Ed and Ron were honored to have on the show Dr. Mark Vonnegut to discuss his 2022 book, The Heart of Caring: A Life in Pediatrics. Yes, Mark is the son of Kurt Vonnegut. This show was a firsthand look at the healthcare system, its impact on children, along with the rest of us.

Here are some brief show notes. Use these to follow along while listening to the show.

When did Dr. Mark know he wanted to be a doctor? Since a child, he knew he wanted to be a doctor but his commune in the 60’s got in the way first :)
The patient is king and if Dr. Mark doesn’t take care of them they go to other doctors. That was the simplified version of how 90% of doctors and hospitals looked at things in the early days of his career.
$6 used to be Dr. Mark’s overhead per visit. Today it is over $100 and attributable to compliance and performance metrics put on him by the insurers.
On medical care costs 30-40 years ago: “It had to be affordable when patients were paying out of pocket.” —Dr. Mark
Today it is virtually illegal for Dr. Mark to take care of someone without taking a co-payment. There is a tremendous amount of paperwork in front of the actual care.
Dr. Mark adopted electronic medical records 10 years before they were required because they can make medicine safer. Today they are billing machines weaponized by big hospitals and insurers.
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Dr. Mark’s is the last generation to experience a time when you could be a doctor and be your own boss. Today, 70% of doctors are actually employees.
Along the way, we have equated health INSURANCE with health CARE. Insurance shouldn’t pay for the mundane. Your car insurance doesn’t pay for oil changes or gasoline.
“Unnecessary administrative costs as much as unnecessary medical procedures. Probably more.” —Dr. Mark
Years ago, 90% of the medical diagnosis came from what the patient said. They physical exam confirmed it. The last few % points came from the lab. Today you troll the patient through the lab and see what bites.
“Most doctors have 10 minutes to see you at most. 40% of that time is spent entering data into a laptop with very little eye to eye contact. They come up with a number or diagnosis as their job.” —Dr. Mark
“Explanations of benefits” are evil bits of propaganda whereby the insurance company claims to have paid X when the cost was Y. —Dr. Mark
“Let the school nurses do immunizations because they don’t suffer fools.” —Dr. Mark
“The only thing dumber than making marijuana illegal is thinking it’s harmless to children.” —Dr. Mark
Hiring a social worker was the smartest thing Dr. Mark ever did. They made the whole pediatric practice much more efficient.
The baby formula shortage was a foreseeable and avoidable problem. Thankfully, Dr. Mark has some of the “fancy” formulas available for patients who really needed them.
We’d like to give a shout out to Blake Oliver (@blaketoliver) of EarmarkCPE.com (@EarmarkCPE) where you can get CPE credits for listening to podcasts!
“There are more similarities than dissimilarities in taking care of patients with Ebola compared to patients with Diabetes.” —Dr. Mark
“There shouldn’t be a revolving door between the pharmaceutical industry and the FDA.” —Dr. Mark
A big THANK YOU to Dr. Mark Vonnegut for joining us today. Check out his book, “The Heart of Caring”

Bonus Content is Available As Well

Did you know that each week after our live show, Ron and Ed take to the microphone for a bonus show? Typically, this bonus show is an extension of the live show topic (sometimes even with the same guest) and a few other pieces of news, current events, or things that have caught our attention.

This week was bonus episode #392 - “The Klessla”. Here are a few links discussed: