Off the Chart: A Business of Medicine Podcast

Kyle Zebley, senior vice president of the American Telemedicine Association (ATA) and executive director of ATA Action, joins the show to talk about what happened when Medicare’s telehealth flexibilities expired during the federal government shutdown earlier this month.

In discussion with Medical Economics Senior Editor Richard Payerchin on October 3, 2025, Zebley explains how the lapse has disrupted care for patients and physicians nationwide, what Congress can do to fix it and why making telehealth permanent remains one of the most urgent priorities in U.S. health policy.

Music Credits:
RELAXED CHILL JAZZ LOUNGE (OVER THE RIVER) by Tasty Tunes - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 1:42 | Introduction
Austin Littrell introduces the episode, summarizing the telehealth lapse following the federal government shutdown and previewing the interview with Kyle Zebley.

1:42 – 2:32 | Setting the stage
Host Richard Payerchin introduces Kyle Zebley. Zebley opens with a description of the “sad, desperate state” of telehealth following the October 1 shutdown.

2:32 – 4:09 | How the lapse happened
Zebley explains the simultaneous expiration of pandemic-era telehealth flexibilities and the government shutdown — calling it a “victim of circumstance.”

4:09 – 6:34 | How telehealth evolved since COVID-19
Discussion of how the COVID-19 pandemic transformed telehealth and accelerated its adoption across Medicare and private insurance.

6:34 – 8:06 | The scope of telehealth today
Zebley outlines usage statistics: about one in four Medicare beneficiaries now use telehealth, accounting for roughly 13% of all visits.

8:06 – 10:15 | Shutdown vs. policy lapse
Clarifying that telehealth’s expiration isn’t automatically tied to the government shutdown — Congress must act to reauthorize.

10:15 – 12:30 | Why permanence matters
Why ATA advocates for making telehealth flexibilities permanent; the legislative gridlock preventing it.

12:30 – 14:07 | Will retroactive reimbursement happen?
Zebley predicts retroactive payments are likely but not guaranteed — urging continued advocacy.

14:07 – 14:21 | Patient Care Online plug
Quick mention of sister site PatientCareOnline.com for additional clinical information.

14:21 – 16:20 | Advice for medical practices
Guidance for physicians weighing whether to continue virtual visits during the lapse; balancing financial risk with patient needs.

16:20 – 18:45 | Impact on private insurance
Zebley notes no major changes among private insurers — but Medicare sets the “floor” for telehealth expectations.

18:45 – 20:40 | Bipartisan support in Congress
Discussion of political dynamics; Zebley praises continued bipartisan support for telehealth under both Trump and Biden administrations.

20:40 – 24:18 | Mental health coverage and the in-person requirement
Explains permanent coverage for telemental health but criticizes the “clinically inappropriate” in-person requirement as a barrier.

24:18 – 25:09 | P2 Management Minute
Interlude with Keith Reynolds sharing practice management tips and inviting audience participation.

25:09 – 25:54 | The Acute Hospital Care at Home program
Zebley discusses why the program is vital for expanding capacity and patient satisfaction — and how the shutdown halted it.

25:54 – 28:47 | Rural health clinics and FQHCs
Why distant-site telehealth flexibilities are critical for rural and underserved communities.

28:47 – 30:30 | How to advocate for telehealth
Zebley explains ATA’s grassroots advocacy tool that connects citizens with Congress to restore telehealth and hospital-at-home programs.

30:30 – 32:31 | What physicians can do now
Calls on physicians to use their credibility to pressure lawmakers: “Stop the insanity and bring back these programs.”

33:53 – 35:12 | Closing remarks
Richard Payerchin closes the interview; Austin Littrell wraps up the episode and reminds listeners to subscribe and visit MedicalEconomics.com and PhysiciansPractice.com.

35:12 – 35:40 | Credits

Kevin Schulman, M.D., MBA, professor of medicine, clinical excellence research center at Stanford University, joins the show to talk about why the U.S. spends more on health care administration than many countries spend on care itself. 

Schulman explains how complexity in billing and payment drives up costs, why current processes are still stuck in the analog era and how ideas from other industries could help create more efficient, digital systems. The conversation also explores the role of AI, the impact of prior authorizations and what reducing administrative waste could mean for physicians, patients and the future of health care.

