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

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

  1. 12H AGO

    230 AI in Medical Education

    Artificial Intelligence in Medical Education: Opportunities, Risks, and Guardrails In 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 Guest 02:25 CME Conference Details 03:13 Hot Topics and New Laws 04:44 EKG Screening Program 07:42 AI Tools in Training 11:42 IRB and Data Privacy 14:39 Meeting Minutes Automation 16:48 Closed Models for Clinicians 19:13 AI Hallucinations and References 24:16 Deskilling and Timing AI 30:11 Teaching Frameworks for AI 32:46 Back to Evidence Basics 33:40 Questioning the Evidence 34:48 AI and Human Empathy 37:45 AI as Clinical Assistant 41:01 Recertification in the AI Era 46:32 Ethics and Prompting 50:40 AI Scribing and Guardrails 54:35 Coding and Care Gaps 57:15 Future of Medical Education 01:01:13 Virtual Trials and Wrap-Up 01:0 Support 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 ➡️ - 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.

    1h 3m

  2. FEB 17

    229 The Real Economics of Pediatric Vaccination with Gail Schonfeld MD

    The Misery of the Vaccine Business: The Real Economics of Pediatric Vaccination In 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 Support 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 ➡️ - 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.

    55 min

  3. FEB 10

    228 Back Where It All Begins with Jason Halegoua, MD, PhD, MBA

    Back to Where It All Begins: The Journey of Dr. Jason Haua In this episode of The Pediatric Lounge podcast, hosts George and Jason introduce Dr. Jason Haua, who shares his unique career story of moving from leading a large, successful independent practice back to solo practice, focusing on mental health and autism. Dr. Haua discusses the importance of finding joy and fulfillment in medical practice, the challenges and benefits of running a smaller practice, and his reasons for stepping away from a larger organizational structure. The conversation explores the intricacies of managing a solo practice, dealing with insurance and administrative challenges, and the importance of maintaining a positive work culture. Dr. Haua also shares insights on legacy planning, practice efficiency, and the evolving landscape of pediatric care. 00:00 Introduction to The Pediatric Lounge 01:00 Meet Dr. Jason Haua: A Journey Back to Solo Practice 01:42 The Philosophy of Returning to Solo Practice 03:24 Building and Managing a Successful Practice 07:17 Challenges and Rewards of Mental Health Focus 08:30 Operational Efficiency in a Small Practice 16:10 Transitioning from Large Group to Solo Practice 20:36 The Role of Technology and Personal Touch 39:46 Future Plans and Legacy 41:44 Balancing Work and Personal Life 42:44 Challenges of Starting a Medical Practice 44:43 Financial Struggles in Pediatrics 46:27 The Cost of Medical Equipment and Supplies 48:21 Navigating Insurance and Billing Issues 01:13:07 The Role of Optimism in Professional and Personal Life 01:15:31 Conclusion and Final Thoughts Support 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 ➡️ - 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.

    1h 18m

  4. FEB 3

    227 The Future of Pediatrics: Navigating Change with Implementation and Leadership

    The Pediatric Lounge: Advocating for Pediatric Care and Independent Practices In this episode of The Pediatric Lounge podcast, the hosts discuss various topics relevant to pediatric care and independent practices. They highlight an upcoming event in New Orleans where pediatric practice leaders will gather to discuss their field. Special guest and pediatrician, Brian Birch from Idaho, shares his concerns about the future of pediatrics and his efforts at the state level, including the establishment of a pediatric council to address changes in Medicaid payments. The episode delves into the implications of legislative changes, the role of pediatric councils in payer relations, and the challenges of maintaining a medical home. The conversation also touches on the importance of independent practices, sharing mistakes, and the value of community support through groups like SOPA. The episode ends with a look ahead to upcoming conferences and talks aimed at fostering leadership and best practices in pediatrics. 00:00 Introduction to The Pediatric Lounge 00:32 Preparing for the PMI Conference 00:51 Guest Introduction: Brian Birch 01:45 Challenges in Idaho's Medicaid Program 05:08 National Medicaid Concerns 10:36 The Role of Pediatric Councils 14:19 The Importance of Practice Management 18:01 Engaging Young Pediatricians 33:50 Upcoming Events and Conferences 39:14 Conclusion and Farewell Support 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 ➡️ - 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.

