Dr. Shenkin on Humanistic Pediatrics, Health Policy, and Fixing Incentives in U.S. Healthcare

On The Pediatric Lounge, the hosts interview Dr. Shenkin, a Harvard-trained pediatrician, physician leader, and health policy expert who founded Bayside Medical Group in Oakland and grew it to a 35-physician, 10-office organization later sold to Stanford/Children’s Hospital. He describes choosing pediatrics as “falling in love,” shaped by a neurosurgeon father, and recounts work in the Public Health Service during the Vietnam era, including leading and reshaping migrant health into early regional rural health centers and studying health systems and policy in Stockholm and Yale. The conversation critiques U.S. insurance, fee-for-service/RBRVS, RVUs, networks, PBMs, and administrative waste, arguing costs stem from high prices and bureaucracy, not patient overuse. They emphasize restoring humanistic care—patients feeling “cared for and cared about”—through values, systems, mentorship, and better measurement, while criticizing hierarchical training, Epic-driven box-checking, and misaligned incentives that prioritize revenue over care.

00:00 Welcome to the Lounge
00:30 Meet Dr. Bud Shenkin
01:18 Why Pediatrics Chose Him
01:34 Family Roots in Medicine
05:13 Policy Path and Vietnam Era
06:48 Training Abroad and Independence
07:47 Great Profession, Bad Job
09:40 Residency Mentors and Customer Service
12:06 Why He Rejected Academia
13:32 Insurance and Fee-for-Service Critique
15:02 Catastrophic Coverage Debate
17:15 Humanistic Care Without Money Anxiety
18:58 Where Healthcare Overspends
20:15 Hospital Pricing and System Power
21:27 PBMs and Pharma Incentives
24:45 Leading While Still Seeing Patients
26:17 Hospitality Lessons for Healthcare
29:07 Systems Thinking and Safety Design
31:33 Building Humanistic Relationships
32:49 Name Tags and Respect
33:58 Selling to Big Systems
36:27 Training and Hierarchy
37:41 Epic and Box Checking
38:14 Humanistic Exam Room
40:27 Mentorship and Great Practices
43:46 Networks vs Fiduciary Duty
44:55 Falling in Love with Pediatrics
48:36 Paying for Humanistic Care
53:06 Trust, Dissent, and Leadership
54:34 Becoming a Great Clinician
01:00:08 Keeping Idealism Alive
01:01:08 Closing and Credits

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Pediatrics, Trust, and the Age of AI: Evidence, AAP Policy, and Vaccine Mandates

Hosts Herb and George welcome back Dr. Jesse Hackell to discuss declining trust in medicine amid overwhelming information and AI summaries, emphasizing the need for physicians to critically appraise evidence rather than rely on authority or EHR prompts. They debate perceptions of the American Academy of Pediatrics (AAP) as a “corporation” versus a volunteer membership organization, how AAP governance works, and how AAP outputs (technical reports, clinical reports, policy statements, and more rigorous clinical practice guidelines) should be read as guidance, not gospel or standards of care, with evolving examples like peanut introduction and biliary atresia screening. The conversation covers malpractice implications, screening controversies (e.g., ferritin/iron, milk and anemia), COVID-era messaging failures and politicization, vaccine policy opposing non-medical exemptions as choice with consequences, nuanced school-entry requirements (e.g., Florida Hib/pneumococcal), and tees up a future discussion on insurance and coverage for all children.

00:00 Show Intro
01:40 AI Trust Crisis
03:42 Reading Evidence Today
07:16 AAP Critics And Mission
09:48 Volunteerism Versus Pay
12:56 AAP Guidance Not Gospel
18:20 Governance And Elections
24:03 Types Of AAP Reports
33:48 Med Legal Standards
42:36 COVID And Vaccine Trust
47:01 RFK And Opinion Politics
48:02 Fauci Versus RFK
48:49 Natural Immunity Messaging
50:41 How Science Pivots
52:36 Peer Review Explained
54:22 Evidence Bars And Coercion
57:32 Bright Futures Screening Debate
58:59 Ferritin Screening Controversy
01:05:01 Cow Milk And Iron Loss
01:06:51 AI And Trust Erosion
01:11:37 School Vaccine Exemptions
01:18:03 Community Versus Freedom
01:19:40 Florida Hib And PCV Nuance
01:24:41 Insurance Policy Teaser
01:26:58 Wrap Up And Credits

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The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

Life After Clinical Practice: Finding Impact Beyond the Exam Room

On The Pediatric Lounge, Herb and George welcome returning guest Jeanne Marconi to discuss “Life After Clinical Practice: What’s Next?” Jeanne describes stepping away from patient care during COVID, wanting to scale what she built in practice (integrated urgent care, behavioral health, lactation, nutrition/obesity care), and helping develop a behavioral health arm at PM Pediatrics leveraging telehealth. The group debates who represents pediatrics, arguing that the AAP prioritizes child advocacy over pediatrician advocacy, while clinical practice faces declining visit volume, rising costs, a worsening payer mix and skewed RVU incentives, growing chronic and mental health complexity, and low adoption of recommendations, which can overwhelm clinicians and erode family trust. Jeanne outlines paths for “burnt on” physicians: redesign services within practice, pursue governance/boards, advocacy, or nonclinical roles, and accept starting as a beginner. They discuss private equity tradeoffs, instability, and the need for strong change management centered on explaining “why,” addressing resistance, and building community forums for pediatricians. Jeanne highlights nonprofit work supporting youth aging out of foster care and her board role at Elizabeth Seton Children’s Center, urging colleagues to support one another’s mental health and view transitions as applying medical skills in new ways.

00:00 Podcast Welcome
00:37 Meet Dr Marconi
02:12 Leaving Clinical Practice
03:36 Building Behavioral Health
04:33 Who Speaks Pediatrics
06:42 Practice Pressures Today
08:05 Payment Model Problems
14:08 Guidelines And Evidence
17:29 Burnt On And Pivoting
20:35 Paths Beyond Medicine
21:43 Private Equity Reality
28:27 Costs And Practice Change
32:18 Finding Your Impact
33:44 Drop the Doctor Ego
33:58 Reframing Leaving Medicine
35:22 Becoming a Change Agent
38:18 Change Management That Works
40:03 Generational Shifts in Practice
43:06 AI Tools for Better Leadership
46:26 When to Move On
51:10 Passion Versus Paycheck
51:50 Mental Health and Toxicity
53:14 Building Community Meetups
57:23 Advocacy That Feeds the Soul
59:03 Final Takeaways and Wrap

Support the show

🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review.
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SOCIAL Media Pages ===============================
📝 - Substack
🎧 - PODCAST
👥 - FACEBOOK
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📸 - Instagram
➡️ - Linkedin

The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between.

The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.