Read "Addressing Health Care’s Administrative Cost Crisis," Schulman's co-authored viewpoint in JAMA. (https://jamanetwork.com/journals/jama/fullarticle/2829283)

Music Credits:
Restless Minds by Yomoti - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

00:00 – 01:32 | Opening & Introduction
Austin Littrell introduces Off the Chart and sets up the interview with Dr. Kevin Schulman, professor of medicine at Stanford, to discuss the administrative cost crisis and “precedence thinking” in health care.

01:32 – 03:01 | Scope of the Problem
Dr. Schulman describes the staggering scale of administrative spending — roughly a third of all U.S. health care costs — and the chaos of 318,000 plans, 600,000 billing codes and 57 billion prices.

03:01 – 04:34 | Administrative Burden in Practice
He shares firsthand frustrations from hospital medicine — coding queries, irrelevant documentation and network gaps that cause endless rework.

04:34 – 14:11 | Precedent Thinking Explained
Defines “precedence thinking,” contrasting analog vs. digital processes, and explores how other industries solved analogous problems.

14:11 – 14:30 | Promo Break – PatientCareOnline.com

14:30 – 19:25 | “Health care Is Different?” and Rebuttal
Addresses skepticism that medicine is too complex to standardize; compares U.S. costs with the Netherlands, explains why analog systems worsen prior auth inefficiencies and warns of fraud risks in analog transactions.

19:25 – 22:49 | Centralization vs. Standardization
Discusses the difference between those concepts, citing Medicare-for-All debates and arguing for a mixed public-private system with streamlined transactions rather than government centralization.
 (Includes Keith Reynolds’ “P2 Management Minute” segment at 22:00 – 22:49.)

22:49 – 27:15 | Digital Contracts and Payment Reform
Explains modular, machine-readable contracts to reduce manual renegotiation, modernize prior authorization and target fraud and waste digitally instead of analog paper processes.

27:15 – 30:03 | Physician Burnout and Workforce Impact
Links admin burden to burnout and hospital employment trends; warns AI could double documentation queries and further erode job satisfaction.

30:03 – 32:32 | AI in Research and Payments
Describes how AI was used in his research and how unregulated AI in payer systems could increase complexity and drive physicians from practice.

32:32 – 34:00 | Policy Context – “Make America Healthy Again”
Frames administrative reform as aligned with federal anti-fraud and efficiency initiatives; calls it a rare bipartisan opportunity.

34:00 – 34:53 | Message to Primary Care Physicians
Urges doctors to advocate for change and reject the notion that current administrative complexity is inevitable.

34:53 – 35:46 | Closing Exchange
Richard Payerchin summarizes themes and thanks Dr. Schulman for joining.

36:01 – 36:58 | Outro and Credits
Austin Littrell closes the episode with subscription and newsletter reminders and production credits.

At the MGMA Leaders Conference 2025 in Orlando, Florida, Andrew Swanson, M.P.A., FACMPE, spoke with Physicians Practice Editor Keith Reynolds about the pressures facing practices, from shrinking reimbursements to rising costs.

He shared why technology, stronger leadership and a focus on patient experience are key to staying resilient — and why finding community and even humor can help practices weather today’s challenges.

Check out all of our MGMA 2025 coverage: https://www.medicaleconomics.com/conference/mgma

Music Credits:
Acoustic Chill by Lorenzoangelucci/MusicRevolution - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Opening Reflections on Resilience (00:00:00)
Finding joy and levity in health care helps teams stay resilient through challenges.

Podcast Introduction & Episode Overview (00:00:32)
Host introduces the episode, guests, and main topics: financial pressures, technology, leadership and resilience.

Live Conference Introduction (00:01:28)
Introduction of Andrew Swanson and the setting at the MGMA Leaders Conference in Orlando.

Biggest Financial Challenge: Compressing Reimbursement (00:01:51)
Discussion of rising overhead costs, shrinking reimbursements and financial pressures on medical practices.

MGMA’s Value to Members (00:02:48)
How MGMA helps practices operate more efficiently, especially through technology and process improvements.

Maintaining Profitability Amid Shrinking Margins (00:03:39)
Strategies for keeping practices profitable despite financial pressures.

