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Fixing America's 'Sick Care' System

If you’ve been to the doctor recently, you probably know that America’s health care system, as good as it is, could really stand some improvements. That’s our topic on the Lean to the Left podcast with a top expert in healthcare, Firouz Daneshgari, M.D.

Dr. Daneshgari is a surgeon-scientist, educator and entrepreneur who has worked at the University of Colorado, Cleveland Clinic and Case Western Reserve University. He has published more than 200 scientific articles, led numerous scientific and clinical panels, and trained hundreds of students, residents, fellows and junior faculty.

Dr. Daneshgari, known as "FD", is author of “Health Guardianship, the Remedy to the Sick Care System,” a must read if you want to understand what’s gone wrong with American healthcare and would like to see a solution.

Following implementation of the Affordable Care Act and approval of its mandates by the Supreme Court, Dr. Daneshgari founded Bow Tie Medical to create systematic innovations for bringing efficiency and value into the healthcare delivery system.

"We are the most expensive healthcare system in the world," he says on the show. "We are spending twice, three to 500% more than our European or Japanese counterpart.. The reason we are the most expensive is because the healthcare is delivered through 5,000 hospitals that they have become financial institutions, that they use delivery of the clinical services as a revenue generating activities and with that they generate about 50% of waste."

That waste, he says, includes clinical services and activities that do not lead to beneficial health outcomes, although they generate revenue for the hospitals, explaining that "There are systematic misalignments between the roles of hospitals as the main providers, consumers, you and I and the third party payer."

A key solution, according to Dr. Daneshgari, would be greater use of online consultations between patient and doctor, saving both time and resources. In addition, he says that rather than doctors being employed by hospitals to whom they send patients for care, primary care providers should be "retained" for a monthly fee by consumers, eliminating conflicts of interest with hospitals reimbursing physicians for their referrals, a practice that leads to unnecessary tests and procedures. Current law allows for such a system, he says.

In addition to Health Guardianship, Dr. Daneshgari shares his views on healthcare and the path forward through his podcast, "Why Can’t We Have it All? The Missing Pieces in Our Healthcare."

For more information, visit

Questions we asked Dr. Daneshgari:

1. America’s healthcare system is the most expensive in the world, but more money hasn’t equated to better patient outcomes, as you explain in your book. Why is that?

2. It’s hard to believe that Americans spend 300 to 500 percent more on healthcare than those in Europe or Japan, but yet we rank between 30th and 40th in the World Health Organization’s ratings. Again, I have to ask why?

3. That’s hard to understand considering that all of this money doesn’t seem to result in better care and fewer medical errors, right?

4. What are some of the problems with America’s fee-for-service model under which providers are encouraged financially to provide services, sometimes more than are really needed?

5. In your book, you describe a new model that would use the primary care infrastructure but integrate virtual health and wellness services. What would that accomplish? How would it work?

6. What did the Covid 19 pandemic teach us about healthcare in America?

7. Part VIII of your book, Health Guardianship: the New and Missing Piece for a post pandemic healthcare system. Explain.

8. President Biden’s Cancer Moonshot – is that really possible?

9. What was your experience being on a hospital board?

10. What are the flaws you see in America's current healthcare system?

11. Can you please explain your business model?

12. What is the main difference between BowTie and other providers?

13. Where can listeners buy your new book?

Listen to the interview:

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