Episode #145: An anatomy of transformative leadership, with Robert Pearl MD (former CEO of The Permanente Group)


It’s always enlightening and inspiring to hear from Dr. Robert Pearl, our guest this episode. He tackles critical issues in healthcare head on and with unabashed honesty and unfiltered integrity. The topics you’ll be hearing about this episode include what Dr. Pearl refers to as “the middleman mentality”, which he argues is “killing American medicine” and limiting the potential of healthcare leadership, leading to an incrementalist approach. We’ll also hear his insightful perspective on how large disruptors like Amazon, CVS & Walmart are playing what he calls “healthcare’s long game”, and the impact that could have on legacy healthcare systems and providers.

Dr. Robert Pearl was the CEO of The Permanente Medical Group (Kaiser Permanente) from 1999-2017. In this role he led 12,000 physicians, 42,000 staff and was responsible for the nationally recognized medical care of over 5 million Kaiser Permanente members on both the west and east coasts.

Named one of Modern Healthcare’s 50 most influential physician leaders, Dr. Pearl serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business.  He is the author of two books, Mistreated: Why we think we’re getting good healthcare – and why we’re usually wrong, and Uncaring: How the culture of medicine kills doctors and patients.  He is also a podcast host and a regular contributor to Forbes.

In this episode, we’ll hear about:

  • The incrementalist “middleman” mindset and the type of transformative leadership that will be required for healthcare systems to thrive.
  • The short, middle and long game that large retailers are playing, and the impact this will have on hospital systems & provider groups.
  • A strong argument for why healthcare must move to capitation, and why it has to be embedded at the healthcare delivery level.

Dr. Pearl is not speaking from an idealistic or ivory tower perspective. He is speaking from decades of delivering some of the highest quality, most accessible, and most cost effective care we’ve witnessed in our country – at scale!  He does not sugarcoat the challenge that healthcare systems face in transitioning from an out-moded fee-for-service (FFS) business model to value-based payment. But, at the same time, he holds no punches in articulating how damaging the FFS based healthcare system is for patients, for providers, and for our communities. He also makes the point that the current system is actively being disrupted. Given those realities, the argument for incrementalism seems indefensible; and yet, that is where we find ourselves today. The solution, according to Dr. Pearl, is leadership. The type of forward-thinking leadership that is willing to make the tough decisions and willing to take the courageous steps to transform healthcare delivery.

Until Next Time, Be Well.

Zeev Neuwirth, MD