The Pediatric Lounge, Where Pediatric Physicians Come to Share Their Stories and Success

Hosted by Dr. George Rogu, MD, MBA and Dr. Herb Bravo

Business Entrepreneurship Health Fitness

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Episodes

248

Latest episode

Jun 2026

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EN-US

About the show

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

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June 9, 2026Episode 31 hr 3 min

238 Why and How Marketing is essential to your business - Cliff James

Four Pillars of Advertising for Pediatric Practices: Newborn ROI, TikTok, Google Maps, and Internal OutreachHosts discuss pediatric practice marketing with repeat guest Dr. Cliff James, focusing on ROI-driven patient acquisition and replacing attrition by targeting newborns while balancing capacity and scheduling efficiency. James argues marketing spend should be measured by cost per acquired patient (nationally ~$80–$100; his ~$32), not percent of revenue, and stresses tracking “how did you hear about us” to avoid misleading metrics like clicks. He outlines advertising pillars: (1) social media content, especially TikTok, to educate pregnant/new parents and generate both patients and platform revenue; (2) hyperlocal visibility via Google Maps/Google Business and consistent listings across many directories, with mobile-optimized, content-rich websites that AI search tools can scrape; (3) targeted paid ads such as geofencing OB offices and filtering by demographics; and (4) internal “advertising” using EHR outreach to drive well visits and chronic care follow-ups. He emphasizes outsourcing execution while physicians stay involved and recommends treating the website like a revenue-producing employee.00:00 Podcast Intro and Guest01:38 Why Market to Newborns03:23 Attrition and Growth Math05:43 Capacity and Scheduling Limits13:47 Walk Ins and Workflow Hacks16:33 Marketing Spend and CPA18:48 Modern Referral Channels20:51 Outsource vs Be the Star23:22 Social Media Pillar TikTok27:59 Tracking Leads and Targeting29:32 High Income Ad Targeting30:10 Geofencing OB Offices31:16 60 Second Video Strategy32:32 Choosing Social Channels33:14 Avoiding Link Penalties35:29 Google Maps Over SEO36:29 AI Search Website Pages39:50 Reviews And Internal Outreach48:19 Quiz Funnels For Leads52:06 Webinars Worth It55:36 Delegate Marketing Work01:00:16 Website As An Employee01:02:23 Closing And DisclaimersSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

May 26, 2026Episode 21 hr 12 min

237 How DPC is Growing in Pediatrics

DPC Is Growing in Pediatrics: Dr. Andrew Hertz on Zest’s Expansion, Survey Findings, and the Future of CareThe Pediatric Lounge welcomes returning guest Dr. Andrew Hertz, co-founder and president of the Zest Pediatric Network, to discuss the growth of direct pediatric care (DPC) and results from Zest’s national survey. Hertz reports Zest’s expansion from three Cleveland-area practices to 10 sites opening by summer, with 13 physicians across Ohio, Pennsylvania, and Florida, and describes using annual surveys because pediatric DPC data was previously lacking and the movement is growing about 25% yearly. Survey findings include that pediatric DPC is largely women-led (about 90%), mid-career, mostly solo practices; most charge $100–$175 per child per month with panels under 250 patients; about 48% are AAP members; and many report improved satisfaction and less moral injury. They discuss DPC benefits such as reduced office, urgent care, and ED visits, challenges with insurance and Medicaid capitation without CPT codes, AI’s operational promise and societal risks, and employer value focused more on employee satisfaction than pediatric ROI.00:00 Welcome Back Dr Hertz01:30 Zest Network Growth02:50 Why Survey DPC03:49 Who Joins DPC05:06 Boards and MOC Debate09:31 AAP Membership Questions13:54 Why DPC Is Rising18:22 AI vs EHR Efficiency22:03 Insurance and Capitation25:14 Hybrid Models and Access29:08 Costs and Who Can Afford32:45 Medicaid Capitation Hurdles35:06 Data Without CPT Codes36:24 Data Without Red Tape37:07 ICD-10 and Simple EMRs38:23 Holistic Prevention Coaching41:32 Defining DPC Success42:43 Net Promoter Score Explained46:10 NPS for Behavior Change49:19 Storytelling to Drive Adoption55:53 AI in Pediatrics Promise and Peril01:03:21 Beyond DPC Payment Models01:06:15 Employers and Care Navigators01:09:24 Closing Thoughts and Growth01:11:31 Podcast OutroSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

