FHC #210: Healthcare’s productivity crisis & how vibe coding could help

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Corr connect two forces that are beginning to reshape the future of medicine: healthcare’s worsening economic inefficiency and the rise of physician-built generative AI tools. The conversation opens with a provocative interpretation of the latest U.S. jobs reports. While healthcare has become the nation’s primary engine of employment growth, Dr. Pearl argues that this is not a sign of strength. It is evidence that medicine continues to meet rising demand by adding labor instead of improving productivity. In his view, that failure to modernize is driving higher costs for employers, families and government programs while setting the stage for inevitable disruption. From there, the discussion shifts to what that disruption could look like. Pearl outlines how generative AI could improve chronic disease monitoring, reduce unnecessary hospital stays and detect inpatient decline earlier than current workflows allow. These advances, he argues, would lower costs not by rationing care but by improving outcomes. The second half of the episode turns to one of the most practical and exciting developments in generative AI: vibe coding. Here, Pearl explains how physicians can now use plain-English prompts to create customized digital tools that reflect their own clinical judgment and practice preferences. Rather than relying on static handouts or generic patient portals, doctors could build affordable applications that monitor patients continuously between visits and intervene earlier when problems arise. Taken together, the episode puts forth a clear thesis: healthcare’s worsening economics are not a sign of resilience. They are a sign that medicine has failed to modernize. What’s more: generative AI, especially through vibe coding, may be the most practical path to higher-quality, lower-cost care. For more, tune into this month’s episode and check out the links below. Helpful links US Jobs Report Spotlights Healthcare’s Inefficiency, Signals Disruption (Forbes) How Vibe Coding Will Reshape Medical Practice (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” 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 X and LinkedIn. The post FHC #210: Healthcare’s productivity crisis & how vibe coding could help appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl balance two sides of American healthcare: the encouraging scientific advances that could help people live longer and healthier lives, and the growing affordability and trust crises threatening patients across the country. The conversation opens on an optimistic note. Dr. Pearl highlights new Yale research showing that aging is far less deterministic than many Americans assume. Rather than a steady and unavoidable decline, the study found that nearly half of adults over 65 improved physically, cognitively or both over a 12-year period. He pairs that story with new cardiovascular guidance from the American College of Cardiology and the American Heart Association, which shifts prevention toward a much longer time horizon and argues that earlier LDL management could prevent a significant share of heart attacks and strokes later in life. The episode then pivots to the mounting financial and institutional pressures facing patients, hospitals and public-health agencies. From rising medical debt and medication nonadherence to declining vaccine trust, hospital cost inflation and the political barriers keeping GLP-1 drugs unaffordable in the United States, the discussion captures both the promise and the fragility of healthcare in 2026. Here are the other major storylines from episode 105: Supplements fail the evidence test: Pearl reviews clinical trial data showing that commonly used supplements such as fish oil, garlic, turmeric, cinnamon and red yeast rice performed no better than placebo in lowering LDL, reinforcing the continued value of lifestyle interventions and low-cost statins. Medical costs continue to destabilize families: New Gallup-linked research shows that 82 million Americans are already making sacrifices to pay medical bills, from skipping meals to delaying retirement. Drug unaffordability worsens medication adherence: A new KFF survey finds that nearly 60% of Americans worry about affording prescriptions, with 43% reporting they have not taken medications as prescribed because of cost. Generative AI adoption surges among physicians: According to a new AMA survey, 81% of doctors now use generative AI in clinical practice, most commonly for documentation, literature summaries and chart support. Hospitals face intensifying economic pressure: The American Hospital Association reports that care delivery costs rose 7.5% last year, driven by higher labor expenses, drug prices, supply inflation and sicker patients. Trust in vaccine authorities continues to erode: Following the legal challenge to RFK Jr.’s overhaul of the federal vaccine advisory committee, new polling shows trust in federal vaccine recommendations has fallen sharply. Newborn preventive care is now affected by distrust: Pearl warns that refusal of vitamin K shots, hepatitis B vaccination and antibiotic eye ointment at birth is rising, reversing decades of scientific progress and reintroducing preventable newborn risks. Alzheimer’s blood tests show progress, but not prediction: New FDA-cleared blood tests can help identify Alzheimer’s disease as the likely cause of current dementia, but Dr. Pearl explains why they remain far less useful for predicting disease years before symptoms begin. The fax machine may finally be dying: In one of the episode’s lighter moments, Dr. Pearl notes that CMS is moving to phase out fax-machine communication across HIPAA-covered entities, a long-overdue modernization step that could save taxpayers nearly $1 billion annually. Residency match reaches record size: The 2026 residency match was the largest in history, with more than 48,000 applicants competing for over 44,000 positions. Early heat waves carry serious health consequences: With unusual March heat across parts of the country, Dr. Pearl explains why early-season heat is especially dangerous, increasing risks of dehydration, kidney injury, cardiovascular strain and mental health emergencies. GLP-1 drugs go generic abroad while U.S. prices stay high: As Novo Nordisk’s blockbuster GLP-1 medications go generic in India and other global markets, Dr. Pearl contrasts international pricing with U.S. costs and argues that congressional inaction on drug pricing remains one of healthcare’s clearest failures. Tune in for more fact-based analysis and practical perspective on the healthcare stories shaping medicine today. * * * Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. 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 X and LinkedIn. The post MTT #105: New science on aging, rising medical debt & healthcare’s fax problem appeared first on Fixing Healthcare.

