FHC #186: From rare diseases to rural America, Optum’s CEO talks healthcare’s future

In this special return to Season 10, which focused on transformative technologies in medicine, Fixing Healthcare hosts Dr. Robert Pearl and Jeremy Corr interview Dr. Patrick Conway, CEO of Optum, a $250 billion division of UnitedHealth Group. A pediatrician and former CMS leader, Dr. Conway has spent his career driving innovation at the intersection of medicine, policy and business.

Conway argues that healthcare stands on the brink of a transformation driven by artificial intelligence, breakthrough therapies, prevention strategies and big data analytics. As CEO of Optum (one of the most influential players in U.S. medicine, employing over 310,000 people worldwide), Conway explains how his organization is using technology and integration to improve quality, lower costs and expand equity.

Here are five key insights from the episode:

After the interview, Dr. Pearl tells Corr that he was struck by the Optum CEO’s optimism about generative AI and its role in reshaping healthcare, noting that Conway sees beyond administrative savings to its potential for improving clinical outcomes and managing chronic disease. Pearl noted Conway’s clear commitment to capitation and value-based care; what Pearl called his “North Star.” Pearl concluded that Conway is a mission-driven leader, highly capable of pushing UnitedHealth Group to accelerate change, and urged him to move faster than feels comfortable in scaling prevention, AI and integrated care.

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #186: Optum CEO on AI, big data & preventing disease appeared first on Fixing Healthcare.

In this Diving Deep episode of Fixing Healthcare, cohosts Dr. Robert Pearl and Jeremy Corr tackle two timely topics shaping the future of American medicine.

First, the pair explore a growing concern among health policy experts and clinicians alike: Is the U.S. medical system headed for economic collapse? Dr. Pearl outlines three troubling trends in support of this concern. Ballooning healthcare costs, an unsustainable rise in medical employment (without associated gains in quality), and the accelerating burnout and exit of practicing physicians. Together, these forces threaten to push American healthcare off a cliff.

More alarming still, the traditional “exit ramps” that once helped the system avoid disaster — federal borrowing, employer cost-shifting and physician overwork — are rapidly disappearing. With options dwindling, Pearl and Corr consider what comes next: Will private equity lead a wave of cost-cutting? Will crisis force rationing? Or could new technology offer a better way forward?

That question sets the stage for part two of the episode: a deep dive into generative AI’s future in medicine. Pearl describes two emerging paths: one led by tech startups developing FDA-approved tools to manage disease, and another championed by physicians who teach patients how to use existing large language models for self-care and symptom triage. Both models aim to reduce costs and improve outcomes. But each comes with tradeoffs.

Throughout the episode, Pearl encourages clinicians to lead (not follow) the adoption of GenAI. Whether American healthcare descends into austerity or rises toward innovation, the decisions made now will shape the system’s trajectory for decades to come.

HELPFUL LINKS

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #185: A System in crisis, a technology in waiting appeared first on Fixing Healthcare.

In this episode of Medicine: The Truth, Dr. Robert Pearl and Jeremy Corr cover a whirlwind of headlines, from a White House push to tie U.S. drug prices to wealthy-nation benchmarks (with tariff threats) to a Big Tech pledge to make medical records truly interoperable. They also unpack what ACA exchange enrollees should expect in 2026 as cost-sharing subsidies teeter and insurers file double-digit premium hikes.

On care delivery, the hosts examine the direct primary care + HSA shift: what it could improve, and where it might widen disparities. They then turn to the FDA’s accelerated approvals, gene-therapy turmoil and why scientific independence matters.

Other key topics discussed:

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Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn

The post MTT #97: Drug prices, Big Tech EHR promises & the 7,000-step surprise appeared first on Fixing Healthcare.

In the first episode of Fixing Healthcare’s 11th season, cohosts Dr. Robert Pearl and Jeremy Corr speak with Dr. Uché Blackstock, an emergency physician, bestselling author and health equity expert.

