20 - Dr. Patrick Pulliam - Systemic Thinking and Leading the GA AAP

It finally happened: Chip Hart talks with his buddy, Paul Vanchiere of PMI. Paul and Chip developed a reputation after delivering 100s of webinars during COVID, but not everyone knows Paul's origin story. Find out where his inspiration comes from and where he thinks our community is headed.Learn more about Paul, his pediatric practice bootcamp, CPOE, PMI, and more at pediatricsupport.com.

Chip Hart provides a quick recap of the 2026 AAP NCE - what went well, what was interesting, and what we have to look forward to in the future. This is just a quick episode to extend the energy of the event.

Chip Hart talks with Dr. Brian Birch of Treasure Valley Children's Clinic in Idaho this week about leaving hospital administration to build an independent practice, why autonomy matters to both care quality and job satisfaction, and how deliberate planning can shape growth, succession, and culture. They also explore the narrative of pediatrics in an authenticity economy, the role of AI in preventive medicine, and what the future may hold for small practices.Learn more about Dr. Birch and Treasure Valley Children's Clinic here.

Chip celebrates the one year anniversary of the podcast by making a return to where it all began: the Florida AAP chapter conference! This time, he welcomes Dr. Shannon Fox-Levine to the microphone, and the two take a deep dive into the world of pediatrics, advocacy, vaccination efforts, and so much more. You don't want to miss Dr. Fox-Levine's story of taking a three-practice operation to the next level, as well as accomplishing astounding advocacy work, and politely refusing the concept of "work-life balance".Dr. Fox-Levine is the medical director for Bluebird Kids Health, the medical director for the Center for Child Counseling, is the former chair of the FCAAP Pediatric Council from 2014 to 2022, and currently serves the AAP at the national level on the Payer Advocacy and Advisory Committee.

On this episode of CTF, Dr. Tanya Altman discusses her journey from traditional pediatric practice to the Direct Primary Care (DPC) model, highlighting the challenges of the traditional healthcare system and the benefits of the DPC model. She also shares her experiences in authorship and consulting for various companies. She and Chip cover the multifaceted role of a pediatrician, including their motivation to help, innovative projects, challenges in dosing and medication safety, concerns in pediatric care, and the importance of early health interventions for longevity and well-being. Dr. Altmann also shares reflections on her career and advice for her younger self.Learn more about Dr. Altmann and her practice, Calabasas Pediatrics, by visiting her website: https://www.drtanya.com/

Dr. Katrina Skinner joins Chip this week to talk about building an independent pediatric practice from the ground up — and why the mindset of a CEO can be just as important as clinical expertise.Dr. Skinner shares how she went from a teenage hospital employee asking to shadow surgeons to opening her own practice immediately after residency, the lessons she learned about entrepreneurship and delegation, and why pediatricians need to spend more time doing what only they can do, as well as more of what they love to do. She also discusses her work creating Women in Pediatrics and Pediatric CEO, the importance of connection and community, and what she believes independent pediatric practice may look like in the years ahead.Learn more:Pediatric CEOWomen in PediatricsDr. Katrina Skinner

Dr. Christoph Diasio joins Chip Hart for a wide-ranging conversation about the challenges—and extraordinary promise—of modern pediatrics. He reflects on rising anti-science sentiment while finding hope in lifesaving advances such as RSV immunization, renewed public advocacy, and the enduring trust between pediatricians and families. Drawing on his experience building a fully integrated behavioral health program, Dr. Diasio explains why every child deserves access to mental healthcare and describes his effort to create a pediatric supergroup capable of expanding that model across North Carolina. Throughout the discussion, he makes a compelling case for physician leadership, greater investment in children, and the courage to keep asking, “Why not?”

In this episode of Charting the Future, Chip Hart sits down with Dr. Brian Bowman to reflect on a career shaped by curiosity, collaboration, and an unusually deep commitment to independent pediatrics. Dr. Bowman describes the growth of his North Carolina practice from a single office into a 17-clinician organization, and explains how he gradually became its go-to leader for billing, payer negotiations, quality programs, and practice operations. His perspective is clear: strong pediatric practices are built not merely by demanding better payment, but by demonstrating value, reducing administrative friction, sharing knowledge, and working collectively to improve care for children.As Dr. Bowman begins transitioning from partner to part-time employed physician, he offers a thoughtful and candid perspective on succession, identity, and knowing when to step away. He discusses preparing younger physicians to lead, leaving the practice in capable hands, and making room for travel, family, and new adventures while he is still physically able to enjoy them. He also reflects on the threats facing pediatrics—including vaccine misinformation and public policy disconnected from public health—and closes with practical wisdom for younger physicians: do not settle for a career or life that leaves you unhappy, and never underestimate how much pediatric care depends on empathy, communication, and the ability to meet families where they are.

Chip is joined at the GA AAP's Pediatrics By The Sea event by practice owner and incoming chapter president, Dr. Patrick Pulliam. Dr. Pulliam has a strong vision for the future of pediatrics and hopes to reorganize how the AAP works for and represents pediatricians and children, starting with his own chapter.

Check out the video version of this episode on our Youtube channel! In this episode of Charting the Future, Chip Hart sits down with Dr. Steven F. Hirsch, MD, FAAP founder and medical director of Hirsch Pediatrics, to explore what it means to build a pediatric practice with intention. From designing an office that feels more like a welcoming European village than a medical clinic to creating workflows that prioritize preventive care, patient convenience, and physician well-being, Dr. Hirsch shares the philosophy that has guided his independent practice from day one.The conversation spans everything from data-driven practice management and patient portals to burnout, vaccine confidence, mental health integration, and the future of independent pediatrics. Along the way, Dr. Hirsch makes a compelling case that thoughtful design of spaces, systems, and relationships can improve both the patient experience and the sustainability of pediatric care.