Fixing Healthcare Podcast

In this “bonus episode,” co-hosts Dr. Robert Pearl and Jeremy Corr offer their take on the best ideas and most promising solutions from seasons one and two of the Fixing Healthcare podcast. During season one, which kicked off a year ago this month, Robert and Jeremy put our nation’s foremost healthcare practitioners, leaders and thinkers on the hot seat—each guest vying for the highly coveted (and totally fictitious) role of “Leader of American Healthcare.” To earn the title, guests needed to provide a detailed road map for achieving major (nationwide) improvements across five key measures. At the end of season one, listeners were asked to vote on the best of the best ideas in the first-ever “Survey To Fix American Healthcare” while also sharing their own solutions, which were featured on air throughout season two. During season two, Robert and Jeremy sought to address the next big set of challenges: how to implement meaningful change and bring bold ideas to life. For answers, they invited unconventional leaders from outside the medical mainstream to join the show. As part of this bonus episode, the listening audience is asked to vote on the most valuable ideas from the second season, and provide their own thoughts on how to improve American healthcare in the future. Voting is now live … Take the NEW “Survey To Fix American Healthcare” To get detailed insights on the top solutions from season two before voting, listen to the full bonus episode or check out the show’s transcript for more details. And just like in the inaugural survey, Robert and Jeremy will ask listeners to write-in their own suggestions for solving healthcare’s biggest issues. The best solutions will be featured on future episodes of Fixing Healthcare. Rounding out this bonus episode, Robert and Jeremy give listeners a preview of season three of Fixing Healthcare, which kicks off September 10. The coming season will focus on the role of politics and policy in American medicine, which lines up perfectly with what should be a loud and raucous year of presidential debate. Read: The full transcript from this bonus episode * * * 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 Bonus episode: The best of ‘Fixing Healthcare’ so far appeared first on Fixing Healthcare.

Welcome to the final episode of season two. This season has welcomed guests from outside of the medical mainstream. Season two’s final guest is Dr. Kevin Pho, a primary care physician, author, public speaker and media consultant. He’s best known for his platform KevinMD, which generates over 3 million monthly page views and communicates with more than 250,000 followers on Twitter and Facebook. He is a leading expert on how social and digital media can connect doctors with each other and their patients to improve medical care. Here are just some of Kevin’s thought-provoking comments from the show: On doctors helping patients navigate health info online “Doctors and patients should be partners… A lot of doctors I talk to don’t want their patients online. But I always tell them that it’s going to happen anyway whether we like it or not, so we might as well partner with patients and help guide them to reputable sources of health information, educate them in terms of what kind of websites are accurate, what kind of websites are legitimate, what are some of the tip-offs that they should look for whenever they’re online.” On why clinicians should be on social media “Clinicians need to use social media to make our voices heard. Our healthcare world is changing by the day. There’s going to be some seismic changes in the coming years. I think it’s important for practicing clinicians to share their story and have a voice in that conversation.” Advice for doctors joining social media “I always say you’ve got to start with your goals first. Why do you want to use social media? Do you want to use it to educate patients? Do you want to use it to guide patients to a better source of health information? Do you want to use it to connect and learn from your colleagues? Do you want to use it to debate healthcare reform? Do you want to use it to advocate for a cause? … On Kevin’s biggest social media fears “Instead of bringing people together, social media is making people more tribal. I think that’s really shutting down the discourse. We’re obviously seeing that in the political world. My biggest fear is that some of that’s going to seep into the healthcare world, as well, where you have patients who may just shut out the medical world and only listen to opinions and stories that they already agree with.” On censuring health misinformation online “To their credit, (Facebook and YouTube) are altering their algorithms. They’re suppressing information that’s clearly false. But I certainly don’t think they go far enough. I think that when it comes to health misinformation, it has the potential, of course, to cost lives. I do think that they need to be more accountable for the health misinformation out there and I think they need to do more than they’re currently doing.” READ: Full transcript of our discussion with Kevin Pho * * * 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 12: Kevin Pho, social media’s No. 1 physician voice appeared first on Fixing Healthcare.

