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JUNE 2023 | ISSUE 68

 

Summer is almost officially here, which means The New York Times bestsellers list is filled with great reads. One of them is a brilliantly written and moving novel from physician and author Abraham Verghese called “The Covenant of Water,” which currently sits at No. 3 on the NYT hardcover fiction list and is an Oprah book-club selection.

I’ve known Abraham as a long-time friend, colleague at the Stanford University School of Medicine, and source of inspiration. I marvel at his ability to create vivid and memorable images through his words. His writing is prose that flows like poetry, and I expect “Covenant” will continue climbing the charts.

Last week, I had the pleasure to interview Dr. Verghese on the Fixing Healthcare podcast. We spoke about his approach to both writing and medical practice. He told me that whether he’s wearing a writer’s hat or a doctor’s hat, “the gaze is the same.” While in the classroom or on rounds, he instructs medical-school students and residents to “read the body like a book.” He concluded our discussion by noting that the best healthcare leaders he has met all read fiction (not just nonfiction or biography).

I encourage you to read this new novel and experience its power. I promise you’ll be transported to another world and that you’ll return to “real life” with renewed passion and inspiration.

This month’s newsletter begins with a look at lessons from recent fiction and nonfiction literature. 


SUMMER READING

FIXING HEALTHCARE

The Covenant of Water & the practice of medicine 

Physician and author Abraham Verghese sees solutions differently than most. In this interview, we discuss his unique perspective on writing, end-of-life care and a range of topics. More »

BREAKING THE RULES

This physicians fiction can help change healthcare

Dichotomous thinking is destroying American medicine. This article borrows a page from Abraham Verghese, who rarely falls into the either/or trap. His way of thinking can transform healthcare. More »

ROBERTPEARLMD.COM

Healthcare lessons from the PEN Literary Gala  

I attended the 2023 PEN America gala as a Literary Host. The evening’s surprise guest, Salmon Rushdie, made his first public appearance since suffering a horrific attack on stage nine months ago. More »

UNFILTERED

‘Just One Heart’ by Jonathan Fisher   

Subtitled A Cardiologist’s Guide to Healing, Health, and Happiness, Dr. Fisher’s upcoming book is all about healing the heart. In this interview, we discuss the heart’s seven traits. More »

FIXING HEALTHCARE

‘Beyond The Walls’

Megatrends, movements and the market disruptors transforming American healthcare are the subjects of Zeev Neuwirth's upcoming book that reads like a collection of insights from the foremost leaders in medicine. More »

THE D.O.

Book review: ‘Uncaring’

In The D.O., Daniel J Walters writes, “As someone who has crossed the bridge from being a practitioner to being a patient, I’ll admit to losing some sleep after reading this book.” Click to see why. More »

LINKEDIN

Leading through change

It was a pleasure speaking with Talila Millman for her upcoming book “TRIUMPH: Leadership through Change, Uncertainty, and Transformation.” More »


HEALTHCARE HEADLINES

FORBES *EDITOR'S PICK*

Kaiser-Geisinger deal: What does it mean?

Kaiser Permanente has a long and ongoing reputation for nation-leading care. But what does its acquisition Geisinger mean for patients, doctors and health systems nationwide? More »

THE HEALTH CARE BLOG (THCB)

‘What did Kaiser get out of it?’

Listen to Matthew Holt, Jeff Goldsmith, Ian Morrison and Vince Kuraitis discuss Kaiser and Geisinger and “what the deal means about the model for the future of care delivery.” More »

DIVING DEEP

AI in medicine: the future

Since bursting onto the tech scene in November 2022, ChatGPT has become one of the hottest topics in the world of medicine. More »

MEDICINE: THE TRUTH

#CovidIsNotOver or is it? 

This episode looks at the end of the Covid-19 pandemic at the same time that the Twitter hashtag #CovidIsNotOver is trending. More »

AXIOS

End of COVID emergency leaves a black hole of data

I spoke with Sabrina Moreno about the expiration of the public health emergency and how ill-prepared our nation is for the next viral outbreak. More »


RESULTS: MAY SURVEY

Medical ethics in the age of AI 

A recent Pew Research survey found that Americans are worried about the ethical impact ChatGPT will have on medical practice. Last month’s reader survey asked for your thoughts on some of medicine’s biggest ethical questions. For each questions, participants had to choose whether they believed the activity to be ethical or unethical. Here are the results:

My thoughts: Musings readers felt the most unethical action—by far—was misleading patients about their cancer prognosis. Much has been written about the harm of providing false hope. And yet, one study found that only 5% of cancer patients with less than six months to live had an accurate understanding of their illness. In others, 69% of patients with metastatic lung cancer and 81% of people with advanced colorectal cancer thought they could still be cured. Whether this is the result of the doctor’s words or the patient’s manufacturing their own hope, we don’t know.

Other behaviors deemed unethical by the majority of readers included paying kidney donors and using IVF to select the sex of a child.

On one hand, the fear that paying for organs will force individuals with financial challenges to donate to wealthy recipients is understandable. But how ethical is it to let patients needing a transplant die unnecessarily? And if money is the issue for transplants, why limit parents who are wanting to take the risk from deciding whether to have a boy or a girl? Without doubt, ethical issues are complex and often contradictory.

Sociologists recognize that ethics are tied to culture. And culture can change. It will be interesting to see how many of these actions—currently prohibited—will be standard practice in 20 years.


NEW: JUNE READER SURVEY

Reading is fundamental

This edition of Monthly Musings on American Healthcare kicked off with a series of articles and podcasts about current and upcoming books.

Now, I’d like to know if you’re making time for reading, what kinds of books you enjoy and which are your all-time favorite books as an adult.

This survey contains two multiple choice questions and two open-field questions, which combined require approximately three minutes to complete. All multiple-choice responses are confidential. Open-field questions are optional and can be answered in the (public) comments section of the survey's website. Cumulative totals will be shared next month in this newsletter.

:: VOTE NOW ::

Parting thought: Commencement

June is graduation season. Many of you will attend these milestone ceremonies in support of family members, friends or colleagues.

I encourage you to think about how different these moments are today compared to three years ago. Many of this year’s graduates spent half or more of their high school, college or graduate-school years in virtual classrooms. They missed the opportunity to interact with friends and enjoy so many of the things that make these academic years special. Not only that. So much of that time was passed in fear and isolation.

A day of celebration can’t make up for all that has been lost, but hopefully we can all do our part to ensure these graduation ceremonies are as special as they can be. There is great beauty in new beginnings—in commencing toward life’s next chapter.

Let’s make this month a time of hope and renewed optimism. We owe that to the class of 2023. And to each other.

 

Best,

Robbie


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