Fixing Healthcare Podcast

No expert has gained more insight into the organizational factors associated with physician and health-system performance than Stephen M. Shortell. He is a graduate school professor and dean emeritus of UC Berkeley’s School of Public Health. He is currently conducting research on Accountable Care Organizations (ACOs) integrated care models, innovations in healthcare delivery, and examining the application of the Lean management in U.S. hospitals. He is the author or co-author of 10 books and has published more than 300 peer-reviewed papers in a variety of organizational and health services/health policy research journals. Dr. Shortell is an elected member of the National Academy of Medicine (formerly the Institute of Medicine), past editor of Health Services Research, and past president of the Association for Health Services Research (Academy Health). He holds PhD, MBA and MPH degrees. In this episode of Fixing Healthcare, he explains how perverse financial incentives combine with a lack of technology to prevent American doctors from providing high-value, patient-centered care. In addition, Dr. Shortell dives deep into the current state of U.S. healthcare and what it will take to emerge from the coronavirus crisis better than before. Also in this episode, we cover the following topics: Why so many doctors fail to follow evidence-based approaches. Why a third of Medicare beneficiaries receive low-value services. What Dr. Shortell has learned from studying the “social determinants of health” and their impact on clinical outcomes. The role of race and the effects of racism in American healthcare. Whether the Affordable Care Act will survive, adapt, or die. What American healthcare has gotten right and wrong during its coronavirus response. How to address the rapidly rising cost of drugs. What to do about the decline of hospitals in the United States. How to improve rural healthcare. Whether a program like Medicare Advantage could be a national solution to high costs and poor quality. READ: Full transcript of our discussion with Stephen Shortell  * * *  Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.  The post Episode 25: Why U.S. doctors provide low-value care appeared first on Fixing Healthcare.

In this, the 20th episode of Coronavirus: The Truth, hosts Dr. Robert Pearl and Jeremy Corr address the most pressing questions concerning the COVID-19 pandemic. What are “super spreaders”? Will the FDA approve a COVID-19 vaccine before phase-three testing wraps up? What do we know about latest testing controversy enshrouding the CDC? And how did Iowa, of all places, become the latest coronavirus hotspot? Since March 2020, this podcast has delivered science-based updates on the coronavirus, insights from public health officials and clinicians, along with an unbiased look at how the COVID-19 news and information impact American life. With informed commentary, helpful context and reporting from only the most credible sources, Coronavirus: The Truth cuts through the politics and misinformation to bring listeners the truth. Questions answered in this episode include: [00:50] What did we learn last week about the coronavirus pandemic?  [03:22] The CDC is at the center of another COVID-19 testing controversy. What are the details?   [05:48] Research on the much-ballyhooed saliva test was just published in NEJM. Are these less-painful tests accurate or not? [07:51] The FDA said it might approve vaccines before phase-three testing results are in. Will that spook the public and would Dr. Pearl take it, himself? [10:51] Why are men faring worse in this pandemic than women? [12:27] Listener question: What is a super spreader? [14:17] What’s with this 6% statistic that pandemic deniers are touting?    [19:15] Do scientists know anything about the psychological consequences of the pandemic so far? [21:43] Jeremy Corr’s home state of Iowa now has highest incidence of coronavirus infection. What’s going on there? [23:40] Why are meat packing facilities continuing to see such high rates of coronavirus infections? Is further disruption to the food chain possible? [25:41] Is “planned herd immunity” (allowing ~150 million relatively healthy people to get infected) a feasible strategy for ending the pandemic in this country? [33:06] Listener question: Should the United States join the global search for a vaccine or continue to go it alone? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #20: What’s the truth about super spreaders, saliva tests and vaccine safety? appeared first on Fixing Healthcare.

Throughout the coronavirus pandemic, Americans have time and again seen highly touted solutions fall short of their hype. Remdisivir, once thought to be a miracle treatment, was recently determined to be statistically no better than standard care. Meanwhile, Russia’s Vladimir Putin announced with great fanfare the production of a Covid-19 vaccine. Yet Western critics point out that the drug “Sputnik V” hasn’t undergone late-stage, large, randomized control trials. The world seems to be starving for good news concerning Covid-19 that isn’t fake news. On this episode of Coronavirus: The Truth, hosts Dr. Robert Pearl and Jeremy Corr separate the superlative claims from the true scientific advances while also offering answers to the following coronavirus questions: [00:52] Update: What should listeners know about the week that was?  [06:56] Per reports, has the coronavirus mutated? Is this good news or bad? [08:21] What is convalescent plasma andhow does it work? [12:19] Yale’s saliva test received FDA approval. What’s the benefit of this Covid-19 test over the alternatives? [14:37] What are the biggest Covid-19 threats facing sports? [17:24] What should we make of Russia’s vaccine, now in production? [18:56] New Zealand had great success containing the virus early on. Last week, the country reported over a dozen new cases. What happened? [21:27] What’s the latest on schools reopening? [24:20] How will voters think about healthcare overall, and the coronavirus in particular, this November? [26:37] What’s the mood on in Iowa, where co-host Jeremy Corr lives? [28:16] Assuming March was the real onset of this pandemic in the United States, we’re nearing the half-year mark. Where are we now? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #19: What’s the most promising scientific development so far? appeared first on Fixing Healthcare.

