The Pediatric Lounge, Where Pediatric Physicians Come to Share Their Stories and Success

SOAPM Reunion: Practice Evolution, Corporate Medicine, and the Future of Pediatric LeadershipHosts reunite longtime colleagues on The Pediatric Lounge to reflect on how the AAP’s SOAPM listserv connected them and shaped their careers in pediatric practice management. Retired pediatricians John, Jesse, Bud, Jeanne, and Hershel, along with Seth (now in the vaccine/pharma industry), describe varied practice paths including solo and group practices, HMOs, faculty practice integration, rapid growth and sales to Stanford or larger groups, and experiences with corporate healthcare and private equity. The group discusses loss of succession planning, younger physicians’ reluctance to manage practices, lifestyle and childcare constraints, inadequate training in business/coding, moral injury, declining reimbursement, and consolidation driven by weak competition and antitrust enforcement. They contrast SOAPM’s earlier community and humor with later moderation and minutiae, highlight examples of successful newer independent leaders, and close with plans to reconnect at future meetings.00:00 Welcome to Pediatric Lounge00:37 SOAPM Reunion Origins01:21 John Practice Journey03:31 Jesse Group Evolution05:17 Bud Growth and Humanism07:43 Jeanne Innovation and Consulting11:28 Hershel SOAPM Stories15:52 Seth Industry Pivot18:58 Why Partners Quit24:08 Corporate Medicine Shift29:13 Training and Leadership Gap33:50 System Failures and Monopolies41:33 Hospital Power Politics42:13 Training Empathy Loss43:35 RBRVS Moral Injury44:09 Two Tier Concierge Care46:10 Pediatrics Pay Crunch49:24 Coding Leadership Fixes51:20 Listserv Moderation Wars56:27 Camaraderie CME Decline01:00:26 Humor Friendship Stories01:03:41 Hope Leaders Market Shakeup01:10:34 Healthcare Billing Absurdity01:11:29 Farewell Reunion Plans01:13:39 Show Wrap CreditsSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Pediatrics in Transition: Revenue Headwinds, Type 1 Diabetes Screening, and Lessons from Serious IllnessIn this Pediatric Lounge episode, Dr. Herb Bravo speaks with Dr. Susan Sirota about challenges facing independent pediatric practices in Chicago, including rising costs, declining physician payments, and the need for creative revenue strategies, as well as concerns that pediatrics could become less accessible without stronger advocacy and better communication with payers. They discuss Pediatrust’s efforts and Dr. Josh Levin’s Type 1 diabetes screening initiative, aiming to reduce DKA presentations and integrate education and early management in primary care. Sirota shares her family’s two-year journey with her husband’s transformed lymphoma, intensive chemotherapy, CAR T-cell therapy, relapse, and matched unrelated donor stem cell transplant, using the experience to highlight key lessons: listening and humanity in care, realistic communication, EHR accuracy, and the frequent lack of care coordination after visits, plus caregiver resilience and being present.00:00 Podcast Welcome01:11 Pediatrics In Transition03:18 Payment Pressures Ahead06:50 Advocacy And Medicaid Math09:51 Type 1 Screening Rollout12:43 Preventing DKA In Primary Care15:41 Screening Fears And Insurance17:54 Husband Lymphoma Journey21:23 Life Before Illness25:47 Humanity In The Exam Room32:57 Listening And Bias In Hospital38:58 Honest Communication Matters45:15 Chart Errors Multiply46:38 Apheresis Note Mixup49:24 Medication Pathway Blindspots52:01 Pediatric Chart Skepticism53:21 Care Coordination Reality Check54:39 Pharmacy Stock Surprises58:46 Follow Up With Automation01:02:08 ER Humanity And Basics01:07:26 Small Acts Big Impact01:09:42 Caregiver Resilience Habits01:14:38 Being Present On Purpose01:19:15 Teaching Death As Normal01:22:31 Final Takeaways And WrapSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Dr. Shenkin on Humanistic Pediatrics, Health Policy, and Fixing Incentives in U.S. HealthcareOn The Pediatric Lounge, the hosts interview Dr. Shenkin, a Harvard-trained pediatrician, physician leader, and health policy expert who founded Bayside Medical Group in Oakland and grew it to a 35-physician, 10-office organization later sold to Stanford/Children’s Hospital. He describes choosing pediatrics as “falling in love,” shaped by a neurosurgeon father, and recounts work in the Public Health Service during the Vietnam era, including leading and reshaping migrant health into early regional rural health centers and studying health systems and policy in Stockholm and Yale. The conversation critiques U.S. insurance, fee-for-service/RBRVS, RVUs, networks, PBMs, and administrative waste, arguing costs stem from high prices and bureaucracy, not patient overuse. They emphasize restoring humanistic care—patients feeling “cared for and cared about”—through