FHC #185: A System in crisis, a technology in waiting

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In this Diving Deep episode of Fixing Healthcare, cohosts Dr. Robert Pearl and Jeremy Corr tackle two timely topics shaping the future of American medicine.

First, the pair explore a growing concern among health policy experts and clinicians alike: Is the U.S. medical system headed for economic collapse? Dr. Pearl outlines three troubling trends in support of this concern. Ballooning healthcare costs, an unsustainable rise in medical employment (without associated gains in quality), and the accelerating burnout and exit of practicing physicians. Together, these forces threaten to push American healthcare off a cliff.

More alarming still, the traditional “exit ramps” that once helped the system avoid disaster — federal borrowing, employer cost-shifting and physician overwork — are rapidly disappearing. With options dwindling, Pearl and Corr consider what comes next: Will private equity lead a wave of cost-cutting? Will crisis force rationing? Or could new technology offer a better way forward?

That question sets the stage for part two of the episode: a deep dive into generative AI’s future in medicine. Pearl describes two emerging paths: one led by tech startups developing FDA-approved tools to manage disease, and another championed by physicians who teach patients how to use existing large language models for self-care and symptom triage. Both models aim to reduce costs and improve outcomes. But each comes with tradeoffs.

Throughout the episode, Pearl encourages clinicians to lead (not follow) the adoption of GenAI. Whether American healthcare descends into austerity or rises toward innovation, the decisions made now will shape the system’s trajectory for decades to come.

HELPFUL LINKS

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Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” 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 or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.