Fixing Healthcare

Originally recorded more than three years ago, this episode explores two issues that remain central to the future of American medicine: how healthcare leaders respond to technological change and whether the nation can finally move beyond fee-for-service reimbursement.

Looking back now, the discussion feels strikingly current. Many of the opportunities Dr. Pearl identified at the time still exist today. Generative AI has advanced dramatically. Remote monitoring tools are more powerful and accessible than ever. And healthcare leaders continue to acknowledge the need for better chronic disease management, prevention and lower-cost care delivery.

Yet despite these advances, many of the nation’s biggest healthcare problems remain unresolved. U.S. quality outcomes still lag peer nations. Life expectancy remains years shorter than in comparable countries. And healthcare costs continue rising at rates that far exceed inflation, wage growth and GDP.

Throughout the episode, Dr. Pearl argues that these failures are not primarily technological. The tools to improve care already existed — and continue to improve rapidly today. The greater challenge is leadership itself: helping clinicians embrace change, aligning incentives around patient outcomes and building the operational systems required to make better care possible at scale.

The conversation also revisits capitation and value-based care, themes that have resurfaced repeatedly in recent Fixing Healthcare episodes. Dr. Pearl explains why fee-for-service reimbursement continues to reward volume over outcomes and why meaningful progress in affordability will require shifting financial incentives toward prevention, chronic disease control and long-term patient health.

Revisiting this episode now offers a useful perspective on the past several years of healthcare transformation: technology has accelerated, but the deeper structural changes required to improve affordability and outcomes have moved far more slowly.

Helpful links

The Anatomy Of Healthcare Leadership: A Mind For Technology (Forbes)

Healthcare Leadership: Following The Money Can Lead To Positive Change (Forbes)

Monthly Musings on American Healthcare (RobertPearlMD.com)

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

The post FHC #215: Revisiting healthcare leadership, technology & capitation appeared first on Fixing Healthcare.

For the next two weeks, Fixing Healthcare hosts Jeremy Corr and Dr. Robert Pearl will be replaying past episodes of Diving Deep while Dr. Pearl travels and keynotes events around the world. But these aren’t random reruns. They were selected for a reason: to highlight just how quickly technology is advancing and how slowly healthcare is adapting.

This week’s flashback revisits a July 2024 conversation recorded shortly after OpenAI released GPT-4o, a major leap forward in generative AI at the time. Less than two years later, the pace of change is striking. Capabilities that once felt groundbreaking now seem primitive compared to what today’s AI tools can accomplish for patients, physicians and healthcare organizations.

At the same time, the episode’s broader themes remain remarkably current. Dr. Pearl and Jeremy discuss the future role of generative AI in medicine, how these tools could improve diagnosis and patient monitoring and why healthcare institutions often struggle to embrace transformative technology quickly.

The episode also examines another issue that remains unresolved today: the high cost of GLP-1 medications like Wegovy and Ozempic. Dr. Pearl explains why these highly effective obesity treatments remain financially out of reach for many Americans despite growing demand and expanding clinical use.

Revisiting this conversation now offers a useful reminder: technology can advance extraordinarily fast, but healthcare systems, incentives and policies often lag far behind.

Helpful links: 

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #214: Revisiting GLP-1 prices and ChatGPT’s early leap forward appeared first on Fixing Healthcare.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr dissect two issues that are often discussed separately but are deeply intertwined: how Americans can live longer, healthier lives and how the nation can make healthcare more affordable.

The conversation begins with longevity. As interest in lifespan and “healthspan” grows, Dr. Pearl challenges three widely held beliefs that, in his view, are holding Americans back. First, the idea that physical and cognitive decline is inevitable with age. New research suggests that nearly half of older adults improve over time, particularly when they maintain a positive outlook and stay physically and mentally active. Second, the belief that longevity can be “hacked” through supplements, peptides and other quick fixes. Despite a $50 billion market and widespread adoption, Pearl explains that most of these interventions lack strong clinical evidence in humans. And third, the assumption that prevention can wait until middle age. Updated cardiovascular guidelines show that earlier screening and intervention, particularly around LDL cholesterol, can dramatically reduce long-term risk.

From there, the discussion shifts to the financial side of healthcare. Pearl argues that improving population health is the most effective way to reduce costs, but that meaningful change will also require a fundamental redesign of how care is delivered. Drawing on behavioral research, he introduces a central concept: healthcare leaders tend to solve problems by adding more resources (staff, beds, technology) when better outcomes often require subtraction first.

The second half of the episode applies this “subtraction before addition” framework across the healthcare system. In outpatient care, Pearl describes how the traditional small physician office has become increasingly inefficient in an era dominated by chronic disease and administrative complexity. He proposes larger, integrated models that share staff, leverage generative AI and shift from calendar-based visits to continuous, need-based care. In emergency departments, he outlines how segmenting patients by clinical severity could reduce wait times, improve outcomes and lower costs by treating low-risk cases through primary care pathways. And in inpatient settings, he points to hospital-at-home programs as a way to safely care for a significant share of patients at lower cost and with better outcomes.

