April 28, 2023 • 43 mins
In episode 92, Robert Pearl, MD, Forbes healthcare contributor, former CEO of The Permanente Medical Group, and author of two highly acclaimed books, "Mistreated" and "Uncaring," provides our audience with outstanding insight into the current and future state of the healthcare system. This episode delves into Pearl’s personal journey to becoming a healthcare leader, the importance of restructuring and repairing inadequacies within our healthcare system, ChatGPT and the innovation of AI in contemporary times, potential trends in the future of healthcare, the importance of prioritizing diversity, equity, and inclusion where Robert Pearl MD claims that “providing great care to everyone” is the ultimate goal, and the purpose of cultivating emotional intelligence in systems of health.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
From Ubian Studios. You're listening toUnsugarcoated with Aliya bringing you interviews with public
figures and inspirational people speaking on selfimprovement with empowering themes. And I'm your
host, ali Elaneus. Hello,and welcome back to another episode of your
favorite social good podcast. I amso happy to be here today and I'm
(00:20):
very excited to bring an amazing guestto your attention. I hope that you
are ready for a conversation that hasthe power to transform the way that you
think about healthcare. Today, we'rediving into this topic that affects us regardless
of our profession. As you allknow, we've been saying all season long,
emotional intelligence. We all know howimportant it is to connect with our
(00:44):
doctors and healthcare providers, and emotionalintelligence is a key component of that connection.
By cultivating emotional intelligence, healthcare providerscan better connect with their patients foster
a deeper understanding with their unique needsand experiences. This lead to improved outcomes,
greater patient satisfaction, and ultimately amore compassionate and equitable healthcare system for
(01:07):
all. Our guest today is aleading expert on this topic and has the
knowledge and experience to show us howwe can all become more emotionally intelligent in
our healthcare interactions, whether as patients, family members, or healthcare professionals.
So get ready to be inspired aswe explore the power of emotional intelligence and
discover how it can revolutionize healthcare forthe better, no matter your background or
(01:32):
profession. So let's go. Let'sbring on our guests. Doctor Pearl is
a renowned advocate for healthcare reform andhas led over ten thousand physicians and thirty
eight thousand staff in providing top notchmedical care for ten million Kaiser Permanente members
on the West and East coasts.He is a clinical professor of plastic Surgery
(01:53):
at Stanford University School of Medicine anda faculty member at the Stanford Graduate School
of Business, where he teaches courseson strategy and leadership. Doctor pearls the
author of two highly acclaimed books,Mistreated and Uncaring, and host the popular
podcast Fixing Healthcare and Coronavirus The Truth. He has been named one of Modern
(02:15):
Healthcare's fifty most Influential Physician leaders andis a frequent keynote speaker at healthcare and
medical technology conferences. We can't waitto learn more from him about this vision
for transforming American healthcare. Ladies andgentlemen, please welcome doctor Robert Pearl.
Hello, doctor Pearl, how areyou today? Thank you so much for
(02:36):
joining us. My pleasure is greatto be here, to be on your
excellent show. Thank you. Well, I know you're zooming in today because
you are so busy traveling the worldspeaking everywhere. Would you mind telling the
audience where you're talking to us fromtoday. Well, today, I'm speaking
to you from New York, butyesterday I was in Las Vegas and two
four thousand in San Diego. So, as you say, this is conference
(02:58):
season and I have a chance totaken a lot of events. But I
was really looking forward to today eventhough we have to be three thousand miles
apart. Ah. Well, Ifeel that you are right here with me,
and thank you for that. Youknow, for the audience, some
people know you, I'm similar toyou. I love that my background has
a lot of different phases and experiencesthat obviously contribute to who we are as
(03:19):
individuals. And one of those littlethings twenty years ago was excuse me,
actually, more specifically, seventeen yearsago, seventeen years ago, I was
working with the DOCKET. I wasactually one of the lead implementation advisors for
what we call the DOCKET, theDoctor's Office Quality Initiative through California, with
the hope of leading other doctors intothe new information technology era. Right,
(03:43):
And this was an exciting time.You and I briefly work together, and
since then you've continued to do amazingthings. You were the CEO of Kaiser
and now you know, if peoplecheck out your LinkedIn as I have,
and get you know, subscribe toyour newsletters, they find you are very
passionate and in your advocating for agreater, more emotionally intelligent healthcare system.
(04:11):
Tell me how that, how thatstarted? You know, you were practicing
doing all these incredible things. Youknow, tell us about the journey to
where you are today. Well,it's actually a fascinating journey in that I
went to college going way back when, to be a professor, and I
was going to study I was studyingphilosophy at the time, and my hero
(04:34):
a tremendous academic who ended up becomingthe chairman of Read College, but he
didn't get tenure because of his politicalviews. I decided I wanted to go
into something with no politics, andthat was going to be healthcare. What
(04:55):
did I know as a seventeen yearold, It was remarkable how night eve
I was. But I think thatsame passion to make the world better,
to have a purpose, to affectthe lives of individuals, their health,
their relationships, that drives me.As you say, I trained with the
(05:16):
medical school at Yale, and Iwent to Standford my residency, and my
passion was fixing children with cleft lipand cleft palate, which is the same
thing to see the smile on aparent's face after their child who has had
this terrible deformity that would probably makeit a social outcast now looks normal and
(05:38):
can have the same life as allthe other children. But out of that,
I came to a recognition that nomatter how hard clinicians, doctors,
and nurses work, and they workvery hard, and how dedicated they are,
there are major problems in the Americanhealthcare system. Ones that create distance
(06:00):
between doctors and patients, between patientsand nurses, Ones that make psychological harm
a constant factor in both healthcare forproviders and for patience. Ways that families
suffer as a result of medical errors. In my first book, I talk
(06:21):
about the death of my father froma medical era. From the economics.
There are so many things wrong thatI dedicated this. I'll call it the
third part of my career, afterbeing the CEO and Kaiser Permanente, now
to trying to improve American medicine foreveryone. That's an incredible story in you
(06:43):
know, before we get into howemotional intelligence revolutionizes patient care in the healthcare
system, you know, I actuallywant to refer to an excerpt in your
book, and it's I loved itbecause it really hit home. And it's
especially because we are still moving througha pandemic in the different phases as we
(07:05):
all, you know, we knewthat there would be and we're still in
that, you know what I stillconsider a post phase or still a phase
of it. We still have peoplegetting sick. But anyways, your excerpt
says this, perhaps no system washit harder than healthcare. Hospitals overflowed,
equipment grew scarce, and the veryfoundation of American medicine crumbled beneath our feet.
(07:28):
As we look back at this acutelydifficult moment in medicine, it is
easy to forget that the trouble hadbeen brewing for some time. Independent research
had by the early two thousands ratedthe US healthcare system the most expensive and
least effective in the developed world,a label that stands to this day.
Doctor Pearl, you know, howcan emotional intelligence revolutionize patient care in the
(07:53):
healthcare system and what steps need tobe taken to integrate it effectively. The
first part to me of emotional intelligenceis being able to recognize and accept the
truth. And that's hard to do. You know, we tend to have
a part of ourselves that we hideand others hide, and we tend to
(08:16):
have a certain amount of distance.But the emotional intelligence to really understand another
person, I think is somewhat lacking. And so when I look at that
healthcare system, we have to accept, as I noted in that quote,
it's broken. In fact, theCommonwealth Fund came out with its newest evaluation
(08:37):
and once again we were the mostexpensive, almost double every other nation,
and yet our outcomes, and I'mtalking about life expectancy, childhood mortality,
maternal mortality, we were the worstamongst the thirteen most industrialized nations, And
(08:58):
so I think we have to acceptthat. At the same time, we
have to accept the fact that thepeople providing the care, that doctors and
the nurses, they're very dedicated.This is not the problem of they're not
caring. This is a problem inthis system. And so when you have
a system that I think is broken, but it doesn't want to acknowledge that,
(09:24):
you need to have this emotional intelligencebecause what ends up happening is there's
a distance, when there's a quality, lack of truth, the lack of
authenticity, then you end up withdistance and emotional intelligence suffers. You you
can't get close enough for that otherperson. You can't put your hands close
(09:46):
enough into the problems that are there. So how does emotional intelligence apply?