Dr. John Whyte has spent his career at the intersection of medicine, media and public policy. Now, as CEO of the American Medical Association, he hears firsthand what physicians, patients and health leaders are most concerned about and what they expect from the future of healthcare. That perspective makes him an ideal guest for Season 11 of Fixing Healthcare with cohosts Dr. Robert Pearl and Jeremy Corr. This season’s guests bring more than impressive résumés and large social-media followings. They bring insight into what people across the country are actually talking about: the fears they express, the questions they ask and the expectations they carry into exam rooms, boardrooms and online conversations. Whyte has held leadership roles at the FDA and Centers for Medicare & Medicaid Services. He later became chief medical officer at WebMD and chief medical expert for Discovery Channel. In each position, he has focused on translating complex medical issues into clear, actionable information. In this conversation, he shares what he is hearing now and why the answers will require both cultural and structural change. Key highlights include: Three concerns dominate for physicians. Whyte opens by identifying what he hears most often across the country: frustration with prior authorization and payment incentives in Medicare and Medicaid, anxiety about scope-of-practice changes, and uncertainty about how physicians should lead (rather than react to) the rapid rise of digital health and generative AI. Medicaid disruption and impact on children. Whyte explains that policy changes at both federal and state levels could leave vulnerable populations without coverage or access to care. He emphasizes that nearly half of U.S. children rely on Medicaid. Payment models and physician autonomy. The discussion explores tensions between fee-for-service, Medicare Advantage and value-based approaches. Whyte argues that physicians must retain meaningful choice in how they practice and get paid, even as consolidation and employment models reduce autonomy. Generative AI as “augmented intelligence.” Whyte notes that more than 80% of physicians now use AI tools professionally, largely for documentation and communication tasks. The real opportunity, he says, lies in improving diagnosis, personalization and continuous monitoring. Home as the future site of care. From wearables to smart diagnostic devices, Whyte envisions a shift away from episodic office visits toward continuous monitoring and preventive care. Outcome-based reimbursement. Pearl asks whether paying for outcomes could unlock broader adoption of AI-enabled tools. Whyte acknowledges the promise but highlights practical challenges, including patient complexity, burnout and the risk that efficiency gains could simply lead to higher patient volumes. The evolving physician-patient relationship in the AI era. With a growing share of patients using generative AI before appointments, Whyte encourages clinicians to view digitally informed patients as partners. Open dialogue, trusted sources and shared decision-making, he argues, will define effective care in the years ahead. There’s so much more to this episode. Tune in to find out what physicians and patients should expect from the future of medicine. * * * 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 The post FHC #209: What the AMA’s new CEO is hearing from doctors & patients right now appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, Dr. Robert Pearl and Jeremy Corr sit down with cardiologist and mindfulness expert Dr. Jonathan Fisher for a wide-ranging conversation about leadership, strategy and the future of physician influence in American medicine. The discussion begins with a challenge to a popular point of view: that empathy, transparency and trust make for an effective leader in medicine. While those qualities matter, Dr. Pearl argues that healthcare also requires strategic thinking, operational discipline and the ability to align people around a common direction. In medicine, says Dr. Fisher, many physicians are taught how to care for patients but not how to lead organizations. From there, the conversation expands into the deeper reasons doctors so often remain subordinate to administrators, why burnout makes strategy harder to execute and why the economics of healthcare continue to reward treatment more than prevention. Some of the key ideas discussed: Empathy is necessary, but not sufficient. Healthcare often treats empathy and trust as the highest forms of leadership. Pearl argues that great leaders also need strategic thinking, financial understanding and operational skill. Doctors are rarely trained to lead. Fisher and Pearl discuss how physicians are taught to avoid mistakes and follow established pathways, not necessarily to take strategic risks. Burnout undermines strategy. A burned-out workforce may struggle to understand, trust or implement leadership goals. Fisher notes that wellness programs can help individuals cope, but they cannot substitute for fixing the systemic forces driving exhaustion. Primary care remains undervalued. Pearl argues that fee-for-service medicine fails to reward prevention. Until payment models shift toward capitation and long-term disease control, primary care will continue to be under-supported despite its central importance. Strategy without implementation goes nowhere. The group explores the difference between setting a vision and making it