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.

Does owning cancer equipment change treatment patterns?

Physician
September 4, 2014

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Today’s article follows the money trail to expose a different form of bias: the kind that takes place when doctors own their own diagnostic and therapeutic equipment.

For people living with cancer, this kind of bias can have a particularly painful impact.

Radiation therapy brings out medical bias

In the United States, cancer is the second most common cause of death, killing nearly 600,000 Americans …

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Does owning cancer equipment change treatment patterns?

Oncologist pay and chemotherapy: Buy and bill needs to stop

Physician
August 19, 2014

Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients — at a profit.

The medical profession has struggled with this controversial practice  for more than 150 years.

In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it.

Around …

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Oncologist pay and chemotherapy: Buy and bill needs to stop

Curbing bias in medical research

Physician
August 3, 2014

To improve patient care, doctors rely on research and published information.

According to an American Medical News report, professional journals are still the most popular source of up-to-date medical information among doctors.

These medical publications inform physicians on new drugs and treatments, and they contain peer-reviewed studies that both physicians and patients assume are scientifically accurate.

But all too often, research findings aren’t as scientific as they should be. And some are flat-out biased.

Research studies …

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Curbing bias in medical research

It’s very difficult to assess a doctor’s true skill or performance

Physician
July 16, 2014

How do you really know if your doctor, surgeon or hospital is good, bad or somewhere in between?

I frequently speak with large audiences, ranging from CEOs to Stanford business school students.

I often start by asking participants to raise their hands if they receive excellent health care. Each time I ask, about 90% of the hands in the room shoot up. But all the hands come down when I ask, “How do …

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It’s very difficult to assess a doctor’s true skill or performance

Doctors often choose to ignore the evidence

Physician
July 9, 2014

Is the practice of medicine more of an art or an applied science?

It’s a debate patients may not even know is taking place. But the way your primary care physician, surgeon or hospital answers this question may determine whether you live or die.

Doctors on the far “art” side of the spectrum maintain that every patient and physician is different. Therefore, they believe there is no one right way to treat …

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Doctors often choose to ignore the evidence

Why do we think more care is better for us?

Policy
June 27, 2014

The U.S. spends nearly $3 trillion a year on health care, significantly more than any other nation.

In fact, America’s annual health care spending is greater than the total gross domestic product (GDP) of every other country except China, Germany and Japan.

Yet our measurable health outcomes — from infant mortality to life expectancy — aren’t any better than nations spending much less.

I’ve written about this paradox before, pointing to a few …

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Why do we think more care is better for us?

Innovation in health care: 3 lessons from Kaiser Permanente

Policy
June 20, 2014

At the end of my interview with Chip Heath, co-author of the New York Times bestsellers “Made to Stick” and “Decisive,” I asked him what topic he’d like me to cover in the future.

“I’m impressed by the culture you’ve created at Kaiser Permanente in Northern California,” he said. “You’ve generated quarter-to-quarter change that I think would have taken three years elsewhere. I don’t think most organizations know how to do that. …

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Innovation in health care: 3 lessons from Kaiser Permanente

How do we fix the high blood pressure problem?

Conditions
May 28, 2014

It’s a leading cause of death and disability in the U.S., leading to hundreds of thousands of preventable heart attacks, strokes and failed kidneys each year. About one-third of all American adults have it, according to the Centers for Disease Control, and it costs the nation about $50 billion annually to treat it and its complications.

“It” is high blood pressure, also known as hypertension. It is a symptomless, silent killer.

There are …

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How do we fix the high blood pressure problem?

Learn from the success of Medicare Advantage

Policy
May 14, 2014

Despite the political angst, the doomsday predictions and a very rocky launch, the Affordable Care Act has enabled more than 8 million Americans to acquire insurance coverage through the public exchanges.

Health insurance increases the probability that patients will access the medical care they need. And my colleagues at Kaiser Permanente are already seeing some positive stories emerging as a result.

They’ve shared dozens of stories with me about patients with undiagnosed …

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Learn from the success of Medicare Advantage

Recognize and minimize the concussion damage from youth sports

Conditions
May 7, 2014

Concussion expert Dr. A. Chainey Umphrey has assessed the damage youth sports can inflict. He has seen it ruin lives.

It happens in one form or another every day: A high school senior leaps to head a soccer ball. She takes an elbow from an opposing player going for the same ball. Woozy, she shakes it off and stays in the game.

Six months later, her blistering headaches have subsided but she still experiences …

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Recognize and minimize the concussion damage from youth sports

How generations of doctors will handle health care change

Policy
April 25, 2014

With American health care in the midst of rapid transformation, both doctors and patients will be forced to adapt to changes stemming from the Affordable Care Act, also known as “Obamacare.”

