Dr. Shenkin on Humanistic Pediatrics, Health Policy, and Fixing Incentives in U.S. Healthcare

On The Pediatric Lounge, the hosts interview Dr. Shenkin, a Harvard-trained pediatrician, physician leader, and health policy expert who founded Bayside Medical Group in Oakland and grew it to a 35-physician, 10-office organization later sold to Stanford/Children’s Hospital. He describes choosing pediatrics as “falling in love,” shaped by a neurosurgeon father, and recounts work in the Public Health Service during the Vietnam era, including leading and reshaping migrant health into early regional rural health centers and studying health systems and policy in Stockholm and Yale. The conversation critiques U.S. insurance, fee-for-service/RBRVS, RVUs, networks, PBMs, and administrative waste, arguing costs stem from high prices and bureaucracy, not patient overuse. They emphasize restoring humanistic care—patients feeling “cared for and cared about”—through values, systems, mentorship, and better measurement, while criticizing hierarchical training, Epic-driven box-checking, and misaligned incentives that prioritize revenue over care.

00:00 Welcome to the Lounge
00:30 Meet Dr. Bud Shenkin
01:18 Why Pediatrics Chose Him
01:34 Family Roots in Medicine
05:13 Policy Path and Vietnam Era
06:48 Training Abroad and Independence
07:47 Great Profession, Bad Job
09:40 Residency Mentors and Customer Service
12:06 Why He Rejected Academia
13:32 Insurance and Fee-for-Service Critique
15:02 Catastrophic Coverage Debate
17:15 Humanistic Care Without Money Anxiety
18:58 Where Healthcare Overspends
20:15 Hospital Pricing and System Power
21:27 PBMs and Pharma Incentives
24:45 Leading While Still Seeing Patients
26:17 Hospitality Lessons for Healthcare
29:07 Systems Thinking and Safety Design
31:33 Building Humanistic Relationships
32:49 Name Tags and Respect
33:58 Selling to Big Systems
36:27 Training and Hierarchy
37:41 Epic and Box Checking
38:14 Humanistic Exam Room
40:27 Mentorship and Great Practices
43:46 Networks vs Fiduciary Duty
44:55 Falling in Love with Pediatrics
48:36 Paying for Humanistic Care
53:06 Trust, Dissent, and Leadership
54:34 Becoming a Great Clinician
01:00:08 Keeping Idealism Alive
01:01:08 Closing and Credits

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Pediatrics, Trust, and the Age of AI: Evidence, AAP Policy, and Vaccine Mandates

Hosts Herb and George welcome back Dr. Jesse Hackell to discuss declining trust in medicine amid overwhelming information and AI summaries, emphasizing the need for physicians to critically appraise evidence rather than rely on authority or EHR prompts. They debate perceptions of the American Academy of Pediatrics (AAP) as a “corporation” versus a volunteer membership organization, how AAP governance works, and how AAP outputs (technical reports, clinical reports, policy statements, and more rigorous clinical practice guidelines) should be read as guidance, not gospel or standards of care, with evolving examples like peanut introduction and biliary atresia screening. The conversation covers malpractice implications, screening controversies (e.g., ferritin/iron, milk and anemia), COVID-era messaging failures and politicization, vaccine policy opposing non-medical exemptions as choice with consequences, nuanced school-entry requirements (e.g., Florida Hib/pneumococcal), and tees up a future discussion on insurance and coverage for all children.

00:00 Show Intro
01:40 AI Trust Crisis
03:42 Reading Evidence Today
07:16 AAP Critics And Mission
09:48 Volunteerism Versus Pay
12:56 AAP Guidance Not Gospel
18:20 Governance And Elections
24:03 Types Of AAP Reports
33:48 Med Legal Standards
42:36 COVID And Vaccine Trust
47:01 RFK And Opinion Politics
48:02 Fauci Versus RFK
48:49 Natural Immunity Messaging
50:41 How Science Pivots
52:36 Peer Review Explained
54:22 Evidence Bars And Coercion
57:32 Bright Futures Screening Debate
58:59 Ferritin Screening Controversy
01:05:01 Cow Milk And Iron Loss
01:06:51 AI And Trust Erosion
01:11:37 School Vaccine Exemptions
01:18:03 Community Versus Freedom
01:19:40 Florida Hib And PCV Nuance
01:24:41 Insurance Policy Teaser
01:26:58 Wrap Up And Credits