real. Pearl argues that healthcare too often suffers from one or the other: plans with no execution or action without coherent strategy. Physicians need broader leadership development. To reclaim influence over the future of medicine, doctors will need more than clinical expertise. They will need training in finance, organizational behavior, incentives and the mechanics of large-scale change. The future of medicine will be collaborative. As generative AI takes on more algorithmic tasks, doctors who succeed will not be the ones who resist change but those who learn to combine clinical judgment, human connection and technological support. Pressure changes performance. Using examples from the Winter Olympics, Fisher explains how elite performers can “freeze” when stress overrides instinct. The same phenomenon can happen in medicine when clinicians are forced into high-stakes moments without the right preparation or support. Machines don’t freeze. That observation leads to one of the episode’s most provocative questions: if AI and robotics continue to improve, will certain technical tasks eventually be performed more reliably by machines than by humans under pressure? Competition should lead to unity, not division. In the closing segment, the discussion broadens from sports to society with a question from Jeremy Corr, offering the patient’s point of view. Pearl argues that high-level competition should ultimately strengthen collective purpose, whether in athletics, healthcare or public life. For more unfiltered conversation, listen to the full episode and explore these related resources: ‘Just One Heart’ (Jonathan Fisher’s newest book) ‘ChatGPT, MD’ (Robert Pearl’s newest book) Monthly Musings on American Healthcare (Robert Pearl’s newsletter) * * * 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 FHC #208: Why empathy alone won’t fix healthcare leadership appeared first on Fixing Healthcare.

In this Diving Deep episode, Dr. Robert Pearl and Jeremy Cor return to a question listeners have been asking for months: What role will generative AI realistically play in American healthcare? Dr. Pearl opens the discussion around three urgent threats that, if ignored, may soon become too large and too expensive to solve: The affordability cliff The chronic disease crisis The risk of training doctors for the wrong future This examination offers a stark warning about healthcare’s lack of flexibility. Unlike most industries, medicine cannot quickly reconfigure its workforce, adopt new care models or cut costs without years of delay. That rigidity, Pearl argues, is what makes the current moment so dangerous. By the time healthcare leaders respond to major problems, those problems often have already deepened into crises. The episode’s second half explores whether generative AI could help avert that future. Pearl argues that the technology is already capable of improving chronic disease management, reducing medical errors and extending care into patients’ homes. The larger barrier is no longer technical but cultural. To illustrate that divide, Pearl uses HBO’s hit show The Pitt to examine how medicine still frames AI as either a helpful tool or an existential threat rather than what it could be: a valuable clinical partner. He credits the show for capturing physicians’ skepticism and enthusiasm but argues that it misses the more important question: not whether AI is perfect, but whether it performs better than clinicians working alone in a system already riddled with error. Looking further ahead, Pearl argues that when it comes to GenAI taking on clinical tasks once exclusive to humans, the Rubicon has already been crossed. Major health systems are beginning to use generative AI for clinical intake and treatment planning. Large technology companies are building patient-facing health tools tied to personal medical data. And states such as Utah are already testing whether AI can safely handle parts of chronic disease care without direct physician oversight. Taken together, these developments point toward a new future for medicine. Primary care physicians may spend less time on routine algorithmic tasks and more time on complex patients. Specialists may become more procedural as outpatient evaluation shifts. And health systems that want to benefit from these changes will need to move away from fee-for-service and toward value-based care. For more on these developments, tune into this month’s episode and check out the links below. Helpful links Three Healthcare Threats That Will Soon Become Too Big To Solve (Forbes) What The Pitt Gets Right And Wrong About Generative AI In Medicine (Forbes) GenAI Will Replace Much Of What Clinicians Do — It’s Already Happening (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” 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. The post FHC #207: Three major healthcare threats GenAI can help solve appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl unpack a wide range of developments shaping healthcare in America today, including the TrumpRx drug discount program. From new legislation affecting telehealth and pharmacy benefit managers (PBMs) to the rapid spread of measles and growing public concern about vaccine policy, this month’s discussion highlights the policy decisions and scientific debates influencing medicine right now. The episode opens with the latest federal legislation passed to avert a government shutdown. While healthcare was not the central focus