writes it up in the leading journal. He writes letters to every delivery service. And guess what happens, Patrick? [00:09:50] Patrick Swift, PhD, MBA, FACHE: [00:09:50] what [00:09:51] Robert Pearl, MD: [00:09:51] Nothing. No one pays attention exactly right now. Well, why don't we? Well, it's not indifference. [00:10:00] See, in the culture of medicine, the doctors were elevated high esteem. The only way to think about them was healers. They were incapable of carrying disease and those leather aprons, the more blood, the more pus the more experience, the last thing they would be as associated with an infection. He dies  four years later alone in a mental institution where no one will listen to them and now we leap forward 150 years. And what do we find? Hospital acquired infections are the number one cause of death for hospitals. 1.7 million people develop a hospital, acquired infection, a hundred thousand die. The bacteria is called claustrum difficile . We know it gets carried on the hands of humans. Doesn't go through the air. And if we have some researchers hiding in the corners, where do they see what? In three [00:11:00] times today, doctors don't wash their hands [00:11:03] Patrick Swift, PhD, MBA, FACHE: [00:11:03] it's so true. It drives me nuts. I was CEO of a hospital in which I was trying to have a conversation with one of my physician colleagues saying I'm a PhD clinical neuropsychologist, not a physician, but talking to a physician saying, I'm not going to say the person's names. I don't wanna give a gender, but the person is saying I do. So it's, it's it's there are individuals who say that they are doing the right thing because they want to believe they're doing the right thing. People don't choose evil for evil sake. They mistake it for happiness. And when, when they're not doing the right thing, people want to believe they are doing the right thing. So it's to your, to your point, uh, they're still not doing it. Like they should , we, are not doing it like we should. [00:11:46] Robert Pearl, MD: [00:11:46] no, this is just humans. . I mean, that's, that's what you have to understand doctors are just humans with the same, uh, for foilties , the same, uh, weaknesses, uh, they'll have excuses. Well, I didn't really plan to  [00:12:00] touch, the patient or I  wore gloves not  we can put it on top of the gloves. Um, and when someone dies. The culture provides the excuse that it had to be someone else. It wasn't a doctor. It had to be the nurse or that housekeeper. [00:12:17] Patrick Swift, PhD, MBA, FACHE: [00:12:17] housekeeper. That's a big one. Thank you. I used to oversee support environmental services and they were the first ones that were brought up as well. They clearly didn't clean the room and they're the ones who are wearing the right PPE. I've got story. After story, I went undercover boss as a CEO to know what it was like to be an EVs worker and you touch on culture. [00:12:37] Um, I, I'm so glad you're talking about this because we've got to look at the culture who we are as healthcare professionals is impacting patients, this episode is on the patients . Um, and, and, and we're talking about quality safety, uh, and this leads to disparities too. It's it's impacting everything. So, but so in your book, um, you're talking about culture, you're talking about moving forward to the future to now. [00:13:00] Um, what do you see is, is where we're going in this culture right now and how can we improve patient care? [00:13:05] Robert Pearl, MD: [00:13:05] Well, I think it's important to look at what's happened during COVID-19 to get a good sense of this culture. And I want to make the point culture's invisible to the people who are in it. I often think about  smokers in North Carolina, they can sit in a small room and they don't notice all the smoke around them. [00:13:27] If you or I walked in the room, we'd start coughing immediately. That's where the culture is. Like others can see it, but not the individuals in that culture. You know, what, what physicians say about washing their hands? Well, first they'd say, as you said, they do it, but they might talk about, you know, expense. [00:13:46] Why don't they do the right thing? Well, it's expense. There's bureaucratic regulation. No, that  takes no time with an alcohol based disinfectant, the cultural lets them not see what is going [00:14:00] on. So during COVID 19, the clinicians were heroes, what they did when they couldn't get protective gear, they put on garbage bags and salad lids . [00:14:12] They went to the hospital and when they pass tubes through the mouth, down the throat, into the lung, they knew the patient would cough spewing virus in their face. They did it anyway. And when they didn't have enough ventilators, they figured out how to put two patients on one machine. Something  that had never been done, not even thought about before they were heroes. [00:14:33] Culture has that ability to make people do remarkable things. And the physician culture is no exception at the same time, all the things I didn't see. That we can tell from the data that exists. Number one 88% of people died from with chronic disease with two or more chronic diseases. Now think about