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Life After Clinical Practice: Finding Impact Beyond the Exam Room

On The Pediatric Lounge, Herb and George welcome returning guest Jeanne Marconi to discuss “Life After Clinical Practice: What’s Next?” Jeanne describes stepping away from patient care during COVID, wanting to scale what she built in practice (integrated urgent care, behavioral health, lactation, nutrition/obesity care), and helping develop a behavioral health arm at PM Pediatrics leveraging telehealth. The group debates who represents pediatrics, arguing that the AAP prioritizes child advocacy over pediatrician advocacy, while clinical practice faces declining visit volume, rising costs, a worsening payer mix and skewed RVU incentives, growing chronic and mental health complexity, and low adoption of recommendations, which can overwhelm clinicians and erode family trust. Jeanne outlines paths for “burnt on” physicians: redesign services within practice, pursue governance/boards, advocacy, or nonclinical roles, and accept starting as a beginner. They discuss private equity tradeoffs, instability, and the need for strong change management centered on explaining “why,” addressing resistance, and building community forums for pediatricians. Jeanne highlights nonprofit work supporting youth aging out of foster care and her board role at Elizabeth Seton Children’s Center, urging colleagues to support one another’s mental health and view transitions as applying medical skills in new ways.

00:00 Podcast Welcome
00:37 Meet Dr Marconi
02:12 Leaving Clinical Practice
03:36 Building Behavioral Health
04:33 Who Speaks Pediatrics
06:42 Practice Pressures Today
08:05 Payment Model Problems
14:08 Guidelines And Evidence
17:29 Burnt On And Pivoting
20:35 Paths Beyond Medicine
21:43 Private Equity Reality
28:27 Costs And Practice Change
32:18 Finding Your Impact
33:44 Drop the Doctor Ego
33:58 Reframing Leaving Medicine
35:22 Becoming a Change Agent
38:18 Change Management That Works
40:03 Generational Shifts in Practice
43:06 AI Tools for Better Leadership
46:26 When to Move On
51:10 Passion Versus Paycheck
51:50 Mental Health and Toxicity
53:14 Building Community Meetups
57:23 Advocacy That Feeds the Soul
59:03 Final Takeaways and Wrap

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

New AAP Anemia Screening Guidelines: Ferritin, Hemoglobin, and Real-World Pitfalls. 

You can read a full review of the Clinical Report from Dr. Bravo et al on The Society for Pediatric Innovation. 

On The Pediatric Lounge, hosts interview Dr. Lia Phillips, a pediatric hematologist at NYU Langone, about new anemia screening guidance that emphasizes using ferritin to detect iron deficiency before anemia develops. They discuss the evidence and limitations linking early iron deficiency to neurodevelopment and IQ, including concerns that correcting iron deficiency may not improve long-term cognition and that proposed ferritin cutoffs (e.g., 20 in toddlers, 30 in females) could label and treat a large share of children. The conversation highlights real-world workflow barriers to lab-based screening, risks of misdiagnosis and inappropriate iron therapy (e.g., in sickle cell disease or thalassemia), the need for follow-up response checks, and focusing on symptoms such as adolescent fatigue, heavy menstrual bleeding management, cow’s milk reduction, and potentially prioritizing maternal iron status in pregnancy.

00:00 Podcast Intro
00:39 Meet Dr Leah Phillips
01:18 Why Pediatrics and Heme
04:45 Iron and Brain Development
08:15 AAP Screening Shift
11:46 Ferritin Cutoffs Debate
14:23 Risks of Misdiagnosis
15:54 Newborn Screen Systems
27:54 Workflow and Access Barriers
35:41 What Screening Should Mean
36:52 Ferritin and Bone Marrow
38:52 CBC Over Hemoglobin
40:00 Microcytosis Early Warning
40:32 Anemia and Brain Oxygen
41:46 Iron Treatment Nuance
43:59 OTC Iron Confusion
46:10 Fatigue and Ferritin
48:47 Heavy Period Root Cause
50:48 Team Based Bleeding Care
53:39 Treat Patient Not Labs
55:25 Ferritin Cutoffs Debate
57:29 Follow Up and Milk
01:00:37 Picky Eaters and Parenting
01:04:23 Pregnancy Prevention Focus
01:05:40 Wrap Up and Credits

