Robert Pearl, MD

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.

How the changing roles of hospitals are isolating physicians

Robert Pearl, MD

Policy

October 11, 2019

Physicians nearing the end of their careers often mourn the loss of the hospital as it once was — the undisputed center of the health care universe. They remember a time when every community doctor rounded on patients in the morning, and every surgery was performed in one of the hospital’s main operating rooms.

Times, like hospitals, have changed. This article looks at how the changing role of the American …

Will separating obstetrics from gynecology help specialist burnout?

Robert Pearl, MD

Physician

August 30, 2019

At the end of a long table covered with hors d’oeuvres and a birthday cake, I struck up a conversation with three primary care physicians.

I was hungry for their opinions.

Inside the crowded apartment, we spoke for some 20 minutes about the systemic and cultural causes of burnout in primary care—a conversation that informed the first article in this series.

As I was about to leave, I …

Clinical performance data: a physician’s friend or foe?

Robert Pearl, MD

Physician

August 16, 2019

According to a recent Harvard report, physician burnout is “a public health crisis that urgently demands action.”

Half of all doctors report troubling symptoms: depression, exhaustion, dissatisfaction, and a sense of failure. These physicians are twice as likely to commit a serious medical error, research finds. Experts predict that if left unaddressed, burnout will further erode the mental health of doctors and radically undermine …

How technology ruined, and can save, the doctor-patient relationship

Robert Pearl, MD

Tech

July 16, 2019

Each year, Medical Economics surveys physician readers to find out what irks them most. Topping the latest list: insurance paperwork, followed closely by electronic health records (EHRs).

The reason is the same for both. Insurers and EHRs get between doctors and their patients.

When it comes to medicine’s computer problem, the obstacle is literal. Doctors sit behind a screen, focused on the EHR and not the patient. …

Technology is corrupting the culture of medicine

Robert Pearl, MD

Tech

July 2, 2019

To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters.

It read, “The economy, stupid.”

The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else.

In health care, it can be hard to define the “big picture” issue when …

The ethics behind the world’s most expensive medication

Robert Pearl, MD

Meds

June 14, 2019

With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center of an intensifying debate over the rising price of medications.

Industry watchdogs are outraged. They say Zolgensma is merely the …

Pay people for their kidneys? It’s time.

Robert Pearl, MD

Policy

May 31, 2019

These are trying times for health care optimists. Despite all the hype surrounding breakthroughs in clinical practice and technology, American medicine is stuck in in neutral. Though the engine is revving loudly, little progress is being made.

This unfortunate truth came into clearer light last week when I was preparing lesson plans for the health care strategy course I teach at the Stanford Graduate School of Business. During the first class of …

3 ways to advance the credibility of online health information

Robert Pearl, MD

Social media

April 17, 2019

As first reported by The Wall Street Journal late last month, the war against anti-vaccination propaganda now has a new battlefront. Pinterest, the social-media platform where users discover images and information, has begun blocking vaccine-related search terms on its site.

Anti-vaccine content contradicts evidence-based science and established research, the company told WSJ, while cautioning that the search ban is only Read more…

3 ways to advance the credibility of online health information

The folly of using money to improve health care quality

Robert Pearl, MD

Policy

February 20, 2019

Imagine you’re a CEO in charge of a health care organization with thousands of physicians and 19 hospitals.

Overall, the quality of care delivered is good. Prices and costs are low. But there is a problem: Patients rate your service below average. Making matters worse, a swarm of low-priced competitors have moved in, challenging your market share. You’re going to need to improve patient satisfaction to survive. What do you do?

About …

5 fears physicians face today

Robert Pearl, MD

Policy

October 12, 2018

Like prep sports or prime-time television, medical meetings have seasons.

In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of medicine.