Well, the first thing is thedoctor patient relationship, because both the patient
has to have the trust in thisposition and the physician has to be able
to really understand the patient as anindividual. And when that's all rushed and
(10:07):
all you can do is feel likeyou're on a treadmill, what happens to
emotional intelligence It starts to disappear.Look at providers of care and the COVID
was a really great example. Youknow, I talked to physicians who lost
four patients in a day. Imaginewhat that's like, I mean, for
a doctor having a patient die that'sterrible storm one day, it's unbearable,
(10:31):
and yet how comfortable with physicians totalk about the pain and the suffering that
they had as a result of theirinability to save these lives. I think
when you start looking about emotional intelligence, you start looking at the totality of
people and what we see, andwe can talk about some more, were
(10:52):
disparities and care based upon race.We see social determinants of health having to
do with socio economics, having todo with geographic factors leading to poor outcomes.
You look at something like chronic diseasesthat account for seventy percent of the
deaths in the United States today,and we do a poor job. And
(11:16):
what emotional intelligence would say, weshould be able to feel the pain of
this other individual. And to alarge extent, what I would say is
that when it comes to the Americanhealth system, I'd like to use the
word it's anesthetized. It's not feeling. It's feeling the individual pain, but
it's not feeling the pain of everyone. Medicine, by its history, has
(11:41):
had a lot of denial. Itmakes physicians heroes. I mean, how
else do you take care of patientsknowing that they have COVID early in the
pandemic, when we had no treatments, no immunizations that can protect the physician,
where we ran out of equipment anddoctors have to put garbage bags in
place of gowns and solad lids inplace of masks, and yet they kept
(12:05):
giving that care, right, Andthat's the heroic part. But the ways
that we don't see the problems,that's where I think we need to magnify
and elevate that emotional intelligence that you'vebeen talking about on the show. Oh,
I love that, and I agree. You know, I'm I'm a
three time cancer survivor and I actually, as a result, lived with several
(12:26):
chronic illnesses, autoimmune diseases, frobymiyagia, pots, just you know,
to be fun, to make mylife interesting, you know. And I
often have to share with people thatbecause they're like, well, how are
you able to do all the thingsthat you do? And it's because I
say, I advocate for myself ina healthcare system that at times can overlook
me or say, oh, you'retoo you know, there was once upon
(12:48):
a time I was too young foreverything. Then he became I was too
old for everything. Right now I'mgetting old. So we're just kind of,
you know, reasoning off why Iwould be feeling that way, instead
of actually getting to the heart ofthe issue. You know, how do
you suggest patience in this day andage with you know? Which with that,
I have to say a lot ofoverwhelmed physicians and care providers, right
(13:09):
Like, I recently had an encounterwith one of my doctors, and I
had noted that it took three weeksfor them to get back to me,
and he just was like, well, my dad died and this and that,
and I was It was a veryinteresting interaction because I wasn't used to
a physician handling it that way.However, being emotionally intelligent, I just
that I hear you, and Iunderstand that you're overwhelmed as part of you
(13:30):
know everything that's happening, but Istill need your care. How do you
feel people who go into an encounterwith a healthcare provider can themselves be more
emotionally aware advocate, but also stillrespect the process of what it means to
deliver healthcare to individuals. So theemotional intelligence makes me ask what's important to
(13:52):
you, what are the things thatyou're worried about, what are the things
that you think are very valuable?And understanding the ways that I can be
of positive force in your life tomagnify the good and to minimize the bad
and vice versa. And that's whatI would say. I think that we've
lost a lot of that in medicinebecause of the broken system that exists.
(14:15):
But that doesn't mean as a patientyou have to just accept it. Most
intelligence is not just taking all thebad. It's been figuring out how you
can have the interaction. So howmight you approach it? Well, the
first thing is to organize your thoughtsbefore you see the physician. Why are
you going there, what is theproblem? How can you provide the information
(14:35):
to make the other person's job easier. The physician's job is to help you
get better, and how can youhave all of that organized in a way
that's going to work. But onthe other hand, I also think that
physicians need to recognize that you've gotto listen to the patient. And the
data says that it's something like twentyseconds of the patient's starting to talk,
(14:56):
physicians interrupt the individual and what's themessage that's given. I don't really care
that much what you have to say. I just have a job to do,
boxes to check. At the endof the day. Healthcare professionals are
our heroes, but they're not Superman. They don't have X ray vision,
you know, they're not psychic.So it's you know, there is a
(15:16):
relationship and a transfer of information thatcan help really make it a better experience.
So I love that you said that. Thank you so much. I
am going to shift a little bitmore to like the leadership and the aspect.
You know, Balancing the need forhigh quality healthcare with cost, effectiveness
and accessibility can obviously be a difficultchallenge that I'm sure you can speak to
(15:39):
all day long. What innovative solutionsand approaches can healthcare organizations use to navigate
this challenge and provide the best carefor their patients. When I think about
how do you improve care? Ithink about three p's number one. There's
process, how is that care deliver? There's a product, what technology can
(16:03):
be used to improve that care that'sprovided? And there's performance. How are
the individuals in your organization doing allof those things? And they're all frucial
and emotional intelligence actually fits into allthree. A lot of the improvements when
I was CEO and Kaiser Permanente thatwe did. We're changing process of keeping
(16:29):
an example, you see a primarycare physician for a problem, and that
individual believes that he or she needssome specialty expertise. What usually happens They
tell you go home and call thespecialist office and make an appointment. That
could be a week from now,six weeks from now. So what do
(16:51):
we decide to do? We said, the patient is not sleeping at night
because they're worried. How do wesolve the problem now? And we change
the process. So rather than justsaying go see a specialist, we brought
the specialist into the room. Nowwe get the product using technology, using
video. Because what we know inmedicine is that somewhere between eighty nine of
(17:14):
the diagnosis is actually made by theconversation, not by the physical examination,
and so we can solve fifty sixtyseventy percent of problems there and then so
that's the opportunity to understand the emotionalintelligence through the patient. And what's interesting
about it is that it improves notjust the clinical outcomes, not just the
(17:38):
patient's status, faction but it alsoactually lowers cost because the added visit is
a wasted visit if the problem canbe solved immediately. At that particular time,
when I was first selected CEO,I gave a talk up the Oregon
Health Sciences Building and I was walkingthe halls after my talk, before I
(18:00):
went to the airport, I sawthis sign. It said big letters of
course the top quality service costs,and the bottom is small font that said
pick any two. And I thinkthat idea is outdated. It's a twentieth
century notion. Today we can giveall three, but we have to decide
we're willing to make those changes.And that's where the leadership point you're coming
(18:22):
up with really ties in, becausepeople are afraid of change. People are
worried that somehow it's not going tobe very good. They're fearful that they'll
never get home and see their familyif they have to do all these new
tasks. They don't understand why whatthey were doing before just wasn't good enough.
And as a leader, you haveto have an emotional intelligence to feel
(18:45):
their pain, to feel their fearand be able to respond to it,
to explain why to have them trustyou. But this maybe in the short
run will be a bit probably mattic, because it always is learning a new
skill. But once you do it'sreally gonna work. You know. You
and I are talking a little bitbefore the show about chat GPT and the
(19:07):
work you do it USC teaching peoplein the film school about it and using
it. That's there. This isgoing to revolutionize medicine, but it's not.
It is a computer application, butit's used by human beings. And
so how do we understand the fearThey're going to have doctors they're gonna be
(19:30):
afraid they're gonna lose their job,Patients are gonna be afraid that some major
mistake will get made. And howdo we not dismissed the fear but work
with the fear? And the samething around performance. My sense as a
leader is that people are very motivated. They want to do the right job,
but they want to do the rightjob for the right purpose. And
(19:53):
that's the job that a leader has. What's the why of what we're doing
just really tied back into health andin medicine today, I think we've lost
that. I think we focus onnot the economics, by which I mean
the affordability to the patient, that'svital. But we see it as a
revenue creation approach and we have tobring back the humanism. And part of
(20:19):
that process is to improve the processes, to bring in the new technological products,
and to help people to perform evenbetter because that's what they want to
do. What do you see somethinglike chat GPT being able to do?
And with regards to the concerns ofpeople saying, oh, it's going to
take my job, I mean,in reality, there are things chat GPT
(20:40):
cannot do. Right, So whenit comes to healthcare, like what do
you think that it can do?And what do you think it can't do?
What's out right now to me isjust it's a It's like a toy
computer that a kid uses as opposedto a big name frame machine. This
is not this is just the beginningand what we know and technology Moore's Law
(21:00):
tells us that the power increases everytwo years. So by ten years from
now, it'll be thirty two timesmore powerful the way I have today,
and by twenty years a thousand timesmore powerful. So no one to be
thinking about what exists right now.It's just, you know, it's fun
and it's a practice toy. Bythe way, it's actually pretty good compared
(21:21):
to whatever else existed, right,but it is nothing like what is coming.
