Fixing Healthcare Podcast

Last Thursday, Dr. Anthony Fauci warned Americans to rethink their Thanksgiving plans. Reactions have been mixed. Some people agree with public health officials. Others are outraged. Regardless of the reaction, one thing’s for sure: People are already feeling down about the holidays. According to one recent poll, less than a quarter of Americans are equally or more excited about the upcoming holidays as they were in 2019. Three in four people say they are less (or much less) excited to celebrate Thanksgiving, Christmas and New Year’s Eve. The question is: should we gather? For Dr. Robert Pearl, this question is “Déjà vu all over again. The same lessons are having to be learned again, and again, and again. We tend to leap to the conclusion rather than starting where I believe we should, with the facts.” This episode of Coronavirus: The Truth addresses the all-important holiday question, along with the following questions about the coronavirus pandemic: [00:47] What was the biggest news concerning the coronavirus this past week and what does it mean? [03:22] Why are some drug makers halting treatment and vaccine trials? [05:30] Why have premature births dropped significantly during the pandemic? [07:08] Cases on college campuses are still surging. What, specifically, isn’t working? [08:55] Should we cancel/scale-back our Thanksgiving plans per Dr. Fauci? [13:26] Two Harvard economists claim Covid-19 will cost the country $16 trillion: Accurate or alarmist? [16:41] Why are Black Americans more skeptical of a coronavirus vaccine? [18:53] Which two groups of Americans are struggling most to maintain social relationships?   [21:11] How has the culture of medicine helped (and harmed) patients during the pandemic? (For more on this subject, check out the new episode of Fixing Healthcare, featuring Dr. Zubin Damania, aka ZDoggMD)  [25:14] Are patients too optimistic, too pessimistic or reasonably objective when it comes to the vaccine timeline? [28:26] Why does Dr. Pearl believe 500,000 people will die from Covid-19. Listeners wanted to know more about this number and how you derived it. Can you tell them? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest.   The post #23: Should I cancel my Thanksgiving plans? appeared first on Fixing Healthcare.

In this episode, Fixing Healthcare hosts Dr. Robert Pearl and Jeremy Corr welcome their first returning guest, Zubin Damania, a physician and entertainer known to his legions of followers as ZDoggMD. Damania hosts the internet’s No. 1 medical news and entertainment show, reaching tens of millions of people weekly. He is a leading voice for patient-centered healthcare, focusing on prevention and team-based medicine. He, along with Zappos CEO Tony Hsieh, started Turntable Health in Las Vegas as an alternative to the broken U.S. healthcare system. Damania returns to Fixing Healthcare program to kick off season five, which focuses entirely on the culture of medicine, including as Dr. Robert Pearl puts it: “the good, the bad, the beauty, the ugliness, the things that inspire and the things about which we are embarrassed.” Highlights from this interview with ZDoggMD 1. On the good parts of medical culture “Ever since the first day of medical school … we start getting exposed to this culture, which is an adaptation of a group of humans to their environment and the challenges at hand. It’s a culture that values science and knowledge and learning. We value human connection. We value empathy, feeling someone else’s pain and then acting from it to alleviate suffering. Those are the real positives.” 2. On the bad parts of medical culture “The culture of medicine is conformity- , inertia- and fear-based. There’s this high sheen of professionalism, which allows us less latitude to be authentically who we are, so we have to sensor how we behave under this perception that, ‘Oh, that’s not professional’ … and there’s this idea that if you deviate too much from the standard practice, you will be squashed.” 3. On how money makes doctors fear change  “Part of the culture of medicine is that our payment models have changed how we actually view what is right and wrong. And that’s been a real problem in moving forward with any kind of real change in medicine. So, medicine by its nature, by its culture, resists change.” 4. On nurses vs. doctors “Let’s just look at doctors and nurses. Wow. Here’s a team. They cannot exist without each other. And then you drill into how different they are … You have this really interesting dynamic. Because you have a power hierarchy, you have a gender hierarchy, you have a difference in how they see the world.” 5. On medicine’s generational differences “There’s this old saying, ‘Medicine changes one retirement or one funeral at a time.’ That’s because the old guard changes and the new guard comes in. What I’m starting to see now, culturally, is, medicine used to be a little more professionally conservative. That’s starting to open up and change. There’s a lot more push in the younger generation to consider issues around, say, climate change, social justice, race, inequity, social determinants of health, than there were in the older generation.” 6. On whether medical culture will change after Covid-19 “If I’m being fully honest, I have a lot of skepticism that anything will change. Even a disaster like this, what I think will happen is we’ll fire up the retrospectoscope and we’ll look back and be like, ‘Ah, we probably overreacted to this thing and under-reacted in certain ways. We didn’t keep our frontline troops safe with PPE. Our administrators, who had one job, which is to prepare us and keep us staffed, didn’t really plan for this. We’ll try to do better next time.’ And people will just go back to a business as usual. Overall, I’m very skeptical that the culture will change.” 7. On specialists vs. primary care physicians “The power dynamic between specialists and primary care is one of the oldest and most interesting. There’s a perception in the culture of medicine that specialists tend to view primary care people as the weak medical students, the people who couldn’t get the board scores or the rotation honors to become a specialist. Because why would you do primary care? It’s miserable, you don’t get paid enough. It’s just drudgery. You never get to really do anything smart. These are perceptions.” READ: Full transcript of our latest discussion with ZDoggMD Listener note: Years of research and reporting on the culture of medicine will culminate in the publication of Dr. Robert Pearl’s 2021 book titled, “Uncaring: How Physician Culture Is Killing Doctors And Patients.” To learn more, subscribe to his newsletter Monthly Musings on American Healthcare. * * * 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. The post Episode 26: ZDoggMD diagnoses the culture of medicine appeared first on Fixing Healthcare.