Consistent with the theme of Season 2, in which we look outside of traditional walls for medicine for ideas to fix healthcare, our guest this month comes to the Fixing Healthcare podcast from an unusual background. Dr. Lindsey Fitzharris is one of the world’s leading scholars on medical history, having earned her doctorate from the University of Oxford. She wrote the bestselling book, “The Butchering Art: Joseph Lister’s Quest to Transform the Grizzly World of Victorian Medicine,” created the popular blog, the Chirurgeon’s Apprentice, and hosts the YouTube series, Under the Knife, which takes a humorous look back at our medical past. Listen as healthcare leader Robert Pearl, MD, and his co-host Jeremy Corr, tap into Lindsey’s vast historical knowledge and extract relevant insights about healthcare today. In this episode, you’ll learn why: Doctors used to smell (and even taste) their patient’s urine, and why that’s not as crazy as it sounds. Patients of the past preferred their doctor’s apron to be covered in dried blood and guts. It takes, on average, 17 years for a medical innovation to become standard clinical practice. Surgery became more (not less) dangerous immediately after the advent of anesthesia. Historians of the future will shake their heads at American medical practice today. The anti-vaccination movement actually dates back as far as the 18th century. Lindsey Fitzharris is hesitant to use the word “quack,” considering its origins. READ: Full transcript of our discussion with Lindsey Fitzharris * * * 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 11: Modern lessons from medicine’s grisly past with Dr. Fitzharris appeared first on Fixing Healthcare.

In a career that spans three decades, Dr. Zeev Neuwirth has held many roles: primary care physician, medical educator, medical director and physician executive. Over the years, he’s observed one constant: people want and need to be treated better. His new book “Reframing Healthcare: A Roadmap For Creating Disruptive Change” calls for a shift from today’s medical mindset to a “marketing mindset,” which Zeev says will lead to more consumer-centric, empathetic, customized healthcare. On this episode, Zeev guides listeners through his road map for disruptive change and the steps required to create a better healthcare system. Here are a few highlights from Zeev Neuwirth’s Fixing Healthcare interview. On doctors embracing a ‘marketing mindset’ The essence of marketing is all about understanding people, understanding their needs, finding customer segments, customizing solutions for those segments, delivering those solutions, and making sure that you’re engaging your customers and continue to make your solution relevant to them. If you think about it, that actually isn’t all that different from the fundamental principles of medical care. It’s really about knowing your patients, understanding your patients, taking the generic training and evidence-based medicine you’ve been taught, and customizing it to that individual in front of you, and then making sure they understand it, and they can actually use the wisdom and knowledge and skill that you’re bringing to them. On redesigning medicine with the consumer in mind If something is designed well, whether that’s an experience at an amusement park or it’s going to a store or anything else for that matter, it engages you. You’re sucked into it … If things aren’t designed well, they become irrelevant to you. In fact, they become caustic to you. I would argue that healthcare has paid very, very little attention to human-centered design. I think it is one of the fundamental flaws of our so-called legacy medical mindset. On rethinking results from the patient’s perspective No one ever asked (the patient), “What are the results that matter to you in this surgery, or in this procedure, or in this treatment?” For me, the results that matter might be that I want to be able to walk my dog, or walk with my wife five blocks, or go on a walk after dinner without having severe pain in my hip, or I want to be able to bend over and tie my shoes without severe pain. Or, if I’m an athlete, I want to get back to jogging, or going skiing. That focus on what we now call patient-reported outcomes measures or PROMs, is really still very, very fringe in healthcare. I think its core to every other industry. On physician burnout The issue of burnout in healthcare is incredibly serious … It’s an epidemic. When one out of every two doctors is burnt out, that means they’re emotionally exhausted. They feel depersonalized. They’re depressed. They’re demoralized. That’s a public health issue. You don’t want your doctor feeling that way because they’re not going to be on top of their game. Who wants a surgeon standing over them who’s depressed and demoralized? I don’t. On making change happen I think we’re in, what I would call, a phase change … in healthcare. The economy can’t bear the burden of the cost of healthcare and the inefficiencies and ineffectiveness anymore. Employers are just not going to stand for it. Payers are not going to stand for it. I think if you don’t pick up this book, and if you don’t see the reality in front of you, and you put it down for another year or two, I think you’re going to be at a major, major competitive disadvantage. READ: Full transcript of our discussion with Zeev Neuwirth * * * 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 10: Dr. Zeev Neuwirth’s roadmap for disrupting healthcare appeared first on Fixing Healthcare.