values, systems, mentorship, and better measurement, while criticizing hierarchical training, Epic-driven box-checking, and misaligned incentives that prioritize revenue over care.00:00 Welcome to the Lounge00:30 Meet Dr. Bud Shenkin01:18 Why Pediatrics Chose Him01:34 Family Roots in Medicine05:13 Policy Path and Vietnam Era06:48 Training Abroad and Independence07:47 Great Profession, Bad Job09:40 Residency Mentors and Customer Service12:06 Why He Rejected Academia13:32 Insurance and Fee-for-Service Critique15:02 Catastrophic Coverage Debate17:15 Humanistic Care Without Money Anxiety18:58 Where Healthcare Overspends20:15 Hospital Pricing and System Power21:27 PBMs and Pharma Incentives24:45 Leading While Still Seeing Patients26:17 Hospitality Lessons for Healthcare29:07 Systems Thinking and Safety Design31:33 Building Humanistic Relationships32:49 Name Tags and Respect33:58 Selling to Big Systems36:27 Training and Hierarchy37:41 Epic and Box Checking38:14 Humanistic Exam Room40:27 Mentorship and Great Practices43:46 Networks vs Fiduciary Duty44:55 Falling in Love with Pediatrics48:36 Paying for Humanistic Care53:06 Trust, Dissent, and Leadership54:34 Becoming a Great Clinician01:00:08 Keeping Idealism Alive01:01:08 Closing and CreditsSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Pediatrics, Trust, and the Age of AI: Evidence, AAP Policy, and Vaccine MandatesHosts Herb and George welcome back Dr. Jesse Hackell to discuss declining trust in medicine amid overwhelming information and AI summaries, emphasizing the need for physicians to critically appraise evidence rather than rely on authority or EHR prompts. They debate perceptions of the American Academy of Pediatrics (AAP) as a “corporation” versus a volunteer membership organization, how AAP governance works, and how AAP outputs (technical reports, clinical reports, policy statements, and more rigorous clinical practice guidelines) should be read as guidance, not gospel or standards of care, with evolving examples like peanut introduction and biliary atresia screening. The conversation covers malpractice implications, screening controversies (e.g., ferritin/iron, milk and anemia), COVID-era messaging failures and politicization, vaccine policy opposing non-medical exemptions as choice with consequences, nuanced school-entry requirements (e.g., Florida Hib/pneumococcal), and tees up a future discussion on insurance and coverage for all children.00:00 Show Intro01:40 AI Trust Crisis03:42 Reading Evidence Today07:16 AAP Critics And Mission09:48 Volunteerism Versus Pay12:56 AAP Guidance Not Gospel18:20 Governance And Elections24:03 Types Of AAP Reports33:48 Med Legal Standards42:36 COVID And Vaccine Trust47:01 RFK And Opinion Politics48:02 Fauci Versus RFK48:49 Natural Immunity Messaging50:41 How Science Pivots52:36 Peer Review Explained54:22 Evidence Bars And Coercion57:32 Bright Futures Screening Debate58:59 Ferritin Screening Controversy01:05:01 Cow Milk And Iron Loss01:06:51 AI And Trust Erosion01:11:37 School Vaccine Exemptions01:18:03 Community Versus Freedom01:19:40 Florida Hib And PCV Nuance01:24:41 Insurance Policy Teaser01:26:58 Wrap Up And CreditsSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Life After Clinical Practice: Finding Impact Beyond the Exam RoomOn The Pediatric Lounge, Herb and George welcome returning guest Jeanne Marconi to discuss “Life After Clinical Practice: What’s Next?” Jeanne describes stepping away from patient care during COVID, wanting to scale what she built in practice (integrated urgent care, behavioral health, lactation, nutrition/obesity care), and helping develop a behavioral health arm at PM Pediatrics leveraging telehealth. The group debates who represents pediatrics, arguing that the AAP prioritizes child advocacy over pediatrician advocacy, while clinical practice faces declining visit volume, rising costs, a worsening payer mix and skewed RVU incentives, growing chronic and mental health complexity, and low adoption of recommendations, which can overwhelm clinicians and erode family trust. Jeanne outlines paths for “burnt on” physicians: redesign services within practice, pursue governance/boards, advocacy, or nonclinical roles, and accept starting as a beginner. They discuss private equity tradeoffs, instability, and the need for strong change management centered on explaining “why,” addressing resistance, and building community forums for pediatricians. Jeanne highlights nonprofit work supporting youth aging out of foster care and her board role at Elizabeth Seton Children’s Center, urging colleagues to support one another’s mental health and view transitions as applying medical skills in new ways.00:00 Podcast Welcome00:37 Meet Dr Marconi02:12 Leaving Clinical Practice03:36 Building Behavioral Health04:33 Who Speaks Pediatrics06:42 Practice Pressures Today08:05 Payment Model Problems14:08 Guidelines And Evidence17:29 Burnt On And Pivoting20:35 Paths Beyond Medicine21:43 Private Equity Reality28:27 Costs And Practice Change32:18 Finding Your Impact33:44 Drop the Doctor Ego33:58 Reframing Leaving Medicine35:22 Becoming a Change Agent38:18 Change Management That Works40:03 Generational Shifts in Practice43:06 AI Tools for Better Leadership46:26 When to Move On51:10 Passion Versus Paycheck51:50 Mental Health and Toxicity53:14 Building Community Meetups57:23 Advocacy That Feeds the Soul59:03 Final Takeaways and WrapSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