of this particular political battle, the bill contains several provisions that affect medical practice. These include extensions for telehealth coverage and hospital-at-home programs, reforms targeting PBM transparency and new requirements designed to address “ghost networks” in Medicare Advantage provider directories. Dr. Pearl explains that while these provisions represent incremental progress, they are unlikely to solve the larger problems driving healthcare costs and access challenges in the United States. Here are the other major storylines from episode 104: Healthcare costs remain nation’s top concern: A new KFF poll finds that healthcare expenses rank above food, housing and utilities as the economic issue Americans worry about most. Prior authorization frustrations grow: Many patients report delays or denials of care due to insurance requirements, highlighting persistent tension between insurers, physicians and patients. Drug pricing debates continue: Pearl examines a new prescription drug website initiative and explains why it may have limited impact compared with broader policy proposals such as “most favored nation” pricing. Telehealth’s uncertain future: Although the latest legislation extends certain pandemic-era flexibilities, the lack of a permanent solution leaves virtual care programs in limbo. PBM reforms move forward slowly: New policies aim to increase transparency and reduce incentives tied to drug list prices, though Pearl notes that meaningful change will depend on future implementation. Site-neutral payment gains attention: A provision requiring unique identifiers for outpatient services could pave the way for policies that eliminate higher reimbursement for hospital-owned facilities providing identical care. Measles outbreaks surge: Nearly a thousand cases have already been reported in 2026, with the overwhelming majority occurring among unvaccinated children. Trust in the CDC declines: Polling shows confidence in the agency has dropped significantly following changes to vaccine recommendations. Independent vaccine review groups emerge: Medical organizations and states are forming new committees to evaluate vaccine evidence as federal guidance becomes more contested. Early colon cancer deaths rise: The death of actor James Van Der Beek at age 48 highlights the growing incidence of colorectal cancer among younger adults and the importance of earlier screening. FDA confusion over a new flu vaccine: The agency initially declined to review Moderna’s mRNA-based flu vaccine before reversing course and agreeing to evaluate it ahead of the next flu season. Younger Americans face worsening health trends: New claims data suggest chronic disease is appearing earlier among millennials and Gen Z, driven by lifestyle factors and reduced connection to primary care. Wearable data reveal health disparities: Apple Watch data show significant differences in resting heart rates across states, reflecting variations in lifestyle, access to care and public health conditions. As the episode concludes, Dr. Pearl warns that growing political conflict around vaccines and biomedical research risks undermining public trust in science. The consequences, he argues, could shape American medicine for decades to come. Tune in for more fact-based analysis and discussion of the biggest stories in healthcare. * * * Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. 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 The post MTT #104: TrumpRx, rising measles cases & the politics of vaccine science appeared first on Fixing Healthcare.

Season 11 of Fixing Healthcare continues its shift away from the traditional top-down model of interviewing CEOs, policymakers and medical leaders to focus this week on something new, different and fascinating: listening to the generation that is inheriting this American healthcare system. In this episode, Dr. Robert Pearl and Jeremy Corr speak with Grace Lynn Keller, VP at Executive Podcast Solutions, former Miss America contestant and the show’s first-ever Gen Z guest. Grace brings a rare vantage point: Professionally, she is immersed in conversations with healthcare executives. Personally, she is part of the generation that consumes health information through social media, wearables and AI tools. For healthcare professionals, the conversation offers an important lens on how Gen Z gathers health information, how they decide when to seek care and what they expect from clinicians, insurers and government leaders. One insight stood out immediately. When asked where she would turn first with a non-emergency symptom, Grace answered without hesitation: ChatGPT. Her answer signals how much the healthcare landscape is changing. While Gen Z may turn to generative AI for initial medical advice, that is only one piece of a broader shift. In this conversation, Grace outlines how her generation is redefining health, prevention and trust. Key insights include: Verification Over Blind Trust. Gen Z does not simply accept what it reads online. Grace describes a culture of cross-referencing, double-checking and comparing sources across platforms before acting. Prevention As Identity. Her generation emphasizes whole foods, ingredient awareness and minimizing processed products. Health is considered a long-term lifestyle investment rather than reactive medical intervention. Wearables As Standard Equipment. Smart watches and rings are commonplace. Continuous data on sleep, movement, heart