With around 63 million beneficiaries, Medicare is the single largest provider of health insurance in the United States, serving Americans aged 65 or older, as well as some younger patients who have certain disabilities. Directing this massive program is Meena Seshamani, MD, PhD, an otolaryngologist and former Vice President of Clinical Care Transformation at MedStar Health, a large health care organization primarily operating in the Baltimore-Washington metropolitan area. There, she led initiatives in palliative care, geriatrics, and community health. She has also served as Director of the Office of Health Reform at the US Department of Health and Human Services. In this episode, Dr. Seshamani discusses her path from surgeon to health policy leader, what draws her to caring for older adults, and her vision for a better, more sustainable health care of the future.

In this episode, you will hear about:

• Dr. Seshamani’s enthusiasm for medicine at a young age and the diverse career trajectory that followed - 2:08
• A discussion of Dr. Seshamani’s past leadership roles, including those at the Office of Health Reform under the Obama administration and at MedStar Health - 6:27
• Balancing the need for clinicians to work collaboratively and the inclination of physicians to value autonomy - 10:20
• An explanation of Medicare’s role in the US healthcare ecosystem - 14:51
• What draws Dr. Seshamani to focus on the care of older adults - 17:39
• The crisis of burnout in the medical profession and Dr. Seshamani’s vision for how this can be addressed - 21:00
• The fee-for-service mechanism of healthcare reimbursement, accountable care relationships, and the value of preventative care - 25:33
• The pay disparity between specialists and primary care physicians, and the role Medicare can play - 30:40
• How the growing population of aging Americans impacts the future sustainability of the Medicare program - 38:41
• How Medicare is reforming its allocation of resources to promote health equity - 42:02
• Dr. Seshamani’s advice to students and clinicians on engaging in meaningful work as they advance in their careers - 48:24

In this episode, we discuss the speech “Cowboys and Pit Crews” by Atul Gawande, published in the New Yorker.

You can follow Dr. Seshamani on Twitter @DrMeenaSesh

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

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