Taken together, this episode teaches that Americans can extend both lifespan and healthspan by rejecting outdated assumptions and focusing on proven behaviors. At the same time, healthcare affordability will not improve by continuing to add more of the same. It will require eliminating inefficiencies, redesigning care delivery and replacing outdated models with ones better suited to modern medicine.

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

Helpful links

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #213: Longevity myths, healthcare costs & why medicine must subtract to improve appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl probe the facts beneath healthcare biggest headlines. Today’s show features an in-depth look at sweeping federal budget cuts, the expanding (and often misunderstood) impact of GLP-1 medications and what’s destabilizing health coverage.

The conversation opens with a stark warning. Dr. Pearl reviews the president’s proposed 2027 budget, which includes a $15.8 billion reduction in healthcare spending. He explains why cuts to Medicaid, NIH research and global health programs could have consequences that extend far beyond the next fiscal year, potentially slowing innovation, increasing patient risk and shifting costs to states and families.

From there, the episode turns to one of the most asked-about topics from listeners: GLP-1 weight-loss drugs. While these medications clearly produce meaningful weight loss and improve outcomes in conditions tied to obesity, Dr. Pearl cautions that many of the broader health claims attributed to them may simply reflect the benefits of weight loss itself, not unique properties of the drugs.

Throughout the episode, an underlying truth: scientific progress continues but policy decisions, pricing dynamics and system design may limit who benefits (and at what cost).

Here are the other major storylines from episode 106:

Tune in for more fact-based analysis and practical perspective on the healthcare policies, technologies and trends shaping medicine today.

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine.

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

The post MTT #106: Trump’s 2027 budget & the other threats to U.S. healthcare appeared first on Fixing Healthcare.

OpenAI didn’t need to convince patients to try generative AI.

According to Dr. Nate Gross, Health of Health at OpenAI, 230 million people already use ChatGPT each week to interpret lab results, prepare for visits, understand diagnoses or ask health-related questions they didn’t have time (or confidence) to raise in the exam room.

But what about clinicians?

On this episode of Fixing Healthcare, Dr. Robert Pearl and Jeremy Corr speak with Dr. Gross, who previously co-founded Doximity and Rock Health, about OpenAI’s latest step: the release of ChatGPT for Clinicians, a new offering that brings healthcare-specific AI tools directly to individual providers, without requiring access through a large health system contract.

In other words, the same capabilities previously limited to enterprise deployments are now being placed in the hands of front-line clinicians.

But as Dr. Gross makes clear in this timely interview, the story of AI in medicine is much bigger than a single product. It’s about how generative AI is beginning to reshape healthcare across three fronts at once: patients, clinicians and health systems.

Key highlights include:

There’s much more in this conversation, including how healthcare leaders should think about AI in long-term planning and a deeper dive into the biggest opportunities that lie ahead.

Tune in to hear what physicians, patients and health systems should expect from the next chapter of medicine.

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Dr. Robert Pearl is the bestselling author of ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine. Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify or wherever you find podcasts. Join the conversation or suggest a guest by following the show on X and LinkedIn.

The post FHC #212: OpenAI’s Nate Gross on ChatGPT’s next big move in healthcare appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, Drs. Robert Pearl and Jonathan Fisher join cohost Jeremy Corr to explore one of medicine’s least discussed forces: how professional culture gradually reshapes physician identity.

The conversation begins with relationships using an unlikely touchpoint: FX’s Love Story: John F. Kennedy Jr. & Carolyn Bessette. Using marriage, friendship, doctor-patient dynamics and colleague trust as a launching point, Pearl and Fisher examine how stress, burnout and emotional spillover affect the people clinicians care about both at home and at work. Fisher draws on his retreat work with healthcare professionals to explain why slowing down, reconnecting socially and stepping outside the clinical environment are often prerequisites for restoring empathy and perspective.

Midway through, the discussion deepens into the powerful theme introduced through the popular SHOWTIME show Billions: the way workplace environments subtly redefine who people become over time. In medicine, that process can begin as early as the first weeks of training. Small acts of conformity, repeated decisions at the edge of one’s values and cultural reinforcement gradually shift how physicians think, behave and ultimately define themselves.

The result is a larger question that runs through the entire episode: How do clinicians preserve their humanity, relationships and deepest values inside a system that often rewards speed, hierarchy and productivity over reflection and connection?

Finally, Jeremy’s closing question on behalf of patients helps to push both physicians to confront a national reality: when specialist access takes months, compassion must be communicated quickly and system design must improve the patient experience itself.