Of course, everyone responds to change differently. But is it possible to predict how doctors will adapt to health care reform based on the year they were born? The answer may surprise some patients and even force them to think differently …

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How generations of doctors will handle health care change

Why the future of health care can be found in the Cayman Islands

Policy
April 9, 2014

The Cayman Islands are nestled in the Caribbean Sea some 430 miles south of Miami. The three-island cluster is known for its inviting coral-sand beaches, laid-back island culture and tax-free status.

While it lures many tourists and big banks, it’s not the first place you’d expect to find the future of American health care. That may change soon.

Last month, I flew to the Caymans to moderate an afternoon-long panel on delivering …

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Why the future of health care can be found in the Cayman Islands

Understand the consequences of preventable infectious diseases

Conditions
April 1, 2014

There is nothing more disheartening for a physician than watching a patient die from a preventable cause. And, of course, the loss for the family involved is unimaginable.

But it’s important, especially for parents, to understand the potential consequences of preventable, infectious diseases.

Here’s a scenario doctors across the country are witnessing first-hand: A 2-year-old girl develops what seems like a cold. Over the next several days, her breathing rate increases. At …

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Understand the consequences of preventable infectious diseases

Help people understand what it is really like to be a physician

Physician
March 24, 2014

In a recent article, Malcolm Gladwell dissected and diagnosed American health care.

Throughout our interview, he tackled controversial topics from the Affordable Care Act and medical malpractice to the contrasting Canadian health care system and much more. I expected him to dive deep below the surface and provide new and intriguing perspectives. He didn’t disappoint.

But it was his closing comment that caught me off guard. When I asked Gladwell what …

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Help people understand what it is really like to be a physician

Malcolm Gladwell on our health care system

Policy
March 17, 2014

Malcolm Gladwell hasn’t written much about American health care. But that doesn’t mean he hasn’t been thinking about it. And it sure hasn’t stopped many of his powerful ideas like “tipping point,” “outlier” and “blink” from gaining entry into the national health care debate.

In his most recent book, “David and Goliath,” Gladwell reshaped our perspectives on the underdog and highlighted our tendency to over-value certain strengths. In the health care …

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Malcolm Gladwell on our health care system

Reversing the epidemic of drug overdoses

Meds
March 10, 2014

The evening news is filled with fatal car crashes and shootings. But drug overdoses kill nearly 40,000 people a year, accounting for more deaths than vehicular accidents or homicides.

Drug overdoses are on the rise in America, fueled largely by prescription meds. Reversing the course of this epidemic will require some dramatic changes.

The facts

Drug overdose rates climbed more than 100 percent between 1990 and 2012. But what most people don’t recognize …

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Reversing the epidemic of drug overdoses

Do we really need more physicians?

Policy
February 17, 2014

The goal of the Affordable Care Act is to make affordable, quality health care coverage available to more Americans. But how many physicians will America need to satisfy this new demand?

The debate over doctor supply rages on with very little conclusive evidence to prove one case or the other.

Those experts who see a shortage point to America’s aging population — and their growing medical needs — as evidence of a …

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Do we really need more physicians?

4 reasons why hospitals can be very dangerous places to be

Physician
February 3, 2014

Hospitals are commonly thought of as the safest place to be for sick people.

Patients have around-the-clock access to skilled care teams. Their vital signs are continuously monitored. A physician stops by every morning to check on them.

While it all sounds safe, a hospital can be a very dangerous place to be. Here are four frightening risks hospitals pose, along with their causes and some easy-to-implement solutions that could save hundreds …

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4 reasons why hospitals can be very dangerous places to be

The high cost of health care: Blame the financial model

Policy
January 28, 2014

The primary debate in health care reform this past year centered on insurance coverage. The next great debate will focus on the cost of providing health care.

For decades, the way we’ve paid doctors and hospitals has driven up health care costs. And while the pace of health care spending has slowed the last four years, it continues to rise faster and more noticeably than improvements in U.S. health care outcomes.

The reason is not …

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The high cost of health care: Blame the financial model

4 scenarios that would dramatically improve health care

Policy
January 14, 2014

Radical change often happens suddenly, the result of a single decision or event.

The fall of the Berlin Wall and the dissolution of the USSR stand out as two dramatic political examples. In a social context, Supreme Court decisions in Brown v. Board of Education or Roe v. Wade both radically changed our society.

Then there’s the U.S. health care system. We know it can take 17 years for a new, proven treatment to …

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4 scenarios that would dramatically improve health care

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