This season turns the spotlight on voices from social media, offering insights into what patients actually want from the U.S. healthcare system. Dr. Blackstock (whose online following is both massive and deeply engaged) shares the concerns she hears most often: fears about rising insurance premiums, confusion around preventive screenings and frustration with a system that feels inaccessible, dismissive or even dangerous for many women and people of color.

Dr. Blackstock is the founder and CEO of Advancing Health Equity and author of Legacy: A Black Physician Reckons with Racism in Medicine, a memoir that blends personal history with data and policy analysis. In her conversation with Dr. Pearl and Jeremy Corr, she highlights several ways the U.S. healthcare system must change to better serve all patients:

Bridging The Access Gap

Rebuilding Trust

Rethinking The System Itself

Throughout the episode, the conversation returns to a central question: What does it mean to be seen, heard and cared for in today’s healthcare system. And how can we ensure everyone receives that kind of care?

Tune in for the full interview and join the conversation on social media.

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #184: Dr. Uché Blackstock on racism, sexism and fixing medicine appeared first on Fixing Healthcare.

In this Diving Deep episode of Fixing Healthcare, cohosts Dr. Robert Pearl and Jeremy Corr tackle two of the most pressing questions in healthcare today, each focused on the future of medical practice in the era of generative AI.

First, the hosts explore the controversial question: Will AI replace doctors? Dr. Pearl argues that, despite recent advances in AI that now outperform physicians in a growing number of diagnostic tasks, the answer is “no.” He explains why the healthcare system’s worsening physician shortage, its rising costs and patients’ enduring need for human connection all point to a future in which doctors remain essential.

However, he warns that clinicians won’t be immune to the pressures GenAI brings. If the technology is controlled by insurers or private equity firms, it will likely be used to speed up visits and reduce costs, not improve care. To avoid that outcome, Pearl urges physicians to lead AI’s integration into medicine, organizing into high-performing groups and shaping how the tools are used. Otherwise, he cautions, GenAI won’t replace doctors. But it will make their jobs miserable.

Later in the episode, the conversation turns to medical education. Pearl argues that U.S. medical schools are falling dangerously behind in preparing students for the AI revolution. While colleges and universities across the country are rapidly integrating generative AI into undergraduate curricula, most medical schools still rely on outdated teaching methods that emphasize memorization rather than application of information in clinical practice.

Pearl calls for an urgent overhaul of faculty training and curricular design, encouraging hands-on exercises where students use GenAI as a clinical partner. With this foundation, students can engage in diagnostic reasoning, design care plans, and collaborate with AI tools to improve patient outcomes. Without these changes, he warns, tomorrow’s physicians may be ill-equipped to lead in a rapidly evolving healthcare landscape.

Together, these topics speak to some of the greatest fears – and greatest opportunities – in the medical profession today. Listen to the episode to hear the full conversation and decide for yourself.

HELPFUL LINKS

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #183: Will GenAI replace docs? How should medical schools respond? appeared first on Fixing Healthcare.

In this episode of Medicine: The Truth, co-hosts Dr. Robert Pearl and Jeremy Corr examine a wide range of healthcare headlines. From the Supreme Court’s ruling on preventive care to heat-related deaths, experimental diabetes treatments and the continued unaffordability of life-saving drugs, this episode focuses on biggest stories in medicine today.

It opens with a breakdown of the Supreme Court’s recent 6–3 decision on pre-exposure prophylaxis (PrEP) for HIV. While the ruling preserves access to services recommended by the U.S. Preventive Services Task Force, Pearl warns that it introduces new risks.

“When politics or finances enter the healthcare world, clinical outcomes suffer,” says Pearl. He draws parallels to the ousting of experts on the CDC’s vaccine advisory panel and highlights the danger of eroding scientific independence.

Pearl then turns to a longstanding pain point in American healthcare: prior authorization.

While insurer companies claim this process guarantees safe, necessary care, studies show it often delays treatment or leads patients to abandon care altogether. Despite new promises from more than 50 insurers to streamline their processes by 2027, Pearl offers words of caution.