Season 2 of Fixing Healthcare welcomes leaders from outside of the medical mainstream to deliver practical solutions for our nation’s deepening healthcare crisis. Elisabeth Rosenthal did not disappoint. She is a physician, author of the 2017 national bestseller “An American Sickness: How Healthcare became Big Business and How You Can Take it Back,” the current editor-in-chief of the Kaiser Health News. Prior to the KHN, she was a The New York Times reporter for 22 years. Through her investigative research, Elisabeth has exposed corrupt healthcare players, fought outrageous medical bills and advocated tirelessly for American patients. On this episode of Fixing Healthcare, Elisabeth recalls some of the most obnoxious medical bills and health insurance denials she has come across in her research. She also offers everyday day patients the tools to advocate on their own behalf, arming them with advice, resources and the courage to push back against the big business of healthcare. Here are some practical suggestions for patients, courtesy of Elisabeth Rosenthal on Episode 9 of Fixing Healthcare: If you leave the hospital and they say, “Do you want some crutches? Do you want a wheelchair? Do you want a breast pump?” Say “no” because the mark up on those things is going to be crazy and you can buy them on Amazon for literally 20% of the price. This sounds like terrible advice to give someone who’s about to have a baby, but … be careful. When someone says, “Do you want the nice nitrous oxide? Do you want the birthing tub? Do you want a private room?” You have to say, “Okay, well how much is that going to cost?” Because the last thing you want as a new parent is to end up with a $10,000 bill you didn’t anticipate. Ask for an itemized bill. See what you’re being charged for. Protest any charge that seems outrageous or unreasonable. I do tell people, also, and this sometimes works, go find out what the Medicare DRG rate is for that same hospitalization and go in armed to the patient ombudsman and say, “You are charging four times what the Medicare approved rate is and I’m not going to pay it. Let’s see if we can do a deal.” Write about (your surprise medical bills). Write to a journalist, write to your local newspaper. Hospitals today are very sensitive about their reputations and they do not want to be shamed by some of these charges. So that is often effective. The problem we have here at Kaiser Health News with our “Bill of the Month” project is there are so many outrageous bills that people are sending us right now that we don’t have the bandwidth to write about even a small fraction of them. I will say the ones we write about, the bills go away. I think we all need to become healthcare voters. I’m here in D.C. now. Many of the politicians, who do they hear from? Their biggest constituent is their local hospital system. They get a lot of campaign donations and lobbying from pharma. They hear from a lot of patient groups that are often connected to pharma, but they don’t hear a lot from average doctors in the trenches and patients who are living this terrible medical system day in day out and I think we really need to have our voices heard. READ: Full transcript of our discussion with Elisabeth Rosenthal * * * 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 9: Elisabeth Rosenthal on how patients can fight the system appeared first on Fixing Healthcare.