Fans of Coronavirus: The Truth have lauded the show’s unbiased, fact-based approach to delivering COVID-19 news and information. But finding unbiased, fact-based info isn’t easy amid today’s politically charged news environment. Says co-host Jeremy Corr, “I keep getting more and more disheartened about how politicized the pandemic has been.” In this episode, Corr and co-host Dr. Robert Pearl offer their thoughts on where to find facts that aren’t skewed by partisan media or pundits looking to score political points. In addition, Pearl and Corr provide answers and analysis for the following questions: [00:50] Update: What should listeners know about the week that was? [04:22] Where are we with the next Congressional economic package? [07:04] Presumed democratic nominee Joe Biden released his healthcare proposal: What was in it and how might it impact the post-coronavirus era? [10:50] What is happening with the economy? Is there a day of reckoning on its way? [12:04] Many people are disheartened by how politicized the pandemic has become. Where can people go for advice and facts that aren’t skewed by politics? [14:50] What’s going on with Major League Baseball and other sports leagues?  [16:41] What can go wrong with a COVID-19 vaccine fail? [21:20] Local school districts are scrambling. What’s going on with schools now? What’s the right strategy for those moving forward with in-class instruction? [25:39] Campus safety policies vs. college-student behaviors: Which will win out this fall as students return to campuses? [28:58] Hypothetical: If all of the restrictions were suddenly lifted and you could return to all of the activities of the past knowing that the virus was still circulating, what would do and what would you continue to avoid? [30:09] Anne Wojcicki, CEO of 23andMe, joined the Fixing Healthcare podcast this week. What did she have to say about genetics and COVID-19? [31:18] The airline and travel industry continue to be hit hard. What is the latest thinking on their future? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #18: Where to go for nonpartisan COVID-19 info? appeared first on Fixing Healthcare.

Anne Wojcicki is a biologist, entrepreneur and the CEO of 23andMe, the leading consumer genetics and research company with more than 12 million customers worldwide.  On this episode, Wojcicki spoke with Dr. Robert Pearl and Jeremy Corr about exciting developments in genetic testing, the possibility for at-home coronavirus testing, her company’s fight with the FDA and what she believes will someday replace primary care.   Here are some of the interview highlights from episode 24: On genetics and depression  Thanks to the 450,000 customers who answered our surveys, where we were able to find a number of novel mutations associated with depression. Most studies are in the hundreds or maybe a thousand individuals, but for us to have a study of 450,000 people, it shows the type of scale of research that 23andMe can do and the fact that we can make findings that no one else really can find. On a genetic basis for the human response to COVID-19 23andMe launched a COVID-19 study on April 6, and we now have over 1 million people who’ve taken this survey. We have … tens of thousands who said that they have it, thousands of people who were hospitalized. We were able to make a number of discoveries. The only one that we’ve publicly talked about is the O blood type looks like it’s protective. Roughly, anywhere from 9% to 20% protective in terms of severity as well as susceptibility. That is exciting because I think it’s been replicated a number of times.   On the next big breakthrough in genetics  The next big breakthroughs are going to be around these polygenic risk scores and really starting to break down each disease into much more specific subtypes. Look at something like Type 2 diabetes where I can see that there’s a percentage of our customers that are genetically just much more likely to have it. You can see this also with drug response that some people are going to respond well to certain kinds of medications and some people are not going to respond well to those same medications. I think that every single disease is going to start to get classified into a genetically defined set of risks.  On the medical benefits of DNA testing There’s no greater reward for me than knowing that we potentially prevented a preventable death … One of the mottos of the company is, “Change what you can, manage what you can’t,” and these cases where customers can learn that they have a potentially pathogenic mutation and there’s something that they can manage with a vasectomy or proactive screening and you can prevent a preventable death, it’s hugely rewarding.  On how money is made in healthcare   No one makes money in healthcare by keeping you healthy. Fundamentally, if I tell you, you’re diabetic, lots of people in the system, in the healthcare system as it is today, will make money, from the companies that make insulin to the needles to the testing to the doctor’s visits to all of the downstream consequences. If I tell you you’re genetically high risk for Type 2 diabetes and then you change your diet and you check in with your doctor and you’re like, “Yeah, I’ve lost weight. I’ve done this. I exercise more,” no one’s making money. On protecting consumer data online We’ve always said that we have no business if we can’t protect your privacy. We do everything we can reasonably to protect privacy … We were really lucky in that a number of our earliest engineers came from the banking industry and really came to us with a mindset of absolute privacy and choice and the highest level of security. READ: Full transcript of our discussion with Anne Wojcicki * * *  Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.  The post Episode 24: Anne Wojcicki of 23andMe talks COVID-19 testing, your genes and the future of medicine appeared first on Fixing Healthcare.

