We Need a Care Revolution: Victor Montori

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GeriPal - A Geriatrics and Palliative Medicine Podcast 47 min 2 speakers 8 chapters transcribed 9 hours ago

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Why does Victor Montori argue that healthcare needs a revolution?

Eric Widera 0:00

This episode of the JerryPal Podcast is CME eligible.

Alex Smith 0:04

To claim credit, please go to the CME tab on jerrypal.org.

Eric Widera 0:09

Welcome to the Jerry Pal podcast, this is Eric Guidara.

Alex Smith 0:12

This is Alex Smith. And Alex, who do we have with us today? Today we are delighted and honored to welcome Victor Montori, who's an endocrinologist at the Mayo Clinic in Rochester, Minnesota. He's an author. His book, Why We Revolt. Why We Revolt is in its second edition. It's been translated to many languages soon to be in Greek. And Victor will be in Greece for that. that that opening of that book there. Um he's a frequent lecturer around the world. We met at the summer lecture series in Portland, Oregon last month. His website is patient revolution. Patientrevolution.org. Victor, welcome to the Jerry Powell podcast.

Victor Montori 0:55

Eric and Alex, thanks for having me. Delighted to be here.

Eric Widera 0:58

I am so excited for this podcast. I just had a chance to read your book, watch a couple of your grand rounds. Uh for our listeners, we're gonna be talking about what's wrong with industrialized healthcare, why it corrupted our mission, corrupted our mission, uh, and why it stopped caring and how we can fix it through revolution. But before we do that, Victor, I think you have a song request for Alex.

Victor Montori 1:21

Yes, the uh song request is Sletch Hammer by Peter Gabriel and please do not ask me why. I

Unknown 1:27

would ask you why, because I will most people don't know. This song is one hundred about sex. Uh there is no doubt about it. That's just in your head. I I um I re

Victor Montori 1:39

Really um I'm a I I'm a retired keyboardist. I was in a band and um and uh when you are you know, when you play an instrument like uh like Alex does, you look around for role models and people that are bringing new sound and I always uh loved what Peter Gabriel brought in terms of music and Sledgehammer is such a great, you know, celebration of joy, happiness and has a great video as well.

Eric Widera 2:04

Yeah, and uh Sledge Hammer to Healthcare, right? It's the revolution. Okay, there you go. Take a sledgehammer to health care. Sledgehammer. But every lyric is really about sex.

Alex Smith 2:16

But you didn't know that, right, Victor? Because you said this was your like your walk on song.

Victor Montori 2:20

Yeah, I'll tell you know, so I got invited to speak at a Cleveland clinic at a patient experiencing and they for the first and only time they asked me what I what I want for a walkout song. I chose this and I, you know, come out and I'm in I'm loving it, I'm enjoying it, I'm feeling it. And then I decided to Google it. And that was the end of that, you know. So I guess the

Eric Widera 2:40

joke

Unknown 2:41

was

Eric Widera 2:41

on that,

Unknown 2:41

but you know.

Eric Widera 2:43

Okay, Alex is Alex is gonna sing the non sexualized version of this.

Alex Smith 2:48

I did not change the lyrics. And uh I think this is the first Peter Gabriel we've had requested. Does that sound right, Eric?

Eric Widera 2:54

Wow.

Alex Smith 2:55

Over three hundred and fifty podcasts. I can't believe we hadn't done Peter Gabriel. I love Peter Gabriel. Shock

Unknown 3:00

the monkey? That's I'm surprised. Oh my god, I forgot about Shock the Monkey.

Alex Smith 3:05

I think this was the first cassette tape I owned. The album's so love this song. Love this album. Great song. Here's a little bit.

Unknown 3:17

Could have a steam train. If you just lay down your tracks. Could have an airplane fine. If you bring your blue sky back All you do is call me. I'll be anything you need. You'd ever think it Going up and down all around the bent. You could have a bump a car bumping. This amusement never ends. I wanna be Your sledge him out. Why don't you call my name? Oh let me be your sledgehammer. This will be my testimony.

