Image - Robert Pearl
Image - Robert Pearl
Image - Robert Pearl

Stanford's Robert Pearl: The Toxic Culture of Medicine

The COVID-19 global pandemic has shined a bright light on our medical system unlike perhaps any other time in this country's history. For more than a year now, we have seen how the daily work of making important, even life-and-death decisions is frequently made harder by factors and variables outside the control of an individual doctor and patient. Meanwhile, even before the pandemic, hospitals and medical offices faced tremendous budget problems, and big pharmaceutical and insurance companies continued to shape the delivery of medical care in all corners of the country; the pandemic only exacerbated these trends.

In a new book, Uncaring, Dr. Robert Pearl—former CEO of The Permanente Medical Group and a Stanford professor—shows how all these stresses have led to a toxic culture in medicine, particularly for physicians. He says doctors resist change, leading to important clerical mistakes. They don't offer equal treatment to all patients. Their competitive work ethic leads to burnout and bad decisions. All these mistakes, he warns, can be and frequently are matters of life and death.

As we emerge from the pandemic and engage in a public debate about the appropriate role of government, technology, big pharmaceutical and insurance companies in our health-care system, Pearl believes we have paid little attention to what it actually feels like to be a doctor. If we want to improve medical outcomes for doctors and patients alike, Pearl believes we need to start seeing health-care professionals as the real and flawed human beings they actually are, and real issues they face every day in their professional lives.

We look forward to welcoming Dr. Pearl back to The Commonwealth Club for an important conversation on how we can have a safer and healthier health-care system.

Moderator Julie Kliger is the digital health transformation leader of the Health Solutions practice at FTI Consulting. She has expertise working with health-care delivery systems, platform-telehealth and bio/med-tech companies to design, optimize and implement new approaches to care delivery, with the goal of improving quality, value and experience of care. Kliger currently serves as a member of the board of directors for a $3 billion health system and chairs the Enterprise-Wide Committee on Quality, Safety and Patient Experience, and is vice chair of the Executive Compensation Committee.​ The views expressed by the moderator are not necessarily the views of FTI Consulting, Inc., its management, its subsidiaries, its affiliates or its other professionals.


In response to the COVID-19 pandemic, we are currently hosting all of our live programming via YouTube live stream. This program was recorded via video conference on May 26th, 2021 by the Commonwealth Club of California.

Image - Dr. Robert Pearl

Dr. Robert Pearl

M.D., Clinical Professor of Plastic Surgery, Stanford University School of Medicine; Author, Uncaring: How the Culture of Medicine Kills Doctors and Patients

Image - Julie Kliger

Julie Kliger

MPA, BSN, Senior Managing Director, Health Solutions, FTI Consulting—Moderator