that. [00:14:57] You don't hear the big societies [00:15:00] going on, about what a poor job physicians are doing relative to chronic disease, you don't hear people. In fact, even talk about the value of prevention and avoiding complications for chronic disease. They talk about the cardiologist who goes in and unblocks a coronary artery, not the person who prevents it from happening. [00:15:22] We'll talk in the next show about primary care and how the physicians there are suffering to some extent from the systemic issues, but equally inside the cultural let's look at some of the other pieces. If you ask physicians, why do black patients have three times the mortality of white patients during COVID-19. [00:15:44] They'll give you a litany of answers. They work in jobs that they have to be there rather than being on zoom from home. They take buses and subways. They live in multi-generational homes and they're all true. What they don't talk about it as the fact that early in the pandemic, [00:16:00] when a black patient or white patient came to the ED with the same symptoms the white patient got tested for COVID twice. [00:16:08] As often as the black patient, they don't talk about the fact that give 40% less pain medication. They don't talk about the fact that, uh, women in labor have three times the higher chances of dying. If there are black patients, except when the attending physician is a  black physician, [00:16:25] Patrick Swift, PhD, MBA, FACHE: [00:16:25] True. [00:16:26] Robert Pearl, MD: [00:16:26] when you put these pieces together, what's going on there. [00:16:30] This is the nature of culture. We see people inside our group differently than we see people outside our group. We think they are more. Worthy. We have greater empathy sympathy. It's not that doctors want to harm anyone. This is not negative. This is just what culture does. But if you want to change that, you need to address the cultural issues. [00:16:59] And that's [00:17:00] why I wrote uncaring, how the culture of medicine kills doctors and patients. [00:17:06] Patrick Swift, PhD, MBA, FACHE: [00:17:06] In credible. And when a colleague, whether you're a physician healthcare professional, hearing the data you just said, knowing, knowing the data about disparity in pain management, for women in labor and long bone breaks, all the disparities you were touching on Dr. Pearl, there are colleagues of ours who will say in the back of their head, they'll think to themselves. [00:17:29] Well, you're calling me racist. There are people I'm a neuropsychologist. I know though the process for some of our colleagues is that instead of hearing the message, basically, if you practice evidence-based evidence-based medicine, the disparages go down, what's heard in the ego is, well, you're calling me racist. [00:17:46] Somehow I'm giving different treatment treatment and it's like the Monty Python response,  "No I'm Not" . So what do you say if there were a colleague sitting here with us now and whether they said it or implied [00:18:00] it, and they said, well, you're basically saying I'm racist  in my care . How do you get around that in a dinner conversation with a colleague sitting next to us, having a glass of wine, talking about this data, how do you get around? When, when someone gets defensive and says, well, you're calling me racist. [00:18:16] Robert Pearl, MD: [00:18:16] As a neuropsychologist, I'm sure you're very familiar with the literature on what's called implicit bias. You take someone and you show them various images and they've got to match. A particular word, be it a positive word, like intellectual or a negative word, uh, against an image with the same word on it. [00:18:39] And what you see is that white physicians will be much slower to put the positive label with the picture of a black patient or a black individual with that same word on his or her picture versus, um, a [00:19:00] white, uh, person with the exact same photos and everything else. That's how our brains work. That's the impact that culture has [00:19:09] Patrick Swift, PhD, MBA, FACHE: [00:19:09] Yes. [00:19:09] Robert Pearl, MD: [00:19:09] now. That's not racist. That's just simply the facts of how our brain work what's racist is if you don't pay attention to it. Now, there are, I'm not saying there's no one out there who intentionally discriminates or is racist, but almost all of these people we're discussing right now. are  not aware. And so if you want to be, what's often called anti-racist, which you have to do is understand the data. That's there recognize that it didn't start with something you decided to do, but now you have the opportunity to do things about it. When you order pain medication and the patient is black, a black patient, you ask yourself, is it possible? I'm ordering the wrong medication. You may not be, but if you stop yourself and ask when you're [00:20:00] seeing a patient in the emergency department, and there's a shortage of supplies, this case COVID testing, you have to just ask yourself if this were my friend, if this was someone who looked a lot more like me, would I do it differently? If you're on rounds in the maternity area. Are you checking all of the patients and recognizing where