For listeners who connected with Jonathan’s discussion of physician recovery, reflection and emotional renewal, check out his upcoming ASPIRE physician retreat, a CME-accredited experience for healthcare professionals, taking place June 12-14 in Boone, North Carolina. Use code ASPIRE15 for 15% off registration.

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

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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 #211: How medical culture slowly reshapes physician identity appeared first on Fixing Healthcare.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr connect two forces that are beginning to reshape the future of medicine: healthcare’s worsening economic inefficiency and the rise of physician-built generative AI tools.

The conversation opens with a provocative interpretation of the latest U.S. jobs reports. While healthcare has become the nation’s primary engine of employment growth, Dr. Pearl argues that this is not a sign of strength. It is evidence that medicine continues to meet rising demand by adding labor instead of improving productivity. In his view, that failure to modernize is driving higher costs for employers, families and government programs while setting the stage for inevitable disruption.

From there, the discussion shifts to what that disruption could look like. Pearl outlines how generative AI could improve chronic disease monitoring, reduce unnecessary hospital stays and detect inpatient decline earlier than current workflows allow. These advances, he argues, would lower costs not by rationing care but by improving outcomes.

The second half of the episode turns to one of the most practical and exciting developments in generative AI: vibe coding. Here, Pearl explains how physicians can now use plain-English prompts to create customized digital tools that reflect their own clinical judgment and practice preferences. Rather than relying on static handouts or generic patient portals, doctors could build affordable applications that monitor patients continuously between visits and intervene earlier when problems arise.

Taken together, the episode puts forth a clear thesis: healthcare’s worsening economics are not a sign of resilience. They are a sign that medicine has failed to modernize. What’s more: generative AI, especially through vibe coding, may be the most practical path to higher-quality, lower-cost care.

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

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

The post FHC #210: Healthcare’s productivity crisis & how vibe coding could help appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl balance two sides of American healthcare: the encouraging scientific advances that could help people live longer and healthier lives, and the growing affordability and trust crises threatening patients across the country.

The conversation opens on an optimistic note. Dr. Pearl highlights new Yale research showing that aging is far less deterministic than many Americans assume. Rather than a steady and unavoidable decline, the study found that nearly half of adults over 65 improved physically, cognitively or both over a 12-year period.

He pairs that story with new cardiovascular guidance from the American College of Cardiology and the American Heart Association, which shifts prevention toward a much longer time horizon and argues that earlier LDL management could prevent a significant share of heart attacks and strokes later in life.

The episode then pivots to the mounting financial and institutional pressures facing patients, hospitals and public-health agencies. From rising medical debt and medication nonadherence to declining vaccine trust, hospital cost inflation and the political barriers keeping GLP-1 drugs unaffordable in the United States, the discussion captures both the promise and the fragility of healthcare in 2026.

Here are the other major storylines from episode 105:

Tune in for more fact-based analysis and practical perspective on the healthcare stories shaping medicine today.

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine.

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

The post MTT #105: New science on aging, rising medical debt & healthcare’s fax problem appeared first on Fixing Healthcare.

Dr. John Whyte has spent his career at the intersection of medicine, media and public policy. Now, as CEO of the American Medical Association, he hears firsthand what physicians, patients and health leaders are most concerned about and what they expect from the future of healthcare.

That perspective makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr.

This season’s guests bring more than impressive résumés and large social-media followings. They bring insight into what people across the country are actually talking about: the fears they express, the questions they ask and the expectations they carry into exam rooms, boardrooms and online conversations.

Whyte has held leadership roles at the FDA and Centers for Medicare & Medicaid Services. He later became chief medical officer at WebMD and chief medical expert for Discovery Channel. In each position, he has focused on translating complex medical issues into clear, actionable information.

In this conversation, he shares what he is hearing now and why the answers will require both cultural and structural change.

There’s so much more to this episode. Tune in to find out what physicians and patients should expect from the future of medicine.

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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 #209: What the AMA’s new CEO is hearing from doctors & patients right now appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, Dr. Robert Pearl and Jeremy Corr sit down with cardiologist and mindfulness expert Dr. Jonathan Fisher for a wide-ranging conversation about leadership, strategy and the future of physician influence in American medicine.

The discussion begins with a challenge to a popular point of view: that empathy, transparency and trust make for an effective leader in medicine. While those qualities matter, Dr. Pearl argues that healthcare also requires strategic thinking, operational discipline and the ability to align people around a common direction. In medicine, says Dr. Fisher, many physicians are taught how to care for patients but not how to lead organizations.

From there, the conversation expands into the deeper reasons doctors so often remain subordinate to administrators, why burnout makes strategy harder to execute and why the economics of healthcare continue to reward treatment more than prevention.

Some of the key ideas discussed:

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

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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 #208: Why empathy alone won’t fix healthcare leadership appeared first on Fixing Healthcare.