“Voters look to elected officials to lead in times of war,” says co-host Dr. Robert Pearl in this episode of Coronvirus: The Truth. “In the minds of most Americans, this is war. As such, voters will gaze beyond the traditional questions of (insurance) coverage and clinical care” toward questions of leadership amid a national health crisis. In 2020, Pearl sees three pandemic-related factors influencing the elections: Overall leadership in addressing the coronavirus threat.How voters feel about the economic relief programs.How well society was informed and held together throughout the pandemic. As a result of these factors, Pearl expects voters are likely to ask the following questions this November: “When the next pandemic strikes, who do I want to be responsible for the health of the people in my state? Who do I want sitting the halls of Congress? And who do I trust to occupy the Oval Office?” In episode 17 of Coronavirus: The Truth, co-hosts Robert Pearl and Jeremy Corr look at the latest news surrounding COVID-19, providing answers and analysis for the following questions: [00:50] What should listeners know about the week that was in Covid-19 news? [05:28] With multiple reports and anecdotes of Covid-19 patients getting re-infected, do scientists have any idea how long immunity lasts?   [08:23] Listener question: Is the coronavirus affecting the U.S. birthing rate? [09:41] Will the upcoming flu season exacerbate the coronavirus pandemic? [11:17] What will Congress’ next coronavirus relief package include? [14:00] On last week’s episode, co-hosts Robert Peral and Jeremy Corr talked about the winners and losers coming out of the current pandemic. Listeners wanted more details: Who’s up and who’s down? [15:53] How is the planning coming for the reopening of schools this September? [19:11] Co-host Jeremy Corr knows people who’ve been infected. How are they doing and how is Corr feeling during this time of uncertainty? [21:53] With schools reopening this fall, what do Jeremy and Robert advise for parents worried about kids? [23:15] What is Robert hearing from hospitals in places that are reportedly at risk of being overwhelmed with Covid-19 cases? Are they actually overwhelmed? [28:03] How might the coronavirus impact elections this November? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #17: Will Covid-19 sway the November elections? appeared first on Fixing Healthcare.

Four months after President Trump announced a “state of emergency,” Americans are still as confused as ever about the true state of the pandemic. Our confusion starts with the news: Every morning, TV anchors around the country list off the latest numbers of newly confirmed cases. Podcast co-host Dr. Robert Pearl says, “We pretend the number of positive tests per day has significance. Don’t get me wrong, most likely, the number of cases is going up. But 60,000 per day isn’t anywhere close to the actual number of infections.” That’s just one of three big points of confusion for the general public, all of which have major consequence on American health. In episode 16 of Coronavirus: The Truth, Robert and Jeremy look at the latest news surrounding COVID-19, providing answers and analysis for the following questions: [00:51] What should listeners know about the week that was in COVID-19 news? [05:03] Any news on sports returning this summer and fall? [07:15] What was with the bruhaha between physicians and the World Health Organization over coronavirus being transmitted in small, aerosolized particles? [10:08] What are Americans still getting wrong about COVID-19 today? [14:51] Dr. Pearl was quoted recently saying, “If I had to pick a word for where we are today, it would be floundering.” What did he mean?    [20:16] All politics aside, what do we know about the Trump-touted drug hydroxychloroquine? What about other treatments? [22:45] With positive cases skyrocketing, why are death rates declining? [26:03] Thousands of small businesses have closed while several big retailers have filed for bankruptcy, yet the stock market is soaring. What’s going on? [31:42] What kinds of healthcare changes will come from changes in the economy? [33:08] How would co-host Jeremy Corr alter his day to day decisions if he knew (for certain) that a vaccine wasn’t coming for at least another two years? [37:27] At what point would it be safe to receive a Covid-19 vaccine? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #16: What are Americans still getting wrong about COVID-19? appeared first on Fixing Healthcare.