President Donald Trump tweeted today that he will soon leave Walter Reed National Military Medical Center, where he has been receiving treatment for Covid-19. Trump’s physician said the president is not “entirely out of the woods yet” but that the patient could continue his ongoing treatment regimen from the White House. In this episode Dr. Robert Pearl and Jeremy Corr examine the available facts about the U.S. president’s illness, current condition and ongoing medical care. In addition, our co-hosts have answers to the following Covid-19 questions: [00:51] What’s the latest on President Trump’s health status following his diagnosis of COVID-19 late last week? What treatment(s) has he received? Why was he given them under a “compassionate use” request? And what’s next? [04:17] Does Trump have a legal right to patient privacy or do Americans deserve to know the president’s health status? [07:18] What are the latest virus developments *outside* of the White House? [10:42] The U.S. mortality rate: what is it for Covid-19 and why is it important? [14:46] What’s happening economically in the county right now? [17:23] Where do drug makers stand with vaccine development? [22:11] People remain skeptical about the safety of the vaccine. Are they wise to be concerned at this stage? [25:07] Trump continues to tout new treatments. Do any of them look scientifically promising yet? [28:50] News outlets are reporting about a new strain of the virus. What are the medical implications? Is it more lethal? [30:41] Which healthcare topics did the presidential candidates fail to touch on in last week’s debate? [32:07] Will the healthcare specifics (or lack of) in last week’s debate sway votes? [34:14] Listener question: If the Supreme Court strikes down the Affordable Care Act in the near future, how would that impact coronavirus treatments? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #22: What do (and don’t) we know about Trump’s illness and treatments? appeared first on Fixing Healthcare.

There has been no shortage of surprising statistics to emerge from this pandemic. Dr. Robert Pearl’s upcoming Forbes article, “Three Misleading, Dangerous Coronavirus Statistics” (available here on Tuesday, Sept. 21), examines a trio of figures that are based on actual data but have proven to be misleading and hazardous to the nation’s health. This episode of Coronavirus: The Truth features several statistics that might surprise you. Take the recent CBS opinion poll, which found that just 21% of voters would take a free vaccine if one became available in the near future (more on that at the 18:32 mark of this podcast). Or what about the new Axios poll, which found that 51% of college students who say it was not the right choice for their schools to allow students on campus (see 21:56 below). Tune in for more surprising stats, along with answers to the following Covid-19 questions: [00:51] What did health experts learn this past week about the coronavirus? [06:28] How are other nations dealing with resurgences of the diseases? [07:47] What are the latest “miscommunications” to come out of the CDC? [09:41] Where are we on the passage of a new stimulus bill in Congress? [12:02] What’s the status of Covid-19 vaccine development? [16:28] How will we know if a vaccine is truly safe and effective? [18:32] Will Americans trust and be willing to take an FDA approved vaccine? [19:49] What’s known about the potential long-term health effects of the virus? [21:56] What’s the deal with college campuses and spikes in cases? [24:54] Why do people in different parts of the country interpret the threat of this virus so differently? [26:36] Elected officials in New York are under fire from critics and local business owners. What’s the latest? [29:28] Listener question: “Is there any chance this virus will be here forever?” [34:42] What hobbies/activities keep our co-hosts happy and mentally healthy? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #21: Do these coronavirus statistics surprise you? appeared first on Fixing Healthcare.