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SOCIAL Media Pages ===============================
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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

What Pediatricians Do Every Day That’s Great—and Nobody Knows About (with Dr. Lisa Cronin)

On The Pediatric Lounge, hosts interview Dr. Lisa Cronin, a general pediatrician and chief marketing officer at Children’s Medical Center, a 17-physician independent practice in the Tampa Bay area with four locations and about 50,000 patients, 40% Medicaid, open 362 days a year with extensive after-hours access and an integrated behavioral health component in Pinellas County through a Juvenile Welfare Board partnership. Cronin describes her path from intending emergency medicine to pediatrics, briefly training in anesthesiology, and choosing primary care for continuity and relationships, while discussing why general pediatrics can be more challenging than controlled inpatient settings. The conversation covers maintaining culture across offices, generational communication, marketing and digital presence, business education, efficiency as reducing pain points without sacrificing quality, and resisting private equity consolidation. Cronin shares how a conference talk on early type 1 diabetes screening led her to identify a 10-year-old with abnormal A1c/glucose and positive antibodies, refer to endocrinology, and confront family reluctance about further testing and treatment.

00:00 Podcast Intro
00:39 Meet Dr Lisa Cronin
01:12 Why Pediatrics
02:10 Inside Her Practice
04:28 Hospitals And Coverage
07:41 Detour Into Anesthesia
10:44 Why General Peds Is Hard
14:37 Culture Across Offices
17:35 Information Overload And Trust
25:01 Chief Marketing Officer Role
31:40 Marketing Meets Modern Pediatrics
34:04 Hiring Accountability And Work Ethic
36:00 Part Time Scheduling Wins
37:20 Flexibility Beats Rigidity
38:47 Weekend Coverage Reality
39:34 Motivating Future Partners
43:02 Leadership Explaining The Why
46:58 Private Equity Misconceptions
49:16 Efficiency Without Volume
54:13 OP Engage Diabetes Screening
56:03 Case Finding Early Type 1
01:04:10 Why Screening Matters
01:06:25 Conference Hook And Hope
01:07:55 Wrap Up And Farewell

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Support the show

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SOCIAL Media Pages ===============================
 📝 - Substack
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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Building Wealth After Residency: Debt, Investing, and Insurance Pitfalls

In this episode of The Pediatric Lounge, George and Herb interview pediatrician Dr. Neil Belovin about building wealth after residency, focusing on why new attendings can still feel broke due to debt, high living costs, and slow income growth in pediatrics. They discuss common mistakes like lifestyle inflation, expensive cars, credit card debt, and ignoring low required student-loan payments during residency that can count toward loan forgiveness. Belovin emphasizes starting early with retirement contributions and simple, low-fee investing (e.g., ETFs and dollar-cost averaging) while comparing loan interest rates to expected returns. The conversation covers insurance priorities—own-occupation disability insurance first, then life insurance when needed, plus umbrella and underinsured motorist coverage—and warns against costly whole life policies. They also address malpractice policy types and tail coverage, keyman insurance for practices, long-term care insurance risks, and the value of reviewing policies annually and using prenuptial/partnership agreements to clarify exits and expectations.

00:00 Welcome And Guest Intro
01:45 Why Doctors Feel Broke
03:38 Cost Of Living Reality
05:56 Lifestyle Inflation Traps
11:28 First Paycheck Priorities
13:27 Saving And 401k Basics
15:29 Loans Versus Investing
16:53 Investing Through Bubbles
18:34 Term Life Versus Whole
20:51 Disability Insurance Must
28:56 Disability Lapse Lesson
29:38 Term Versus Whole Life
30:58 Umbrella Coverage Basics
32:32 Keyman Insurance Planning
35:18 Prenup As Negotiation
41:41 Malpractice Tail Explained
48:50 Long Term Care Reality
53:02 Annual Policy Checkups
55:15 Insurance Priority Order
55:52 Closing Thanks

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SOCIAL Media Pages ===============================
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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

From Exam Room to Empire: Building a Practice, Brand, and Wealth with Dr. Po Raval (Doc Dynasty)

In this episode of The Pediatric Lounge, the hosts interview Dr. Po Raval, founder of Doc Dynasty, who shares her remarkable journey from launching a solo podiatry practice to becoming a successful entrepreneur, consultant, and physician branding expert.