But I'll give you three ways thatI think it will be different.
And understand what CHAT with a GPTstands for. It's a generative pre trained
transformer. What does that mean pretraining is it's loaded with all the information.
Everything on the internet, every textbook, every journal, every obscure diagnosis
(21:45):
that's been made is in that system. When it starts. Transformer means that
it's going to have a series byseries. It's actually I think in the
billions of instructions about how to answerquestions related to that pre training to that
information and then it generates a response. So that's how the technology works.
(22:08):
So as a patient, you havea lot of questions. You want to
know what's going on. It's hardto get those answers you mentioned before.
Having chronic diseases. Chronic diseases,as you will know, affect you every
day. That's why they're called chronic. Doctors in general see you every three
to four months. What happens inbetween chat GPT can monitor that. If
(22:30):
you have diabetes, as a glucometercan use that information if you have high
blood pressure an electric cuff. Youcan use that information because all the tools
that are there, and it cancontinually measure it, and it can update
you as the patient every single day. You don't have to worry about what's
going on. You can know what'sgoing on. It can help you with
(22:51):
lifestyle issues, diet, exercise.I think it will empower patients in ways
they want to be empowered, butthey're not yet today. And the third
thing, and again, I suspectthat in all the treatment you've received,
you've been in hospitals. I knowa lot of people say, you're gonna
be admitted to a hospital, bringsomeone along to protect you. Medical errors
(23:11):
and living in general of medicines andone and four hospitalized patients in the United
States have a medical error. ChatGPT can prevent it. The way the
methodology works is it predicts. Thereason it can write all these essays is
it's learned using these rules to predictin the most appropriate. Next word,
it does the same thing. Whatwe know is when doctors and nurses do
(23:33):
things that there's a right way todo it. Evidence space that's been shown
to reduce the two hundred thousand medicalerrors every year that happen, and it
actually can tell the clinician you justskipped the step. I think it's gonna
totally change medicine. I think ifit's sort of like the iPhone. Who
(23:56):
would have thought when the iPhone cameout that it would be crucial for how
you drive because it will tell youwhere to go, or would be the
way that you find your lover orthe future by going to one of the
apps that are there, or itallows you to arrange your vacation, all
the ways that we use that technologyto us it was a mobile telephone,
but it's not that at all.Chat Gypt will be exactly the same,
(24:19):
and yet you know all the thingsthat it will do, it still won't
replace, to be honest, thehuman care element. You know how we
experience healthcare right absolutely, And thisis where the emotional intelligence will never be
replaced. I mean, computers willbe able to mimic it. And that's
what I'm sure you've followed along allthe debate in the media about this whether
(24:41):
it can actually have feelings and havea personality and fall in love with you.
But let's skip all out right.It can't do those things. It's
a machine. And you need ahuman being to have that relationship, you
know, I had. I havea friend who told me a quote actually
a few years ago that I justlove it. She said to me,
(25:03):
when I pick a doctor, Iwant that individual to spend at least an
hour with me, and then Inever want to say that personal again in
person. I want to use telemedicine, I want to use technical tools.
I want my healthcare to be managed. But in that hour, I got
to build that trust. And asyou said, the emotional intelligence is how
(25:26):
do we understand the uniqueness of thatindividual, And that's what that hour's about.
And so to me, the technology, the chat GPT, will be
the assistant to the physician. Therebe a lot of tasks that it does
that doctors do today, but theprimary relationship you have is going to be
with another human being. It won'tbe with a software application. That's incredible.
(25:49):
And by the way, I honestlyI'm smiling from ear to ear because
I just love the way that youspeak on this. You know, you
are so informative, you are soknowledgeable, and on top of it,
I can feel your passionate about it. I can feel the way that you
want to help the world clearly,you know, especially people overcome their fear
and overcome these challenges. I meanI do remember taking some you know,
(26:15):
nurses live with an electronic medical recordsystem, for example, and I mean
they would cry, some of themwould break down in tears. Doctor pro,
I'm sure you've seen it because justthat change. But you know,
a week later, after they haddeveloped an understanding and then once they found
their rhythm, they were fine,and then they would come back and say,
Okay, I see how this isimproving our process. I see how
(26:36):
this is helping me get home ontime to my kids for dinner, you
know, which is obviously is youknow one of the other big complaints in
healthcare is they put so much work, they sacrifice so much time, you
know, with their families to providecare. So I love that you say
that, what obviously we have theAI and that component in technology. What
trends do you anticipate in the nextfive to ten years, and how do
(27:00):
you think healthcare systems should position themselvesto adapt and respond to these changes effectively.
I believe that the biggest change we'regoing to see is the movement away
from fee for service to what Icall capitation, which is paying a group
of physicians and hospitals a set amountof dollars to provide the care. And
(27:21):
as a consequence of that, italigns the incentives with what you want is
a patient, you don't want tohave a heart attack, You want someone
to help you prevent it. Youwant them there if you have the heart
attack, but you don't want tohave it in the first place. You
want to make sure that they've donethe things to keep you maximally safe.
You'd like them to prevent the cancerbefore it happens, and then what it
(27:42):
happened, you'd like them to diagnoseit as quickly as possible, and you
want them to do the procedure withthe fewest complications. And that aligns the
economic incentives. I teach you theStanford Graduate School of Business and the graduate
of the Medical School, and inthe business school we talk a lot about
incentives, and in every other industrywe recognize how incentives and the context of
(28:06):
which work has done changes perception andimpacts behavior, and we just don't acknowledge
it in medicine. But it's equallytrue. I think the biggest question is
who's going to drive this process ofchange. I personally believe I'd like to
see it driven by the clinicians,by the people inside the system, the
(28:26):
doctors and the nurses. I'd liketo see it driven by healthcare professionals who
are expert. I'd have that relationshipwith patients. Unfortunately, I'm not seeing
that. I wish I were.I'm just not seeing the change happen.
There's a guy named Peter Drucker wasa very famous leadership guru, and he
said, to take on something new, you have to give up something old.
(28:47):
And I'm not sure we're willing insidethe healthcare system to give up the
things that need to be given upto make the change, to move from
fee for service, which rewards volumeeven when it doesn't add any value to
a capitated system. I think alot of the change may come from the
retail giants, and this is Amazon, CBS, Walmart. People who are
(29:10):
listening and watching, who maybe readthe news in the medical world the business
world have seen that these companies havetaken on new additional companies that allow them
to provide the totality of medical care. At Amazon, that brought a medical
group called One Medical. You havecvs that purchase a medical group called oak
(29:30):
Street and another one called Signify.You have Walmart that signed to deal with
United Health. And I think thatthese and I'll call them consumer focused companies
because when we get order a productfrom Amazon, we have a wide choice,
we have a good price, it'sdelivered on time. You know,
(29:51):
people who show up at Walmart willfind a good product of the price they're
able and willing to pay. SoI think these organizations will be very consumer
focused. The questions really going tobe is that what's going to be best
for both the providers of the careand actually in the end for patients.
So I think that still is tobe determined. But as I look at
(30:11):
the landscape shifting, I'm fearful actuallythat a lot of the control that I
believe should and I would like tosee come out of the system come directly
from the clinicians is now going tobe seeded to a different set of organizations
who in the end the values willbe different. It still may deliver a
(30:32):
better product. I'm not saying it'sdefinitely gonna be worse, but it's not
as good as I believe that itpossibly could be. That's what I see
happening over the next five to tenyears. You know, when you talk
about the system being broken, Iyou know, when I owned my medical
billing company and practice management, Ihandled a lot of the billing, and
I familiar with the negotiations for contractfor HMOs and PPOs and back in the
(30:55):
epos and all the different things,and you know, and us from my
perspective, you learned to see howa lot of healthcare providers overcharged. Billing
was a very you know, aprocess in which I want to bill as
high as I can so I canbecause I know I'm going to get cut
this much money, and I wantto try and make, you know,
make what I can. But youknow, and I only say that because
(31:17):
I feel, like you said,the processes has been going a muck for
so long, and it's just beenerror after or error building and not fixing
it. And I genuinely would lovefor it to come to that point,
which is I love that you encouragethat type of you know, leadership and
addressing these issues so that we couldat least somewhere in this find a good
starting place to to rebuild it properlyor to change it so that it can
(31:42):
help everyone as a as a healthcareas healthcare organization excuse me, effectively addressed
diversity, equity and inclusion both intheir hiring practice and in delivering healthcare to
services. How you know, howcan they do that effectively rather to their
for their patients. This is wherewhy I think the notion of purpose is
(32:06):
so crucial, and I think purposeand emotional intelligence fit together because purpose gives
you the right framework that then allowsyou to have that emotional intelligence to be
able to be open, authentic,to be able to interact with people in
(32:28):
a way that is open and honest. That sits there. You know,
going back to what you just saidabout your experience, if you were going
to try to recruit a doctor andyou gave the physician two choices, I
have two organizations, so you canjoin either one the one over here.
