FHC #68: Diving deep into the medicine’s middlemen & the future giants of healthcare

This Fixing Healthcare podcast series, “Diving Deep,” probes into some of healthcare’s most complex topics and deep-seated problems.

On today’s episode, hosts Dr. Robert Pearl and Jeremy Corr explore how the middleman mentality is killing American medicine, and then contrast it with how some of the nation’s largest retail companies (including CVS, Walmart and Amazon) are planning to expel the middlemen of medicine with an effective long-term strategy. Whether you provide medical care or receive it, you’ll learn much from this deep dive into the future of healthcare.

For more information on these topics, check out Dr. Pearl’s latest healthcare columns on Forbes and LinkedIn. For listeners interested in show notes, here’s a discussion guide:

  • What is a middleman?
  • What did healthcare look like before middlemen?
  • When and why did middlemen enter the picture?
  • What is the ‘middleman mentality’?
  • What are examples of it in healthcare today?
  • Are middlemen medicine’s biggest problem?
  • How does the middleman mindset harm patients and doctors?
  • Why do middlemen love “fee for service” payments?
  • How have insurers and insurance purchasers (employers) responded?
  • What might effective leadership look like in healthcare?
  • Where does change begin?
  • Retailers are making major news in healthcare. Why?
  • What are biggest, boldest healthcare acquisitions in recent months?
  • Based on the past few years, are giant retailers doomed to fail in medicine?
  • What reason is there to believe Amazon, CVS or Walmart can succeed?
  • What is the short-term strategy for these retailers in healthcare?
  • CVS and Amazon paid billions for primary care companies that are losing money. Why?
  • What’s the middle game for these retailers?
  • Why are they all interested moving from fee-for-service to capitation?
  • How do their latest acquisitions and partnerships tie into Medicare Advantage?
  • What does the long game look like and how long will it take to plat out?
  • How will the winner be determined?

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Dr. Robert Pearl is the author of a book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.” All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.