On Leading Medicare (with Dr. Meena Seshamani)

The Doctor's Art

Henry Bair and Tyler Johnson

Medicine, Society & Culture, Health & Fitness, Philosophy

5 • 2.1K Ratings

🗓️ 20 September 2022

⏱️ 51 minutes

🔗️ Recording | iTunes | RSS

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Summary

With around 63 million beneficiaries, Medicare is the single largest provider of health insurance in the United States, serving Americans aged 65 or older, as well as some younger patients who have certain disabilities. Directing this massive program is Dr. Meena Seshamani, an otolaryngologist and former Vice President of Clinical Care Transformation at MedStar Health, a large health care organization primarily operating in the Baltimore-Washington metropolitan area. There, she led initiatives in palliative care, geriatrics, and community health. She has also served as Director of the Office of Health Reform at the US Department of Health and Human Services. In this episode, Dr. Seshamani discusses her path from surgeon to health policy leader, what draws her to caring for older adults, and her vision for a better, more sustainable health care of the future.

In this episode, you will hear about:

Dr. Seshamani’s enthusiasm for medicine at a young age and the diverse career trajectory that followed - 2:08
A discussion of Dr. Seshamani’s past leadership roles, including those at the Office of Health Reform under the Obama administration and at MedStar Health - 6:27
Balancing the need for clinicians to work collaboratively and the inclination of physicians to value autonomy - 10:20
An explanation of Medicare’s role in the US healthcare ecosystem - 14:51
What draws Dr. Seshamani to focus on the care of older adults - 17:39
The crisis of burnout in the medical profession and Dr. Seshamani’s vision for how this can be addressed - 21:00
The fee-for-service mechanism of healthcare reimbursement, accountable care relationships, and the value of preventative care - 25:33
The pay disparity between specialists and primary care physicians, and the role Medicare can play - 30:40
How the growing population of aging Americans impacts the future sustainability of the Medicare program - 38:41
How Medicare is reforming its allocation of resources to promote health equity - 42:02
Dr. Seshamani’s advice to students and clinicians on engaging in meaningful work as they advance in their careers - 48:24

In this episode, we discuss the speech “Cowboys and Pit Crews” by Atul Gawande, published in the New Yorker.

You can follow Dr. Seshamani on Twitter @DrMeenaSesh

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to [email protected].

Transcript

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0:00.0	Hi, I'm Henry Bear.
0:03.4	And I'm Tyler Johnson.
0:04.8	And you're listening to the Doctors' Art, a podcast that explores meaning in medicine.
0:09.9	Throughout our medical training and career, we have pondered, what makes medicine meaningful?
0:15.2	Can a stronger understanding of this meaning create better doctors?
0:18.8	How can we build healthcare institutions that nurture the doctor-patient connection?
0:23.1	What can we learn about the human condition from accompanying our patients in times of suffering?
0:28.0	In seeking answers to these questions, we meet with deep thinkers working across healthcare,
0:33.1	from doctors and nurses to patients and healthcare executives, those who have collected a career's worth of harder and wisdom.
0:40.2	Proving the moral heart that beats at the core of medicine, we will hear stories that are by turns heartbreaking,
0:45.6	amusing, inspiring, challenging, and enlightening.
0:49.3	We welcome anyone curious about why doctors do what they do.
0:52.9	Join us as we think out loud about what illness and healing can teach us about some of life's biggest questions.
1:04.8	With more than 60 million beneficiaries, Medicare is a single largest provider of health insurance in the United States,
1:11.1	serving Americans, age 65 or older, as well as some younger patients who have certain disabilities.
1:17.8	Today, we are delighted to be joined by Dr. Mina Sashamani, an Oda-Layrngologist and head at Nexturjan,
1:23.6	who is the Director of Medicare.
1:25.8	Prior to a current position, Dr. Sashamani was a vice president of Clinical Care Transformation at MedStar Health,
1:32.5	a large healthcare organization primarily operating in the Baltimore, Washington metropolitan area.
1:37.7	There, she led initiatives in palliative care, geriatrics, and community health.
1:43.2	She has also served as Director of the Office of Health Reform at the U.S. Department of Health and Human Services.
1:48.7	In this episode, Dr. Sashamani discusses her diverse medical career,
	...

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