Clinical Resource Plug: Patient Care Online (00:03:54)
Brief mention of Patient Care Online as a clinical resource for primary care physicians.

Conference Theme: “Next is Now” (00:04:19)
Emphasizing leadership, action and embracing current challenges in health care.

Empowering Leaders & Building Community (00:05:45)
Encouraging leaders to take ownership, act now and support each other through challenges.

Staff Shortages & Patient Consumerism (00:06:07)
Addressing staff shortages and the shift to viewing patients as consumers in a digital age.

Embracing Consumerism in Health care (00:07:45)
How adopting a consumer-friendly mindset benefits both patients and practices.

P2 Management Minute Segment (00:08:13)
Quick tips for practice management and a call for listener contributions.

Critical Leadership Skill: Finding Joy (00:09:03)
The importance of humor and joy in leadership to foster resilience and team cohesion.

Advice for 2026: Leveraging Technology (00:11:05)
Encouragement to adopt technology and find people who can implement it for greater efficiency and scalability.

Final Thoughts: Community and Support (00:12:55)
Emphasizing the value of community and mutual support in overcoming industry challenges.

Episode Closing & Subscription Info (00:13:52)
Host wraps up, provides subscription info and thanks listeners.

As Women in Medicine Month comes to a close, Yalda Jabbarpour, M.D., director of the Robert Graham Center at the American Academy of Family Physicians and Annie Koempel, Ph.D., M.A., RDN, LD, qualitative scientist at the American Board of Family Medicine, join the show to discuss their recent study on early career women in family medicine.

They share insights on how women physicians are already leading in unrecognized ways, why traditional definitions of leadership often miss their contributions and what needs to change to create more inclusive models of leadership in medicine.

Read their full study, "'I consider myself to be a leader': a qualitative exploration of early career women family physicians' intentions to assume a leadership role," published in Family Practice.

Music Credits:
Lo-Fi Chillhop by AVANT-BEATS - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Episode Overview (00:00:00) Host introduces the podcast, guests, and the focus on women in medicine and leadership roles.

Invisible Leadership Roles of Women Physicians (00:01:07) Discussion of unrecognized leadership tasks like mentorship, teaching, and collaborative team leadership.

Impact of Unrecognized Leadership on Career Advancement (00:04:02) Explores how lack of recognition affects career progression, compensation and contributes to burnout.

Emotional Labor and Frustration (00:05:25) Addresses the emotional toll and frustration women experience from unacknowledged leadership work.

Traditional Definitions of Leadership in Medicine (00:05:43) Examines why leadership is seen as bureaucratic and disciplinary, and its impact on women’s aspirations.

Collaborative vs. Traditional Leadership Styles (00:08:25) Highlights how women define and practice leadership differently, emphasizing collaboration and community.

Examples of Invisible Leadership in Practice (00:09:01) Specific examples of quality improvement and collaborative leadership that go unrecognized.

Balancing Leadership, Career and Family (00:11:10) Discusses challenges and myths around balancing family responsibilities with leadership roles.

Consequences of Narrow Leadership Definitions (00:13:42) Explores risks to primary care, workforce and patient outcomes if leadership definitions don’t broaden.

Innovative Leadership Models: Collaboration and Flexibility (00:16:53) Describes what collaborative, flexible leadership models could look like in real practice.

Small Changes and Practical Examples (00:19:23) Shares practical, everyday changes that foster a more inclusive and supportive work environment.

Restructuring Leadership in Family Medicine (00:20:55) Suggestions for changing leadership structures to include those impacted by decisions.

Advice for Early Career Women Physicians (00:21:49) Guidance on mentorship, self-advocacy and redefining leadership for early career women.

Optimism for the Future of Women in Leadership (00:24:53) Panelists share reasons for hope, including the new generation’s willingness to challenge the status quo.

Acknowledging Gender Diversity and Broader Relevance (00:26:30) Notes the importance of recognizing gender diversity and the relevance of these issues beyond medicine.

Closing and Podcast Information (00:27:20) Host wraps up, thanks guests and provides information on subscribing and further resources.

