Unstable Vitals – Détails, épisodes et analyse

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Unstable Vitals

Dr. Adam Brown and Dr. Lara Zibners

Forme & Santé

Fréquence : 1 épisode/20j. Total Éps: 26

Welcome to Unstable Vitals, where healthcare experts Dr. Adam Brown and Dr. Lara Zibners navigate the ever-evolving healthcare landscape. Adam, an emergency physician, professor, and founder of ABIG Health, brings a wealth of leadership experience and expertise in healthcare strategy and DEI. Lara, a nationally recognized educator and co-founder of Calla Lily Clinical Care, combines clinical insights with business expertise to address the industry's most pressing challenges.

In each episode, Adam and Lara break down complex topics, offering practical insights and clarity in the often unstable world of healthcare. From policy shifts to healthcare economics, they provide the knowledge you need to navigate today's healthcare system.

Tune in for fresh perspectives, expert analysis, and a dose of reality in every episode!

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Données mises à jour le 13/09/2026

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https://www.youtube.com/watch?v=C2XcPo_3Pnc
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https://www.youtube.com/@UnstableVitals
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https://www.linkedin.com/company/theunstablevitals
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https://www.instagram.com/theunstablevitals
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No Insurance Card, No Copay: What US Doctors Learn Living Under the NHS

Saison 2 · Épisode 10

mardi 1 septembre 2026 • Durée 41:04

Dr. Adam Brown and Dr. Lara Zibners reunite from London for a deep dive into how American and British healthcare actually compare, not in theory, but from two physicians living it. Lara walks through her own visit (no insurance card, no copay, no bill) and breaks down what she's really paying for US coverage versus UK coverage. The conversation turns personal when Lara shares the story of her mother's ALS diagnosis and the weeks-long wait to see a neurologist. They also dig into why the US and New Zealand are the only two countries that allow direct-to-consumer prescription drug advertising, the downstream effects of recent Medicaid and SNAP cuts, and why NHS wait times get more attention than what's actually broken. It closes out with a British-vs-American medical vocabulary round that gets predictably out of hand.

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Beyond the Prescription: Dr. Lucy McBride on Fixing a Broken Healthcare System

Saison 2 · Épisode 9

mardi 18 août 2026 • Durée 43:35

Unstable Vitals is back, and this time Dr. Adam Brown and Dr. Lara Zibners sit down with primary care physician, Substack favorite, and Beyond the Prescription author Dr. Lucy McBride.

Lucy has spent 25+ years watching medicine become transactional and impersonal, and she's written a book that isn't a "do as I say" guide, but a "here's how to think" guide. In this episode, we get into why the wellness industry is thriving on 15-minute doctor's appointments, the real difference between "health" and "wellness" (one is objective, one is a marketer's dream), how to spot a credentialed expert from a snake-oil influencer, and the "linked to" vs. "caused by" trick that turns every headline into a panic headline.

We also dig into some uncomfortable truths: why 95% of U.S. healthcare spending goes to damage control while only 5% goes to primary and preventive care, the conspiracy theory that doctors are profiting off patient illness (and why it's wrong), and whether AI is going to save primary care or just make the broken system move faster.

Grab Lucy's new book, Beyond the Prescription, and follow her on Substack.

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Cleared by the FDA, Ignored by Everyone Else: The Real Medtech Journey w/ Allison Komiyama

Saison 2 · Épisode 8

mardi 4 août 2026 • Durée 47:03

Dr. Adam Brown and Dr. Lara Zibners sit down with Allison Komiyama, PhD, RAC, former FDA reviewer, founder of Bluestocking Health, and self-proclaimed "med tech hype woman", to demystify what actually happens when a medical device tries to reach patients.

Allison breaks down PMA pathways, why "the FDA is the big bad hurdle" is only half the story, and why getting cleared is often just the starting line: insurers won't pay, hospitals won't adopt, and promising life-saving tech can quietly shut down within a year.

They dig into AI's real (and overhyped) role in medical devices, why 8 of the last 10 drugs pulled from FDA clearance failed women specifically, and how the same inequality showing up in clinical trials shows up in art museums too.

Plus: summer camp chaos, killer houseplants, and why everyone needs a "food distribution engineer."

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Pre-Sell the Thing That Doesn't Exist Yet: Dr. Alison Curfman on Building a Pediatric Powerhouse

Saison 2 · Épisode 7

mardi 23 juin 2026 • Durée 49:28

What does it take to leave a steady hospital job and build a value-based care company for the most medically complex kids in America?