rate and hormonal cycles shape daily decisions and reinforce prevention. Convenience And Cost Sensitivity. Time away from work, co-pays and scheduling delays influence care decisions. If reliable AI-based treatment were available for routine conditions, many Gen Zers would use it immediately. Mental Health As Mainstream. Therapy is normalized. Work-life balance is considered protective, not indulgent. “Mental health days” may frustrate older generations but are viewed as necessary boundaries by younger workers. Skepticism Of Bureaucracy. Insurance complexity is a major frustration. Deductibles, out-of-pocket maximums and opaque pricing create confusion for first-time independent users. Demand For Transparency. Grace compares healthcare to e-commerce: if nearly every other industry offers clear pricing and frictionless purchasing, why not medicine? Alcohol And Cultural Moderation. Among her peers, alcohol consumption is more situational and less habitual. Health-conscious decision-making extends beyond diet and exercise. Education Gaps. Public school health education was limited largely to sex ed and anti-drug messaging. She sees schools as the only scalable venue to improve health literacy nationwide. There’s so much more to this episode. Tune in to find out what the next generation of patients expects from doctors, nurses and healthcare leaders. Helpful links “From TikTok to Telehealth: 3 Ways Medicine Must Evolve to Reach Gen Z” (Fulcrum) “Why younger patients turn away from doctors & toward GenAI” (Fixing Healthcare podcast) “Healthcare Regulators’ Outdated Thinking Will Cost American Lives” (Forbes) “ChatGPT, MD: How AI-Empowered Doctors and Patients Can Take Back Control of American Medicine” (Pearl’s newest book) * * * 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. The post FHC #206: What Gen Z expects from healthcare & why it matters appeared first on Fixing Healthcare.

In this Unfiltered episode of Fixing Healthcare, hosts Dr. Robert Pearl and Jeremy Corr sit down with cardiologist and mindfulness expert Dr. Jonathan Fisher for a wide-ranging conversation on leadership, culture and team performance, inspired by lessons from the movie F1. What begins as a discussion about racing quickly becomes a deep exploration of how high-performing teams operate under pressure. In the movie (and in real Formula 1 racing), success depends not on a single star driver but on flawless coordination, communication and shared accountability. The same, the trio argues, is true in healthcare where patient outcomes increasingly depend on the strength of teams, not individual brilliance. From there, Drs. Pearl and Fisher focus on how leaders are developed, how to handle disruptive personalities, how to align departments and how physicians can prepare for long-term career success in a rapidly changing healthcare landscape that includes the rise of generative AI. Some of the key ideas discussed: Healthcare is a team sport. Like an F1 pit crew, modern medical teams operate in high-stakes, time-sensitive environments. Excellence requires clarity of roles, rehearsal, debriefing and mutual trust not just individual skill. Leadership can be learned. Charisma helps, but effective leadership is less about personality and more about behavior. Empathy, emotional regulation and intentional communication are skills that can be developed with practice. Delivery often matters more than content. Fisher emphasizes the gap between what leaders intend to communicate and what their teams hear. Non-verbal cues (posture, tone, eye contact and “prosody”) often determine whether a message lands. Curiosity over judgment. When faced with disruptive or “toxic” behavior, leaders must stay regulated, address unacceptable actions clearly and then seek to understand the underlying drivers. Culture flows from leadership. If an entire department resists change, the issue often centers on the department’s leader. Alignment requires clarity of values, expectations and consequences … and sometimes difficult conversations. Excellence requires transparency. High-performing organizations define standards, measure outcomes and make performance visible. Coaching and incentives must align with expectations. Physician leaders need training not just promotion. The group discusses how brilliant clinicians are often elevated into leadership roles without preparation, and why formal leadership development is essential for healthcare’s future. Planning for succession matters. Pearl points out that great leaders build a “bench.” Teams should be structured to endure transitions, not collapse when one individual exits. The future of medicine will reward human skills. As generative AI takes on more algorithmic tasks, communication, empathy and leadership will become even more essential competencies for physicians. Throughout the episode, Dr. Fisher reminds listeners that leadership is not about dominance or perfection. It is about presence, self-awareness and the willingness to understand how others think, feel and respond. For more unfiltered conversation, listen to the full episode and explore these related resources: ‘Just One Heart’ (Jonathan Fisher’s newest book) ‘ChatGPT, MD’ (Robert Pearl’s newest book) Monthly Musings on American Healthcare (Robert Pearl’s newsletter) * * * 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 FHC #205: What ‘F1’ movie teaches us about leadership in medicine appeared first on Fixing Healthcare.