    41 min

  5. JAN 26

    226 What's New With Chip Hart and Where Does The Business of Peds Go Next

    In this episode of The Pediatric Lounge, Dr. Rogu and Dr. Bravo welcome Chip Hart from PCC to discuss practical paths to fairer insurance reimbursement in pediatrics. They delve into the complexities of pediatric payment structures, including disparities in payments based on practice ownership and the impact of insurance models. The conversation also explores broader healthcare issues, including the economic implications of preventive care, the federal government's role in ensuring equitable healthcare, and potential solutions to make pediatric practices financially sustainable.  Highlighting successful practices that have thrived, the discussion underscores the importance of vision, business acumen, and an abundance mindset in pediatrics.  Additionally, the episode emphasizes the significance of the upcoming PMI (Pediatric Management Institute) conference, noting that it offers valuable opportunities for learning, networking, and professional growth. It is mentioned that PMI is fully sold out for in-person attendance but provides a streaming option, with speakers like Sandy Chung and Sue Kressley participating. Special attention is given to a T1D Mastermind Class at PMI with world-renowned pediatrician Dr. Kimber Simmons, showcasing the event as a pivotal occasion for anyone in the pediatric field. 00:00 Welcome to The Pediatric Lounge 00:32 Introducing Chip Hart and Today's Topic 01:02 Understanding Insurance Payments in Pediatrics 02:08 Private Equity and Practice Ownership 03:04 Medicaid and Payment Disparities 05:01 The Single Payer Model Debate 06:34 Value-Based Care in Pediatrics 07:55 Challenges in Preventive Care Funding 10:29 The Role of Managed Medicaid 14:02 Investment in Early Life Healthcare 19:41 Universal Coverage and Moral Hazards 20:14 Historical Context of Healthcare Policies 26:28 The Importance of Preventive Care 31:40 Public Schooling and Healthcare Parallels 40:27 Revisiting the Original Question 41:50 The Economics of Pediatric Care 42:53 Challenges with Insurance and Cash Payments 45:04 The Vaccine Debate and Physician Responsibility 47:29 Incentivizing Preventive Care 49:00 The Importance of Cash Systems in Healthcare 51:33 The New MSMS Codes and Payment Issues 01:01:39 Success Stories in Pediatric Practices 01:08:51 Upcoming PMI Conference and Final Thoughts Support 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 ➡️ - 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.

    1h 13m

  6. JAN 20

    225 Years In Independent Practice, What Worked and What I learned

    The Journey of Independent Pediatric Practice with Dr. Brian Birch In this episode of The Pediatric Lounge, hosts George and Herbie welcome back Dr. Brian Birch to discuss his two years of experience running an independent pediatric practice. They explore the successes and challenges of starting the practice, the key technologies that have supported its operation, and the culture and values driving its mission. The conversation covers the use of AI ambient scribes, patient communication tools, and the importance of maintaining relationships with patients. Dr. Birch also shares insights into leadership, team building, and the complexities of vaccine hesitancy in a changing healthcare landscape. 00:00 Introduction to the Pediatric Lounge 00:24 Welcoming Dr. Brian Birch 00:39 Independent Practice Journey 01:19 Practice Operations and Team Structure 03:10 Technology in Practice 03:29 AI and Digital Scribes 18:12 Challenges and Solutions in Practice Management 24:31 Building a Positive Culture 29:25 The Courage to Prune for Growth 30:46 Enterprise First Mindset 31:55 Client Relationships and Non-Negotiables 32:52 Navigating Vaccine Hesitancy 36:41 Building Trust with Patients 46:36 Challenges in Pediatric Practice 47:13 Advocacy and Future Plans 51:54 Networking and Community Support 53:14 Conclusion and Farewell Support 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 ➡️ - 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.