the bias is likely to be? You know, I often refer to it like golf. If you know, you have, what's called a hook and you hit the ball right handed to the left all the time, you might be smart to consider aiming occasionally to the right, especially when there's water hazard to your left. [00:20:38] The same thing exists within racism. What's interesting is there was an article on artificial intelligence published about a year ago where the headline was, AI is racist. Now what happened is United health group's   subsidiary Optum. decided they wanted to invest some dollars in the patients who were sickest. [00:21:00] So there's an AI application to figure out who those patients were. [00:21:04] The problem was that as a insurer, they had claims data. What they didn't have was actual care delivery. So they made the assumption that the more money that's spent on you, the sicker you are now in actuality, physicians provide $1,800 a year, less care to black patients with the same insurance as white patients. [00:21:27] So guess what happened? It picked a disproportionate number of white patients. Not black patients only had 14% black patients that should have been over 40%. The headlines blamed AI. It wasn't AI. It's the way we practice medicine [00:21:44] Patrick Swift, PhD, MBA, FACHE: [00:21:44] that's , it's the question they ask. [00:21:45] Robert Pearl, MD: [00:21:45] All AI is  doing is duplicating the results that we get doing it even better than we can do it. But if we have an implicit bias, we have to be aware of it. And I think hopefully researchers will be aware about this in the future. [00:21:58] Patrick Swift, PhD, MBA, FACHE: [00:21:58] incredible, [00:22:00] incredible. I, I love everything you've said. And the notion of AI being described as being racist when we're just asking the wrong questions and I love the analogy you gave about golf, and if you've got a hook to the left, you adjust your, your, your, your, your golf club. Um, and then you will hit more straight. [00:22:22] I think the parallel goes on to say, if you're rounding in the maternity ward, for example, Pick your patient population. But when we take care of our patients, if we're more mindful that there are these biases, at least that'll help us adjust to be more in the center. And that is the opposite of perceiving it as being, just being, giving disproportionate extra effort, which also gets people defensive. [00:22:47] Thanks. No, I'm not going to give extra effort to someone else. That's not what you're saying. You're saying, just adjust your club so you can hit straight. How about you just get the right diagnosis for everybody? Not just for some so, [00:23:00] before I run out of time on this, I want to ask you, I know there's a chapter in your book. Nine questions patients should ask doctors. [00:23:06] Could you tell us a little bit about that please? [00:23:09] Robert Pearl, MD: [00:23:09] This goes back to what you just said, Patrick, about the golf story, which is that if you know that there's a water hazard, you want to do things to try to avoid it. If the culture of medicine, the physician culture is one in which there's potential hazards. How do you minimize them? And again, I want to stress to the viewers. [00:23:36] I could not be more positive about medicine, about  the profession, I encourage everyone to try to be part of it, to have the ability to provide care, to go home at the end of the night. knowing , you saved a life. So it's not negative in that way. It's just a recognition of that culture that exists that we need to get over. [00:24:00] But until that happens, there are dangers out there. So I don't have time for all nine, but I'll give you three areas. One area is if, as a patient you have the kind of problem. That's not very significant, but it requires some kind of follow-up. For the physician to see how you're doing over the possibility that maybe it was the wrong diagnosis or the possibility you might need more care. [00:24:28] There's a set of questions you should ask. Can I contact you with email? Can I send you a text message? Can we just speak over the phone? Can we have a video visit? How can I get care without having to miss another day of work or school ? If the answer is I don't do any of those things, at least you're prepared for what's likely to happen in the follow-up period. [00:24:57] If you need a procedure done, the [00:25:00] questions to ask is how many of these did you do last year? And how many did the most experienced person do in this community last year? And what's the worst complication you ever had? And how many of these procedures would you require someone to have done for  you to let them operate on you or do whatever the intervention is going to be. [00:25:25] Patrick Swift, PhD, MBA, FACHE: [00:25:25] great question. [00:25:26] Robert Pearl, MD: [00:25:26] then you can figure out whether that experience that this person has is worth it. It's not necessarily a right wrong answer. And then finally, for people who have advanced disease, heart failure, lung failure, they'd been in the hospital a couple of times or cancer. That's recurred multiple times. You want to know what are the other options that I have for care. You