Justin Osmond, international keynote speaker, best-selling author, producer and humanitarian, joins the show to share his journey of overcoming profound hearing loss and breaking through self-imposed limits. In conversation with Keith Reynolds, editor of Physicians Practice, Osmond explains how leaders can reframe setbacks, build supportive teams and use mindset as a powerful tool to turn challenges into opportunities for growth.

Interested in the upcoming HCLA Virginia 2025 Fall Conference (Oct. 5-7, 2025)? Click here to register!

And don't miss Justin's keynote presentation, "Don't Limit Your Challenges... Challenge Your Limits," on Tuesday, Oct. 7 at 10:30 a.m.

Music Credits:
LoFi Morning Coffee by Elonix - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Episode Overview (00:00:18) Austin Littrell introduces the podcast, speakers, and Justin Osmond’s background and keynote topic.

Common Self-Imposed Limitations (00:01:35) Justin discusses the stories professionals tell themselves and the importance of a mindset shift to overcome limitations.

Living Below Your Capacities (00:03:01) Explores what it means to live below potential, the dangers of “faking it” and Justin’s personal journey with his deaf accent.

Embracing Authenticity and Overcoming Fear (00:04:46) Justin shares how embracing his unique voice led to freedom and joy, encouraging others to be authentic.

Settling for Comfort vs. Pursuing Growth (00:05:47) Discusses why people settle for comfort, and how true success comes from facing fears and discomfort.

Clinical Resource Interjection (00:06:46) Brief mention of Patient Care Online as a clinical resource for physicians.

Living Above Your Abilities and Team Support (00:07:09) Justin explains living above abilities, avoiding burnout and the importance of supportive teams using his 250-mile run as an example.

Building High-Performance Teams (00:08:15) Advice on fostering team support, knowing when to push or pause and celebrating milestones together.

Reframing Challenges as Growth Opportunities (00:08:53) How leaders can help teams see setbacks as opportunities for growth, using Justin’s hearing loss as an example.

The Power of Mindset in Unlocking Potential (00:11:04) Justin discusses how mindset shapes outcomes, the importance of positivity and leading by example.

Overcoming Obstacles Through Mindset (00:12:53) Encourages seeing limitations as launchpads, not barriers and shares his personal motto about overcoming hearing loss.

P2 Management Minute Segment (00:14:04) Keith Reynolds introduces a quick segment on practical management tips for medical practices.

Challenging Limits: Personal Example (00:15:10) Justin recounts running 250 miles to raise awareness for deaf children, illustrating how challenging limits reshaped his perspective.

First Steps to Overcoming Doubt and Fear (00:17:04) Advice on taking small, bold actions to break cycles of doubt and build confidence.

Keynote Takeaway: Redefining Limitations (00:18:41) Justin’s core message: limitations don’t define you—your response does. Challenges can refine and empower you.

Episode Closing and Credits (00:20:16) Austin Littrell thanks listeners, recaps the episode and provides subscription and newsletter information.

In the U.S., billions of dollars are spent each year on medical research and drug development, but too often those dollars don't match up with the diseases and patient needs that matter most.
 
In this episode of Off the Chart: A Business of Medicine Podcast, Donald Berwick, M.D., M.P.P., president emeritus and senior fellow at the Institute for Healthcare Improvement, and former director of the Centers for Medicare & Medicaid Services (CMS) joins Medical Economics Senior Editor Richard Payerchin to discuss a new National Academies of Sciences, Engineering, and Medicine report on aligning therapeutic investments with actual disease burden and unmet needs.

Berwick explains why the U.S. lacks the data needed to track disease burden and research funding, how market forces and policy decisions shape drug development and what role agencies like CMS and the Food and Drug Administration (FDA) can play in closing the gap.

Check out the National Academies article: https://nap.nationalacademies.org/catalog/29157/aligning-investments-in-therapeutic-development-with-therapeutic-need-closing-the

Check out IHI's Turn on the Lights Podcast:
https://www.ihi.org/library/turn-on-the-lights-podcast

Music Credits:
Golden Swing by Fatima Mhedden - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Podcast Overview (00:00:19) Host introduces the podcast, guests, and main topics: medical research alignment and the National Academies report.

Dr. Berwick’s Background (00:01:25) Dr. Berwick shares his education, career, and experience in healthcare improvement and policy.