In this week’s episode of Medicine: The Truth, hosts Jeremy Corr and Dr. Robert Pearl examine a sweeping set of developments shaping American healthcare. From the first state-approved use of generative AI to prescribe medications without human oversight to rising healthcare costs, from worsening vaccine misinformation to the stubborn persistence of preventable disease, this show focuses on biggest stories in medicine today. The episode opens with a groundbreaking and controversial pilot program in Utah that allows a generative AI system to renew prescriptions for chronic disease without physician involvement. From there, the conversation turns to the relentless rise in healthcare spending. New federal data show Americans now spend more than $15,700 per person annually on medical care, with costs growing twice as fast as the economy. While insurance coverage remains high for now, Pearl warns that expiring subsidies, Medicaid restrictions and rising premiums are already pushing millions out of coverage. For many families, healthcare affordability has become a top issue and, increasingly, a political fault line heading into the midterm election cycle. Here are more major storylines from MTT episode 103: Exercise as medicine for depression: A large meta-analysis finds that regular exercise can be as effective as antidepressant medication for many patients. Trump’s healthcare plan fades quickly: Pearl explains why the president’s proposal disappeared from the headlines. Measles returns in force: Cases are nearing 1,000 and outbreaks concentrated in under-vaccinated communities. Vaccine battles intensify under RFK Jr.: New appointments to federal advisory committees raise alarm among scientists, as anti-vaccine voices gain influence. Chronic disease remains America’s top killer: Cardiovascular disease continues to claim nearly one million lives annually. Generative AI’s biggest promise: Pearl makes the case that AI-driven, at-home monitoring could finally transform chronic disease management. Cancer trends turn ominous: Colorectal cancer deaths among Americans under 50 are rising sharply, becoming the leading cancer killer in this age group. Genetics vs. lifestyle revisited: New research suggests genetics may account for half of lifespan variation but lifestyle still determines how many of those years are lived in good health. High-deductible health plans: New data show cancer patients with high-deductible insurance have significantly higher mortality. GLP-1 weight-loss pills arrive: The first oral GLP-1 drug launches to record demand. A devastating flu season for children: Despite the availability of safe vaccines, pediatric flu deaths reach alarming levels among unvaccinated kids. As the episode closes, Dr. Pearl delivers a stark warning about the resurgence of pseudoscience in medicine. Tune in for more fact-based coverage and analysis of healthcare’s biggest stories.   * * * Dr. Robert Pearl is the author of the new book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine” about the impact of AI on the future of medicine. 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 The post MTT #103: Can generative AI safely prescribe medicine on its own? appeared first on Fixing Healthcare.

This Diving Deep episode with Dr. Robert Pearl and Jeremy Corr looks at U.S. healthcare across three time horizons: past, present and future. The hosts use 2025 as a case study in disruption without reform, 2026 as a year of mounting pressure and near-term transition, and the coming decade as a period when generative AI will fundamentally reshape how medicine is practiced. Looking back at 2025 Dr. Pearl argues that despite political upheaval, executive orders, agency shakeups and constant headlines, American healthcare ended the year largely unchanged. Just more expensive and less trusted. He walks through five domains where chaos dominated but improvement failed to materialize. The throughline? Intense disruption produced little structural change in care delivery, affordability or outcomes. Turning to 2026 The conversation shifts from stagnation to pressure. Pearl identifies two forces that make inaction increasingly risky: the midterm elections and accelerating healthcare costs. He outlines how that pressure is likely to shape behavior across the system — not through sweeping reform, but through targeted, politically visible moves. Looking further ahead Pearl describes how generative AI could alter medicine at a profound level, especially through the convergence of AI and surgical robotics. He argues that autonomous surgery, once the realm of science fiction, is now technologically plausible and could upend long-standing hierarchies between cognitive and procedural specialties. Helpful links Healthcare In 2025: A Year Of Chaos, Confusion — But Little Improvement (Forbes) Healthcare In 2026: How Much Change Should We Expect? (Forbes) Will Your Next Surgeon Be A Robot? (Forbes) Monthly Musings on American Healthcare (RobertPearlMD.com) * * * Dr. Robert Pearl is the author of “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” 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. The post FHC #204: Why healthcare chaos didn’t lead to change & what comes next appeared first on Fixing Healthcare.