We're really going to teach you howto do a lot of things that are
(32:49):
not necessary. We're going to teachyou how to make a lot of money
by taking care of people are sick, but let them get sick in the
first place, so you can takecare of them. We're going to teach
you how to generate a lot ofdollars and over hear you say this organization
when teach how to keep people healthy, how to avoid heart attacks and strokes,
how to have people have better relationships, less isolation, to be able
(33:12):
to do more activities, and tohave a greater fulfilling life. And that's
how you'll generate your money, whichyou think you can recruit too more easily.
My experiences, it's the one,the second one, and the same
thing I think is true when youtalk about inclusion and issues with discrimination and
bias. I think that as humanbeings, the negative feelings are ones that
(33:39):
undermine us. They erode the purpose. And so I think if you start
with the idea that says providing greatcare to everyone is what we're trying to
do, not just to those whoare wealthy, those who look like us,
so those who have a background likeus, to be whatever it's going
to be, I think you startto motivate people in ways that just you
(34:04):
can't do when money is the factor. You know. In the business school
I teach, I often tell peopleincentives, monetary incentives, particularly big ones,
always produce change, but rarely thechange you want. What moves.
The change you want is to beable to talk about purpose, to connect
with people, to touch them insome way. It's got to be authentic.
(34:28):
They'll see right through you if you'remaking it all up. But that's
what I see within the kinds oforganizations you're describing. The reason they work
is because the purpose is there.It's not a business imperative, it's not
a legal requirement. It's just theright thing to do. And when you
have that as the motivation, peopleexperience it and they really want it and
(34:52):
they'll go the extra mile, notbecause they're paid to do so, not
because they're told to do so,not because it's in the Maple Manual,
because they know it's the right thingto do. Aspiring healthcare leaders can learn
so much from your experience. Whatadvice do you have for developing emotional intelligence
(35:12):
and leadership skills for themselves aside fromtaking your courses. Yeah, Well,
the first thing I think is youhave to become comfortable with yourself, and
I think a lot of people arenot. You can do that by working
at it. You can do thatthrough therapy, you can do that through
friends and relationships. There's a lotof ways you can get to it.
But if you're not comfortable with whoyou are, you're not honest with who
(35:35):
you are. You can't get emotionalintelligence because you're always hiding, you're always
protecting. And so that's what Ithink is I'll call it the first step
along the process. I think thesecond step is you have to have a
genuine interest and caring for the peopleyou lead it. And again, these
are nothings. You can try tofake them. And there's some people out
(35:58):
there who are probably pretty good.They're a little bit sociopathic, is how
I would label them. I don'twant to mention them by name or your
show will get sued, but peopleprobably can guess who some of them are.
But I would say that as thatauthenticity of individuals. And then you
work at it. You work atit, you practice it. You have
to be willing to take feedback,you have to be able to acknowledge when
(36:21):
you don't know what to do,and you have to spend a lot of
time. I used to spend itwhen I was the CEO. I spent
very little time in the regional office. I spent most of my time out
in medical centers, talking to doctors, talking to the nurses, talking to
(36:43):
patients, trying to be able tounderstand the world through their eyes. I
think that emotional intelligence to me isthis ability to simultaneously see the world through
your eyes also see it through theeyes of others, to recognize that their
(37:05):
view in your view are equally valuable. And that a lot of success.
A lot that success is business relationships, friendships, teams, it doesn't matter
where you look, is getting acohesion between those two. And I'll go
back again to this notion of purpose. Purpose becomes so important because you and
(37:28):
I may have a lot of differencesas individuals, but the chances of us
sharing a common purpose, I thinkthat's pretty high. And as they say,
I think it's a magnet to attractother people. To'll always be people
in a business, in an organizationwho are only out for themselves, and
the job of a leader is tofind them and request that they leave.
(37:51):
But of people they share a commonnessand being able to maximize that is how
I think you have to do it, and you need to look for it.
And as they say, I thinkit's a skill you can develop,
and it's a skill you can getothers to help you to develop. I
love that. And you know we'veonly got a few more minutes with you,
so I'll ask you this last question. As a thought leader in healthcare,
(38:15):
how do you envision the future ofhealthcare and what role do you see
yourself playing in that. One ofmy fears about the future healthcare is that
the default position is going to be, well, what all labels a two
tier system of medicine, and wealready have a two tier system of medicine.
(38:38):
The people who are who don't getthe same care as people who have
the money. But I'm fearful thatover time that's going to spread because what
we'll see is that those who don'thave very much conceivably will drop lower and
lower, whereas those people who canafford to buy what they want to buy
the healthcare that they need will havethe dollars to do so and not fall
(39:05):
down along with those who can't.So that's my big fear. So my
big hope is that we will findthe ways, and that's why that is
what I'm dedicated to. That's thepurpose that I have Right now. I
can see the ways it could happen. I can see the waste that's in
the current system, and that ifwe extracted that waste. You know,
(39:28):
you mentioned in my book and Caring, how the culture medicine kills doctors and
patients. And by the way,if any of your listeners and doers want
more information, to go to mywebsite, Robert Pearl, MD. But
it was December twenty nineteen, COVIDhad not yet come to the United States,
and the federal government announced or predictedthat healthcare costs we're going to go
five and a half percent a yearfor the next decade. I did the
(39:52):
math. You compound five and ahalf percent, you apply it against the
base at the time of three pointnine trillion dollars, and it said that
by twenty thirty our country to bespending two and a half trillion more dollars
that we were spending for the samehealthcare that was giving poor results at least
(40:12):
at the national level. You know, I said to myself, Wow,
imagine we took two and a halftrillion dollars and we've prevented chronic disease,
two and a half trillion dollars weinvested in taking care of the social determinants
of health, or the racial disparities, or even preschool education for kindergarten kids.
There are so many ways I couldcome up with to use that two
(40:35):
and a half trillion dollars and thehealthcare system. No one spoke out and
said that's inappropriate. This is theculture of medicine that says what we're doing
today is the best that we canAnd again I'll say, I think the
people are working as hard as theycan, but the results that we're getting
don't match either the dollars or theamount of work. And so it's changing
(40:59):
all of that. It's why Ido the writing, that's why I'm so
privileged to be on your show,It's why I have my own podcasts.
I think changing all of that wouldmake a massive difference, and letting us,
letting medicine move from a sick caresystem to a true health system,
(41:20):
not just a health care but ahealth system. And if we can improve
the health of people, that's thephysical health, the mental health, the
emotional health, I think that wewould solve many of the problems that are
plaguing our country today. That's mypurpose, that's my vision, and I'm
so glad that you're coming along onthe journey with me because I know you
and I both want to land inthe same place. Agreed, and you
(41:44):
know, thank you so much.I could not agree with you more.
I am so grateful and thankful thatwe've reconnected after all these years. And
then I get to be, youknow, an observer and a collaborator because
I, you know, from thefirst thing I started reading, when it
came, I was like, ohmy gosh, I just I love it.
So thank you so much. Iappreciate you. I appreciate your time
(42:05):
because I know you're so busy,but doctor Pearl, I do look forward
to getting you in LA one day. We're going to get you in the
studio next time you're down here,you let me know, because honestly,
I really do appreciate you in yourtime. Thank you so much for joining
us today. Thank you again,it's been a great time. Thank you,
And to our audience at home,what a thought provoking and inspiring conversation
we've had today. It is clearthat emotional intelligence is a critical component of
(42:30):
healthcare and one that we should allstrive to cultivate in our personal and professional
lives. Doctor Pearl, thank youfor sharing your knowledge and experiences with us
and showing us the power of emotionalintelligence and healthcare. Whether you're a healthcare
provider, a patient, or justsomeone who cares deeply about the future of
healthcare. The lessons we've learned todayare powerful and actionable. By recognizing and
(42:52):
managing our own emotions, we cancreate deeper connections with those around us,
leading to better outcomes, satisfaction,and a more compassionate and equitable healthcare system.
