In this podcast originally published early last year, Alex Akers and I had a chance to speak with Dr. Robert Pearl about his book Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong. Besides being an author, Dr. Pearl is former CEO of the Permanente Medical Group; he’s a frequent keynote speaker; and he is also the host of a podcast called Fixing Healthcare.
Here’s what Dr. Pearl said at the recent HLTH conference in Vegas, and I’m editorializing a little bit here. Dr. Pearl said day after day, patients and their families experience the unnecessary frustrations and heartaches that are so rife in American health care. Mistreatment is certainly a continuum, but in all of its manifestations, it’s pretty much nothing less than rampant. I mean, how else do Americans manage to pay more than twice as much per patient for a health system that ranks 37th in the world? There are definitely bright spots, and there are definitely great men and women working within health care. So, I do not—and I’m certain Dr. Pearl does not—mean to be all doom and gloom. But we’ve got some realities to deal with here.
There’s a simple answer to the question, “What happens if we fail to change?” Disruption will happen. While the pace of health care disruption in many sectors hasn’t exactly set world speed records, it’s inevitable. And, according to Dr. Pearl, status quo health care providers will lament their decision not to have embraced change sooner.
To wrap our heads around this, Dr. Pearl suggests that there are four must-haves, four pillars to get the American health care industry back on track. Spoiler alert: Those four pillars are (1) integration, (2) pay-for-value, (3) modernize our approach to technology, and (4) clinician- and physician-led organizations.
You can learn more by connecting with Dr. Pearl on Twitter at @RobertPearlMD.
Robert Pearl, MD, is the former CEO of the Permanente Medical Group (1999-2017), the nation’s largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 10,000 physicians and 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts.
Named one of Modern Healthcare’s 50 most influential physician leaders, Dr. Pearl is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led health care delivery.
He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership and lectures on information technology and health care policy.
In 2017, he authored Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong, a Washington Post bestseller that offers a road map for transforming American health care. All proceeds from the book benefit Doctors Without Borders.
As a regular contributor to Forbes, Dr. Pearl covers the business of health care and the culture of medicine. He has been featured on CBS This Morning, CNBC, and NPR, and in Time, USA Today, and Bloomberg News. He has published more than 100 articles in various medical journals and contributed to numerous books. He is a frequent keynote speaker at health care and medical technology conferences. Dr. Pearl has addressed the Commonwealth Club, the World Health Care Congress, and the Institute for Health Care Improvement’s National Quality Forum.
Board certified in plastic and reconstructive surgery, Dr. Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, he served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation’s largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC.
When not hosting the show, Stacey Richter is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient.
Alex Akers is vice president for business development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst.
02:26 Dr. Robert Pearl, author of Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong.
02:44 How bad is the problem in American health care?
05:25 How our health system lags in overall health, according to third-party, objective data analysis.
06:02 Rampant overtreatment, and how this adds to the problem.
09:11 How can context improve health care?
09:19 The four pillars of improving health care outcomes.
13:06 Integration as a crucial step to maximizing quality.
13:24 Pay-for-value as the second pillar of improving health outcomes.
17:39 Technology as the third pillar.
17:55 How current health care tech being utilized is 50+ years old.
19:38 Why video isn’t utilized more in health care, despite being relatively inexpensive.
21:32 Do doctors hate technology?
22:52 “All of medicine is probability.”
23:18 EP157 with Dr. Ethan Basch.
25:12 “We fail to do the things that we know we should do.”
27:10 Physician- and clinician-led organizations as the fourth pillar.
29:00 “We don’t have a system; we don’t have a structure.”
29:35 “To do that will require leadership.”
29:56 Dr. Pearl’s advice for actionable change.
31:10 “This is the time to change; don’t wait for disruption to occur.”