New AAP Anemia Screening Guidelines: Ferritin, Hemoglobin, and Real-World Pitfalls. You can read a full review of the Clinical Report from Dr. Bravo et al on The Society for Pediatric Innovation. On The Pediatric Lounge, hosts interview Dr. Lia Phillips, a pediatric hematologist at NYU Langone, about new anemia screening guidance that emphasizes using ferritin to detect iron deficiency before anemia develops. They discuss the evidence and limitations linking early iron deficiency to neurodevelopment and IQ, including concerns that correcting iron deficiency may not improve long-term cognition and that proposed ferritin cutoffs (e.g., 20 in toddlers, 30 in females) could label and treat a large share of children. The conversation highlights real-world workflow barriers to lab-based screening, risks of misdiagnosis and inappropriate iron therapy (e.g., in sickle cell disease or thalassemia), the need for follow-up response checks, and focusing on symptoms such as adolescent fatigue, heavy menstrual bleeding management, cow’s milk reduction, and potentially prioritizing maternal iron status in pregnancy.00:00 Podcast Intro00:39 Meet Dr Leah Phillips01:18 Why Pediatrics and Heme04:45 Iron and Brain Development08:15 AAP Screening Shift11:46 Ferritin Cutoffs Debate14:23 Risks of Misdiagnosis15:54 Newborn Screen Systems27:54 Workflow and Access Barriers35:41 What Screening Should Mean36:52 Ferritin and Bone Marrow38:52 CBC Over Hemoglobin40:00 Microcytosis Early Warning40:32 Anemia and Brain Oxygen41:46 Iron Treatment Nuance43:59 OTC Iron Confusion46:10 Fatigue and Ferritin48:47 Heavy Period Root Cause50:48 Team Based Bleeding Care53:39 Treat Patient Not Labs55:25 Ferritin Cutoffs Debate57:29 Follow Up and Milk01:00:37 Picky Eaters and Parenting01:04:23 Pregnancy Prevention Focus01:05:40 Wrap Up and CreditsSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

What Pediatricians Do Every Day That’s Great—and Nobody Knows About (with Dr. Lisa Cronin)On The Pediatric Lounge, hosts interview Dr. Lisa Cronin, a general pediatrician and chief marketing officer at Children’s Medical Center, a 17-physician independent practice in the Tampa Bay area with four locations and about 50,000 patients, 40% Medicaid, open 362 days a year with extensive after-hours access and an integrated behavioral health component in Pinellas County through a Juvenile Welfare Board partnership. Cronin describes her path from intending emergency medicine to pediatrics, briefly training in anesthesiology, and choosing primary care for continuity and relationships, while discussing why general pediatrics can be more challenging than controlled inpatient settings. The conversation covers maintaining culture across offices, generational communication, marketing and digital presence, business education, efficiency as reducing pain points without sacrificing quality, and resisting private equity consolidation. Cronin shares how a conference talk on early type 1 diabetes screening led her to identify a 10-year-old with abnormal A1c/glucose and positive antibodies, refer to endocrinology, and confront family reluctance about further testing and treatment.00:00 Podcast Intro00:39 Meet Dr Lisa Cronin01:12 Why Pediatrics02:10 Inside Her Practice04:28 Hospitals And Coverage07:41 Detour Into Anesthesia10:44 Why General Peds Is Hard14:37 Culture Across Offices17:35 Information Overload And Trust25:01 Chief Marketing Officer Role31:40 Marketing Meets Modern Pediatrics34:04 Hiring Accountability And Work Ethic36:00 Part Time Scheduling Wins37:20 Flexibility Beats Rigidity38:47 Weekend Coverage Reality39:34 Motivating Future Partners43:02 Leadership Explaining The Why46:58 Private Equity Misconceptions49:16 Efficiency Without Volume54:13 OP Engage Diabetes Screening56:03 Case Finding Early Type 101:04:10 Why Screening Matters01:06:25 Conference Hook And Hope01:07:55 Wrap Up And FarewellSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Support the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Building Wealth After Residency: Debt, Investing, and Insurance PitfallsIn this episode of The Pediatric Lounge, George and Herb interview pediatrician Dr. Neil Belovin about building wealth after residency, focusing on why new