want to know when, as my problem progresses, will you be able to keep my pain adequately managed? [00:26:00] Maybe the most important question to me is when I decide that I do not want any more intervention, you still be with me or will you desert me? And that to me , I think, is what people want to know as they face a terminal illness and end of life set of decisions. [00:26:20] Those are the kinds of questions. They're all put into the context of the physician culture, but people who want to understand what to ask doctors respectfully, but for the information they need to participate in the decision-making process will find that chapter particularly relevant and helpful. [00:26:39] Patrick Swift, PhD, MBA, FACHE: [00:26:39] Absolutely  powerful questions, Dr. Pearl. I, I recall, uh, a, a dear colleague of mine, who I was interviewing for another episode, and she's currently battling ovarian cancer a silent killer. And she was with a urologist who, um, uh, was not doing [00:27:00] the testing and the assessment necessary to get to the bottom of it to help. [00:27:04] And when she shared, there were some abdominal pain, uh, some GI symptoms, he turned around and said, well, I guess I'm off the hook. And it's the antithesis about what you described? Uh, this episode coming up was with Diane Powis . Um, when this episode comes out, we'll see, which comes out first, but, um, uh, in Diane show, she speaks about the urologist saying, well, I guess I'm off the hook. [00:27:28] Your question, the third question you touched on there. If, if, if there's no longer care required, will you abandon me? You're touching on, are you still caring for me? You're not asking, are you going to continue to treat me gratis and forever be my best friend? No, you're talking about really the question is, do you respect me enough to keep a relationship? If I need care, if I just need you to care, um, is there connection there, right? Is that where you're going? [00:27:58] Robert Pearl, MD: [00:27:58] In the culture of medicine [00:28:00] as physicians, death is not something we're used to, but something we don't really like. We see it as our own failure. [00:28:07] Patrick Swift, PhD, MBA, FACHE: [00:28:07] Oh, sure. [00:28:08] Robert Pearl, MD: [00:28:08] We feel powerless. Um, we worry that how people are gonna view us as a failure. Of course, that's not the reality, but that is the culture. [00:28:21] Patrick Swift, PhD, MBA, FACHE: [00:28:21] A hundred, a hundred percent of us die. [00:28:23] Robert Pearl, MD: [00:28:23] I can't necessarily cure you. In fact, I probably can't, but I'll be there for you and I'll make sure you're comfortable and I'll make sure you have the information you need and I'll help you find the resources. And again, people will point to the systemic issues. Well, that kind of conversation is not reimbursed and that conversation is not adequately funded, but it's why we chose medicine in the first place. When we get to the episode around physicians, I think not doing that creates the loss of mission and purpose [00:29:00] and harms doctors, as much as it harms patients. [00:29:04] Patrick Swift, PhD, MBA, FACHE: [00:29:04] and your book is titled uncaring. How the culture of medicine is killing doctors and patients, and for listeners, viewers, where can people get a copy of that? Dr. Pearl [00:29:17] Robert Pearl, MD: [00:29:17] The easiest thing to do is to go to my website, Robert Pearl md.com because there they'll have a choice of nine different providers, including Amazon and Porchlight and Barnes and noble, they can pick what they want to have the purchase go through. Uh, and they also can get, if they pre-order all the freebies that are available and they can check out other pieces of information, uh, I'll be writing an article next week. About the impact that the COVID-19 pandemic has had on physicians, particularly critical care physicians and infectious disease individuals, because I think they're going to have post-traumatic stress disorder [00:30:00] and it's going to be a crisis in medicine. If we don't act now and provide the mental health and psychological support that they need and deserve. [00:30:11] Patrick Swift, PhD, MBA, FACHE: [00:30:11] there is that crisis. As a practicing psychologist, I'm caring for health care professionals, struggling with that burnout. And, um, as an executive coach, I'm supporting, um, executive struggling with that. Dr. Pearl, you, you hit the nail on the head, um, that that crisis is occurring as we speak. And I'm just so grateful that you've worked on this book, it's the culmination of the love and passion and care that you bring to medicine, uh, and our culture. So I want to thank you for being on this show on the Swift healthcare podcast. And I want to encourage folks to tune in for our next episode which we'll be touching on uncaring, how the culture of medicine, killing doctors and patients, um, as we discuss in the next episode, we'll be focusing on our, our providers, our doctors, and the [00:31:00] providers in healthcare. [00:31:00] So Dr. Pearl, thank you so much for being on the show. [00:31:03] Robert Pearl, MD: [00:31:03] Thank you, Patrick. I'll look forward to the next episode next week.  