    55 min

  7. JAN 13

    224 The Brain-Gut Connection

    Applying Implementation Science to the New Paradigm of Autoimmune Diabetes: Preserving Beta Cells Through Early Screening The Brain-Gut Connection: Exploring Pediatric Gastrointestinal Psychology In this episode of The Pediatric Lounge, the hosts introduce Dr. Ali Navidi, a clinical psychologist and founder of GI Psychology. Dr. Vedi specializes in the brain-gut connection and works with children and families to manage chronic gastrointestinal and stress-related conditions. The conversation covers topics such as the significance of the brain-gut connection, the role of cognitive-behavioral therapy (CBT) and hypnosis in treating disorders like IBS, and the impact of diet, sleep, and exercise on mental health. Dr. Vedi discusses the importance of understanding and treating hypervigilance, catastrophic thinking, and visceral hypersensitivity in patients. The episode also explores hypnosis as a therapeutic tool, its applications in various conditions, and its integration with CBT. Additionally, the challenges of persuading parents to accept psychological explanations for their children's symptoms are highlighted, along with the complex interplay of trauma and gastrointestinal issues. 00:00 Introduction to The Pediatric Lounge 00:28 Upcoming Event Announcement 01:03 Guest Introduction: Dr. Ali Navidi 03:01 Understanding the Brain-Gut Connection 04:53 Impact of Lifestyle on Mental Health 06:20 Managing IBS with CBT 12:02 Challenges in Diagnosing Pediatric Conditions 20:31 Exploring Hypnosis in Clinical Practice 28:01 Entering the Flow State in Sports and Surgery 30:35 Hypnosis for IBS and Abdominal Pain 33:02 Hypnosis and Trauma Therapy 37:59 The Role of GI Psychology 39:32 Challenges with Medicaid and Insurance 52:45 Managing Chronic Pain with Mindfulness and Hypnosis 55:47 Concluding Thoughts and Farewell Support 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 ➡️ - 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.

    57 min

  8. JAN 6

    Redefining type 1 diabetes: Early identification, staging, and clinical implications for pediatric care

    Article: https://www.contemporarypediatrics.com/view/redefining-type-1-diabetes-early-identification-staging-and-clinical-implications-for-pediatric-care Table: https://thepediatriclounge.com/screening-to-prevent-dka Petiete Trial: https://link.springer.com/article/10.1007/s00125-025-06586-1#Sec5 Prevent Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2308743 Screening Summit: https://medschool.cuanschutz.edu/barbara-davis-center-for-diabetes/news-profdev/conferences-events/8th-childhood-diabetes-prevention-symposium---november-10th-11th--2025 In this episode, Herb Bravo is joined by Dr. Andrew Cagel, a pediatric endocrinologist, and Dr. Dan Feiten, a pediatrician , to discuss groundbreaking advancements in Type 1 Diabetes (T1D) care. The episode delves into their recent publication, 'Redefining Type 1 Diabetes: Early Identification, Staging, and Clinical Implications of Pediatric Care,' highlighting the critical importance of early detection and intervention. The guests emphasize the urgent need for universal screening. 00:00 Introduction to the Pediatric Lounge 00:45 Meet the Guests: Dr. Andrew Cagel and Dr. Dan Fen 01:08 Redefining Type 1 Diabetes 01:36 Personal Stories and Experiences 01:52 The Importance of Early Detection 04:40 Advancements in Type 1 Diabetes Treatment 13:55 The Role of EHR and AI in Pediatric Care 19:13 Future Directions and Guidelines 29:06 Pivotal Study in Pediatric Diabetes 30:45 The Protect Trial: Slowing Disease Progression 33:19 Challenges in Screening and Implementation 37:46 The Role of Pediatricians and Influencers 43:03 Advocacy and Future Directions 56:22 Conclusion and Final Thoughts 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. Support 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 ➡️ - 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.

    58 min
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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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