No expert has gained more insight into the organizational factors associated with physician and health-system performance than Stephen M. Shortell. He is a graduate school professor and dean emeritus of UC Berkeley’s School of Public Health. He is currently conducting research on Accountable Care Organizations (ACOs) integrated care models, innovations in healthcare delivery, and examining the application of the Lean management in U.S. hospitals. He is the author or co-author of 10 books and has published more than 300 peer-reviewed papers in a variety of organizational and health services/health policy research journals. Dr. Shortell is an elected member of the National Academy of Medicine (formerly the Institute of Medicine), past editor of Health Services Research, and past president of the Association for Health Services Research (Academy Health). He holds PhD, MBA and MPH degrees. In this episode of Fixing Healthcare, he explains how perverse financial incentives combine with a lack of technology to prevent American doctors from providing high-value, patient-centered care. In addition, Dr. Shortell dives deep into the current state of U.S. healthcare and what it will take to emerge from the coronavirus crisis better than before. Also in this episode, we cover the following topics: Why so many doctors fail to follow evidence-based approaches. Why a third of Medicare beneficiaries receive low-value services. What Dr. Shortell has learned from studying the “social determinants of health” and their impact on clinical outcomes. The role of race and the effects of racism in American healthcare. Whether the Affordable Care Act will survive, adapt, or die. What American healthcare has gotten right and wrong during its coronavirus response. How to address the rapidly rising cost of drugs. What to do about the decline of hospitals in the United States. How to improve rural healthcare. Whether a program like Medicare Advantage could be a national solution to high costs and poor quality. READ: Full transcript of our discussion with Stephen Shortell  * * *  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.  The post Episode 25: Why U.S. doctors provide low-value care appeared first on Fixing Healthcare.

In this, the 20th episode of Coronavirus: The Truth, hosts Dr. Robert Pearl and Jeremy Corr address the most pressing questions concerning the COVID-19 pandemic. What are “super spreaders”? Will the FDA approve a COVID-19 vaccine before phase-three testing wraps up? What do we know about latest testing controversy enshrouding the CDC? And how did Iowa, of all places, become the latest coronavirus hotspot? Since March 2020, this podcast has delivered science-based updates on the coronavirus, insights from public health officials and clinicians, along with an unbiased look at how the COVID-19 news and information impact American life. With informed commentary, helpful context and reporting from only the most credible sources, Coronavirus: The Truth cuts through the politics and misinformation to bring listeners the truth. Questions answered in this episode include: [00:50] What did we learn last week about the coronavirus pandemic?  [03:22] The CDC is at the center of another COVID-19 testing controversy. What are the details?   [05:48] Research on the much-ballyhooed saliva test was just published in NEJM. Are these less-painful tests accurate or not? [07:51] The FDA said it might approve vaccines before phase-three testing results are in. Will that spook the public and would Dr. Pearl take it, himself? [10:51] Why are men faring worse in this pandemic than women? [12:27] Listener question: What is a super spreader? [14:17] What’s with this 6% statistic that pandemic deniers are touting?    [19:15] Do scientists know anything about the psychological consequences of the pandemic so far? [21:43] Jeremy Corr’s home state of Iowa now has highest incidence of coronavirus infection. What’s going on there? [23:40] Why are meat packing facilities continuing to see such high rates of coronavirus infections? Is further disruption to the food chain possible? [25:41] Is “planned herd immunity” (allowing ~150 million relatively healthy people to get infected) a feasible strategy for ending the pandemic in this country? [33:06] Listener question: Should the United States join the global search for a vaccine or continue to go it alone? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #20: What’s the truth about super spreaders, saliva tests and vaccine safety? appeared first on Fixing Healthcare.

