FHC #187: Autonomy, burnout & the future of medical care

In this candid episode of Unfiltered, cohosts Dr. Robert Pearl and Jeremy Corr sit down with cardiologist Dr. Jonathan Fisher to examine why so many clinicians feel trapped between rising bureaucracy and shrinking autonomy.

Together, they detail what it will take to build a system that serves both patients and physicians. Drawing on Fisher’s experiences in small private practice and in a large health system, the trio explores RVUs and metric overload, private equity’s growing footprint and the treadmill effect driving burnout.

They then turn to solutions: team-based care, capitation/value-based models and new primary-care designs (from direct primary care to micro-IPAs). In the second half of the episode, the conversation widens from lifespan and health span to “joy span,” arguing for practical, low-cost ways to strengthen social connection, meaning and wellbeing without overburdening clinicians.

Later, a listener question prompts a timely discussion of Gen Z and younger millennials who avoid traditional primary care, and how medicine must adapt communication, access and expectations to meet people where they are.

For more 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.

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