In this episode, Dr. Adam Brown and Dr. Lara Zibners sit down with Alison — pediatric emergency physician, mom of 4, host of Startup Physicians, and co-founder of Imagine Pediatrics — to trace her path from clinician to telehealth pioneer to founder of a company that now takes full risk for children on Medicaid.

Along the way, they get into the realities of homeschooling four kids through COVID, why complex pediatric care has been ignored by investors for so long, and the analogy that finally explains the broken math of insuring only the sickest kids (hint: it involves teenage boys and car insurance).

Alison also delivers the single best piece of advice we've heard for physician founders: stop polishing the pitch deck and pre-sell the thing that doesn't exist yet. It's how Imagine Pediatrics walked into day one with thousands of patients already under contract — and it's the playbook she now teaches other doctors who want to build.

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The Safety Net You've Never Heard Of: Inside America's FQHCs with Dr. Rui Ariyapala

Saison 2 · Épisode 6

mardi 9 juin 2026 • Durée 48:57

What if there were a network of clinics quietly delivering full-suite care — primary care, dental, behavioral health, pharmacy, prenatal, mobile units — to anyone who walks in, regardless of their ability to pay? Spoiler: there is, and most Americans have no idea it exists.

Adam and Lara sit down with Dr. Rui Ariyapala, Associate Chief Medical Officer at Piedmont Health Services and a public health physician trained across New Zealand, the UK, and the US, to unpack the Federally Qualified Health Center model, a 55-year-old experiment in keeping vulnerable patients out of the ED and inside coordinated, value-based care.

Along the way: why a father walked out of his child's cancer diagnosis, how $4,500 of NHS coverage stacks up against $26,000 a year in US premiums and what it actually takes to move a system built on sick-care toward real prevention.

Plus: Gary the Word Bird, Ginger Spice at the London Zoo, and a proposal hidden inside an escape room.

A conversation about the parts of US healthcare that are working and the upstream shifts that could fix the parts that aren't.

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The Women's Health Funding Gap: Why Nobody Opposes It but Nothing Gets Done with Kathryn Schubert

Saison 2 · Épisode 5

mardi 26 mai 2026 • Durée 46:05

Endometriosis affects as many women as diabetes. Diabetes research gets $1 billion a year from NIH. Endometriosis gets $28 million. That kind of gap doesn't exist because people are against women's health research, it exists because it hasn't been made a priority.

In this episode, Dr. Adam Brown and Dr. Lara Zibners sit down with Kathryn Schubert, President & CEO of the Society for Women's Health Research, to unpack why the women's health funding gap persists, how policy actually gets shaped behind the scenes in Washington, and what it's going to take to close the gap for good.

Kathryn shares her journey from Capitol Hill scheduler to registered lobbyist to leading one of the longest-standing organizations fighting for women's health equity. Along the way, we get into the real role lobbyists play in healthcare policy (it's not what you think), how advocates tailor their message to move lawmakers on both sides of the aisle, the history of excluding women from clinical trials — and the assumptions that made it seem reasonable at the time, navigating women's health advocacy in a politically charged environment, and why the private sector is finally waking up to women's health as a market opportunity.

This conversation will change how you think about where health policy comes from and who's actually moving it forward.

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Ringworm, MRSA & Broken Buckles: The PPE Problem Nobody's Talking About w/ Justin McKay

Saison 2 · Épisode 4

mardi 12 mai 2026 • Durée 46:41

You put on a lead apron and assume it's keeping you safe. But what if it's carrying MRSA, ringworm, and nearly 10 times the bacteria of a gas station pump handle? Even worse, what if nobody's required to clean it?

Justin McKay, founder of RadCare Services, joins Dr. Adam Brown and Dr. Lara Zibners to share how a ringworm infection, a torn-up apron on his first day in the OR, and a year of quietly studying hospitals across the country led him to build something the healthcare industry didn't even know it needed: a full-service lead apron cleaning, repair, and compliance program.

In this episode, we dig into the disgusting (and dangerous) reality of radiation protection garments in U.S. hospitals from blood and fecal-stained aprons going right back on the rack, to a culture study that found MRSA on the majority of aprons tested. Justin shares the moment a skeptical surgical director called his pitch "snake oil," so he tested her busiest surgeon's apron on the spot. The results were jaw-dropping.

We also talk about the uphill battle of building a business around a problem no one is required to fix, why financial incentives in healthcare make or break innovation, and what gives Justin hope for the future of medicine.

