Robert Pearl is a plastic surgeon and author of ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine and Uncaring: How the Culture of Medicine Kills Doctors and Patients. He can be reached on Twitter @RobertPearlMD.

The emotional toll of a broken health care system

Physician
January 28, 2025

As a physician and health care leader, I initially declined to comment on the killing of UnitedHealthcare CEO Brian Thompson. I felt that speculating about the shooter’s intent would only sensationalize a terrible act.

Regardless of the circumstances, vigilante violence has no place in a free and just society.

But now, more than a month later, I feel compelled to address one aspect of the story that has been widely misunderstood: the …

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The emotional toll of a broken health care system

Medicare’s cobra effect: How a well-intentioned policy spiraled into a health care crisis

Policy
September 6, 2024

In the sweltering heat of 19th-century colonial Delhi, legend has it that cobras were taking over the streets. To eliminate the dangerous snakes, British officials offered a bounty for every dead cobra brought to government offices. Soon, locals began breeding and killing cobras for profit. When British officers caught wind of the scheme, they ended the program immediately. In response, the breeders released their now-worthless snakes back into the streets, …

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Medicare’s cobra effect: How a well-intentioned policy spiraled into a health care crisis

Empowering patients: Navigating medical information with AI

Tech
April 8, 2024

An excerpt from ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.

Imagine a ship at sea, its engine idle. The boat drifts dangerously close to the shoals, a mere hundred yards from land. The captain, fearing the worst, radios for help. The lighthouse watchman responds, sending an experienced mechanic named Charlie to the rescue.

With a single precise hit of his hammer, Charlie gets the …

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Empowering patients: Navigating medical information with AI

How generative AI will upend the doctor-patient relationship

Tech
December 3, 2023

After decades of “doctor knows best,” the traditional physician-patient relationship is on the verge of a monumental shift. Generative AI tools like OpenAI’s ChatGPT, Google’s Bard, and Microsoft’s Bing are poised to give people significantly more power and control—not just over their personal lives and professional tasks but over their own medical health, as well.

As these tools become exponentially smarter, safer, and more reliable (an estimated Read more…

How generative AI will upend the doctor-patient relationship

Health care wins, losses, and lessons

Policy
September 19, 2023

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 …

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Health care wins, losses, and lessons

“System-ness”: the key to successful health care transformation

Policy
September 4, 2023

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. …

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“System-ness”: the key to successful health care transformation

Kaiser-Geisinger vs. Amazon, Walmart, CVS: Who will reign supreme?

Policy
August 6, 2023

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…

Kaiser-Geisinger vs. Amazon, Walmart, CVS: Who will reign supreme?

The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

Policy
June 2, 2023

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 …

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The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

ChatGPT: How generative AI is revolutionizing health care

Tech
March 13, 2023

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 …

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ChatGPT: How generative AI is revolutionizing health care

3 shocking health care statistics for 2023

Policy
January 27, 2023

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 …

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3 shocking health care statistics for 2023

Health care leadership: Making medicine a team sport

Physician
January 22, 2023

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 …

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Health care leadership: Making medicine a team sport

Amazon, CVS, and Walmart are playing health care’s long game

Policy
October 25, 2022

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 …

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Amazon, CVS, and Walmart are playing health care’s long game

The middleman mentality is killing American medicine

Physician
October 18, 2022

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 …

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The middleman mentality is killing American medicine

Amazon vs. Apple: Only one will rewrite the rules of health care

Tech
September 25, 2022

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 …

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Amazon vs. Apple: Only one will rewrite the rules of health care

Get ready for a COVID culture shock

Physician
June 27, 2022

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 …

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Get ready for a COVID culture shock

Gender inequality is making burnout worse

Physician
May 12, 2022

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 …

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Gender inequality is making burnout worse

Restoring the value of primary care

Physician
March 26, 2022

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 …

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Restoring the value of primary care

Break the rules of health care with technology

Tech
February 23, 2022

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 …

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Break the rules of health care with technology

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