Origins of the National Academies Report (00:02:34) Discussion of how the report on aligning research investments with need was initiated and funded.

Report’s Five Goals and Committee Approach (00:03:29) Overview of the committee’s goals: disease burden, unmet needs, investment mapping, causes of mismatch, and recommendations.

Data Gaps and the Need for Transparency (00:05:24) Explains the lack of comprehensive data on disease burden and research investment, and the need for a tracking consortium.

Recommendation: Interagency Consortium (00:06:19) Details on the proposed federal consortium to track unmet needs and investment, and its reporting structure.

Causes of Misalignment: Science and Markets (00:08:41) Explores why research investment doesn’t match disease burden: scientific gaps and market forces.

Role of CMS and Medicare in Drug Development (00:12:32) How CMS coverage, reimbursement, and price negotiation can influence research and drug development priorities.

FDA’s Role and Accelerated Approval (00:13:50) Discussion of FDA’s regulatory standards, accelerated approval, and the need for confirmatory studies.

Challenges with Confirmatory Studies and FDA Resources (00:17:39) Problems with incomplete confirmatory studies and the need for more FDA resources to ensure drug safety.

Private Sector’s Role and Transparency (00:19:36) How private funders can help realign research, the need for public data, and public-private partnerships.

Primary Care and Research Alignment (00:23:39) How research priorities affect primary care, and the importance of physician advocacy for research funding.

Underinvestment in Key Disease Areas (00:26:27) Specific examples of underfunded conditions in public and private sectors, and the need for targeted investment.

Social Determinants of Health and Policy (00:29:44) Emphasis on non-medical factors affecting health, and concern over declining investment in social supports.

Potential of Artificial Intelligence in Research (00:31:06) AI’s promise for identifying research gaps, supporting clinical decisions, and accelerating therapeutic development.

Values and Rare Diseases in Research Prioritization (00:32:53) The ethical challenge of balancing investment in common versus rare diseases, and the importance of value judgments.

Message to Primary Care Physicians (00:34:22) Dr. Berwick urges primary care physicians to advocate for science and research funding.

Closing and Podcast Outro (00:35:46) Host wraps up the episode, thanks guests, and provides subscription and contact information.

In today’s digital marketplace, a physician’s reputation is no longer shaped only by word-of-mouth — it’s built online through reviews, search results and digital presence. In this episode of Off the Chart, Scott Bartnick, co-founder & CEO of Otter Public Relations, sits down with Medical Economics Managing Editor Todd Shryock to explore how physicians can create strong, credible personal brands that attract patients and support practice growth.

Bartnick shares practical advice on starting with reviews, managing negative feedback, leveraging social media without sacrificing professionalism and using storytelling to build patient trust. He also discusses common mistakes to avoid, the role of SEO and online visibility and how a strong personal brand can expand a physician’s influence beyond the clinic.

Music Credits:
Coffee Shop Sketches by Buurd - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Episode Overview (00:00:24) Austin Littrell introduces the episode, focusing on personal branding for physicians with guest Scott Bartnick, co-founder and CEO of Otter Public Relations.

Why Personal Branding Matters for Doctors (00:01:15) Scott Bartnick explains the importance of personal branding in attracting patients and building trust in the digital age.

Defining a Strong Personal Brand for Physicians (00:01:55) Discussion on what constitutes a strong personal brand, emphasizing reviews and online presence.

First Steps to Building a Personal Brand (00:02:47) Advice on starting with good patient care, collecting reviews and gradually expanding to social media and SEO.

Differentiation While Maintaining Professionalism (00:04:15) How physicians can stand out without compromising credibility or trust.

Importance of Digital Presence (00:05:36) The role of websites, blogs and social media in building and defending a physician’s brand.

Best Platforms and Content Types (00:07:11) Which platforms and content formats (video, writing, podcasts) work best for physician visibility.

Engaging Audiences Through Storytelling (00:08:11) Using storytelling and authentic content to connect with patients and build trust.

Clinical Information Resources Mention (00:09:28) Brief mention of Patient Care Online as a clinical resource for physicians.

Common Mistakes in Personal Branding (00:09:47) Pitfalls like chasing trends or trying to go viral, and the importance of authenticity.

