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August 20, 2025 54 mins

What do clunky insurance networks and subscription-style doctor care have in common? According to Preston Alexander, they’re both part of the same fixable puzzle. 

Healthcare advocate, writer, and author of The Healthcare Breakdown, Preston joins Dr. Michael Jerkins to explore where the U.S. healthcare system is broken and the quiet, practitioner-led shift already underway. 

They dig into how insurance-driven incentives frustrate doctors and patients, why employers hold untapped power to change costs, and the growing appeal of subscription models like direct primary care. Preston shares how technology can make care more direct and transparent, how large health systems’ misaligned incentives hold progress back, and why physician voices are essential in decision-making. 

From legislative barriers to the business skills doctors need to thrive, this conversation blends big-picture strategy with actionable ideas for building patient-centered, sustainable practices. Whether you’re a physician, employer, or simply curious about what’s driving healthcare costs, you’ll walk away with a clear-eyed view of what’s broken and what’s working. 

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