Figuratively speaking, the industry’s pulse is racing with fear. I’ve observed that in just the past …

Read more…

5 fears physicians face today

The way U.S. drug makers price their products is legal, but it’s not moral

Robert Pearl, MD

Meds

October 3, 2018

While walking through the duty-free at Dulles International Airport in Washington, DC, I happened upon the price tag of an imported French purse. Looking around, I wondered how many travelers could afford a $2,000 handbag.At the gate, I found a seat and logged on to the internet, where I happened upon a story about the CEO of Nostrum Laboratories, Nirmal Mulye. In an interview, Mr. Mulye explained why he raised the …

3 ways to decrease emergency department wait times

Robert Pearl, MD

Policy

August 28, 2018

Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.”

Now, imagine walking into an empty waiting area at your local emergency …

Will Atul Gawande succeed as a health care CEO?

Robert Pearl, MD

Policy

July 5, 2018

When news broke that Dr. Atul Gawande had been named CEO of the Amazon-Berkshire-JPMorgan Chase health care partnership, industry insiders were quick to raise doubts about his credentials.

Some pointed to his limited administrative experience, questioning how someone who has never managed a hospital or health system could oversee the care of some 1 million patient-employees. They also noted that the surgeon and bestselling author doesn’t know much …

Stranger Things are happening in health care

Robert Pearl, MD

Policy

May 3, 2018

About 30 miles east of LA, on the quiet tree-lined campus of Claremont Graduate University, sunlight pierces the ornately covered windows of a lower-level classroom in Harper Hall. A glow is cast upon the 25 students of Dr. Debbie Freund’s health policy course; PhD candidates and practicing physicians among them.

Many of these bright young scholars will go on to take leadership roles in health policy, public health, IT and medical research. I …

Why blockchain technology might replace today’s EHRs

Robert Pearl, MD

Tech

April 24, 2018

Physicians have a love-hate relationship with the electronic health record (EHR). On the one hand, doctors know they can’t provide the best possible medical care without them. And on the other, today’s EHR systems are cumbersome, clunky and slow physicians down.

Indeed, there’s much to love and much to hate about today’s EHRs, alongside a variety of ways to address the problems they create. One solution may lie in blockchain, the technology currently …

A radical proposal to save America’s hospitals

Robert Pearl, MD

Policy

April 12, 2018

Hospitals serve as the economic lifeblood of their communities. They are the second-largest source of private-sector jobs in the United States, employing 5.4 million Americans who, together, embrace a virtuous mission to heal and help others in need.

And yet, every year, more and more of them are forced to shut their doors. With soaring costs, eroding margins and mounting pressure from competing providers, the American hospital industry is on life …

How inflation will affect our health system

Robert Pearl, MD

Policy

March 19, 2018

All eyes are on interest rates as investors look for more signs of trouble ahead.

If their concerns over higher-than-expected inflation prove accurate, many players in the U.S. economy will suffer the burden of higher costs. But perhaps no sector would feel the strain more than health care. Higher costs would be just the start of many problems to come for providers, insurers and, eventually, patients.

Surging inflation would create a vicious …

Why hospital mergers are destined to fail

Robert Pearl, MD

Policy

January 24, 2018

In the early 1960s, President John F. Kennedy said, “The time to repair the roof is when the sun is shining.” It was a clarion call, a full-throated warning against national complacency in an era of great prosperity.

It was during this same period that community hospitals stood as the dominant force in American health care. By the mid-20th century, some 6,000 inpatient facilities had spread throughout the country, often serving …

Hospitals are struggling and the future is grim

Robert Pearl, MD

Policy

November 20, 2017

A strange thing happened last year in some the nation’s most established hospitals and health systems. Hundreds of millions of dollars in income suddenly disappeared.

This article, part two of a series that began with a look at primary care disruption, examines the economic struggles of inpatient facilities, the even harsher realities in front of them, and why hospitals are likely to aggravate, not address, health care’s rising …

What health care can learn from Game of Thrones

Robert Pearl, MD

Policy

October 25, 2017

Over the past seven seasons, Game of Thrones fans have demonstrated the ability to spot an emerging threat early on — a quality more leaders in health care need to possess.

If you’ve tuned into the popular HBO series from the beginning, you likely recall Ned Stark (Lord of Winterfell) forecasting doom and gloom in the show’s opening episode, appropriately titled “Winter Is Coming.” Right then, you knew something bad was …

Robert Pearl, MD

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