So let's commit to being more emotionallyintelligent in our healthcare interactions, and
let's continue to explore new ideas andperspectives that can transform the system itself for
(43:13):
the better. Thank you so muchfor joining us today. Don't forget to
check out our website as well.Www. Unsugarcoated media dot com. Sign
up for this newsletter so you canstay connected and find out what's going on
with us. We'll see you onthe next episode in the meantime. Thanks
for letting us be unsugarcoated. Takecare
From Ubian Studios. You're listening toUnsugarcoated with Aliya bringing you interviews with public
figures and inspirational people speaking on selfimprovement with empowering themes. And I'm your
host, ali Elaneus. Hello,and welcome back to another episode of your
favorite social good podcast. I amso happy to be here today and I'm
(00:20):
very excited to bring an amazing guestto your attention. I hope that you
are ready for a conversation that hasthe power to transform the way that you
think about healthcare. Today, we'rediving into this topic that affects us regardless
of our profession. As you allknow, we've been saying all season long,
emotional intelligence. We all know howimportant it is to connect with our
(00:44):
doctors and healthcare providers, and emotionalintelligence is a key component of that connection.
By cultivating emotional intelligence, healthcare providerscan better connect with their patients foster
a deeper understanding with their unique needsand experiences. This lead to improved outcomes,
greater patient satisfaction, and ultimately amore compassionate and equitable healthcare system for
(01:07):
all. Our guest today is aleading expert on this topic and has the
knowledge and experience to show us howwe can all become more emotionally intelligent in
our healthcare interactions, whether as patients, family members, or healthcare professionals.
So get ready to be inspired aswe explore the power of emotional intelligence and
discover how it can revolutionize healthcare forthe better, no matter your background or
(01:32):
profession. So let's go. Let'sbring on our guests. Doctor Pearl is
a renowned advocate for healthcare reform andhas led over ten thousand physicians and thirty
eight thousand staff in providing top notchmedical care for ten million Kaiser Permanente members
on the West and East coasts.He is a clinical professor of plastic Surgery
(01:53):
at Stanford University School of Medicine anda faculty member at the Stanford Graduate School
of Business, where he teaches courseson strategy and leadership. Doctor pearls the
author of two highly acclaimed books,Mistreated and Uncaring, and host the popular
podcast Fixing Healthcare and Coronavirus The Truth. He has been named one of Modern
(02:15):
Healthcare's fifty most Influential Physician leaders andis a frequent keynote speaker at healthcare and
medical technology conferences. We can't waitto learn more from him about this vision
for transforming American healthcare. Ladies andgentlemen, please welcome doctor Robert Pearl.
Hello, doctor Pearl, how areyou today? Thank you so much for
(02:36):
joining us. My pleasure is greatto be here, to be on your
excellent show. Thank you. Well, I know you're zooming in today because
you are so busy traveling the worldspeaking everywhere. Would you mind telling the
audience where you're talking to us fromtoday. Well, today, I'm speaking
to you from New York, butyesterday I was in Las Vegas and two
four thousand in San Diego. So, as you say, this is conference
(02:58):
season and I have a chance totaken a lot of events. But I
was really looking forward to today eventhough we have to be three thousand miles
apart. Ah. Well, Ifeel that you are right here with me,
and thank you for that. Youknow, for the audience, some
people know you, I'm similar toyou. I love that my background has
a lot of different phases and experiencesthat obviously contribute to who we are as
(03:19):
individuals. And one of those littlethings twenty years ago was excuse me,
actually, more specifically, seventeen yearsago, seventeen years ago, I was
working with the DOCKET. I wasactually one of the lead implementation advisors for
what we call the DOCKET, theDoctor's Office Quality Initiative through California, with
the hope of leading other doctors intothe new information technology era. Right,
(03:43):
And this was an exciting time.You and I briefly work together, and
since then you've continued to do amazingthings. You were the CEO of Kaiser
and now you know, if peoplecheck out your LinkedIn as I have,
and get you know, subscribe toyour newsletters, they find you are very
passionate and in your advocating for agreater, more emotionally intelligent healthcare system.
(04:11):
Tell me how that, how thatstarted? You know, you were practicing
doing all these incredible things. Youknow, tell us about the journey to
where you are today. Well,it's actually a fascinating journey in that I
went to college going way back when, to be a professor, and I
was going to study I was studyingphilosophy at the time, and my hero
(04:34):
a tremendous academic who ended up becomingthe chairman of Read College, but he
didn't get tenure because of his politicalviews. I decided I wanted to go
into something with no politics, andthat was going to be healthcare. What
(04:55):
did I know as a seventeen yearold, It was remarkable how night eve
I was. But I think thatsame passion to make the world better,
to have a purpose, to affectthe lives of individuals, their health,
their relationships, that drives me.As you say, I trained with the
(05:16):
medical school at Yale, and Iwent to Standford my residency, and my
passion was fixing children with cleft lipand cleft palate, which is the same
thing to see the smile on aparent's face after their child who has had
this terrible deformity that would probably makeit a social outcast now looks normal and
(05:38):
can have the same life as allthe other children. But out of that,
I came to a recognition that nomatter how hard clinicians, doctors,
and nurses work, and they workvery hard, and how dedicated they are,
there are major problems in the Americanhealthcare system. Ones that create distance
(06:00):
between doctors and patients, between patientsand nurses, Ones that make psychological harm
a constant factor in both healthcare forproviders and for patience. Ways that families
suffer as a result of medical errors. In my first book, I talk
(06:21):
about the death of my father froma medical era. From the economics.
There are so many things wrong thatI dedicated this. I'll call it the
third part of my career, afterbeing the CEO and Kaiser Permanente, now
to trying to improve American medicine foreveryone. That's an incredible story in you
(06:43):
know, before we get into howemotional intelligence revolutionizes patient care in the healthcare
system, you know, I actuallywant to refer to an excerpt in your
book, and it's I loved itbecause it really hit home. And it's
especially because we are still moving througha pandemic in the different phases as we
(07:05):
all, you know, we knewthat there would be and we're still in
that, you know what I stillconsider a post phase or still a phase
of it. We still have peoplegetting sick. But anyways, your excerpt
says this, perhaps no system washit harder than healthcare. Hospitals overflowed,
equipment grew scarce, and the veryfoundation of American medicine crumbled beneath our feet.
(07:28):
As we look back at this acutelydifficult moment in medicine, it is
easy to forget that the trouble hadbeen brewing for some time. Independent research
had by the early two thousands ratedthe US healthcare system the most expensive and
least effective in the developed world,a label that stands to this day.
Doctor Pearl, you know, howcan emotional intelligence revolutionize patient care in the
(07:53):
healthcare system and what steps need tobe taken to integrate it effectively. The
first part to me of emotional intelligenceis being able to recognize and accept the
truth. And that's hard to do. You know, we tend to have
a part of ourselves that we hideand others hide, and we tend to
(08:16):
have a certain amount of distance.But the emotional intelligence to really understand another
person, I think is somewhat lacking. And so when I look at that
healthcare system, we have to accept, as I noted in that quote,
it's broken. In fact, theCommonwealth Fund came out with its newest evaluation
(08:37):
and once again we were the mostexpensive, almost double every other nation,
and yet our outcomes, and I'mtalking about life expectancy, childhood mortality,
maternal mortality, we were the worstamongst the thirteen most industrialized nations, And
(08:58):
so I think we have to acceptthat. At the same time, we
have to accept the fact that thepeople providing the care, that doctors and
the nurses, they're very dedicated.This is not the problem of they're not
caring. This is a problem inthis system. And so when you have
a system that I think is broken, but it doesn't want to acknowledge that,
(09:24):
you need to have this emotional intelligencebecause what ends up happening is there's
a distance, when there's a quality, lack of truth, the lack of
authenticity, then you end up withdistance and emotional intelligence suffers. You you
can't get close enough for that otherperson. You can't put your hands close
(09:46):
enough into the problems that are there. So how does emotional intelligence apply?
Well, the first thing is thedoctor patient relationship, because both the patient
has to have the trust in thisposition and the physician has to be able
to really understand the patient as anindividual. And when that's all rushed and
(10:07):
all you can do is feel likeyou're on a treadmill, what happens to
emotional intelligence It starts to disappear.Look at providers of care and the COVID
was a really great example. Youknow, I talked to physicians who lost
four patients in a day. Imaginewhat that's like, I mean, for
a doctor having a patient die that'sterrible storm one day, it's unbearable,
(10:31):
and yet how comfortable with physicians totalk about the pain and the suffering that
they had as a result of theirinability to save these lives. I think
when you start looking about emotional intelligence, you start looking at the totality of
people and what we see, andwe can talk about some more, were
(10:52):
disparities and care based upon race.We see social determinants of health having to
do with socio economics, having todo with geographic factors leading to poor outcomes.