As a Stanford business professor and author of four bestselling books, Chip Heath knows a thing or two about what motivates human behavior and organizational change. This month, he’ll put that wisdom to the test and take on the toughest of all tasks: Fixing Healthcare. In Season Two of the podcast, the focus shifts away from searching for the “Leader of American Healthcare” to yet another challenging question. Co-hosts Dr. Robert Pearl and Jeremy Corr are looking for strategists and implementers from outside the medical mainstream to help translate big ideas and disruptive-change theories into real-life healthcare solutions. As a change-management expert, Chip has been sought out by organizations like Google, Gap, The Nature Conservancy and American Heart Association. But can his knowledge and experience in business translate into practical solutions for twenty-first century healthcare? The answer is undeniably yes. Click the play button above to learn:  What American hospitals can learn from Amazon’s one-click ordering. How a simple meeting shaved $500,000 off the cost of caring for a single patient. The allegory of the elephant, the rider and how they, together, can take us on a path to fixing American medicine. Whether a “one-song workout” can help get Americans off the couch and exercising. How Jerry Sternin improved the health of 2 million Vietnamese children on a tight deadline. Why a middle-manager filled a conference room with 424 different pairs of work gloves (and what U.S. surgeons can learn from this surprisingly effective stunt). Why giving inpatients lavender-scented hand cloths and ear plugs at night speaks to “The Power Of Moments.” READ: Full transcript of our discussion with Chip Heath * * * 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 8: Chip Heath on what US healthcare can learn from one-click ordering appeared first on Fixing Healthcare.

Welcome to Season Two of Fixing Healthcare. In this eye-opening episode, Robert Pearl and Jeremy Corr welcome Dr. Devi Shetty, India’s leading heart surgeon and founder of Narayana Health, which offers world-class cardiac surgery for as little as $1,200 a case with clinical outcomes that rival the best in the world. READ: Full transcript of our discussion with Dr. Devi Shetty In a departure from Season One, guests of the show will no longer vie for the fictitious role of “Leader of American Healthcare.” Instead, experts from outside the mainstream of American healthcare will assist with the toughest task of all: figuring out how to translate disruptive-change theories into real-life solutions. Dr. Shetty proved to be the perfect guest to usher in the show’s new format and focus. Here’s a small sampling of his more memorable quotes: On the rising cost of healthcare If the solution is not affordable, it is not a solution. There is no point in me talking about all the advances in heart care or cancer care if 90% of the world’s population cannot afford it. I did my first heart surgery in Kolkata (India) and the patient paid $2,000 for the heart surgery. Thirty years later, we’re doing the same heart surgery for $1,200. Tell me another example of costs coming down in healthcare over the past 30 years. On improving healthcare’s information technologies We have to get the electronic medical records designed for the mobile phone. Today all the billion-dollar electronic medical records you are using in the United States, they’re all designed for the desktop … What you have to realize (is) that doctors look at the desktop only five to 10 times in a day. But doctors look at their mobile phone 200 times in a day. On the price of a human life Most of my patients are little kids, sitting on a mother’s lap. I examine that kid then I tell the mother that her baby has a hole in the heart and she needs to go for an open heart surgery … (The mother) has only one question, “How much it is going to cost?” If I tell her that the heart surgery on her kid costs $800, which she doesn’t have, that is a price tag on that kid’s life. She comes up with $800, I can save her kid. If she doesn’t have $800, she’s going to lose the child. This is what I do from morning ‘til evening, putting price tag on human life. This is what every doctor living in developing countries do from morning ‘til evening, putting price tag on human life. This is totally unacceptable. This can’t go on. On providing mission-driven care Typically, when a new hospital starts by a traditional corporate entity, the CEO of the group will address all the employees and the doctors. He would end the speech saying that, “This is a hospital we have built for the rich people but we have an obligation. We also take care of poor people.” Whereas me or one of my colleagues … commissioning a hospital, we tell our employees that we have built this hospital primarily for the poor people, but we also take care of the rich people. That dramatically changes your attitude. On Health City in the Cayman Islands, Dr. Shetty’s new, world-class facility, just 1-hour by plane from Miami My message to Americans physicians is to visit our Health City in Cayman Islands and experience it themselves. Be our guests and see how the hospital runs. * * * 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 7: India’s top doctor has a message for American healthcare appeared first on Fixing Healthcare.