Dr. Raval explains how a podiatrist's successful treatment of her mother's ankle injury inspired her career path. She discusses gaining valuable hands-on experience during training and opening her first practice immediately after residency by leasing an affordable office inside a health club—creating an instant referral base among athletes and active patients.

As healthcare reimbursement evolved, Dr. Raval diversified her income through nursing home care, consulting, and business development. She describes how earning an MBA expanded her perspective beyond clinical medicine and led to opportunities advising New Jersey Medicaid and other healthcare organizations on practice operations and systems improvement.

The conversation then shifts to the modern realities of physician entrepreneurship. Dr. Raval explains why every physician should develop a personal brand, build a strong digital presence, and consistently create educational content. She shares practical strategies for leveraging websites, search engine optimization, social media analytics, and AI tools such as ChatGPT and Gemini to generate ideas, optimize profiles, and improve marketing efficiency.

Throughout the discussion, Dr. Raval emphasizes that AI should enhance—not replace—clinical judgment. She encourages physicians to think critically, question guidelines when appropriate, maintain authentic relationships with patients, and recognize that building a successful medical practice requires both excellent clinical care and intentional business strategy.

Whether you're starting your first practice, growing an established office, or exploring physician entrepreneurship, this episode provides practical advice on building a sustainable career and lasting professional legacy.

Episode Chapters

• 00:00 – Welcome and Guest Introduction
• 01:49 – Why Dr. Raval Chose Podiatry
• 04:04 – Understanding Podiatry Training
• 05:29 – Building a Specialty Referral Network
• 07:34 – Launching a Practice on a Budget
• 11:56 – Early Growth and Marketing Strategies
• 14:25 – Adapting to HMOs and Creating New Revenue Streams
• 18:22 – An MBA Mindset: Consulting and Business Growth
• 22:29 – The Modern Practice Growth Playbook
• 26:46 – Reaching the Right Audience on Social Media
• 31:03 – Patient Outcomes, Reviews, and Practice Growth
• 32:35 – Creating an Effective Marketing Budget
• 33:59 – The Story Behind Doc Dynasty
• 37:29 – Batch Content Creation for Busy Physicians
• 39:01 – Using AI for Hooks, Headlines, and Hashtags
• 42:29 – Why Consistency Outperforms Viral Content
• 44:26 – Why Marketing Is Essential for Every Practice
• 47:52 – Patient Retention and Staying Top of Mind
• 50:21 – Negotiation Lessons for Physicians
• 52:33 – AI Tools Every Physician Should Know
• 57:08 – Why AI Still Requires Critical Thinking
• 1:02:00 – Why AI Won't Replace Great Physicians
• 1:03:12 – Closing Remarks

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Evidence-Based Pediatric Office Emergency Preparedness: Practical Implementation and Real-World Debate

Hosts: Dr. Herb Bravo & Dr. George Rogu
Guests: Dr. David Mathison & Dr. Seth Toback

In this episode of The Pediatric Lounge, hosts Dr. Herb Bravo and Dr. George Rogu welcome Dr. David Mathison, Senior Vice President of Clinical Performance at PM Pediatrics, and Dr. Seth Toback, Chief Medical Officer at ARMR Science, for a timely discussion on evidence-based pediatric office emergency preparedness.

The conversation explores the American Academy of Pediatrics' 2026 Technical Report, which updates and replaces the 2007 guidance on office emergency preparedness. Together, the panel examines how pediatric practices can translate evidence into practical workflows while balancing patient safety, costs, staffing realities, and the diverse environments in which pediatricians practice.

Dr. Toback also discusses the science behind ARMR Science's investigational fentanyl conjugate vaccine, its potential role in addressing the opioid crisis, and the populations that may benefit if future clinical studies prove successful.