“Although this pledge sounds like a major commitment, clinicians remain doubtful Clinicians remain doubtful … And, of course, 2027 is two years away.”

Other key topics discussed in this episode include:

The episode closes with a hard truth: U.S. healthcare spending is expected to exceed 20% of GDP by 2033. “Despite spending more, we’re not seeing improvements in outcomes,” Pearl says. He promises to revisit this issue in a future episode of Diving Deep.

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Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn

The post MTT #96: Cancer confusion, obesity clarity & a $3M drug failure appeared first on Fixing Healthcare.

In a special episode of Fixing Healthcare, Jeremy Corr turns the mic once more to cohost Dr. Robert Pearl, inviting him to reflect on Season 10, marking the duo’s most ambitious deep-dive into the technologies transforming American medicine.

Over the past nine episodes, Corr and Pearl welcomed leading thinkers in health tech, including high-profile executives from Microsoft, Google, Oracle and Nvidia; the CEOs of Zocdoc and Hippocratic AI; pioneers of generative AI like investor Vinod Khosla; and renowned physician-leaders like Drs. Eric Topol and Maria Ansari.

This week, Corr and Pearl offer listeners a wide-angle view of what they learned … and what comes next.

Pearl begins by identifying four major “eras” of healthcare technology. The first was defined by anatomic understanding and miracle drugs. The second brought powerful machines like CT and MRI. The third saw the arrival of EHRs and the internet, technologies that failed to meet expectations. The fourth era, he says, began on “November 30th of 2022, with the release of OpenAI’s ChatGPT.”

Since then, Pearl notes, generative AI has at least doubled in power annually. “By the time the current cohort of medical students complete their training,” he says, “generative AI will be at least 30 times more powerful than today. That’s the equivalent of your car going as fast as an airplane.”

Corr asks Pearl to walk through what stood out most from the season’s interviews. Pearl highlights Dr. Topol’s focus on “precision preventive care,” David Feinberg’s vision of AI as a personal assistant, and Vinod Khosla’s belief that “AI won’t replace 80% of doctors, but it will replace 80% of what doctors do.” Others predicted tech-enabled call centers, hospital-at-home programs, and smarter EHRs that anticipate a clinician’s needs.

Before the episode ends, Corr asks Pearl to summarize his own top three technologies for the next five to 10 years. Pearl’s answer mirrors — but also expands upon — his earlier appearance in episode #170. Here are the three innovations he believes will have the greatest impact:

Pearl ends with a bold forecast: “I’m convinced that over the next five to 10 years, the combination of dedicated clinicians and empowered patients and generative AI technology will achieve clinical outcomes that are exponentially better than what any of the three could achieve alone.”

Click play to hear this wide-ranging wrap-up to Season 10, including predictions for medicine’s future and a call to action for patients, clinicians and tech innovators alike.

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #182: How GenAI, telemedicine and AI assistants will reshape medicine appeared first on Fixing Healthcare.

In this introspective episode of Unfiltered, cohosts Dr. Robert Pearl and Jeremy Corr sit down once again with cardiologist Dr. Jonathan Fisher to explore the emotional and psychological dimensions of medical treatment — this time from the perspective of a physician as a patient.

Prompted by Dr. Fisher’s own recent orthopedic surgery, the discussion examines the complexities and uncertainties patients face when deciding on medical interventions. Fisher candidly shares his reflections on the importance of setting clear expectations, the role of empathy in patient care, and the profound isolation and vulnerability experienced during his own recovery.

The episode expands into a broader dialogue about hope, optimism and honesty in medical care, particularly in oncology. Pearl and Fisher debate the balance between providing realistic expectations and maintaining patient optimism, highlighting how the right mindset can significantly influence healing and recovery.

Finally, in response to a listener’s thoughtful question, the hosts explore how medical specialties metaphorically influence a physician’s worldview and approach to patient care, underscoring the profound interplay between personal experience and professional practice.