attendings can still feel broke due to debt, high living costs, and slow income growth in pediatrics. They discuss common mistakes like lifestyle inflation, expensive cars, credit card debt, and ignoring low required student-loan payments during residency that can count toward loan forgiveness. Belovin emphasizes starting early with retirement contributions and simple, low-fee investing (e.g., ETFs and dollar-cost averaging) while comparing loan interest rates to expected returns. The conversation covers insurance priorities—own-occupation disability insurance first, then life insurance when needed, plus umbrella and underinsured motorist coverage—and warns against costly whole life policies. They also address malpractice policy types and tail coverage, keyman insurance for practices, long-term care insurance risks, and the value of reviewing policies annually and using prenuptial/partnership agreements to clarify exits and expectations.00:00 Welcome And Guest Intro01:45 Why Doctors Feel Broke03:38 Cost Of Living Reality05:56 Lifestyle Inflation Traps11:28 First Paycheck Priorities13:27 Saving And 401k Basics15:29 Loans Versus Investing16:53 Investing Through Bubbles18:34 Term Life Versus Whole20:51 Disability Insurance Must28:56 Disability Lapse Lesson29:38 Term Versus Whole Life30:58 Umbrella Coverage Basics32:32 Keyman Insurance Planning35:18 Prenup As Negotiation41:41 Malpractice Tail Explained48:50 Long Term Care Reality53:02 Annual Policy Checkups55:15 Insurance Priority Order55:52 Closing ThanksSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

From Exam Room to Empire: Building a Practice, Brand, and Wealth with Dr. Po Raval (Doc Dynasty)In this episode of The Pediatric Lounge, the hosts interview Dr. Po Raval, founder of Doc Dynasty, who shares her remarkable journey from launching a solo podiatry practice to becoming a successful entrepreneur, consultant, and physician branding expert.Dr. Raval explains how a podiatrist's successful treatment of her mother's ankle injury inspired her career path. She discusses gaining valuable hands-on experience during training and opening her first practice immediately after residency by leasing an affordable office inside a health club—creating an instant referral base among athletes and active patients.As healthcare reimbursement evolved, Dr. Raval diversified her income through nursing home care, consulting, and business development. She describes how earning an MBA expanded her perspective beyond clinical medicine and led to opportunities advising New Jersey Medicaid and other healthcare organizations on practice operations and systems improvement.The conversation then shifts to the modern realities of physician entrepreneurship. Dr. Raval explains why every physician should develop a personal brand, build a strong digital presence, and consistently create educational content. She shares practical strategies for leveraging websites, search engine optimization, social media analytics, and AI tools such as ChatGPT and Gemini to generate ideas, optimize profiles, and improve marketing efficiency.Throughout the discussion, Dr. Raval emphasizes that AI should enhance—not replace—clinical judgment. She encourages physicians to think critically, question guidelines when appropriate, maintain authentic relationships with patients, and recognize that building a successful medical practice requires both excellent clinical care and intentional business strategy.Whether you're starting your first practice, growing an established office, or exploring physician entrepreneurship, this episode provides practical advice on building a sustainable career and lasting professional legacy.Episode Chapters00:00 – Welcome and Guest Introduction01:49 – Why Dr. Raval Chose Podiatry04:04 – Understanding Podiatry Training05:29 – Building a Specialty Referral Network07:34 – Launching a Practice on a Budget11:56 – Early Growth and Marketing Strategies14:25 – Adapting to HMOs and Creating New Revenue Streams18:22 – An MBA Mindset: Consulting and Business Growth22:29 – The Modern Practice Growth Playbook26:46 – Reaching the Right Audience on Social Media31:03 – Patient Outcomes, Reviews, and Practice Growth32:35 – Creating an Effective Marketing Budget33:59 – The Story Behind Doc Dynasty37:29 – Batch Content Creation for Busy Physicians39:01 – Using AI for Hooks, Headlines, and Hashtags42:29 – Why Consistency Outperforms Viral Content44:26 – Why Marketing Is Essential for Every Practice47:52 – Patient Retention and Staying Top of Mind50:21 – Negotiation Lessons for Physicians52:33 – AI Tools Every Physician Should Know57:08 – Why AI Still Requires Critical Thinking1:02:00 – Why AI Won't Replace Great Physicians1:03:12 – Closing RemarksSupport the show🔴 Subscribe for more Doctor stories like this:  🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.