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

Dr. George Rogu, MD, MBA and Dr. Herb Bravo
  • 4.8 (30)
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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. 2D AGO

    236 Fixing Primary Care Shortage

    Dr. Sherif Taraman on Fixing the Primary Care Shortage: Economics, Culture, Policy, and Technology In 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 They argue the core driver is broken health economics: low reimbursement, outdated CPT practice-expense assumptions, high overhead, time-strapped 10–15 minute visits, and EHR-driven administrative burden that pushes volume over prevention and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 They discuss loss of generalist skills, outdated training and regulation, medical debt discouraging primary care, and cultural preference for quick fixes over preventive care.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Back Sherif 01:43 Why Primary Care Matters 03:44 Reimbursement Drives Shortage 05:29 Generalist Skills Fading 07:58 Outdated Rules and Costs 11:11 Practice Models Shifting 13:14 Workforce and Policy Crunch 14:47 Tech Incentives and Burnout 17:54 Collaborative Care Scaffolding 19:03 Culture Debt and Training Reform 26:17 Reinventing Physician Careers 27:44 Credentialing Roadblocks 28:46 Regulation Versus Access 29:45 Modernizing Training Models 30:52 Paying Primary Care Right 32:55 Telehealth Licensing Mess 33:47 Learning Without Certificates 34:52 Screening Belongs Upstream 36:34 Workforce Fixes And Scope 39:48 Guidelines And Critical Thinking 42:44 Medicine As Art And Trust 48:49 EHRs Billing And Burnout 49:44 Closing Thoughts And Action 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.

    50 min

  2. MAY 5

    235 Communication is our Thing with Dr. Todd Wolynn

    Communication Is Our Thing: Dr. Todd Wolyn on Vaccine Misinformation, Online Attacks, and Training Trusted Messengers In 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 Intro 01:55 Why Pediatrics 02:25 Meeting Seth and Thinking Bigger 04:42 Building Kids Plus Pediatrics 05:53 New Moms Coffee Community 07:56 Shots Heard Around World Origins 11:54 Online Attacks and COVID Echoes 15:11 HPV Uptake and Vaccine Baggage 21:50 Why Communication Training Fails 27:45 Curiosity With Resistant Families 30:14 Vaccine Concern Spectrum 32:52 Practice Policies and Trust 37:24 Natural vs Liberty Beliefs 40:03 Talking Points Backlash 46:50 Better Vaccine Messaging 49:28 Trusted Messenger Mission 51:54 Scaling Trust Locally 59:04 Training the Trainers 01:01:57 Wrap Up and Credits 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

  3. APR 28

    234 Will AI Replace Pediatricians with Dr. Igor Trogan MD

    AI Won’t Replace Pediatricians—But Pediatricians Using AI Will In 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 Premise 01:24 Why AI Is Now Essential 01:50 Ambient AI Restores Connection 05:05 Billing Pressures and EHR Mandates 08:15 Care Pathways vs Clinical Judgment 13:05 Pediatrics Complexity and Art 17:17 AI for Coding and Billing Accuracy 24:15 Fighting Downcoding With AI 25:50 Quality Checks and Care Gaps 33:08 Clinical Safety and Error Catching 34:41 Custom Apps for Operations 37:03 Scheduling App Fix 39:06 Vibe Coding Explained 39:56 Practice Hub App 40:42 War Room Dashboard 42:57 Will EHRs Be Replaced 47:17 Website Chatbots Agents 49:53 Ambient AI Billing Boost 53:49 NotebookLM For Students 55:34 Care Gaps Holy Grail 01:00:50 Dashboards Outreach Agents 01:02:42 Marketing Training With AI 01:03:54 First Step Start Today 01:04:37 Closing Credits 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 6m

  4. APR 21

    233 The Brand Is Your Doctor Now

    The Brand Is Your Doctor Now: Provider-Agnostic Care and the Risk to Relationship-Based Pediatrics On 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 Lounge 00:45 Meet Dr. James Reilly 01:53 Why Relationships Matter 03:12 What Is Provider Agnostic Care 04:40 Efficiency vs Assembly Line Care 07:28 Private Equity and Interchangeability 10:35 Top of License Mental Health Lesson 14:58 How Protocols and EHRs Started It 20:33 Algorithms vs Human Wisdom 26:38 Pediatrics Funding and Algorithm Upsides 31:00 Pediatrics Value Gap 31:36 Telemedicine Eye Miss 32:53 MinuteClinic Strep Mixup 35:27 Brand Versus Doctor 37:07 Thinking Sciences Model 43:09 Continuity Catches Problems 44:24 Lipoprotein A Wisdom 48:50 Medicine Art And Science 50:27 Interchangeable Doctors Burnout 53:46 Humans Not Algorithms 55:08 Wrap Up And Credits 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

  5. MAR 10

    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 Pediatricians In 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 Plug 00:50 Snowy Weekend Banter 01:27 Meet Dr Neil Bevin 02:07 Planning the Exit 04:42 Financial Independence Basics 06:17 How Much Is Enough 07:17 Common Retirement Mistakes 10:42 Practice Legacy and Adaptation 16:33 Giving Up Control 18:46 Retirement Mindset and Hobbies 21:42 401k and Roth Basics 23:30 Pensions and Private Equity Risks 26:29 The Five Day Weekend 27:36 Fair Scheduling Mindset 28:11 Flexibility Beats Absolutes 28:20 529 Plans For Kids 30:21 Inflation Crushing Doctors 32:36 Law Pay Versus Pediatrics 35:07 Private Equity Job Risk 38:26 Starting A Practice Today 39:30 Mortgage And Refi Strategy 42:42 Retirement Advice By Age 45:11 Keyman Insurance Matters 46:43 Practice Culture Horror Story 49:11 Wrap Up And Credits 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.

    50 min

  6. MAR 3

    231 Payor Advocacy and Payment Systems

    Expanding Bluebird Kids Health: Access, Value-Based Pediatrics, and Payment Advocacy Host 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 CME 00:55 Meet Shannon Levine 01:46 Bluebird Kids Expansion 03:35 Tech and Mobile Clinics 06:55 Ambient AI for Notes 11:27 Training New Clinicians 14:13 Florida Advocacy Updates 16:37 Autism Diagnosis Pilot 20:11 Medicaid Contracts and Pay 22:31 Value Based Care Future 23:14 Florida MPIP Basics 24:08 Incentives Versus Quality 25:39 Risk Models And Proformas 28:11 Care Coordinators In Action 31:10 Stop Loss And Carve Outs 32:54 Metrics And Vaccine Denominators 35:35 AAP Payer Advocacy Workflow 40:11 Price Transparency Tool 42:26 Negotiating With Payers 45:11 Burnout And Closing 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.

    47 min

  7. FEB 24

    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 01:02:1 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

  8. 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 Get 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
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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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