As a second generation physician, Alan Pitt, MD, realizes the U.S. healthcare system is majorly flawed.
In America, receiving care is just as confusing as the hallways of a hospital, and navigating healthcare's twists and turns often confuses patients to the point they don't want to seek care or stick to their care regimes.
Capitalism further forces hospitals to focus their energy on driving profits, which often leaves the community's well-being in the dust.
"America is the wealthiest country in the world, yet we often bankrupt our citizens when they become ill," Dr. Pitt writes on his website. "We cure what seems incurable, but then abandon the many others."
To help healthcare consumers get up to speed on all things healthcare, Dr. Pitt — a neuroradiologist at the Barrow Neurological Institute, part of Dignity Health's Phoenix-based St. Joseph's Hospital and Medical Center — began a blog that has since evolved into the podcast "Healthcare Pittstop."
"I am super interested in how we are moving from fee-for-service to value-based care," he said. "[My podcast] is something I do out of passion. It started as a blog post trying to explain healthcare to those who are not in healthcare and kind of continued to evolve and change."
Dr. Pitt, who also advises a number of healthcare technology companies and serves as CMO of the telehealth vendor Avizia, recently spoke with Becker's Hospital Review about his podcast and the inspiration behind it.
Editor's notes: Responses have been lightly edited for clarity and length.
Question: What inspired you to start making your own podcast?
Dr. Alan Pitt: In many ways, healthcare has gone off the rails where things are not as we hoped they would be, and the podcast is my effort to educate the public about the malalignment of capitalism.
Unfortunately, [I believe] the way you get things done [in a capitalist society] is to create greater value at a lower cost, but there is a malalignment between that and the idea that I am always going to take care of the sick. That makes it super difficult to figure out how you build a healthcare system aligned with capitalism. I started a blog as an opportunity to talk about some of the malalignments I see in healthcare and the strange things we create. I am hoping to explain that to folks that aren't directly in healthcare so they have a better understanding of this system that is really important for all of us.
Q: Could you elaborate on some of those malalignments?
AP: Many times we have healthcare systems that have to make a profit and they end up doing things that are not aligned with the overall wellness of their communities. For instance, I trained for a year in Sweden. In Sweden, if you want care you go to the regional center of excellence where you have the best people for your problem that are organized in a regional way. Here in Phoenix, we have many cancer centers, all of which claim excellence. Patients are left to figure out where the good doctors are and how to get the best care, which makes no sense in terms of creating a market. To have a capitalistic market, you have to have transparency in terms of price and value, and we don't do that in healthcare. Fundamentally, that is one of the biggest problems we have. We just haven't figured out how to balance these bizarre ways that we think about healthcare.
Q: Who are some of the guests you bring on to your podcast, and what do some of the episodes touch on?
AP: Guests and episodes are varied. One of the things I struggle with is who is my audience and what should I be presenting. I am often asked to narrow it down to one disease, but I'm not as interested in disease as the way we care for each other and how difficult it is. I've interviewed people on the ethics side of things and] I have talked to people on the legislative side of things, like lobbyists in the telemedicine space.
Q: Can you describe one of your episodes to paint a picture of your podcast?
AP: An early guest I brought in was a good friend of mine. She was a hospital administrator who was also a nun. She talked about a woman who came in for an abortion at her hospital. As part of the ethics committee, she agreed to an abortion for this woman because both the mother and baby would die, and this was a mother of four. She thought that would be a meaningless loss. Because she agreed to an abortion at 10 or 12 weeks, whatever it was, she was ex-communicated from the church. I talked to her about how she grapples with being a religious authority and a hospital administrator at the same time because they are not always aligned.
Q: How can healthcare leaders take the information you discuss and benefit from it?
AP: Healthcare leaders need to figure out better ways to migrate healthcare from a fee-for-service world to a value-based world and that means looking at the population more holistically. I am a big believer in looking at the social determinants of care. In my dream, the place I work — Dignity Health — drops the word "health" and is just "Dignity" and it is a corporation that says, "My mission is to take care of the poor, and I know that it is not necessarily their health that drives this." Maybe it is giving someone a place to live or feeding them, so they won't continue to come in and out of my ER all the time. We need to begin to think about ways to stitch up all of the determinants of an outcome rather than the transaction.
For more, listen to Dr. Pitt's podcast here.
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