Successful Physician Branding Example (00:11:42) Case study of Dr. Ben Fleischman and how strong reviews benefited his practice.

Extending Influence Beyond the Clinic (00:13:35) How a strong brand enables doctors to speak, appear in media and launch related businesses.

Handling Negative Reviews (00:15:26) Strategies for addressing and resolving negative patient reviews to protect reputation.

P2 Management Minute Segment (00:17:47) Keith Reynolds shares quick practice management tips and invites listener contributions.

Responding to Negative Reviews Publicly (00:18:36) Best practices for responding to negative reviews online, including timing and personalization.

Avoiding Automated Responses (00:20:11) Why automated or copy-paste responses to reviews should be avoided in favor of personalized replies.

Final Tips for Building a Personal Brand (00:21:54) Scott Bartnick's closing advice: focus on one platform, build credibility and expand gradually.

Episode Closing and Credits (00:23:14) Austin Littrell wraps up the episode, provides subscription info and credits the production team.

David Eisenberg, M.D., director of culinary nutrition at the Harvard T. H. Chan School of Public Health, founding co-director of the Healthy Kitchens, Healthy Lives conference, and founder and former executive director of the Teaching Kitchen Collaborative, joins the show to talk about the importance of nutritional education for physicians.

"Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement" in JAMA Network Open.

Music Credits:
Saxophonia by Offenbach Project - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Podcast Overview (00:00:00) Podcast introduction, host and guest introductions, and overview of the episode’s focus on nutrition in medical education.

Dr. Eisenberg’s Background and Motivation (00:01:34) Dr. Eisenberg shares his personal and professional background, and how he became interested in culinary medicine.

Defining Lifestyle Medicine and Teaching Kitchens (00:02:53) Explanation of lifestyle medicine, the concept of teaching kitchens and their role in health education.

Development and Impact of Teaching Kitchens (00:03:13) History and evolution of teaching kitchens, their integration into health care and ongoing research and collaborations.

Teaching Kitchens Collaborative and Clinical Integration (00:05:23) Formation of the Teaching Kitchen Collaborative, multi-site trials and the potential for primary care integration.

Clinical Resource Interlude (00:08:28) Brief mention of Patient Care Online as a clinical resource for primary care physicians.

Nutrition Competencies in Medical Education: Policy and Advocacy (00:08:58) Discussion of efforts to mandate nutrition education for physicians, including congressional action and policy changes.

Medical Education Response and Consensus Building (00:11:38) Medical education organizations’ response to policy pressure, the need for experiential learning and the rise of teaching kitchens in medical schools.

Developing and Publishing Nutrition Competencies (00:13:22) Process of creating consensus-based nutrition competencies for medical students and residents, and their publication.

Challenges in Nutrition Counseling and Social Determinants (00:16:17) Barriers to effective nutrition counseling, social determinants of health and the need for improved physician training.

Transformational Moment in Medical Education (00:18:10) Current momentum and transformation in nutrition education for primary care and the broader medical field.

Primary Care Practices and Teaching Kitchens (00:19:09) Adoption of teaching kitchens in primary care, benefits for patients and clinicians and impact on burnout.

P2 Management Minute Interlude (00:19:43) Short segment offering practice management tips and inviting listener contributions.

Ethnographic Food Life Questions in Patient Interviews (00:20:33) Introduction of ethnographic questions to improve patient communication about food and nutrition.

Building Trust and Non-Judgmental Nutrition Conversations (00:20:58) Strategies for empathetic, non-judgmental conversations about food and the importance of trust in patient care.

Practical Application and Referral Pathways (00:23:18) How to use food life questions to guide referrals and support patients in changing their relationship with food.

Historical Analogy and Value Proposition (00:24:46) Comparison to mental health screening, and the value of improving nutrition conversations in clinical practice.

Reimbursement and Policy for Nutrition Interventions (00:26:34) Discussion of insurance coverage for nutrition interventions, the Diabetes Prevention Program and future opportunities.

GLP-1 Drugs and Teaching Kitchens: Future Directions (00:27:45) Potential for combining medication with teaching kitchen interventions to improve outcomes and reduce costs.

Quality of Life, Prevention, and Physician Burnout (00:31:01) Broader benefits of lifestyle interventions for patients and clinicians, including prevention and reduced burnout.

