Robert Pearl is a plastic surgeon and author of Uncaring: How the Culture of Medicine Kills Doctors and Patients. He can be reached on Twitter @RobertPearlMD.
Albert Einstein determined that time is relative. And when it comes to health care, five years can be both a long and a short amount of time.
In August 2018, I launched the Fixing Healthcare podcast. At the time, the medium felt like the perfect auditory companion to the books and articles I’d been writing. By bringing on world-renowned guests and engaging in difficult but meaningful discussions, I hoped the show would have …
Value-based health care, the holy grail of American medicine, has three parts: excellent clinical quality, convenient access, and affordability for all.
And as with the holy grail of medieval legend, the quest for value-based care has been filled with failure.
In the 20th century, U.S. medical groups and hospital systems could — at best — achieve two elements of value-based care, but always at the sacrifice of the third. …
For decades, research studies and news stories have concluded the American system is ineffective, too expensive and falling further behind its international peers in important measures of performance: life expectancy, chronic-disease management and incidence of medical error.
As patients and health care professionals search for viable alternatives to the status quo, a recent mega-merger is raising new questions about the future of medicine.
In April, Read more…
Health care’s most recent billion-dollar deal took the industry by surprise, leaving medical experts and hospital leaders grappling to comprehend its implications.
In case you missed it, California-based Kaiser Foundation Health Plan and Hospitals, which make up the insurance and facilities half of Kaiser Permanente, announced the acquisition of Geisinger, a Pennsylvania-based health system once acknowledged by President Obama for delivering “high-quality care.”
Upon regulatory approval, Geisinger will become the first …
In health care, as in life, people devote a lot of time and attention to the way things should be. They’d be better off focusing on what actually could be.
As an example, 57% to 70% of American voters believe our nation “should” adopt a single-payer health care system like Medicare for all. Likewise, public health …
Over the past decade, I’ve kept a close eye on the emergence of artificial intelligence in health care. One truth remained constant: Despite all the hype, AI-focused startups and established tech companies alike have failed to move the needle on the nation’s overall health and medical costs.
Finally, after a decade of underperformance in AI-driven medicine, success is approaching faster than physicians and patients currently …
As the New Year begins, a trio of health care statistics cast an intense and unflattering light on a nation in crisis.
These figures, all of them unimaginable just a generation ago, set the stage for a financial reckoning in 2023 and beyond.
Shocking stat #1: the number of Americans on Medicaid
Without looking it up: What percentage of Americans receive some or all health-insurance coverage from the government?
You might assume a low …
Americans give lip service to the importance of teamwork. But most often, we credit success to individuals. Perhaps nowhere is this “MVP mindset” more apparent than in medicine.
The brilliant lone physician — gallantly battling to save a patient’s life — is the TV-inspired image most of us conjure up when we think of the medical profession. While that archetypal hero was, in fact, the best hope for patients in the …
In recent months, three of the nation’s largest retailers have stirred up a frenzy on Wall Street with a string of high-profile health care deals.
Amazon bought primary-care company One Medical in early August for $3.9 billion. That was a month before CVS spent $8 billion to acquire Signify Health and its network of 10,000 clinicians who make home visits (both virtually and IRL). A day later, Walmart inked a 10-year …
Between producers and consumers, you’ll find a cadre of professionals who broker deals, facilitate transactions, and move goods and services along.
They’re called “middlemen,” and they thrive in virtually every industry — from real estate and retail to finance and travel services. If not for middlemen, houses and blouses wouldn’t sell. Banks and online booking sites wouldn’t exist. Middlemen are the reason a tomato grown in South America makes it aboard …
Big Tech has had a surprisingly small impact on U.S. health care, so far.
Artificial intelligence, for example, outperforms physicians in many complex tasks (like reading mammograms and analyzing chest X-rays), yet AI remains woefully underused. Meanwhile, many have tried to spur operational efficiency using big-data analytics, but care delivery remains as inconsistent and ineffective as ever. Perhaps the most telling example of Big Tech’s struggles in medicine: 9 in 10 …
A friend called me for medical advice two weeks ago. He’s single, in his 30s and generally healthy, but he’d developed a dry cough with mild congestion. After a self-administered COVID-19 test turned up negative results, he remained suspicious he could be infected.
He was set to fly west in a couple of days for a conference and dreaded the thought of infecting other passengers. I recommended a PCR test if …
The 2022 Medscape poll on physician burnout confirms what has been painfully obvious to doctors on the frontlines of COVID-19: Their burnout is intensifying.
According to the survey of 13,000 doctors, the nation’s most burned-out physicians are those in emergency medicine (60%) and critical care (56%). Medscape, a leading health care publication, describes burnout as “long-term, unresolvable job-related stress that leads to exhaustion, cynicism, and …
In most professions, the pecking order is clear, even when there’s no formal designation.
Take pro football. Although nothing in the rulebook grants status or authority to certain players, everyone knows the starting quarterback is the most valuable person on the field. That’s because no other player can do more to win (or lose) a game.
You might assume the same type of logic applies to medicine. If saving …
In the 21st century, all but one U.S. industry has used information technology (IT) to cut costs, increase access to products and services, and improve quality.
Health care is the lone exception. For decades, medical costs have risen faster than inflation — with spending now above $4 trillion annually. For patients, accessing medical care is both time-consuming and burdensome. Meanwhile, U.S. health …
There was a time, not long ago, when COVID-19 was one of the scariest things on earth. In the summer of 2020, scientists were stunned as infections climbed and deaths spiked. They couldn’t say (exactly) how the virus spread, how deadly it was or how to cure it. ICU beds were filling up while officials scrambled to retrofit local …
When I was young, my father told me that baseball is a metaphor for life. As a lifelong fan, I’ve found professional inspiration and valuable lessons in this game, time after time after time.
This year was no different. Throughout the 2021 MLB playoffs, and amid an exciting World Series between the Houston …
When medical historians write about the coronavirus pandemic, they’ll likely focus on the slow U.S. response and failures of leadership that led to a tragically high death toll. But that will be only part of the story.
From the wreckage and devastation will emerge something few contemporary observers would expect: a brighter future for American health care.
Five technologies, all previously underappreciated and underutilized, will help …
Earlier this year, Houston Methodist gave its 26,000 hospital employees an ultimatum: Get vaccinated or get a new job. It was one of the nation’s first vaccine mandates. And it was a big, multilayered risk: with legal, financial and ethical consequences all hanging in the balance.
In the end, …
Thanks to the marvels of medicine, newly vaccinated Americans are returning to life as normal and partying like it’s 2019. Doctors, who are emerging from the pandemic as national heroes, would like to turn back the clock even further—to the halcyon days of 20th-century medicine.
But doctors, unlike their maskless and freewheeling patients, will be disappointed with what the future holds.
Trying to turn back the clock
Physicians have had a rough century, …
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