In this episode:

Why hospital lead aprons are virtually unregulated for cleanliness in the U.S.
The ATP test that proved aprons are nearly 10x dirtier than gas pump handles
How a 2017 lawsuit tied defective PPE to cancer deaths among OR staff
The founder's journey: quitting a VP of sales job, two years without a paycheck, and bootstrapping a new business

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The NHS Up Close: Emergency Care and Lessons from Across the Pond With Robert Pinate

Saison 2 · Épisode 3

mardi 28 avril 2026 • Durée 45:44

In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners are joined by a very special guest, Lara's husband, Robert Pinate, a nurse consultant with over 30 years in UK emergency medicine.

Rob helps emergency departments rethink outdated workflows and improve patient flow. The conversation dives into how the NHS actually works from its funding model and workforce of to the freedom clinicians feel when billing isn't part of the equation. Rob breaks down the rapid assessment and treatment model he champions, the culture shock of implementing America's Epic EHR in a system that doesn't bill, and what it's like walking into struggling hospitals that feel like they've regressed.

The trio explores the sobering parallels between the NHS's decline after years of austerity and the growing cracks in the U.S. system, from Medicare cuts to frontline burnout. But it's not all doom. Rob shares where he's seeing improvement and makes the case that sometimes all it takes is pulling the right people off the floor, handing them a blank sheet of paper, and asking: how can we do this better?

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Saving the Independent Practice: How One Company Is Trying to Stop Healthcare's Consolidation Crisis

Saison 2 · Épisode 2

mardi 14 avril 2026 • Durée 42:12

What happens when a Canadian finance guy with zero healthcare experience decides to take on one of the most broken systems in the world? You get Alex Barrett, co-founder and CEO of Meroka, and a genuinely different perspective on why independent medicine is dying and what can actually be done about it.

In this episode, Drs. Lara Zibners and Adam Brown sit down with Alex to unpack the real force behind healthcare consolidation, and it's not the "silver tsunami" you keep hearing about. CMS reimbursement rates have been essentially flat since 2002 while costs have surged, making the business model of running an independent practice quietly unsustainable for thousands of physicians across the country.

Alex shares how Meroka is building a third exit path for retiring physicians, one that keeps practices out of private equity hands and transfers ownership to the staff who actually do the work. But the conversation goes deeper: Why does the only OB delivering babies in a 100-mile radius in rural West Virginia still have no negotiating power? Why are non-compete clauses one of the biggest hidden barriers to independent medicine? And is the system so broken it simply can't be fixed?

Spoiler: Alex doesn't think so.

Listen now.

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Season 2: We're Back. And Healthcare Is Still a Mess

Saison 2 · Épisode 1

mardi 31 mars 2026 • Durée 31:50

Dr. Adam Brown and Dr. Lara Zibners are back for Season 2 of Unstable Vitals, and they're wasting no time. After catching up on life, including Laura's Arctic Circle dog sledding adventure, Adam's new London life, Calla Lily's first Big Pharma partnership, and a spirited rant about Yorkshire pudding, the duo lays out their ambitious plan for the season ahead.

This episode introduces the "Five P's" framework that will guide Season 2: Politicians/Policymakers, People (patients), Providers, Payers, and Producers. They argue that fixing America's broken healthcare system requires engaging all five groups, and they plan to do exactly that through conversations with health tech founders, clinical innovators, device executives, regulators, and investors.

From the cost of estrogen gel in Europe vs. the U.S. to why walking to the grocery store might be better healthcare policy than anything coming out of Washington, this season promises to be equal parts hilarious and eye-opening.

Topics covered:

The "Five P's" of healthcare: the season's guiding framework
Public transportation, walkability, and downstream population health
Lifestyle medicine and transatlantic perspectives on healthcare costs
A preview of Season 2 guests and episodes
What Adam and Lara have been up to since last season

Follow Unstable Vitals on LinkedIn to stay connected.

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Unstable Vitals – Détails, épisodes et analyse

Détails du podcast

Classements récents

Apple Podcasts

Spotify

Liens partagés entre épisodes et podcasts

Youtube2

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Qualité et score du flux RSS

Historique des publications

Derniers épisodes publiés

Podcasts et contenus similaires

Podcasts Similaires Basées sur le Contenu

Apple Podcasts

Spotify

Podcasts Similaires Basées sur le Contenu

Youtube2

LinkedIn1

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