Exactly what went wrong? Exactly when? Exactly how did we fail and exactly what could have been done to prevent it? Exactly which errors did U.S. healthcare officials make between the first known cases in China and the first recorded coronavirus death on U.S. soil? And, exactly what can we do to minimize the damage going forward?  This month’s episode of Fixing Healthcare offers the most thorough review of COVID-19 errors and events ever to be packed in a 45-minute podcast. Jeremy Corr, who also co-hosts Coronavirus: The Truth, joins Dr. Robert Pearl, a medical expert and former CEO of The Permanente Medical Group, to discuss the following topics in vivid, fact-based detail:  The five key mistakes that kept the U.S. from containing the virus in January and February 2020Why the U.S. got bested by smaller, less-wealthy countries in testing and control measures.   The most overlooked measure of success (or failure) when it comes to containing the virus. Why the U.S. response to the virus is best described as “one-size-fits-none.” The possibility of resuming sports, school or large events safely in the near future. Which minimally invasive steps will have the greatest impact on American health and safety. How the U.S. response has produced a major mental health crisis. The actual vaccine timeline and the likelihood of an effective medical treatment. How American businesses should approach the risky process of reopening.How the economic consequences of the virus will reshape American healthcare.  READ: Full transcript of this episode * * * Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple Podcasts or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.  The post Episode 23: How the U.S. coronavirus response went wrong and how to make it right appeared first on Fixing Healthcare.

“One step forward, two steps back,” is how Dr. Robert Pearl describes the recent rise in coronavirus cases throughout the country. He notes that further attempts to hurry the nation’s reopening along will produce similar setbacks. Take pro sports, for example. Major League Baseball is moving closer to locking in a 60-game schedule to start in July, despite dozens of players already testing positive. “I fear that pro sports will follow the pattern that we have seen in so many areas of society. One step forward, then two back.” In episode 15 of Coronavirus: The Truth, Robert and Jeremy look at the latest news surrounding COVID-19, providing answers and analysis for the following questions: [00:50] What should listeners know about the past week in COVID-19 news, including plans to move forward with pro sports? [08:00] As deaths passed 110,000, nearly half were patients from nursing homes. Can we protect this vulnerable population? [09:05] How are elected official prioritizing the two biggest coronavirus threats their constituents face: the health risks and the economic threats? [10:57] Dr. Robert Pearl will address the New York Stock Exchange on Tuesday, June 30. What message do CEOs need to hear? [16:45] How are businesses are planning for the post-coronavirus era? [18:33] What’s the latest news on COVID-19 testing and contract tracing? [20:44] What should Americans learn from the Broadstreet cholera epidemic in 1854 and other historical events that threatened human existence? [24:49] If we are at a tipping point with coronavirus, what might happen next? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn. *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #15: Is it too soon for sports? appeared first on Fixing Healthcare.

Looking back on the coronavirus pandemic and the national response, Dr. Robert Pearl says, “I believe that historians will judge the American people well and nearly all of our leaders poorly.” Robert’s co-host and fellow history buff Jeremy Corr notes that past outbreaks led to significant social and political shakeups: “Epidemics are the kinds of events in history that set off a chain reaction of other events that often have very serious consequences that change things forever.” In episode 14 of Coronavirus: The Truth, Robert and Jeremy examine the available facts and historical trends to imagine what historians will see when they look back on the year 2020. Also, in this podcast, the hosts answer your coronavirus questions relating to masks, sexual transmission and more: [00:51] What were the biggest coronavirus news updates from the past week? [04:12] What can be done about the uptick in new cases as states reopen?   [08:56] The World Health Organization (WHO) caused mass confusion last week concerning asymptomatic transmission of the virus. What happened and what’s the truth? [16:02] As political debate rages over the use of masks, how can people make sense of what will or won’t keep them safe? [17:58] Listener question: Can the coronavirus spread through sexual transmission? [20:23] Are we at the beginning of another surge or a “second wave” of the pandemic? [22:03] In hindsight, did we shut down too hard for too long? [25:28] Many have compared the coronavirus to war. What are the biggest parallels and differences? [29:34] How might historians talk about our current response to this viral pandemic 25 years from now? This episode is available on Apple Podcasts, Google Play, Spotify and other podcast platforms. If you have coronavirus questions for the hosts, please visit the contact page or send us a message on Twitter or LinkedIn.   *To ensure the credibility of this program, Coronavirus: The Truth refuses to accept sponsorship, outside funding sources or guests with any financial or personal conflicts of interest. The post #14: How will historians look back on our nation’s handling of the coronavirus? appeared first on Fixing Healthcare.