FHC #176: What AGI means for medicine & what Trump means for healthcare
May 28, 2025
The discussion dives into the early impacts of Trump's presidency on healthcare, comparing it to Obama's focus on access expansion. Key healthcare reforms and potential Medicaid changes set the stage for an uncertain future. On a futuristic note, the conversation explores the imminent rise of artificial general intelligence (AGI) in medicine, potentially reshaping clinical decision-making and patient care. The hosts underscore the need for healthcare professionals to adapt and rethink their roles in a world where AI becomes a key medical partner.
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Trump vs Obama Early Healthcare Priorities
President Trump's first 100 days focus sharply contrasts with Obama's approach, impacting healthcare's future.
How the Culture of Medicine Kills Doctors & Patients
Robert Pearl
In this book, Dr. Robert Pearl delves into the unseen and often toxic culture of medicine, highlighting how physicians' earliest experiences in medical school shape their norms, beliefs, and expectations. The book explores the disdain for technology, obsession with status, and complicated relationships with patients that many physicians develop. Pearl provides a detailed analysis of how these cultural issues affect the healthcare system, leading to burnout, overtesting, and overprescribing. He also offers a clear plan to improve American healthcare by restoring the physician-patient relationship and advocating for a more integrated, patient-centered care system.
Mistreated
Why We Think We're Getting Good Health Care — and Why We're Usually Wrong
Robert Pearl
In 'Mistreated,' Dr. Robert Pearl examines the flaws in the American healthcare system, arguing that patients and healthcare professionals often misperceive what constitutes good care. The book emphasizes the need for improved preventive medicine, reduced medical errors, and the adoption of modern technology. Pearl draws from his extensive experience as a healthcare leader to provide a roadmap for transforming the healthcare system, focusing on prevention over intervention and addressing systemic issues such as burnout and inefficient use of resources.
In this month’s Diving Deep episode of the Fixing Healthcare podcast, cohosts Dr. Robert Pearl and Jeremy Corr tackle two major questions:
How have the first 100 days of Presidents Obama and Trump shaped American healthcare—and where is Trump’s second term headed?
What happens to medicine when artificial general intelligence (AGI) arrives, making generative AI as capable as human doctors?
The conversation begins with a comparison of the first 100 days of each president’s time in office. Dr. Pearl contrasts Obama’s focus on expanding access through the ACA with Trump’s emphasis on cutting costs by reducing federal spending. With Trump is back in the White House, what can Americans expect going forward? Pearl offers a clear-eyed assessment, drawing on past behavior, current executive orders, outside-the-box health agency appointments and campaign promises to project where healthcare may be headed next.
In the second half of the show, the cohosts shift to what may seem like a more futuristic question: what will it mean when machines match or exceed doctors in clinical reasoning, diagnosis and decision-making? But as Pearl explains, the arrival of AGI isn’t decades away. It’s coming soon and will be understood as a milestone rather than a tool, one that fits into the exponential evolution of GenAI. Here, Pearl examines what systems and cultures need to change to prepare for this fast-approaching change in medicine.
Together, these stories raise urgent questions about what’s driving American healthcare: Is it politics or technological progress? Listen to the full episode to hear both conversations and decide for yourself.
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.
Fixing Healthcare Podcast 