The discussion focuses on preparing pediatric practices for the emergencies they are most likely to encounter—including respiratory distress, seizures, anaphylaxis, behavioral health crises, and diabetic emergencies—while emphasizing rapid recognition, stabilization, activation of EMS, structured communication during patient handoffs, defined team roles, simulation-based training, and continuous quality improvement through post-event debriefing.

The panel also explores:

• How evidence should guide recommendations for office emergency preparedness
• Whether "essential" equipment recommendations should vary by practice setting
• The costs, return on investment, and potential liability associated with emergency equipment
• The role of AEDs, CPR, PALS, and ACLS training in outpatient pediatric practices
• Why simulation training may be more effective than traditional mock codes
• Recognition skills for front-office staff and non-clinical personnel
• Appropriate stocking of emergency medications, including naloxone and epinephrine
• Innovation gaps in pediatric emergency preparedness
• The growing challenge of pediatric behavioral health emergencies
• Creating practical, scalable guidance for practices of every size

Whether you are a solo pediatrician, part of a large health system, or responsible for quality improvement within your organization, this episode provides a thoughtful discussion of how to build an emergency preparedness program that is evidence-based, sustainable, and realistic.

Episode Chapters

00:00 — Introduction and Guest Welcome
02:24 — Why Dr. Mathison Chose Pediatrics
04:18 — Understanding the Fentanyl Vaccine
05:56 — Dr. Mathison's Journey at PM Pediatrics
08:40 — The Biggest Challenges Facing Pediatrics Today
11:46 — Training Gaps and Effective Patient Handoffs
15:02 — Reviewing the 2026 AAP Emergency Preparedness Guidance
20:48 — The Debate: Practical Office Emergency Preparedness
32:28 — Mock Codes vs. Real-World Readiness
38:45 — Why Simulation Training Matters
40:33 — Gaps in Current Training Standards
42:15 — Teaching Front Desk Staff to Recognize Emergencies
45:10 — What Every Office Should Stock—and What It Can Skip
47:25 — Naloxone, Epinephrine, and Medication Preparedness
50:32 — AEDs: Liability, Cost, and Return on Investment
55:33 — The Public Health Role of Pediatric Practices
58:03 — Should Offices Maintain ACLS Skills?
1:03:40 — Developing Right-Sized Guidance for Every Practice
1:06:22 — Debriefing, Continuous Improvement, and Future Updates
1:10:59 — Final Takeaways

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

International Medical Graduates, Community Health Workers, and Access to Care in the U.S.

On The Pediatric Lounge, hosts discuss with Dr. Ilan Sharps, a pediatrician at AltaMed in California (serving about 600,000 patients across 70+ clinics), how promotores de salud/community health workers support care by translating medical information culturally and linguistically, connecting families to resources, addressing barriers like food insecurity, safe spaces for exercise, transportation, and improving outcomes and costs through programs such as CalAIM and risk-based funding. They explore follow-up challenges for asymptomatic conditions (e.g., early type 1 diabetes screening) and how telehealth and home monitoring can reduce unnecessary visits while maintaining engagement. The conversation then focuses on international medical graduates (about 25% of the U.S. physician workforce), their role in underserved primary care communities, visa and licensing barriers, discrimination in training and hiring, balancing “brain drain” concerns, and developing safe pathways that verify competency while meeting U.S. workforce needs.

00:00 Podcast Intro and Guest
01:12 AltaMed Role and Reach
02:37 Access and Urgent Care Options
03:45 Promotoras Explained
07:48 Funding and ROI
09:37 Lifestyle Support for Diabetes
11:53 Getting Patients to Follow Up
15:55 Telehealth and Removing Barriers
18:33 Immigrants and IMG Contributions
23:05 Brain Drain and Underserved Care
25:38 Healthier Workforce Case
27:03 IMGs Fill Primary Care
29:05 Primary Care Shortages
30:18 Public Health Models Abroad
31:57 Mexico Doctor Oversupply
33:14 Mexican Physician Program
34:50 Quality And Fair Exams
38:02 Licensing Barriers Worldwide
41:55 IMG Exploitation And Bias
45:49 Building Better Pipelines
46:37 IMGs To Admire
50:14 Parting Thoughts And Wrap

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.