Throughout the coronavirus pandemic, Americans have time and again seen highly touted solutions fall short of their hype. Remdisivir, once thought to be a miracle treatment, was recently determined to be statistically no better than standard care. Meanwhile, Russia’s Vladimir Putin announced with great fanfare the production of a Covid-19 vaccine. Yet Western critics point out that the drug “Sputnik V” hasn’t undergone late-stage, large, randomized control trials. The world seems to be starving for good news concerning Covid-19 that isn’t fake news. On this episode of Coronavirus: The Truth, hosts Dr. Robert Pearl and Jeremy Corr separate the superlative claims from the true scientific advances while also offering answers to the following coronavirus questions: [00:52] Update: What should listeners know about the week that was?  [06:56] Per reports, has the coronavirus mutated? Is this good news or bad? [08:21] What is convalescent plasma andhow does it work? [12:19] Yale’s saliva test received FDA approval. What’s the benefit of this Covid-19 test over the alternatives? [14:37] What are the biggest Covid-19 threats facing sports? [17:24] What should we make of Russia’s vaccine, now in production? [18:56] New Zealand had great success containing the virus early on. Last week, the country reported over a dozen new cases. What happened? [21:27] What’s the latest on schools reopening? [24:20] How will voters think about healthcare overall, and the coronavirus in particular, this November? [26:37] What’s the mood on in Iowa, where co-host Jeremy Corr lives? [28:16] Assuming March was the real onset of this pandemic in the United States, we’re nearing the half-year mark. Where are we now? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #19: What’s the most promising scientific development so far? appeared first on Fixing Healthcare.

Fans of Coronavirus: The Truth have lauded the show’s unbiased, fact-based approach to delivering COVID-19 news and information. But finding unbiased, fact-based info isn’t easy amid today’s politically charged news environment. Says co-host Jeremy Corr, “I keep getting more and more disheartened about how politicized the pandemic has been.” In this episode, Corr and co-host Dr. Robert Pearl offer their thoughts on where to find facts that aren’t skewed by partisan media or pundits looking to score political points. In addition, Pearl and Corr provide answers and analysis for the following questions: [00:50] Update: What should listeners know about the week that was? [04:22] Where are we with the next Congressional economic package? [07:04] Presumed democratic nominee Joe Biden released his healthcare proposal: What was in it and how might it impact the post-coronavirus era? [10:50] What is happening with the economy? Is there a day of reckoning on its way? [12:04] Many people are disheartened by how politicized the pandemic has become. Where can people go for advice and facts that aren’t skewed by politics? [14:50] What’s going on with Major League Baseball and other sports leagues?  [16:41] What can go wrong with a COVID-19 vaccine fail? [21:20] Local school districts are scrambling. What’s going on with schools now? What’s the right strategy for those moving forward with in-class instruction? [25:39] Campus safety policies vs. college-student behaviors: Which will win out this fall as students return to campuses? [28:58] Hypothetical: If all of the restrictions were suddenly lifted and you could return to all of the activities of the past knowing that the virus was still circulating, what would do and what would you continue to avoid? [30:09] Anne Wojcicki, CEO of 23andMe, joined the Fixing Healthcare podcast this week. What did she have to say about genetics and COVID-19? [31:18] The airline and travel industry continue to be hit hard. What is the latest thinking on their future? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #18: Where to go for nonpartisan COVID-19 info? appeared first on Fixing Healthcare.

