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

EPISODE · Sep 4, 2025 · 1H 11M

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

from The Short Coat: An Inside Look at Getting Into and Getting Through Medical School · host Dave Etler and the Students of the University of Iowa Carver College of Medicine

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 We Want to Hear From You: YOUR VOICE MATTERS! We welcome your feedback, listener questions, and shower thoughts. Do you agree or disagree with something we said today? Did you hear something really helpful? Can we answer a question for you? Are we delivering a podcast you want to keep listening to? Let us know at https://theshortcoat.com/tellus and we’ll put your message in a future episode. Or email [email protected]. We need to know more about you! https://surveys.blubrry.com/theshortcoat (email a screenshot of the confirmation screen to [email protected] with your mailing address and Dave will mail you a thank you package!) The Short Coat Podcast is FeedSpot’s Top Iowa Student Podcast, and its Top Iowa Medical Podcast! Thanks for listening! We do more things on… Instagram: https://www.instagram.com/theshortcoat YouTube: https://www.youtube.com/theshortcoat You deserve to be happy and healthy. If you’re struggling with racism, harassment, hate, your mental health, or some other crisis, visit http://theshortcoat.com/help, and send additions to the resources there to [email protected]. We love you.

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

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How long is this episode of The Short Coat: An Inside Look at Getting Into and Getting Through Medical School?

This episode is 1 hour and 11 minutes long.

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This episode was published on September 4, 2025.

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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...

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