You look at something like chronic diseasesthat account for seventy percent of the
deaths in the United States today,and we do a poor job. And
(11:16):
what emotional intelligence would say, weshould be able to feel the pain of
this other individual. And to alarge extent, what I would say is
that when it comes to the Americanhealth system, I'd like to use the
word it's anesthetized. It's not feeling. It's feeling the individual pain, but
it's not feeling the pain of everyone. Medicine, by its history, has
(11:41):
had a lot of denial. Itmakes physicians heroes. I mean, how
else do you take care of patientsknowing that they have COVID early in the
pandemic, when we had no treatments, no immunizations that can protect the physician,
where we ran out of equipment anddoctors have to put garbage bags in
place of gowns and solad lids inplace of masks, and yet they kept
(12:05):
giving that care, right, Andthat's the heroic part. But the ways
that we don't see the problems,that's where I think we need to magnify
and elevate that emotional intelligence that you'vebeen talking about on the show. Oh,
I love that, and I agree. You know, I'm I'm a
three time cancer survivor and I actually, as a result, lived with several
(12:26):
chronic illnesses, autoimmune diseases, frobymiyagia, pots, just you know,
to be fun, to make mylife interesting, you know. And I
often have to share with people thatbecause they're like, well, how are
you able to do all the thingsthat you do? And it's because I
say, I advocate for myself ina healthcare system that at times can overlook
me or say, oh, you'retoo you know, there was once upon
(12:48):
a time I was too young foreverything. Then he became I was too
old for everything. Right now I'mgetting old. So we're just kind of,
you know, reasoning off why Iwould be feeling that way, instead
of actually getting to the heart ofthe issue. You know, how do
you suggest patience in this day andage with you know? Which with that,
I have to say a lot ofoverwhelmed physicians and care providers, right
(13:09):
Like, I recently had an encounterwith one of my doctors, and I
had noted that it took three weeksfor them to get back to me,
and he just was like, well, my dad died and this and that,
and I was It was a veryinteresting interaction because I wasn't used to
a physician handling it that way.However, being emotionally intelligent, I just
that I hear you, and Iunderstand that you're overwhelmed as part of you
(13:30):
know everything that's happening, but Istill need your care. How do you
feel people who go into an encounterwith a healthcare provider can themselves be more
emotionally aware advocate, but also stillrespect the process of what it means to
deliver healthcare to individuals. So theemotional intelligence makes me ask what's important to
(13:52):
you, what are the things thatyou're worried about, what are the things
that you think are very valuable?And understanding the ways that I can be
of positive force in your life tomagnify the good and to minimize the bad
and vice versa. And that's whatI would say. I think that we've
lost a lot of that in medicinebecause of the broken system that exists.
(14:15):
But that doesn't mean as a patientyou have to just accept it. Most
intelligence is not just taking all thebad. It's been figuring out how you
can have the interaction. So howmight you approach it? Well, the
first thing is to organize your thoughtsbefore you see the physician. Why are
you going there, what is theproblem? How can you provide the information
(14:35):
to make the other person's job easier. The physician's job is to help you
get better, and how can youhave all of that organized in a way
that's going to work. But onthe other hand, I also think that
physicians need to recognize that you've gotto listen to the patient. And the
data says that it's something like twentyseconds of the patient's starting to talk,
(14:56):
physicians interrupt the individual and what's themessage that's given. I don't really care
that much what you have to say. I just have a job to do,
boxes to check. At the endof the day. Healthcare professionals are
our heroes, but they're not Superman. They don't have X ray vision,
you know, they're not psychic.So it's you know, there is a
(15:16):
relationship and a transfer of information thatcan help really make it a better experience.
So I love that you said that. Thank you so much. I
am going to shift a little bitmore to like the leadership and the aspect.
You know, Balancing the need forhigh quality healthcare with cost, effectiveness
and accessibility can obviously be a difficultchallenge that I'm sure you can speak to
(15:39):
all day long. What innovative solutionsand approaches can healthcare organizations use to navigate
this challenge and provide the best carefor their patients. When I think about
how do you improve care? Ithink about three p's number one. There's
process, how is that care deliver? There's a product, what technology can
(16:03):
be used to improve that care that'sprovided? And there's performance. How are
the individuals in your organization doing allof those things? And they're all frucial
and emotional intelligence actually fits into allthree. A lot of the improvements when
I was CEO and Kaiser Permanente thatwe did. We're changing process of keeping
(16:29):
an example, you see a primarycare physician for a problem, and that
individual believes that he or she needssome specialty expertise. What usually happens They
tell you go home and call thespecialist office and make an appointment. That
could be a week from now,six weeks from now. So what do
(16:51):
we decide to do? We said, the patient is not sleeping at night
because they're worried. How do wesolve the problem now? And we change
the process. So rather than justsaying go see a specialist, we brought
the specialist into the room. Nowwe get the product using technology, using
video. Because what we know inmedicine is that somewhere between eighty nine of
(17:14):
the diagnosis is actually made by theconversation, not by the physical examination,
and so we can solve fifty sixtyseventy percent of problems there and then so
that's the opportunity to understand the emotionalintelligence through the patient. And what's interesting
about it is that it improves notjust the clinical outcomes, not just the
(17:38):
patient's status, faction but it alsoactually lowers cost because the added visit is
a wasted visit if the problem canbe solved immediately. At that particular time,
when I was first selected CEO,I gave a talk up the Oregon
Health Sciences Building and I was walkingthe halls after my talk, before I
(18:00):
went to the airport, I sawthis sign. It said big letters of
course the top quality service costs,and the bottom is small font that said
pick any two. And I thinkthat idea is outdated. It's a twentieth
century notion. Today we can giveall three, but we have to decide
we're willing to make those changes.And that's where the leadership point you're coming
(18:22):
up with really ties in, becausepeople are afraid of change. People are
worried that somehow it's not going tobe very good. They're fearful that they'll
never get home and see their familyif they have to do all these new
tasks. They don't understand why whatthey were doing before just wasn't good enough.
And as a leader, you haveto have an emotional intelligence to feel
(18:45):
their pain, to feel their fearand be able to respond to it,
to explain why to have them trustyou. But this maybe in the short
run will be a bit probably mattic, because it always is learning a new
skill. But once you do it'sreally gonna work. You know. You
and I are talking a little bitbefore the show about chat GPT and the
(19:07):
work you do it USC teaching peoplein the film school about it and using
it. That's there. This isgoing to revolutionize medicine, but it's not.
It is a computer application, butit's used by human beings. And
so how do we understand the fearThey're going to have doctors they're gonna be
(19:30):
afraid they're gonna lose their job,Patients are gonna be afraid that some major
mistake will get made. And howdo we not dismissed the fear but work
with the fear? And the samething around performance. My sense as a
leader is that people are very motivated. They want to do the right job,
but they want to do the rightjob for the right purpose. And
(19:53):
that's the job that a leader has. What's the why of what we're doing
just really tied back into health andin medicine today, I think we've lost
that. I think we focus onnot the economics, by which I mean
the affordability to the patient, that'svital. But we see it as a
revenue creation approach and we have tobring back the humanism. And part of
(20:19):
that process is to improve the processes, to bring in the new technological products,
and to help people to perform evenbetter because that's what they want to
do. What do you see somethinglike chat GPT being able to do?
And with regards to the concerns ofpeople saying, oh, it's going to
take my job, I mean,in reality, there are things chat GPT
(20:40):
cannot do. Right, So whenit comes to healthcare, like what do
you think that it can do?And what do you think it can't do?
What's out right now to me isjust it's a It's like a toy
computer that a kid uses as opposedto a big name frame machine. This
is not this is just the beginningand what we know and technology Moore's Law
(21:00):
tells us that the power increases everytwo years. So by ten years from
now, it'll be thirty two timesmore powerful the way I have today,
and by twenty years a thousand timesmore powerful. So no one to be
thinking about what exists right now.It's just, you know, it's fun
and it's a practice toy. Bythe way, it's actually pretty good compared
(21:21):
to whatever else existed, right,but it is nothing like what is coming.
But I'll give you three ways thatI think it will be different.
And understand what CHAT with a GPTstands for. It's a generative pre trained
transformer. What does that mean pretraining is it's loaded with all the information.
Everything on the internet, every textbook, every journal, every obscure diagnosis
(21:45):
that's been made is in that system. When it starts. Transformer means that
it's going to have a series byseries. It's actually I think in the
billions of instructions about how to answerquestions related to that pre training to that
information and then it generates a response. So that's how the technology works.