Anne Wojcicki is a biologist, entrepreneur and the CEO of 23andMe, the leading consumer genetics and research company with more than 12 million customers worldwide.  On this episode, Wojcicki spoke with Dr. Robert Pearl and Jeremy Corr about exciting developments in genetic testing, the possibility for at-home coronavirus testing, her company’s fight with the FDA and what she believes will someday replace primary care.   Here are some of the interview highlights from episode 24: On genetics and depression  Thanks to the 450,000 customers who answered our surveys, where we were able to find a number of novel mutations associated with depression. Most studies are in the hundreds or maybe a thousand individuals, but for us to have a study of 450,000 people, it shows the type of scale of research that 23andMe can do and the fact that we can make findings that no one else really can find. On a genetic basis for the human response to COVID-19 23andMe launched a COVID-19 study on April 6, and we now have over 1 million people who’ve taken this survey. We have … tens of thousands who said that they have it, thousands of people who were hospitalized. We were able to make a number of discoveries. The only one that we’ve publicly talked about is the O blood type looks like it’s protective. Roughly, anywhere from 9% to 20% protective in terms of severity as well as susceptibility. That is exciting because I think it’s been replicated a number of times.   On the next big breakthrough in genetics  The next big breakthroughs are going to be around these polygenic risk scores and really starting to break down each disease into much more specific subtypes. Look at something like Type 2 diabetes where I can see that there’s a percentage of our customers that are genetically just much more likely to have it. You can see this also with drug response that some people are going to respond well to certain kinds of medications and some people are not going to respond well to those same medications. I think that every single disease is going to start to get classified into a genetically defined set of risks.  On the medical benefits of DNA testing There’s no greater reward for me than knowing that we potentially prevented a preventable death … One of the mottos of the company is, “Change what you can, manage what you can’t,” and these cases where customers can learn that they have a potentially pathogenic mutation and there’s something that they can manage with a vasectomy or proactive screening and you can prevent a preventable death, it’s hugely rewarding.  On how money is made in healthcare   No one makes money in healthcare by keeping you healthy. Fundamentally, if I tell you, you’re diabetic, lots of people in the system, in the healthcare system as it is today, will make money, from the companies that make insulin to the needles to the testing to the doctor’s visits to all of the downstream consequences. If I tell you you’re genetically high risk for Type 2 diabetes and then you change your diet and you check in with your doctor and you’re like, “Yeah, I’ve lost weight. I’ve done this. I exercise more,” no one’s making money. On protecting consumer data online We’ve always said that we have no business if we can’t protect your privacy. We do everything we can reasonably to protect privacy … We were really lucky in that a number of our earliest engineers came from the banking industry and really came to us with a mindset of absolute privacy and choice and the highest level of security. READ: Full transcript of our discussion with Anne Wojcicki * * *  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.  The post Episode 24: Anne Wojcicki of 23andMe talks COVID-19 testing, your genes and the future of medicine appeared first on Fixing Healthcare.

“Voters look to elected officials to lead in times of war,” says co-host Dr. Robert Pearl in this episode of Coronvirus: The Truth. “In the minds of most Americans, this is war. As such, voters will gaze beyond the traditional questions of (insurance) coverage and clinical care” toward questions of leadership amid a national health crisis. In 2020, Pearl sees three pandemic-related factors influencing the elections: Overall leadership in addressing the coronavirus threat.How voters feel about the economic relief programs.How well society was informed and held together throughout the pandemic. As a result of these factors, Pearl expects voters are likely to ask the following questions this November: “When the next pandemic strikes, who do I want to be responsible for the health of the people in my state? Who do I want sitting the halls of Congress? And who do I trust to occupy the Oval Office?” In episode 17 of Coronavirus: The Truth, co-hosts Robert Pearl and Jeremy Corr look at the latest news surrounding COVID-19, providing answers and analysis for the following questions: [00:50] What should listeners know about the week that was in Covid-19 news? [05:28] With multiple reports and anecdotes of Covid-19 patients getting re-infected, do scientists have any idea how long immunity lasts?   [08:23] Listener question: Is the coronavirus affecting the U.S. birthing rate? [09:41] Will the upcoming flu season exacerbate the coronavirus pandemic? [11:17] What will Congress’ next coronavirus relief package include? [14:00] On last week’s episode, co-hosts Robert Peral and Jeremy Corr talked about the winners and losers coming out of the current pandemic. Listeners wanted more details: Who’s up and who’s down? [15:53] How is the planning coming for the reopening of schools this September? [19:11] Co-host Jeremy Corr knows people who’ve been infected. How are they doing and how is Corr feeling during this time of uncertainty? [21:53] With schools reopening this fall, what do Jeremy and Robert advise for parents worried about kids? [23:15] What is Robert hearing from hospitals in places that are reportedly at risk of being overwhelmed with Covid-19 cases? Are they actually overwhelmed? [28:03] How might the coronavirus impact elections this November? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #17: Will Covid-19 sway the November elections? appeared first on Fixing Healthcare.