Friends, Our guest this week, Dr. Robert Pearl, introduces a fundamental reframe in our understanding of healthcare transformation with his second book, ‘Uncaring – How the Culture of Medicine Kills ...

“Culture allows us to see the things that are in our interest and not see the things that are not.” Listen to this fascinating interview with Robert Pearl, MD, former CEO of The Permanente Medical Group (Kaiser Permanente) as he talks about the basis of his new book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients.” The current healthcare system is designed to do well for insurance companies, hospitals, drug companies, and medical device manufacturers – everyone except doctors and patients, says Dr. Pearl. The post-coronavirus era is going to be the potential catalyst for the kind of change in healthcare “that we were waiting for decades.” @RobertPearlMD @DonCrane @AmerPhysGrps #Uncaring  

This week's episode is the second part of our conversation with Dr. Robert Pearl. In his book, Uncaring: How the Culture of Medicine Kills Doctors & Patients, Dr. Pearl asserts that doctors are taught how to cure people, but they don't always know how to care for them. There are many contributing factors, ranging from how doctors are trained, to increasing workloads and lack of resources, a widening disconnect between patients' and doctors' values and expectations, and increased risk and death due to the pandemic, all of which are intertwined with systemic and cultural issues. These are people who, with the highest ideals of caring for people, have entered a system rife with misaligned incentives that undermine and contradict their own hopes and expectations, and a culture that shapes them into being unable to care in the way they originally intended. The book examines the elements of physician culture that need to be corrected, the ones that should be preserved, and how to accomplish both. Dr. Robert Pearl is the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 10,000 physicians, 38,000 staff, and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. He is the author of Washington Post bestseller “Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong,” and “Uncaring: How the Culture of Medicine Kills Doctors & Patients” which is scheduled to be published in spring 2021 (all proceeds from the book go to Doctors Without Borders). Dr. Pearl also hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. Episode Bookmarks: 00:30 The cultural hierarchy in medicine 01:00 Research on effects of concentrated primary and specialty care on life expectancy 03:00 Dr. Pearl explains how primary care was once on top of the cultural hierarchy before technology advancements 04:00 The need for Primary care to adjust to the current world (The Acceptance stage of the Kübler-Ross grief cycle) 05:30 Leading innovation in Primary Care and the success of ChenMed as a primary care model that can lower cost and improve outcomes 06:30 How the current fee-for-service model creates ineffective primary care delivery to ensure population health (e.g. lack of access and availability) 08:00 The use of telemedicine in the primary care setting to improve patient outcomes 09:15 The need for interdisciplinary, technology-enabled primary care teams and the integration of specialty services 10:00 How Kaiser Permanente leveraged telemedicine and other digital tools for clinical integration 11:30 PCP/SCP collaboration to determine evidence-based practices in a consistent, technologically-enabled, efficient way 12:00 Redefining primary care to elevate its value. 12:20 “Primary care shouldn't just be the gatekeeper for referrals; they should be the facilitators of higher quality care by collaborating with specialists." 12:40 Inefficient, low-value referrals from primary care for consultations that could be prevented with better integration 14:00 Onsite primary care clinics for Apple employees that are improving collaboration with specialists 14:30 Consumerism and Patient Experience -- patients feel disrespected by long wait times, short visits, and poor communication. 17:00 “Culture, to some extent, allows you to avoid the harm you inflict and take privilege in what you desire.  Some of that exists within the physician world.” 17:20 Physicians that refuse to value patients' time as much as their own as seen by long wait times, limited access and availability, and limited consumer-driven technology 18:20 The culture of customer-focused technology and service, exemplified by Amazon, has changed patient expectations 18:50 Patients value empathy,