(22:08):
So as a patient, you havea lot of questions. You want to
know what's going on. It's hardto get those answers you mentioned before.
Having chronic diseases. Chronic diseases,as you will know, affect you every
day. That's why they're called chronic. Doctors in general see you every three
to four months. What happens inbetween chat GPT can monitor that. If
(22:30):
you have diabetes, as a glucometercan use that information if you have high
blood pressure an electric cuff. Youcan use that information because all the tools
that are there, and it cancontinually measure it, and it can update
you as the patient every single day. You don't have to worry about what's
going on. You can know what'sgoing on. It can help you with
(22:51):
lifestyle issues, diet, exercise.I think it will empower patients in ways
they want to be empowered, butthey're not yet today. And the third
thing, and again, I suspectthat in all the treatment you've received,
you've been in hospitals. I knowa lot of people say, you're gonna
be admitted to a hospital, bringsomeone along to protect you. Medical errors
(23:11):
and living in general of medicines andone and four hospitalized patients in the United
States have a medical error. ChatGPT can prevent it. The way the
methodology works is it predicts. Thereason it can write all these essays is
it's learned using these rules to predictin the most appropriate. Next word,
it does the same thing. Whatwe know is when doctors and nurses do
(23:33):
things that there's a right way todo it. Evidence space that's been shown
to reduce the two hundred thousand medicalerrors every year that happen, and it
actually can tell the clinician you justskipped the step. I think it's gonna
totally change medicine. I think ifit's sort of like the iPhone. Who
(23:56):
would have thought when the iPhone cameout that it would be crucial for how
you drive because it will tell youwhere to go, or would be the
way that you find your lover orthe future by going to one of the
apps that are there, or itallows you to arrange your vacation, all
the ways that we use that technologyto us it was a mobile telephone,
but it's not that at all.Chat Gypt will be exactly the same,
(24:19):
and yet you know all the thingsthat it will do, it still won't
replace, to be honest, thehuman care element. You know how we
experience healthcare right absolutely, And thisis where the emotional intelligence will never be
replaced. I mean, computers willbe able to mimic it. And that's
what I'm sure you've followed along allthe debate in the media about this whether
(24:41):
it can actually have feelings and havea personality and fall in love with you.
But let's skip all out right.It can't do those things. It's
a machine. And you need ahuman being to have that relationship, you
know, I had. I havea friend who told me a quote actually
a few years ago that I justlove it. She said to me,
(25:03):
when I pick a doctor, Iwant that individual to spend at least an
hour with me, and then Inever want to say that personal again in
person. I want to use telemedicine, I want to use technical tools.
I want my healthcare to be managed. But in that hour, I got
to build that trust. And asyou said, the emotional intelligence is how
(25:26):
do we understand the uniqueness of thatindividual, And that's what that hour's about.
And so to me, the technology, the chat GPT, will be
the assistant to the physician. Therebe a lot of tasks that it does
that doctors do today, but theprimary relationship you have is going to be
with another human being. It won'tbe with a software application. That's incredible.
(25:49):
And by the way, I honestlyI'm smiling from ear to ear because
I just love the way that youspeak on this. You know, you
are so informative, you are soknowledgeable, and on top of it,
I can feel your passionate about it. I can feel the way that you
want to help the world clearly,you know, especially people overcome their fear
and overcome these challenges. I meanI do remember taking some you know,
(26:15):
nurses live with an electronic medical recordsystem, for example, and I mean
they would cry, some of themwould break down in tears. Doctor pro,
I'm sure you've seen it because justthat change. But you know,
a week later, after they haddeveloped an understanding and then once they found
their rhythm, they were fine,and then they would come back and say,
Okay, I see how this isimproving our process. I see how
(26:36):
this is helping me get home ontime to my kids for dinner, you
know, which is obviously is youknow one of the other big complaints in
healthcare is they put so much work, they sacrifice so much time, you
know, with their families to providecare. So I love that you say
that, what obviously we have theAI and that component in technology. What
trends do you anticipate in the nextfive to ten years, and how do
(27:00):
you think healthcare systems should position themselvesto adapt and respond to these changes effectively.
I believe that the biggest change we'regoing to see is the movement away
from fee for service to what Icall capitation, which is paying a group
of physicians and hospitals a set amountof dollars to provide the care. And
(27:21):
as a consequence of that, italigns the incentives with what you want is
a patient, you don't want tohave a heart attack, You want someone
to help you prevent it. Youwant them there if you have the heart
attack, but you don't want tohave it in the first place. You
want to make sure that they've donethe things to keep you maximally safe.
You'd like them to prevent the cancerbefore it happens, and then what it
(27:42):
happened, you'd like them to diagnoseit as quickly as possible, and you
want them to do the procedure withthe fewest complications. And that aligns the
economic incentives. I teach you theStanford Graduate School of Business and the graduate
of the Medical School, and inthe business school we talk a lot about
incentives, and in every other industrywe recognize how incentives and the context of
(28:06):
which work has done changes perception andimpacts behavior, and we just don't acknowledge
it in medicine. But it's equallytrue. I think the biggest question is
who's going to drive this process ofchange. I personally believe I'd like to
see it driven by the clinicians,by the people inside the system, the
(28:26):
doctors and the nurses. I'd liketo see it driven by healthcare professionals who
are expert. I'd have that relationshipwith patients. Unfortunately, I'm not seeing
that. I wish I were.I'm just not seeing the change happen.
There's a guy named Peter Drucker wasa very famous leadership guru, and he
said, to take on something new, you have to give up something old.
(28:47):
And I'm not sure we're willing insidethe healthcare system to give up the
things that need to be given upto make the change, to move from
fee for service, which rewards volumeeven when it doesn't add any value to
a capitated system. I think alot of the change may come from the
retail giants, and this is Amazon, CBS, Walmart. People who are
(29:10):
listening and watching, who maybe readthe news in the medical world the business
world have seen that these companies havetaken on new additional companies that allow them
to provide the totality of medical care. At Amazon, that brought a medical
group called One Medical. You havecvs that purchase a medical group called oak
(29:30):
Street and another one called Signify.You have Walmart that signed to deal with
United Health. And I think thatthese and I'll call them consumer focused companies
because when we get order a productfrom Amazon, we have a wide choice,
we have a good price, it'sdelivered on time. You know,
(29:51):
people who show up at Walmart willfind a good product of the price they're
able and willing to pay. SoI think these organizations will be very consumer
focused. The questions really going tobe is that what's going to be best
for both the providers of the careand actually in the end for patients.
So I think that still is tobe determined. But as I look at
(30:11):
the landscape shifting, I'm fearful actuallythat a lot of the control that I
believe should and I would like tosee come out of the system come directly
from the clinicians is now going tobe seeded to a different set of organizations
who in the end the values willbe different. It still may deliver a
(30:32):
better product. I'm not saying it'sdefinitely gonna be worse, but it's not
as good as I believe that itpossibly could be. That's what I see
happening over the next five to tenyears. You know, when you talk
about the system being broken, Iyou know, when I owned my medical
billing company and practice management, Ihandled a lot of the billing, and
I familiar with the negotiations for contractfor HMOs and PPOs and back in the
(30:55):
epos and all the different things,and you know, and us from my
perspective, you learned to see howa lot of healthcare providers overcharged. Billing
was a very you know, aprocess in which I want to bill as
high as I can so I canbecause I know I'm going to get cut
this much money, and I wantto try and make, you know,
make what I can. But youknow, and I only say that because
(31:17):
I feel, like you said,the processes has been going a muck for
so long, and it's just beenerror after or error building and not fixing
it. And I genuinely would lovefor it to come to that point,
which is I love that you encouragethat type of you know, leadership and
addressing these issues so that we couldat least somewhere in this find a good
starting place to to rebuild it properlyor to change it so that it can
(31:42):
help everyone as a as a healthcareas healthcare organization excuse me, effectively addressed
diversity, equity and inclusion both intheir hiring practice and in delivering healthcare to
services. How you know, howcan they do that effectively rather to their
for their patients. This is wherewhy I think the notion of purpose is
(32:06):
so crucial, and I think purposeand emotional intelligence fit together because purpose gives
you the right framework that then allowsyou to have that emotional intelligence to be
able to be open, authentic,to be able to interact with people in
(32:28):
a way that is open and honest. That sits there. You know,
going back to what you just saidabout your experience, if you were going
to try to recruit a doctor andyou gave the physician two choices, I
have two organizations, so you canjoin either one the one over here.