Season One of the Fixing Healthcare podcast concludes this month, along its search for a candidate worthy of becoming the first-ever “Leader of American Healthcare.” Our sixth and final guest of the season is healthcare futurist and bestselling author Ian Morrison, who brought a welcome combination of humility and humor to the interview. Said Ian, “My definition of futurist is an economist who couldn’t handle the calculus. I’m in a sweeping generalization business and have been for a very long time.” As a self-described Scottish-Canadian-Californian, Ian also brought a uniquely international perspective to this discussion about fixing American healthcare. Here now are five of Ian Morrison’s most memorable quotes from Episode 6: 1. On U.S. healthcare versus systems in other countries “I have come to believe that every healthcare system in the world sucks in its own unique way. They’re all ugly compromises and trade-offs of what I think of as a “value equation” of quality, access, security and benefits, divided by cost. And they all suck. There is no perfect health system.” 2. On the closest thing to perfect for American healthcare “I would say that our best hope moving forward is to migrate American healthcare to a system I would put under the label of “Medicare Advantage for All.” It tries to reconcile these different values with regard to competition and the role of government, but mandates that everybody is in the system and everyone is covered. What that would necessitate is migrating and building on the growth of integrated delivery systems, providing some kind of global budget framework from the top down, setting perhaps targets at the state level for spending not to exceed GDP per capita targets, much as they’ve done in Massachusetts on a voluntary basis.” 3. On America’s declining life expectancy “It is remarkable how poorly we are performing. I think it’s partly our priority setting. We don’t do the things that would lift up the bottom of the life expectancy tables, simple things like universal primary care and access to generic drugs that you would think would be a starting point to bring people up from the bottom. We have this unbelievable oipiod epidemic, which many people, economists and physicians alike, believe is driven by diseases of despair, having to do with the lost Nirvana of the American Dream. I think there are economic and social policy solutions there that are going to be much more effective than medical care.” 4. On physician “burnout” “I’ve done surveys over the years showing that the majority of doctors feel burned out, feel in some senses, alienated and that their work is not valued. So, perhaps ‘burnout’ is not the right term, it might be demoralization. I do think that providing systems with control, where the physicians, as you said in your book, lead the organization. I’m not 100% convinced you have to be a doctor but I think it sure helps if you’re a clinician leading large organizations. I think trying to encourage colleagues to transform in the name of improving care for patients is a professional motivation and these organizations need to be professionally led with that kind of ethos.” 5. On predicting the future of healthcare by understanding the past “We’re at start of 2019. What’s different since 2009? It’s Obamacare, the iPhone and Trump. The question is what’s going to be different within a 10-year time horizon? The reality we’re going to be dealing with 10 years from now is the absolute peak of the Baby Boom moving through the medical care system. Peak of the baby boom, roughly 1957, so do the math. It’s right in that sweet spot of 2029, 2030, when we’re at the maximum demographic effect. We will have done one of two things. We will either have anticipated that better and have a system where we use high technology to keep people aging in place with tremendous support, where we’ve made investments in social determinants of health, where we have a system of universal coverage all the way through, which is sustainable politically and financially because it’s done on a bipartisan basis. We will have a built the kind of delivery we design into our ongoing health system that incorporates new technology effectively and swiftly at scale. That’s the vision that I hope we have. READ: Full transcript of our discussion with Ian Morrison * * * We hoped you enjoyed the final episode of Season One and will participate in a special project we’re launching to make you, the listener, a part of Season Two. We want to know what changes you would make as “Leader of American Healthcare.” Click here for a chance to share your solutions with Fixing Healthcare listeners. A very big thanks to Ian Morrison for helping us wrap up a fantastic first season. Season Two kicks off in February 2019 with a totally different format. Our first guest will be the cardiac surgeon, entrepreneur and disruptor, Dr. Devi Shetty. He is chairman and founder of Narayana Health, a chain of 21 medical centers in India. He has performed over 15,000 heart operations throughout his career and is committed to making healthcare as affordable as possible. Today, he provides cardiac surgery for less than $1,800 per patient, a fraction of what it costs in United States with results that match the best American hospitals. We cannot wait to have him on the show. 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 6: Ian Morrison says every healthcare system ‘sucks in its own unique way’ appeared first on Fixing Healthcare.