The extraordinary scientific and technological innovations around the COVID-19 vaccines have enabled the U.S. government and governments around the world to deploy multiple vaccines against the lethal virus — allowing a gradual reopening of society and return to a new normal. What do we need to do to defeat COVID-19 once and for all and how can technology be used to prevent such devastating pandemics in the future? It's always a wake-up call to speak with Dr. Robert Pearl, author of a new book out this spring called “Uncaring: How the Culture of Medicine Kills Doctors and Patients.” Dr. Pearl also hosts two popular podcasts, Fixing Healthcare and Coronavirus: The Truth. Read the Transcript Download the PDF Chitra Ragavan: The extraordinary scientific and technological innovations around the COVID-19 vaccines, have enabled the U.S. Government and governments around the world to deploy multiple vaccines against the lethal virus, allowing a gradual reopening of society and return to a new normal. Hello, everyone I'm Chitra Ragavan and this is Techtopia. What do we need to do to defeat COVID-19 once and for all? And how can technology be used to prevent such devastating pandemics in the future? Here to answer those questions and more is Dr. Robert Pearl. He's the author of a new book out this Spring called Uncaring: How the Culture of Medicine Kills Doctors and Patients. Dr. Pearl hosts, the popular podcasts, Fixing Healthcare and Coronavirus, The Truth. Dr. Pearl, welcome to Techtopia. Robert Pearl: Thank you so much. It's a pleasure to be here. Chitra Ragavan: It seems as if we're finally seeing the light at the end of a very dark tunnel with these multiple vaccines being given emergency authorization, more and more shots given in arms, schools starting to reopen, businesses reopening. What's your assessment of where we are today compared to even a month ago, here in the U.S. and what are we likely to see in coming days, weeks, and months? Robert Pearl: Great question. Let me go back to one thing that you said earlier. I want listeners to know that all the profits from the book Uncaring: How the Culture of Medicine Kills Doctors and Patients, goes to a charity, Doctors without Borders, so if they purchase the book, they actually are going to be contributing to some global healthcare delivery. Thank you. In terms of the vaccine, this is a massive breakthrough. In "The Coronavirus: The Truth" podcast that Jeremy Corr and I do, I talk about chess games, an opening set of moves that the United States totally failed at. We did insufficient amount to limit the spread, to provide education, to have a national strategy, we could spend hours talking about the failures. But the middle game that we're in right now, is one of the vaccine and it's absolutely brilliant, particularly the messenger RNA vaccines. Robert Pearl: I know that a lot of your listeners are in the tech world, CEOs of companies, so to help to provide context, the human body or the viral organism has genetic material, and that material directs the body to create proteins. And between the genetic material in humans inside the nucleus and the actual proteins that are created, there is a code sent out. It's called messenger. Think about that, the message is trotting out there with the code and RNA for the ribonucleic acid. And although it's been thought of for a long time, that we could take this RNA, this messenger RNA, and inject it into people, get their bodies to produce the proteins that are responsible for the infection, the proteins that are specific to the virus or the bacteria for that matter, and then get our bodies to create an immune response, it had never been done. Despite two decades of trying to make it work. Robert Pearl: It's why it was a long shot. And I wrote a piece in August questioning whether we'd be successful. And that was only seven months ago, and today 95% efficacy, tremendous safety,