We're really going to teach you howto do a lot of things that are
(32:49):
not necessary. We're going to teachyou how to make a lot of money
by taking care of people are sick, but let them get sick in the
first place, so you can takecare of them. We're going to teach
you how to generate a lot ofdollars and over hear you say this organization
when teach how to keep people healthy, how to avoid heart attacks and strokes,
how to have people have better relationships, less isolation, to be able
(33:12):
to do more activities, and tohave a greater fulfilling life. And that's
how you'll generate your money, whichyou think you can recruit too more easily.
My experiences, it's the one,the second one, and the same
thing I think is true when youtalk about inclusion and issues with discrimination and
bias. I think that as humanbeings, the negative feelings are ones that
(33:39):
undermine us. They erode the purpose. And so I think if you start
with the idea that says providing greatcare to everyone is what we're trying to
do, not just to those whoare wealthy, those who look like us,
so those who have a background likeus, to be whatever it's going
to be, I think you startto motivate people in ways that just you
(34:04):
can't do when money is the factor. You know. In the business school
I teach, I often tell peopleincentives, monetary incentives, particularly big ones,
always produce change, but rarely thechange you want. What moves.
The change you want is to beable to talk about purpose, to connect
with people, to touch them insome way. It's got to be authentic.
(34:28):
They'll see right through you if you'remaking it all up. But that's
what I see within the kinds oforganizations you're describing. The reason they work
is because the purpose is there.It's not a business imperative, it's not
a legal requirement. It's just theright thing to do. And when you
have that as the motivation, peopleexperience it and they really want it and
(34:52):
they'll go the extra mile, notbecause they're paid to do so, not
because they're told to do so,not because it's in the Maple Manual,
because they know it's the right thingto do. Aspiring healthcare leaders can learn
so much from your experience. Whatadvice do you have for developing emotional intelligence
(35:12):
and leadership skills for themselves aside fromtaking your courses. Yeah, Well,
the first thing I think is youhave to become comfortable with yourself, and
I think a lot of people arenot. You can do that by working
at it. You can do thatthrough therapy, you can do that through
friends and relationships. There's a lotof ways you can get to it.
But if you're not comfortable with whoyou are, you're not honest with who
(35:35):
you are. You can't get emotionalintelligence because you're always hiding, you're always
protecting. And so that's what Ithink is I'll call it the first step
along the process. I think thesecond step is you have to have a
genuine interest and caring for the peopleyou lead it. And again, these
are nothings. You can try tofake them. And there's some people out
(35:58):
there who are probably pretty good.They're a little bit sociopathic, is how
I would label them. I don'twant to mention them by name or your
show will get sued, but peopleprobably can guess who some of them are.
But I would say that as thatauthenticity of individuals. And then you
work at it. You work atit, you practice it. You have
to be willing to take feedback,you have to be able to acknowledge when
(36:21):
you don't know what to do,and you have to spend a lot of
time. I used to spend itwhen I was the CEO. I spent
very little time in the regional office. I spent most of my time out
in medical centers, talking to doctors, talking to the nurses, talking to
(36:43):
patients, trying to be able tounderstand the world through their eyes. I
think that emotional intelligence to me isthis ability to simultaneously see the world through
your eyes also see it through theeyes of others, to recognize that their
(37:05):
view in your view are equally valuable. And that a lot of success.
A lot that success is business relationships, friendships, teams, it doesn't matter
where you look, is getting acohesion between those two. And I'll go
back again to this notion of purpose. Purpose becomes so important because you and
(37:28):
I may have a lot of differencesas individuals, but the chances of us
sharing a common purpose, I thinkthat's pretty high. And as they say,
I think it's a magnet to attractother people. To'll always be people
in a business, in an organizationwho are only out for themselves, and
the job of a leader is tofind them and request that they leave.
(37:51):
But of people they share a commonnessand being able to maximize that is how
I think you have to do it, and you need to look for it.
And as they say, I thinkit's a skill you can develop,
and it's a skill you can getothers to help you to develop. I
love that. And you know we'veonly got a few more minutes with you,
so I'll ask you this last question. As a thought leader in healthcare,
(38:15):
how do you envision the future ofhealthcare and what role do you see
yourself playing in that. One ofmy fears about the future healthcare is that
the default position is going to be, well, what all labels a two
tier system of medicine, and wealready have a two tier system of medicine.
(38:38):
The people who are who don't getthe same care as people who have
the money. But I'm fearful thatover time that's going to spread because what
we'll see is that those who don'thave very much conceivably will drop lower and
lower, whereas those people who canafford to buy what they want to buy
the healthcare that they need will havethe dollars to do so and not fall
(39:05):
down along with those who can't.So that's my big fear. So my
big hope is that we will findthe ways, and that's why that is
what I'm dedicated to. That's thepurpose that I have Right now. I
can see the ways it could happen. I can see the waste that's in
the current system, and that ifwe extracted that waste. You know,
(39:28):
you mentioned in my book and Caring, how the culture medicine kills doctors and
patients. And by the way,if any of your listeners and doers want
more information, to go to mywebsite, Robert Pearl, MD. But
it was December twenty nineteen, COVIDhad not yet come to the United States,
and the federal government announced or predictedthat healthcare costs we're going to go
five and a half percent a yearfor the next decade. I did the
(39:52):
math. You compound five and ahalf percent, you apply it against the
base at the time of three pointnine trillion dollars, and it said that
by twenty thirty our country to bespending two and a half trillion more dollars
that we were spending for the samehealthcare that was giving poor results at least
(40:12):
at the national level. You know, I said to myself, Wow,
imagine we took two and a halftrillion dollars and we've prevented chronic disease,
two and a half trillion dollars weinvested in taking care of the social determinants
of health, or the racial disparities, or even preschool education for kindergarten kids.
There are so many ways I couldcome up with to use that two
(40:35):
and a half trillion dollars and thehealthcare system. No one spoke out and
said that's inappropriate. This is theculture of medicine that says what we're doing
today is the best that we canAnd again I'll say, I think the
people are working as hard as theycan, but the results that we're getting
don't match either the dollars or theamount of work. And so it's changing
(40:59):
all of that. It's why Ido the writing, that's why I'm so
privileged to be on your show,It's why I have my own podcasts.
I think changing all of that wouldmake a massive difference, and letting us,
letting medicine move from a sick caresystem to a true health system,
(41:20):
not just a health care but ahealth system. And if we can improve
the health of people, that's thephysical health, the mental health, the
emotional health, I think that wewould solve many of the problems that are
plaguing our country today. That's mypurpose, that's my vision, and I'm
so glad that you're coming along onthe journey with me because I know you
and I both want to land inthe same place. Agreed, and you
(41:44):
know, thank you so much.I could not agree with you more.
I am so grateful and thankful thatwe've reconnected after all these years. And
then I get to be, youknow, an observer and a collaborator because
I, you know, from thefirst thing I started reading, when it
came, I was like, ohmy gosh, I just I love it.
So thank you so much. Iappreciate you. I appreciate your time
(42:05):
because I know you're so busy,but doctor Pearl, I do look forward
to getting you in LA one day. We're going to get you in the
studio next time you're down here,you let me know, because honestly,
I really do appreciate you in yourtime. Thank you so much for joining
us today. Thank you again,it's been a great time. Thank you,
And to our audience at home,what a thought provoking and inspiring conversation
we've had today. It is clearthat emotional intelligence is a critical component of
(42:30):
healthcare and one that we should allstrive to cultivate in our personal and professional
lives. Doctor Pearl, thank youfor sharing your knowledge and experiences with us
and showing us the power of emotionalintelligence and healthcare. Whether you're a healthcare
provider, a patient, or justsomeone who cares deeply about the future of
healthcare. The lessons we've learned todayare powerful and actionable. By recognizing and
(42:52):
managing our own emotions, we cancreate deeper connections with those around us,
leading to better outcomes, satisfaction,and a more compassionate and equitable healthcare system.
So let's commit to being more emotionallyintelligent in our healthcare interactions, and
let's continue to explore new ideas andperspectives that can transform the system itself for
(43:13):
the better. Thank you so muchfor joining us today. Don't forget to
check out our website as well.Www. Unsugarcoated media dot com. Sign
up for this newsletter so you canstay connected and find out what's going on
with us. We'll see you onthe next episode in the meantime. Thanks
for letting us be unsugarcoated. Takecare
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
NFL Daily with Gregg Rosenthal
Gregg Rosenthal and a rotating crew of elite NFL Media co-hosts, including Patrick Claybon, Colleen Wolfe, Steve Wyche, Nick Shook and Jourdan Rodrigue of The Athletic get you caught up daily on all the NFL news and analysis you need to be smarter and funnier than your friends.
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.