May 19, 2026Episode 150 min

236 Fixing Primary Care Shortage

Dr. Sherif Taraman on Fixing the Primary Care Shortage: Economics, Culture, Policy, and TechnologyIn a Tuesday-morning discussion, repeat guest Dr. Sherif Taraman (dual board-certified child neurology and clinical informatics; CEO of Cognoa behind FDA-authorized Canvas DX for autism) joins Herb and George to examine the U.S. primary care shortage. They argue the core driver is broken health economics: low reimbursement, outdated CPT practice-expense assumptions, high overhead, time-strapped 10–15 minute visits, and EHR-driven administrative burden that pushes volume over prevention and fuels burnout, direct-care models, and consolidation or profit-driven ownership. They discuss loss of generalist skills, outdated training and regulation, medical debt discouraging primary care, and cultural preference for quick fixes over preventive care. Potential solutions include clinician-driven tech (e.g., ambient scribes), collaborative care scaffolding with reimbursable codes, more flexible retraining and licensing reciprocity, better education in health economics/population health, and restoring patient-physician relationships to rebuild trust (e.g., vaccines).00:00 Welcome Back Sherif01:43 Why Primary Care Matters03:44 Reimbursement Drives Shortage05:29 Generalist Skills Fading07:58 Outdated Rules and Costs11:11 Practice Models Shifting13:14 Workforce and Policy Crunch14:47 Tech Incentives and Burnout17:54 Collaborative Care Scaffolding19:03 Culture Debt and Training Reform26:17 Reinventing Physician Careers27:44 Credentialing Roadblocks28:46 Regulation Versus Access29:45 Modernizing Training Models30:52 Paying Primary Care Right32:55 Telehealth Licensing Mess33:47 Learning Without Certificates34:52 Screening Belongs Upstream36:34 Workforce Fixes And Scope39:48 Guidelines And Critical Thinking42:44 Medicine As Art And Trust48:49 EHRs Billing And Burnout49:44 Closing Thoughts And ActionSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

May 5, 2026Episode 431 hr 3 min

235 Communication is our Thing with Dr. Todd Wolynn

Communication Is Our Thing: Dr. Todd Wolyn on Vaccine Misinformation, Online Attacks, and Training Trusted MessengersIn this Pediatric Lounge episode, hosts interview nationally recognized pediatrician and vaccine advocate Dr. Todd Wolyn, co-founder and former CEO of Kids Plus Pediatrics in Pittsburgh, about communication in pediatric care. Wolyn shares why he chose pediatrics, how Kids Plus grew from a small practice to three offices with expanded services like a regional breastfeeding center and the free, community-based “New Moms Coffee” support groups. He recounts creating an HPV vaccine PSA in 2017 that drew a coordinated global anti-vaccine social media attack, leading to research, a clinician toolkit, and the not-for-profit Shots Heard Around the World. The discussion critiques reliance on talking points and limited communication training, explores why vaccine concerns vary along a continuum, and introduces Wolyn’s Trusted Messenger program, including free CME and a June launch of a train-the-trainer institute using the AIMS methodology.00:00 Welcome and Guest Intro01:55 Why Pediatrics02:25 Meeting Seth and Thinking Bigger04:42 Building Kids Plus Pediatrics05:53 New Moms Coffee Community07:56 Shots Heard Around World Origins11:54 Online Attacks and COVID Echoes15:11 HPV Uptake and Vaccine Baggage21:50 Why Communication Training Fails27:45 Curiosity With Resistant Families30:14 Vaccine Concern Spectrum32:52 Practice Policies and Trust37:24 Natural vs Liberty Beliefs40:03 Talking Points Backlash46:50 Better Vaccine Messaging49:28 Trusted Messenger Mission51:54 Scaling Trust Locally59:04 Training the Trainers01:01:57 Wrap Up and CreditsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