Should physicians also be leaders?    Our guest is none other than Dr. Robert Pearl, named one of Modern Healthcare's 50 most influential physician leaders.  He believes that every doctor needs to learn leadership skills to improve the healthcare system for better patient satisfaction and financial sustainability.   Dr. Pearl has an impressive background in physician leadership, being the former CEO of The Permanente Medical Group, the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group.   He is a clinical professor of plastic surgery at Stanford University School of Medicine and faculty of the Stanford Graduate School of Business, bestselling author, podcast host, keynote speaker, and a healthcare contributor at Forbes.   “Strategic thinking without action is powerless and action without thinking is aimless.” - Robert Pearl MD   Highlights: (03:19)  Serendipitous route to leadership (09:54)  Leadership through service (11:56)  Ideal physician job description (13:52)  Culture of medicine and hierarchy  (19:26)  Modulating the cultural organization (23:56)  Capitation and quality healthcare (28:52)  Advice for aspiring physician leaders   Resources: Mistreated: Why We Think We're Getting Good Health Care -- and Why We're Usually Wrong https://www.amazon.com/gp/product/1610397657 Uncaring: How the Culture of Medicine Kills Doctors and Patients https://www.amazon.com/Uncaring-Culture-Medicine-Doctors-Patients/dp/1541758277/ref=sr_1_1?dchild=1&keywords=uncaring&qid=1618490368&s=books&sr=1-1 Fixing Healthcare Podcast https://podcasts.apple.com/us/podcast/fixing-healthcare-podcast/id1423874033?mt=2 Coronavirus: The Truth Podcast https://podcasts.apple.com/us/podcast/coronavirus-the-truth-with-dr-robert-pearl-and-jeremy-corr/id1503171243 Doctors Without Borders: https://www.doctorswithoutborders.org/   Connect with Dr. Pearl: Website: https://robertpearlmd.com/ Facebook: https://www.facebook.com/RobertPearl.MD/ Twitter: https://twitter.com/RobertPearlMD/ Linkedin: https://www.linkedin.com/in/robert-pearl-m-d-32427b98/   Watch on Youtube: https://youtu.be/IJ5BtPCJqKQ   Learn more about Dr. Dike and The Happy MD: https://linktr.ee/dikedrummond We would love to hear your feedback.  Send us your review on Apple Podcasts/Itunes, or in other directories through this link: https://www.podchaser.com/podcasts/physicians-on-purpose-1546320

In this episode, we chat with Dr. Robert Pearl about how happy doctors equals happy patients. We also discuss Dr. Pearl's new book, "Uncaring - How the Culture of Medicine Kills Doctors and Patients." You can preorder Dr. Pearl's new book here and get a discussion group guide, book reference list, signed bookplate, and chance to read the introduction before others. Amazon will deliver it on May 18. The proceeds from Dr. Pearl's book will be going to Doctors Without Borders/Médecins Sans Frontières (MSF) Canada.Being a doctor is your calling because you couldn't imagine doing anything else. Let's talk about your career goals in medicine. Connect with us and tell us how you dream of practicing medicine. Want to learn more about how we do healthcare? Visit our resource center and check out how we are transforming healthcare. Don't forget subscribe to ChenMed Rx to receive the latest news and articles from ChenMed.

#135: In this episode, our Host, Micheal Pope, will be joined by Dr. Robert Pearl, the former CEO of The Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of The Mid-Atlantic Permanente Medical Group (2009-2017). Named one of Modern Healthcare's 50 most influential physician leaders, Pearl is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led healthcare delivery.He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the Stanford Graduate School of Business faculty. Dr. Pearl is the author of "Mistreated: Why We think We're Getting Good Healthcare—And Why We're Usually Wrong," a Washington Post bestseller that offers a roadmap for transforming American healthcare. All proceeds from the book go to Doctors Without Borders. His next book, Uncaring: How the Culture of Medicine Kills Doctors and Patients, will be published in spring 2021. Pre-order today: http://bit.ly/3e69QOt and you will receive a signed bookplate, a book group discussion guide, a reading list, and the introduction before the publication date.Dr. Pearl hosts the popular podcasts Fixing Healthcare and Coronavirus: The Truth. He publishes a newsletter with over 12,000 subscribers called Monthly Musings on American Healthcare and is a regular contributor to Forbes. He has published more than 100 articles in medical journals and contributed to numerous books—a frequent keynote speaker at healthcare and medical technology conferences.www.michealpopeproductions.com