This month, co-hosts Robert Pearl and Jeremy Corr agree our nation could learn so much from our next guest, Dr. Don Berwick. Few healthcare leaders have as much global experience, industry respect and applied knowledge as Don. He is the former president and CEO of the Institute for Healthcare Improvement (IHI) and led the organization’s 100,000 Lives Campaign, a nationwide initiative to significantly reduce morbidity and mortality in American healthcare. He’s the former administrator for CMS and has served on the faculty for Harvard Medical School and Harvard School of Public Health. As always, guests are given 10 minutes to present a plan for radically improving the U.S. medical system. As expected, Don made the most of every minute. You won’t want to miss any of Don’s thoughts. Here are five of his most memorable quotes: 1. On the responsibility of becoming “Leader of American Healthcare.” “I decline. This can only be done together. And the most important component of action is that action begin to be consolidated among stakeholders. We have a highly fragmented system in which people are trying to solve problems separately. That is just not going to work. So, the first step I take is to form a table of healthcare leaders and stakeholders who we share a common intent. We’re going to have to fix healthcare together.” 2. On his trademark Triple Aim. “We need a system of three goals: better care for people when they’re in the care system, better health for populations, and lower per capita cost through improvement, not through rationing or withholding. That was the mission I brought to the Centers for Medicare & Medicaid Services when I took over in the Obama administration. The Triple Aim became tattooed on every single person there: better care, better health, and lower costs.” 3. On healthcare as a human right: “Concomitant with the Triple Aim is another goal, which is healthcare as a human right. For some reason that I do not understand, this country has been ambivalent about declaring as an intention what every other civilized democracy in the world has said, which is healthcare is a human right. It’s the same as the right to clean air, to primary education or to food security. 4. On lowering per capita costs in healthcare: “I’m worried about 18% of GDP (being spent on healthcare). I would set an unequivocal goal to be at 15% within the next five to six years. There’s no reason we can’t do it at 15. Every other nation is below 13 or 12. If we get out of fee-for-service payment, if we move toward global population-based budgets, the payment system should get far easier to manage and far lower cost. There’s probably 10% of the total American healthcare bill right there, right in the simplification of payment systems.” 5. On healthcare’s many improvement metrics: “We have made so many stupid rules and those stupid rules have to be stopped. They have to be taken down. Many of the are rules make no sense, metrics that don’t help people at all. We need to put ourselves on a metric diet, a measurement diet. I’ve called for a reduction in the amount of measurement that’s going on in American healthcare by 75% over a four or five year period.” READ: Full transcript of our discussion with Don Berwick * * * We hoped you enjoy this episode of “Fixing Healthcare.” A very big thanks to Dr. Donald Berwick for coming on the show and sharing his extraordinary ideas. Next month, healthcare futurist, Ian Morrison joins the show. Ian is an internationally known author, consultant and futurist, specializing in long-term forecasting and planning with an emphasis on healthcare in today’s changing business environment. He has worked with more than 100 Fortune 500 companies and is president emeritus of the Institute For The Future and chair of its health advisory panel. Ian is the author of the bestselling books “Health Care in The New Millennium: Vision, Values and Leadership,” and “The Second Curve: Managing the Velocity of Change.” We cannot wait to have him on the show. 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 5: Don Berwick brings a global perspective to fixing US healthcare appeared first on Fixing Healthcare.