April 28, 2026Episode 421 hr 5 min

234 Will AI Replace Pediatricians with Dr. Igor Trogan MD

AI Won’t Replace Pediatricians—But Pediatricians Using AI WillIn this Pediatric Lounge episode, hosts George and Herb talk with Dr. Igor Trogan about why AI is becoming essential for independent pediatric practices, emphasizing that ambient AI scribing restores eye-to-eye patient interaction, improves documentation, and enables more accurate CPT coding and billing. They discuss financial pressures from declining reimbursement and rising overhead, how EHRs were built largely for accounting and reporting, and the need to balance evidence-based pathways with clinical judgment. Dr. Igor Trogan describes using HIPAA-compliant Google Gemini agents to support coders, catch underbilling, generate rebuttals to payer downcoding, and improve care quality by finding care gaps and medication or dosing errors. He also shares using Base44 (non-HIPAA) to rapidly build custom operational apps (inventory, scheduling, command-center dashboards), plus website chatbots, insurance-card and immunization-record agents, AI-generated training materials and social media content. They conclude the best first step is adopting ambient AI.00:00 Podcast Intro and Premise01:24 Why AI Is Now Essential01:50 Ambient AI Restores Connection05:05 Billing Pressures and EHR Mandates08:15 Care Pathways vs Clinical Judgment13:05 Pediatrics Complexity and Art17:17 AI for Coding and Billing Accuracy24:15 Fighting Downcoding With AI25:50 Quality Checks and Care Gaps33:08 Clinical Safety and Error Catching34:41 Custom Apps for Operations37:03 Scheduling App Fix39:06 Vibe Coding Explained39:56 Practice Hub App40:42 War Room Dashboard42:57 Will EHRs Be Replaced47:17 Website Chatbots Agents49:53 Ambient AI Billing Boost53:49 NotebookLM For Students55:34 Care Gaps Holy Grail01:00:50 Dashboards Outreach Agents01:02:42 Marketing Training With AI01:03:54 First Step Start Today01:04:37 Closing CreditsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

April 21, 2026Episode 4156 min

233 The Brand Is Your Doctor Now

The Brand Is Your Doctor Now: Provider-Agnostic Care and the Risk to Relationship-Based PediatricsOn The Pediatric Lounge, hosts discuss “provider-agnostic” or “physician-agnostic” care with pediatrician Dr. James Reilly, arguing corporate and private-equity models use protocols, EHR-driven algorithms, and lower-cost staffing to make clinicians interchangeable and reduce patient loyalty to individual physicians. They contrast efficient team-based support that preserves continuity with cost-cutting that sacrifices time, empathy, and physician satisfaction, and warn that “top-of-license” restructuring in psychiatry led to underfunding and a lasting mental health crisis. The conversation links critical pathways and Epic-style cognitive offloading to diminished clinical judgment, citing examples of inappropriate protocol orders, urgent-care misses, and MinuteClinic prescribing. They emphasize that longitudinal “thinking sciences” benefit from trust and wisdom that computers can’t replace, and predict worse outcomes, burnout, and access problems if relationships are replaced by brand-driven, algorithmic care.00:00 Welcome to Pediatric Lounge00:45 Meet Dr. James Reilly01:53 Why Relationships Matter03:12 What Is Provider Agnostic Care04:40 Efficiency vs Assembly Line Care07:28 Private Equity and Interchangeability10:35 Top of License Mental Health Lesson14:58 How Protocols and EHRs Started It20:33 Algorithms vs Human Wisdom26:38 Pediatrics Funding and Algorithm Upsides31:00 Pediatrics Value Gap31:36 Telemedicine Eye Miss32:53 MinuteClinic Strep Mixup35:27 Brand Versus Doctor37:07 Thinking Sciences Model43:09 Continuity Catches Problems44:24 Lipoprotein A Wisdom48:50 Medicine Art And Science50:27 Interchangeable Doctors Burnout53:46 Humans Not Algorithms55:08 Wrap Up And CreditsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

March 10, 2026Episode 4050 min

232 “The Five-Day Weekend: What a Doctor Needs to Know About Retirement” Neil Bellovin M.D.

The Five-Day Weekend: Retirement Planning and Practice Legacy for PediatriciansIn this Pediatric Lounge episode, hosts discuss Nicholas Children’s upcoming postgraduate pediatrics CME conference and then interview repeat guest Dr. Neil Bevin of RBK Pediatrics about physician retirement. Bevin describes planning a year ahead to transition administrative responsibilities, defining financial independence based on cost of living, and how taxes affect retirement withdrawals. He highlights common mistakes such as underfunding retirement in peak earning years, failing to adapt practice models as pediatrics shifts toward chronic disease management, and retaining control too long, which can damage practice value and legacy. He explains RBK’s move from a defined benefit plan to a 401(k) and Roth options, notes limited retirement participation among younger employees, and discusses private equity’s impact on job security and pensions. Bevin shares his semi-retired “five-day weekend” schedule, stresses planning hobbies and purpose, recommends saving early (including 529 plans), and emphasizes leaving unhealthy practices, avoiding divorce, and using keyman insurance in small practices.00:00 Podcast Intro and CME Plug00:50 Snowy Weekend Banter01:27 Meet Dr Neil Bevin02:07 Planning the Exit04:42 Financial Independence Basics06:17 How Much Is Enough07:17 Common Retirement Mistakes10:42 Practice Legacy and Adaptation16:33 Giving Up Control18:46 Retirement Mindset and Hobbies21:42 401k and Roth Basics23:30 Pensions and Private Equity Risks26:29 The Five Day Weekend27:36 Fair Scheduling Mindset28:11 Flexibility Beats Absolutes28:20 529 Plans For Kids30:21 Inflation Crushing Doctors32:36 Law Pay Versus Pediatrics35:07 Private Equity Job Risk38:26 Starting A Practice Today39:30 Mortgage And Refi Strategy42:42 Retirement Advice By Age45:11 Keyman Insurance Matters46:43 Practice Culture Horror Story49:11 Wrap Up And CreditsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

