In this episode of Life of Flow, we sit down with Dr. Robert Pearl, M.D., former CEO of The Permanente Medical Group, author of ChatGPT, MD, and a leading voice on how generative AI could change American medicine. The conversation moves between physician-led systems, private practice, capitation, chronic disease control, and what happens when AI begins working inside the daily gaps between patient visits. Dr. Pearl makes the case that AI is not just an administrative tool, but a way to improve quality, lower costs, and give physicians more time for the patients who need them most. 05:35 Writing ChatGPT, MD, and the malpractice question around AI 08:47 Patient trust, human presence, and vulnerable moments in care 11:14 AI-assisted diagnosis, malpractice premiums, and physician autonomy 18:19 Administrative AI and the bigger shift inside care delivery 25:58 What AI means for physicians entering medicine now 33:42 Why generative AI has to be discussed in the context of capitation 38:33 The tools physicians have today that did not exist three years ago 45:17 Bringing the capitation conversation back to AI 48:10 AI agents and the future of patient follow-up 51:32 Where to find Dr. Pearl’s book and ongoing work Who Should Listen This episode is for physicians, private practice owners, healthcare operators, and anyone thinking seriously about how generative AI, capitation, and physician-led care could change the economics and delivery of medicine. It is especially relevant for clinicians trying to understand where independence, technology, and patient trust fit into the next phase of healthcare. About Dr. Robert Pearl, M.D. Dr. Robert Pearl, M.D., served as CEO of The Permanente Medical Group, where he was responsible for physicians across the East Coast and West Coast, and describes Permanente as the physician side of Kaiser Permanente. In the episode, he explains that Permanente was physician-owned and physician-run, with its own board of directors, and that the organization established standards of care across settings, including the OR, cath labs, and ERs. Dr. Pearl is also the author of ChatGPT, MD, a book focused on how AI empowered patients and physicians can take back control of American medicine. He writes for Forbes, posts articles on LinkedIn, hosts the Fixing Healthcare podcast, and continues to speak and write about generative AI, healthcare strategy, capitation, and the future of physician-led care. Connect with Dr. Pearl 💼 LinkedIn: Robert Pearl, M.D. 🗞️ Website: robertpearlmd.com About Locumstory Locumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course. Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this conversation changed how you think about generative AI, physician-led care, and what it could take to improve outcomes without losing the human side of medicine, share it with a colleague who’s thinking about where healthcare is heading. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.

In this episode of Life of Flow, we sit down with Preston Alexander, co-founder of Forward Slash Health, for a practical conversation about the business side of private practice. Preston shares how he went from medical device product management to healthcare startups, consulting, revenue cycle work, and building a financial management platform for independent practices. We talk through the financial blind spots many physicians face when they leave employed medicine, including revenue cycle, cash flow, accounts receivable, accounts payable, outsourcing, staffing, and why understanding the numbers matters if you want to build a sustainable practice. 07:30 Preston’s path from MBA to medical devices and healthcare business 09:01 Using LinkedIn to learn how healthcare really works 11:02 How Forward Slash Health started from private practice pain points 18:27 Why Miguel keeps his revenue cycle team close to the practice 24:04 Cash flow, seasonality, and why big checks can be misleading 35:00 Where private practices commonly leak money 42:40 Why “doctors are bad at business” misses the point 54:30 What to know before outsourcing revenue cycle management 57:35 How to connect with Preston and Forward Slash Health Who Should Listen This episode is for physicians, surgeons, private practice owners, and doctors thinking about leaving the hospital system to build something independent. It’s also useful for anyone in healthcare operations who wants a clearer understanding of how revenue cycle, staffing, vendor relationships, and cash flow affect a practice. About Preston Alexander Preston Alexander is the CEO and co-founder of Forward Slash Health and Chief Operating Officer at Underscore Law. His background spans healthcare business, medical device product management, digital health, revenue cycle work, and private practice financial management. In the episode, he shares how his path from earning an MBA to working inside healthcare companies, launching and selling a medical device company, and helping build independent practices led him to focus on the financial systems physicians need to understand when running a practice. Connect with Preston 💼 LinkedIn: Preston Alexander 🗞️ Substack: The Healthcare Breakdown About Locumstory Locumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course. Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow 📲 Instagram: @LifeofFlowPodcast 👍 Facebook: Life of Flow Podcast 💼 LinkedIn: Life of Flow Podcast 🐦 X: @VascularPodcast If this conversation made you think differently about the business side of medicine, share it with a colleague who’s building, running, or considering an independent practice. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare leaders find conversations like this.