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.

Is the U.S. addicted to fee-for-service health care?

Robert Pearl, MD

Policy

October 20, 2017

For its many users, health care’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking, and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more health care services, regardless of whether the additional care adds value.

I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a …

Doctors and patients want the same thing in health care

Robert Pearl, MD

Physician

June 29, 2017

The “doctor-patient” relationship is tightly woven into the culture and history of medicine. But that special bond is under enormous pressure today. And to keep it from fraying, we need periodically to examine the fabric. Last month, the Council of Accountable Physician Practices (CAPP), representing 28 of the nation’s largest and best medical groups in the U.S., did just that.

Annually, CAPP sponsors a meeting in Washington D.C. where it invites …

Achieving health care’s holy grail: Improved quality at lower costs

Robert Pearl, MD

Policy

June 9, 2017

For years, health care reform has pursued the holy grail of higher quality at lower cost. I’ve always believed it’s achievable, and now it’s needed more than ever.

The U.S. health care system is failing. Costs continue to increase faster than our nation’s ability to pay, and the quality of our outcomes lag those of most other industrialized nations. People increasingly ask me what concrete steps could make a difference. The …

How long can high drug prices last?

Robert Pearl, MD

Meds

May 20, 2017

“Pigs get fat, but hogs get slaughtered,” the saying goes. And so may it prove to be true for the pharmaceutical industry.

Three articles, all published May 3, illustrate the greed and egregious pricing by certain drug companies that are gaining public recognition and scrutiny.

As an example, Marathon invested $370,000 to obtain the license for the data on “deflazacort,” a steroid available for about $1,200 a year in the United Kingdom. …

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How long can high drug prices last?

After 100 days: 5 things we learned about health reform

Robert Pearl, MD

Policy

May 7, 2017

For much of the first 100 days of the new Congress and administration, the news has featured health care and the frequently rancorous debate on its future. Will the Affordable Care Act (ACA) be repealed, replaced, revised or remain essentially intact? Will funding be cut or will subsides and cost-sharing reduction payments stay the same in order to encourage insurers to stay on the health care exchanges?

At this point, we’re …

Why physicians are anxious today

Robert Pearl, MD

Physician

April 23, 2017

Recently, I heard from a student in her third year of medical school. To date, she has borrowed more than $100,000 to fund her education. She is in the top 10% of her class, with honors in all of her subjects and high scores on her national exams. She would be a valued resident in the most competitive specialty training programs. Her goal is to become a primary care physician …

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Why physicians are anxious today

3 myths about a single-payer system and why it’s doomed to fail

Robert Pearl, MD

Policy

March 27, 2017

It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork.

The problem is that it won’t work.

For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now …

Is health care rationing our only hope?

Robert Pearl, MD

Policy

March 6, 2017

Rationing of health care services according to an individual’s ability to pay — or, as the case may be, the inability to do so — is becoming more prevalent in the United States, both in the public and private insurance spheres. Commercial payers, for example, increasingly require doctors to follow a complex and time-consuming authorization process. Recent surveys show that 75 percent of doctors complain about this often unnecessary step.

Insurance …

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Is health care rationing our only hope?

The patent protection in the drug industry is out of control. Here’s why.

Robert Pearl, MD

Meds

February 21, 2017

In the United States, the patent protection process — as it relates to the drug industry — has been distorted by the political system, intense lobbying and large campaign contributions. The result has been pricing contrary to the greater good of the nation.

Patents originated in ancient Greece. This legal protection assumed greater importance in 15th-Century Venice as a means to protect the nation-state’s glassblowing industry. The first patent granted in …

Until the gap between doctors and patients is fixed, the nation will suffer

Robert Pearl, MD

Physician

December 7, 2016

It’s widely acknowledged that the American health care system achieves relatively poor quality outcomes compared to most industrialized nations and at much higher cost. A new survey, conducted by Nielsen Strategic Health Perspectives and commissioned by the Council of Accountable Physician Practices (CAPP), provided important insights into why this could be the case — and more ominously, why the future may be no better.

CAPP is made up of …

Doctors should stop using the language of war. Here’s why.

