They Way Most Docs are Paid Doesn’t Lead to Healthier Patients

How the system pays doctors can change healthcare outcomes—sometimes in scary ways.

The way docs are paid can make patients sicker…or can lead to healthier ones. The payment schemes most docs work under incentivize them to fix patients, while others motivate them to prevent illness—and geriatrician Dr. Jonathan “Nathan” Flacker is here to explain why. This episode rips the curtain off RVUs, fee-for-service traps, and the real reason your doc is rushing through your visit (hint: it’s not personal, it’s math).

We dig into ChenMed’s wild idea: what if clinics got paid to keep you out of the hospital? Turns out, when money flows toward health instead of procedures, everyone wins. Except maybe the $400M proton beam facility (for the record, we love proton beams, but you might not need them if you can avoid cancer altogether).

Is concierge-style medicine only for the wealthy? What happens when you build “rich person care” for low-income seniors? And how many patients can a doc see well before it all breaks? If you’re dreaming of a career where you actually help people instead of just clicking boxes—this one’s a wake-up call.

Also: Love calls, RVU debt, and why pajama time should be illegal.

Episode credits:

• Producer: Jeff Goddard
• Co-hosts: Riley Behan-Bush, Zach Grissom, Alex Nigg
• Guest: Dr. Jonathan “Nathan” Flacker, ChenMed

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