March 3, 2026Episode 3946 min

231 Payor Advocacy and Payment Systems

Expanding Bluebird Kids Health: Access, Value-Based Pediatrics, and Payment AdvocacyHost Dr. Her Bravo welcomes Dr. Shannon Fox Levine and talk about her move into Bluebird Kids Health, which is expanding Palm Beach Pediatrics’ value-based, technology-forward model to new de novo sites in Florida to address pediatric care deserts for Medicaid populations, including new offices in Jacksonville and Broward County, and the use of a partnered mobile clinic. They discuss keeping Athena Health, hiring and training new clinicians, and interest in ambient AI to reduce documentation burden and improve patient relationships. Levine outlines Florida AAP concerns, including school vaccine mandate changes, Medicaid payment advocacy (including Medicare parity via incentives), and a pilot workflow to diagnose autism in primary care using tools like RITA-T and CARS-2 with appropriate reimbursement. She also describes her national AAP payer advocacy role, addressing issues like downcoding, EOB monitoring, and use of a price transparency tool, emphasizing sustainable payment to reduce burnout and maintain access.00:00 Podcast Intro and CME00:55 Meet Shannon Levine01:46 Bluebird Kids Expansion03:35 Tech and Mobile Clinics06:55 Ambient AI for Notes11:27 Training New Clinicians14:13 Florida Advocacy Updates16:37 Autism Diagnosis Pilot20:11 Medicaid Contracts and Pay22:31 Value Based Care Future23:14 Florida MPIP Basics24:08 Incentives Versus Quality25:39 Risk Models And Proformas28:11 Care Coordinators In Action31:10 Stop Loss And Carve Outs32:54 Metrics And Vaccine Denominators35:35 AAP Payer Advocacy Workflow40:11 Price Transparency Tool42:26 Negotiating With Payers45:11 Burnout And Closing ThoughtsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

February 24, 2026Episode 381 hr 3 min

230 AI in Medical Education

Artificial Intelligence in Medical Education: Opportunities, Risks, and GuardrailsIn this episode of The Pediatric Lounge, the hosts welcome back Dr. Rani Gareige, director of medical education and designated institutional official at Nicklaus Children’s Hospital and a clinical professor at Florida International University, to discuss artificial intelligence in medical education now and in the future. They preview Nicklaus Children’s Hospital’s 61st annual postgraduate pediatrics CME conference in Fort Lauderdale (Hilton Marina Resort, March 20–22), highlighting sessions on IBD, short stature, dermatology, psychological screening, AI in practice management, social media communication, genetic testing/personalized medicine, and Florida’s new requirement for EKG screening to clear athletes starting ninth grade. The conversation covers common AI tools learners use (ChatGPT, Claude, OpenEvidence) and institutional concerns about HIPAA/PHI, including blocking public tools and using a secure in-house system (“Ask Nick”) and closed or constrained approaches (e.g., tools that search only approved sources or documents provided, such as Google Notebook). They explore concerns about de-skilling and when to introduce AI in training, faculty development needs, and a precepting framework (DEFT-AI: Diagnosis, Evidence, Feedback, Teaching, and Recommendations for AI use) to assess clinical reasoning. The episode also discusses AI for simulated patient interactions (bad news delivery, motivational interviewing), ambient AI scribing pilots, clinician responsibility to review notes, and AI-driven coding that may reduce undercoding and administrative burden. The discussion concludes that AI will not replace physicians, but clinicians who use AI wisely may replace those who do not, stressing the importance of policies, ethics, transparency, and maintaining empathy and the art of medicine.00:00 Podcast Intro and Guest02:25 CME Conference Details03:13 Hot Topics and New Laws04:44 EKG Screening Program07:42 AI Tools in Training11:42 IRB and Data Privacy14:39 Meeting Minutes Automation16:48 Closed Models for Clinicians19:13 AI Hallucinations and References24:16 Deskilling and Timing AI30:11 Teaching Frameworks for AI32:46 Back to Evidence Basics33:40 Questioning the Evidence34:48 AI and Human Empathy37:45 AI as Clinical Assistant41:01 Recertification in the AI Era46:32 Ethics and Prompting50:40 AI Scribing and Guardrails54:35 Coding and Care Gaps57:15 Future of Medical Education01:01:13 Virtual Trials and Wrap-Up01:02:19 Closing CreditsSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.