For more candid, unfiltered conversation, listen to the full episode and explore these related resources:

‘Just One Heart’ (Jonathan Fisher’s newest book)

‘ChatGPT, MD’ (Robert Pearl’s newest book)

Monthly Musings on American Healthcare (Robert Pearl’s newsletter)

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #181: When the doctor becomes the patient appeared first on Fixing Healthcare.

In this episode of Fixing Healthcare’s “Diving Deep,” co-hosts Dr. Robert Pearl and Jeremy Corr examine two pressing healthcare issues through thoughtful Q&A: the impact of Trump’s healthcare promises on policy and the hidden psychological bias that impedes everything from tariff decisions to chronic disease management.

First, the hosts discuss President Donald Trump’s bold healthcare promises, including significantly lowering prescription drug prices, reversing chronic diseases and leveraging generative AI to transform American medicine. With midterm elections looming, Pearl emphasizes the urgency for real policy action rather than rhetoric. On drug pricing, he notes the significant legislative and regulatory hurdles facing Trump’s proposed solutions, such as Most-Favored-Nation (MFN) pricing. Regarding food quality and obesity, Pearl addresses RFK Jr.’s criticism of ultra-processed foods and urges the administration to move beyond symbolic reports to concrete policies, including front-of-package labeling, taxation of unhealthy foods, and stricter food additive regulations. Additionally, Pearl highlights the administration’s enthusiasm for generative AI, advocating for real-world applications to manage chronic conditions and enhance diagnostic accuracy, while cautioning against potential disconnects caused by outdated FDA processes and insufficient investment in innovation.

Later in the episode, the hosts delve into the hidden psychological traps impacting chronic disease management, particularly the Dunning-Kruger effect, a cognitive bias causing individuals to overestimate their competence. Pearl explains how this bias affects healthcare providers, resulting in clinical inertia, where doctors overestimate their control over patients’ chronic conditions such as diabetes, hypertension, and heart disease. This often leads to inadequate disease management and avoidable complications like heart attacks and strokes. Pearl suggests several strategies for overcoming this bias, including objective self-assessment against national benchmarks, proactive investigation of treatment gaps, and the use of generative AI tools such as ChatGPT to enhance patient engagement and clinical responsiveness.

This episode of “Diving Deep” underscores the importance of transitioning from political and professional promises to tangible healthcare improvements, highlighting both the potential and pitfalls in current healthcare strategies.

HELPFUL LINKS

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #180: Diving Deep into healthcare politics & the biases blocking chronic disease care appeared first on Fixing Healthcare.

With Dr. Robert Pearl traveling abroad this week to keynote a major conference on patient data transparency, the Fixing Healthcare team is revisiting one of its most popular episodes: an Unfiltered conversation with Dr. Zubin Damania (aka ZDoggMD), originally recorded three years ago in the lead-up to Independence Day.

At the time of the recording, America was grappling with the aftermath of a deadly mass shooting at the Highland Park parade in Illinois. Cohost Jeremy Corr, near the end of the episode, asks Drs. Pearl and Damania how America — despite its ideals of freedom and democracy — continues to struggle with societal divides, mental illness and isolation. Corr drew on a quote from founding father Thomas Jefferson to set the stage: “Yes, we did produce a near-perfect republic. But will they keep it? Or will they, in the enjoyment of plenty, lose the memory of freedom? Material abundance without character is the surest way to destruction.”

In his response, and throughout the episode, Dr. Damania emphasizes that the key to overcoming these challenges lies in embracing authenticity, promoting community connection, and helping people discover and realize their purpose.

“We have a crisis of meaning. And the question we ought to be really trying to process is how do we bring back a sense of meaning?”

Damania argues passionately for authenticity in medicine, believing that openness, transparency, and emotional honesty are vital for both patient care and physician satisfaction.

As the Fourth of July approaches once again, this replay encourages listeners to reflect on how authentic relationships and a commitment to community can enhance not only medical care but societal cohesion overall. Tune in for a thought-provoking reminder of how fostering authenticity and empathy can strengthen medicine and our broader society.

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Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #179: An unfiltered look back at independence, authenticity in medicine appeared first on Fixing Healthcare.