Fixing Healthcare co-hosts Dr. Robert Pearl and Jeremy Corr thought they new a lot about their latest guest, Dr. Eric Topol. They’d both read his bestselling books and closely followed his groundbreaking work at Scripps Research. And then Dr. Topol opened up about his plan for fixing American healthcare. Each month, a new guest appears on the show to compete for the highly coveted (and totally fictitious) role of “Leader of American Healthcare.” The guest is given 10 minutes to present his plan for radically improving the U.S. medical system and Dr. Topol didn’t waste a second of his time. Here are some of his most memorable quotes: The United States is the only country that does not provide healthcare to all of its citizens. That needs to be fixed. We can’t address the reduction in these critical metrics unless we provide healthcare equitably among all U.S. citizens. That’s step No. 1. At least a third of the $3.6 trillion a year in the U.S. that is spent (on healthcare) is wasteful, unnecessary, and harmful. That has to stop. I view the professional societies as trade guilds. Basically, their role … is largely to preserve the reimbursement of their constituents. They’re not interested in fixing these problems. They don’t have any role—and that goes not just for the AMA but across the board—in dealing with the waste and unnecessary procedures and testing and treatments. That’s a problem. We can’t rely on professional societies to lead the way because they’ve shown us for decades that they are not part of the solution. One of the most absurd aspects of medical care in this country (is) that our electronic health records are proprietary systems (owned) by the likes of Epic and Cerner and Allscripts. They have no real interest in the patient. The problem with electronic health records is that no one in this country has all their data—from being in the womb through the present time—and they all should. They should see their data, they should own their data, and it’s just the opposite of the way we’re set up here. That has to change. My solution there is that we forget the whole idea of the current model. We need to reboot. Every individual should have their medical data. How can we reduce hospital costs, because that’s $1.2-trillion-a-year and rising quickly? The way we can do that is to get rid of hospital rooms. We’re not talking about getting rid of the emergency room or the operating room or the intensive care unit, but the rest of the hospital should be gutted and (patients) should be at home to avoid the 1 in 4 chance of serious harm or error that takes place in the hospital … and the ridiculous cost of a hospital stay in the United States, which is approaching on average $5,000 a day. We have exquisite remote monitoring capabilities now and we should be using that. Just like decades ago when we saw the big shift from inpatient to outpatient, we need to have the shift … from inpatient to home. Seven minutes for an appointment in a clinic is grossly inadequate, and that’s for a return visit. Twelve minutes, on average, for a new patient consult is ridiculous. The gift of time can be achieved by using analytics. That is: deep learning, artificial intelligence, taking data that’s from not just the electronic record, (but also) from sensors, from genomics, from all different sources and being able to process that data and put an investment in making life better. It can make medicine more efficient, improve workflow, and give the gift of time to both clinicians and patients. I’m very much a proponent of telemedicine. I think it’s a welcome addition to the ways that we can connect clinicians and patient. Unfortunately, today we still have most American physicians unwilling to communicate with their patients through email or other electronic means, which is remarkable. If you ask them why don’t they do that, it’s just because we don’t get reimbursed. Everything’s ‘I don’t get reimbursed,’ so we have to fix the model of reimbursement if we’re going to make some headway. We’ve got some real roadblocks there. We know that the doctor who suffers from burnout has twice (the) rate of medical errors. We know there are more than 12 million serious medical errors in the United States every year and that number is not going down, but rather increasing as the rate of burnout increases. We need to make life better for clinicians. We have a lot of genomics today that we’re not using, particularly polygenic risk scores for the most common conditions that include heart disease, breast and prostate cancer, type 2 diabetes. These are probabilistic, but if you have hundreds of variants from a low cost, high throughput genotyping that costs today less than $50, you could go into prevention mode. All these things are actionable, but we’re not using them. Part of this problem is we have a lack of comfort among clinicians using genomics. We hope you enjoyed listening to this episode of “Fixing Healthcare.” Don’t forget, you can also read this episode, as well … READ: Full transcript of our discussion with Dr. Topol Next month, Dr. Donald Berwick joins the podcast to share his plan to transform healthcare. Dr. Berwick is the former president and CEO of the Institute for Healthcare Improvement (IHI) and led the organization’s 100,000 Lives Campaign, a nationwide initiative to significantly reduce morbidity and mortality in American healthcare. He’s the former administrator for CMS and has served on the faculty for Harvard Medical School and Harvard School of Public Health. We’re looking forward to having him on the show. * * * 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 4: Dr. Eric Topol says ‘step one is providing healthcare to all citizens’ appeared first on Fixing Healthcare.