February 17, 2026Episode 3755 min

229 The Real Economics of Pediatric Vaccination with Gail Schonfeld MD

The Misery of the Vaccine Business: The Real Economics of Pediatric VaccinationIn this episode of The Pediatric Lounge, the hosts reflect on the PMI conference in New Orleans and discuss how U.S. pediatricians are portrayed as “bad guys” because of vaccines, leading into a conversation with Dr. Gail Schoenfeld about the “misery of the vaccine business.” Schoenfeld describes her participation in a white paper on the real economics of pediatric vaccination, motivated in part by feeling insulted by claims that pediatricians profit from vaccines, and explains she tried to educate the authors on vaccine financing and delivery costs. The discussion details the extensive, time-intensive workflow and infrastructure required to store, track, administer, and document vaccines, including staffing time, inventory reconciliation between VFC and commercial stock, compliance tasks, refrigeration and monitoring systems, generators, maintenance, insurance, space costs, and after-hours emergencies. They address vaccine “wastage” such as broken vials, patient refusal after preparation, expiration, documentation errors that prevent billing, and demand shifts (including Schoenfeld’s experience wasting 70 Moderna COVID doses at $133 each). The group argues that fixed reimbursement set by insurers and Medicaid often fails to cover true costs, making vaccination a money-losing service for pediatric practices; they cite examples including Medicare valuing vaccine administration code 90460 at $24 and Virginia’s Medicaid not paying 90460 and restricting VFC reimbursement to a limited admin fee, resulting in losses per vaccine, with a Mississippi example of $11 payment. They discuss why adult practices often refer vaccination to pharmacies and note pediatricians cannot easily do so. The conversation expands to broader issues with Medicaid underfunding, VFC compliance burdens and liability, quality incentive programs (HEDIS/NCQA) and how incentives can be perceived as conflicts of interest despite being framed as deferred or conditional payment, and how vaccine mandates and distrust after COVID have reduced routine vaccination uptake. Schoenfeld shares past work running community COVID vaccine clinics and contrasts inefficiencies seen elsewhere. The episode ends with reflections on pediatricians being underpaid despite providing essential preventive care, Schoenfeld’s commitment to serving a largely Medicaid population in the Hamptons, and her upcoming presentation on cost center/call center reports at a future conference, followed by standard podcast outro and disclaimer.00:00 Welcome Back + PMI New Orleans Takeaways (Why Pediatricians Get Blamed)00:56 Meet Dr. Gail Schoenfeld: The ‘Misery of the Vaccine Business’01:58 Why She Joined the White Paper: Setting the Record Straight on Vaccine Economics04:18 The Hidden Workflow: Staff Time, Inventory, Documentation & Compliance06:07 Wastage Is Real: Expired Doses, Missed Billing, and the True Cost per Shot07:51 Cold-Chain Overhead: Fridges, Generators, Monitoring, and 1AM Alarm Calls10:59 Why Adults Can Outsource Vaccines (and Pediatrics Can’t)12:15 Remembering the Pre-Vaccine Era: What These Diseases Looked Like14:26 Reimbursement Reality Check: RVUs, Admin Codes, and Losing Money on Medicaid22:24 VFC Program: Free Vaccine, Heavy Burden, and Unfunded Liability25:11 Politics, RFK Jr., and the ‘Team Evil vs Team Stupid’ Debate27:22 Where the ‘Pediatricians Profit from Vaccines’ Myth Comes From27:37 Vaccine Payments vs Profit: What the Numbers Miss28:09 Pay-for-Performance & HEDIS: The ‘Perverse Incentive’ Debate29:01 How QIP Metrics Were Built (and Why Pediatrics Doesn’t Fit Adult Models)32:39 Why ‘Quality Incentives’ Feel Like Withheld Routine Earnings33:20 Conflicts of Interest, COVID Distrust, and Falling Vaccine Rates35:45 Fixing Behavior: Incentivize Parents, Not Pediatricians (Carrots & Sticks)42:18 ManSupport the show🔴 Subscribe for more Doctor stories like this: 🎧Apple and give us a 5-star review. Read more on the TPL Website SOCIAL Media Pages =============================== 📝 - Substack🎧 - PODCAST👥 - FACEBOOK🐦 - TWITTER📸 - Instagram➡️ - LinkedinThe 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.