Why does 2026 mark an inflection year for American health?

In this episode, Robin Blackstone, MD, offers a spoken companion to her recent systems essay, explaining what has changed and why the current health system can no longer rely on delay, fragmentation, or diffuse responsibility.

Drawing on three converging forces—continuous advisory intelligence, upstream biological intervention, and unavoidable public accountability—this episode explores why new health system architecture is no longer optional, but necessary.

This is not a policy proposal or a technology pitch. It is a systems diagnosis of where American health stands as a new year begins.

Why does a hospital bill look nothing like a receipt?

Why do identical services cost wildly different amounts—sometimes in the same building?

In this episode of Doctor AI, Dr. Robin Blackstone unpacks the hidden architecture behind American medical pricing. Not the headlines. Not the politics. The machinery.

You’ll hear how billing codes replaced judgment, how committees—not markets—set prices, and how a system designed for accounting quietly came to govern care itself. This is the story of RVUs, CPT codes, negotiated rates, and the unintended consequences of turning medical work into units of volume rather than acts of care.

This episode is not about blaming clinicians or patients. It is about understanding how a pricing system built decades ago now shapes time, trust, access, and outcomes—and why real reform must start with how value is defined.

Clear. Uncomfortable. Necessary.

This episode examines why.

Rather than focusing on burnout or individual behavior, the discussion looks at the payment structures that shape modern medical work—and how efficiency gains are absorbed instead of released. What appears as acceleration is often the result of a system designed to reward volume, not relief.

This episode serves as the entry point to a larger series on how American medicine is paid, how physician work is valued, and where the costs of that system surface first.

Being Human looks at the part of medicine the system cannot measure or value: the judgment, empathy, intuition, and deep experience clinicians bring to the bedside. Through stories of patients, surgeons, nurses, pediatricians, and innovators, this episode reveals how the most important work in healthcare is often the least visible to CPT codes and RVUs. Before returning to the machinery of American healthcare, we pause to remember what the system was built to serve—human beings, and the healing that happens only between them.

CPT isn’t just a billing tool. It’s the private language that defines what American medicine can see, name, measure, and pay for. In this episode, we step beyond the economics and look at CPT as a culture — a worldview that shapes how clinicians work, how innovation enters the system, and how care is constrained by a vocabulary built for a vanished era. When one organization owns the language of medicine, it owns the contours of care. This episode explores how that culture formed, what it overlooks, and why modern medicine is forced to speak in a syntax that no longer fits the work.

Two teachers, in two different states with different insurance plans, experience the same impossible barrier: a healthcare system that will not act until they get sicker.

Early autoimmune symptoms are dismissed, testing is delayed, and intervention begins only after visible decline.

This episode reveals the architecture behind those delays—how diagnostic thresholds, insurance rules, and payment models reward crisis over prevention and force patients to wait for deterioration before help arrives.

A story about two lives, one system, and the pattern that repeats across American healthcare.

RVU Nation – Day 3: The Economics of Physician Pay in America

Today we break open the quiet formula that governs every physician’s life: the RVU.

Invented in the late 1980s to price medical work like a mechanical task, RVUs still dictate schedules, salaries, bonuses — and the very shape of care.

This episode exposes how RVUs distort modern medicine by rewarding transactions over outcomes, rescue over prevention, and complexity over stability. We explore why doctors aren’t paid for what works, only for what can be billed — and how private equity has accelerated the shift toward treating health as a commodity.

RVUs aren’t broken.

They’re obsolete.

And understanding them is the first step toward redesigning the architecture of American healthcare.

RVU Nation pulls back the curtain on the architecture of American healthcare, revealing how a system built for billing — not health — governs every clinical decision and rewards the wrong work. Through clear, evidence-grounded analysis and grounded stories, the podcast shows how physicians, patients, and innovators are trapped inside structures they didn’t design, and why the future will require a new operating system.