Alex Smith 4:27

Well, for those of you listening on the audio only podcast, you got my son jamming it on guitar. Apologies to those of you watching on YouTube. That is definitely not a guitar song.

How does the airline‑industry analogy illustrate the problem of industrialized care?

Alex Smith 4:37

But that was a lot of fun. Thank you, Victor. Appreciate that.

Eric Widera 4:40

Great song. Uh we're gonna be talking about taking a sledgehammer to healthcare. But um maybe I could start with a question for you, Victor. Because I'm j again, just reading our title, Why We Revolt a Patient Revolution for Careful and Kind Care. You know, I I see a lot, and I actually Googled this last night, is you know, this this idea that healthcare should be like other industries, in particular like airline industries.

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Chapters

8 chapters

1 Why does Victor Montori argue that healthcare needs a revolution? 0:00–4:37 2 How does the airline‑industry analogy illustrate the problem of industrialized care? 4:37–12:02 3 What is minimally disruptive medicine and why is it important for patients with chronic illness? 12:02–18:41 4 How does digital burden (apps, passwords, CGMs) add to treatment workload for patients? 18:41–24:36 5 Why should the care revolution be patient‑led rather than clinician‑led? 24:36–30:59 6 What role do shared decision‑making and guidelines play in a care‑focused system? 30:59–35:39 7 How might AI, automation, and “value‑extraction” threaten the human side of medicine? 35:39–42:04 8 What concrete actions can listeners take today to join the care revolution? 42:04–47:39

Speakers

2 identified

Eric Widera 8 min Alex Smith 6 min

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Topics in this episode

AI 2 Google 1 Amazon 2 Delta 1 Alex Smith 2 diabetes 1 Cleveland Clinic 1 Mayo Clinic 2 Chris Jones 1 Ed Martin 1 Elizabeth Chung 1 Harry Hahn 1

Source

Recorded31 Jul 2025

Publisherrss.libsyn.com ↗

Transcriptspeaker-named · 100+ languages

Handlerec:20524497

Show notes

In his book, "Why We Revolt," Victor Montori decries the industrialization of healthcare. We've become a healthcare factory, beholden to health systems motivated by profit. In particular, he laments the loss of the "care" aspect of healthcare. Clinicians are under the clock to churn through patients. Patients are tasked with doing work outside of the clinic. Patients are tasked with hours and hours of work to self manage, obtain and manage medications, track weights and fingersticks, not to mention scheduling visits and waiting around for the visit to start. Now we have an app for that. For what, you ask? Well, for everything! Digital burden is real. Think about what we ask patients to do: charge your device, remember your password, 2 factor authentication, each interface is different, wait…where do you enter your fingersticks again? Victor is an endocrinologist who often provides care for older patients with multiple chronic conditions, polypharmacy, and complex social situations. He's "one of us." Some might argue that these circumstances call for incremental change. Not Victor. He argues that we need a revolution. In particular, he argues that the revolution must come from patients to be successful. On this podcast we discuss: Why do we need a revolution? What made him get to this point of arguing for a revolt? Why should the revolution be patient led, rather than clinician led? What role do clinicians have to play? What is minimally disruptive medicine (a term Victor coined with Carl May and Francis Mair in 2009)? How does shared decision making fit into the revolution? What's the matter with guidelines? What's the role of standardization? We suspect that most geriatrics and palliative care providers feel like they've escaped many of the issues Victor describes, trading less glamorous and remunerative work for more satisfying time spent caring for patients; focusing on what matters, goals of care, and attention to emotion and social well-being. Are we deluding ourselves? If you'd like to join the revolution, please check out Victor's website, patientrevolution.org And I believe this is the first Peter Gabriel song request! I think Peter Gabriel's album So was the first cassette tape I purchased. About time, 350+ podcasts in. My son Kai turns this very non-guitar friendly song into an acoustic jam for the audio-only podcast version; you get my weaker attempt on YouTube :) Finally, a quick plug for the Sommer Lecture series in Portland OR. Victor and I had a terrific time bonding at this year's lecture series. While not strictly geriatrics and palliative care focused, the lectures seem targeted at a broad audience, with something for everyone. And yes, I made them sing parody songs :) -Alex Smith

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