Robert Pearl, MD

Physician

November 15, 2016

As soon as the microphone opened for Q&A at a conference I recently attended in New York City, a physician in the audience began his question with, “as a front-line physician.” Another asked from the perspective of someone “in the trenches.” And a third wondered how to provide medical care when we are getting “bombarded by mandates.”

As I speak to physicians across the country, I am increasingly jarred by these …

6 actions new medical students should take

Robert Pearl, MD

Education

August 15, 2016

Dear Class of 2020,

You’ve worked hard to earn the privilege of becoming a physician. I hope you took some time before starting medical school to enjoy yourself and embrace your passions, be they travel, music or art, or simply spending time with family and friends. Becoming a doctor is a long, bumpy and often lonely road. Resiliency is essential. My first and most important piece of advice is to be …

How our patients make us better

Robert Pearl, MD

Physician

June 19, 2016

My last column told the stories of two patients from whom I learned important lessons about gratitude and compassion. In this column, I share stories about patients who taught me critically important lessons about truly listening and the power of acceptance.

Samantha — or Sam, as she preferred to be called — was a young surfer recovering from a serious car accident, and Paul a young father with cancer. …

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How our patients make us better

As physicians, we learn much from our patients

Robert Pearl, MD

Physician

June 7, 2016

When I first met Mary, already in her forties, she had suffered throughout her life from an arteriovenous malformation of the face. As a result, from early childhood, she had endured the discomfort and humiliation that accompanies the stares of strangers. She came to me hoping I could improve her appearance.

The abnormal connection between the arterial and venous halves of her circulatory system caused her cheek, jaw, and neck to …

Improving our health system requires a culture change. Can it happen?

Robert Pearl, MD

Policy

May 20, 2016

Most industrialized nations have long supported the idea that access to health care is a fundamental right, and have built centrally planned systems to accomplish that goal. The result has been universal coverage that delivers excellent-quality outcomes at lower costs than the United States.

In some countries, such as England and Canada, the government controls both financing and certain aspects of health care delivery, while in others, including Australia, Sweden, and …

How the medical profession can solve the opioid crisis

Robert Pearl, MD

Meds

April 14, 2016

Opioids, also known as opiates, serve as important prescription medications in medical practice. But within the last decade or so, because of their overuse, misuse and abuse, they’ve also emerged as a leading cause of addiction and death.

Sadly and surprisingly, those most instrumental in creating this epidemic — however unwittingly — are physicians and the pharmaceutical industry.

The question is, how could this crisis have happened? What responsibility should physicians take, …

5 reasons why physicians fail as leaders

Robert Pearl, MD

Physician

February 28, 2016

Most physicians are smart and very talented. They’re skilled clinicians and technically superb. But despite such abilities, they fail to get others to follow them, once they take on the role of leader. As a consequence, they’re unable to get physicians to change or improve performance.

Jay Conger, a professor of business at Claremont McKenna College who has devoted his career to the study of leadership, has helped me understand why …

These are the reasons why health insurers have to change

Robert Pearl, MD

Policy

January 8, 2016

Consumers spend 16 times as long choosing a computer as they do selecting a health plan for themselves and their family. And it should not be a big surprise.

For decades, nearly all insurance companies offered similar choices of in-network physicians and hospitals. And as a result, plans differed only minimally in clinical quality, access and service. And even when clinical outcomes varied, consumers had no easy way to access comparative data.

So …

5 health questions every presidential candidate should answer

Robert Pearl, MD

Policy

December 2, 2015

With fewer than 100 days until the first primaries, the leading candidates have received ample airtime to address the important issues our nation faces. But even though health care accounts for around 18 percent of our nation’s GDP and consumes close to half of the total tax revenue collected by the federal government, their silence on providing solutions to the most pressing health care challenges our nation faces continues with …

So who are we, patients or consumers?

Robert Pearl, MD

Physician

November 11, 2015

What should we call the people who get medical care? Are they “patients,” the traditional term for anyone receiving medical attention from physicians, nurses, pharmacists, therapists, dentists and other providers? Or are they “consumers,” people who purchase goods and services for personal use?

The debate about nomenclature is growing, and it’s more than a matter of hair-splitting semantics. Among passionate advocates on both sides of the argument, emotions run high.

Sometimes we …

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So who are we, patients or consumers?