Final Thoughts and Message to Primary Care Physicians (00:32:16) Encouragement for primary care doctors to engage with teaching kitchens and lifestyle medicine for professional fulfillment.

Closing Remarks and Episode Wrap-Up (00:33:27) Final thanks, closing statements and information on subscribing to the podcast and newsletter.

Robert G.G. Piccinini, D.O., D.FACN, an adult, geriatric and forensic psychiatrist and recently-appointed president of the American Osteopathic Association (AOA), joins the show to talk about leadership, mental and behavioral health and his goals as president.

Music Credits:
Rooftops by Buurd - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Episode Overview (00:00:00) Overview of the episode, guest introduction and topics to be discussed.

Dr. Piccinini’s Background and Career Path (00:01:26) Dr. Piccinini shares his education, training and journey into psychiatry and private practice.

Importance of Community and Mentorship (00:03:12) Discussion on the value of mentorship, community support and its impact on leadership and medicine.

Advice for Physician Mentors (00:04:31) Tips for physicians on mentoring younger colleagues and fostering supportive relationships.

Leadership Philosophy: Strength and Humility (00:06:27) Exploring what it means to lead with strength and humility in the medical profession.

Improving AOA Communication and “Mind the Gap” (00:07:52) Plans to enhance communication within the AOA and ensure all members are connected and heard.

Certifying Board Services Reform (00:10:17) Current certification process and proposed improvements for osteopathic board exams and communication.

Supporting First-Generation Medical Students (00:13:27) Dr. Piccinini’s personal experience as a first-generation physician and initiatives to support similar students.

Physician Mental Health and Barriers to Support (00:17:02) Current state of mental health support for physicians and needed changes to reduce stigma and barriers.

Osteopathic Medicine’s Role in National Health Initiatives (00:20:29) How osteopathic medicine aligns with national health initiatives and the importance of research and whole-person care.

Integrating Behavioral Health into Primary Care (00:22:57) Collaboration between primary care and mental health, strengths and areas for improvement.

Addressing Physician Shortages (00:28:03) Policies and actions needed to increase the number of physicians, especially in primary care.

Artificial Intelligence in Mental Health (00:29:48) Dr. Piccinini’s views on the role and limitations of AI in mental health treatment.

Message to Primary Care Physicians and Building Community (00:33:04) Encouragement for primary care physicians to seek community, support, and connection within osteopathic medicine.

Closing Remarks and Outro (00:36:32) Final thanks, episode wrap-up and information on subscribing to the podcast.

Kem Tolliver, FACMPE, CPC, CMOM, president and CEO of Medical Revenue Cycle Specialists, joins the show to talk leadership in medicine, including key insights into the importance of innovation, vulnerability and teamwork, and how to recognize and reduce burnout and prepare for upcoming changes in medicine.

Kem will also be the opening keynote speaker at the HCLA Virginia 2025 Fall Conference, October 5-7 in Williamsburg, Virginia.

Music Credits:
CHILL HIPHOP SLOW GROOVE by Future Vision - stock.adobe.com
Relaxing Lounge by Classy Call me Man - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:20 – Introduction to the episode and guest: Kem Tolliver, President & CEO of Medical Revenue Cycle Specialists

1:43 – Moving beyond personal insights to create measurable improvements

3:48 – Essential leadership competencies: innovation, vulnerability and team mentality

6:10 – Applying solutions strategically across organizations (patient portal example)

6:55 – Turning strategy into execution: readmission reduction in Maryland

10:39 – Quick promo for PatientCareOnline.com

10:58 – Addressing burnout: listening for unspoken messages and reducing workflow burdens

15:53 – Supporting team growth with empathy and grace

15:53 – Using health care data effectively: accuracy, KPIs and frontline insights

20:00 – Preparing for the next five years: interoperability, analytics and AI adoption

23:42 – “P2 Management Minute” with Keith Reynolds: smarter data use and delegation tips

24:48 – Reflecting on pivotal leadership moments and lessons learned

27:54 – Key takeaway for conference attendees: “Lead where you stand”

29:48 – Preview of HCLA Virginia 2025 Fall Conference breakout session on revenue cycle oversight and workflow mapping

31:00 – Closing remarks and subscription reminder