Microdosing

For years, the story of American healthcare has read like an obituary for small, independent medical practices. Faced with shrinking reimbursements, staffing shortages, and rising administrative burden, many physicians traded autonomy for stability, selling to health systems or private equity. Yet beneath the consolidation headlines, a quiet rebellion is taking shape. Across the country, small specialty and multi-site practices are not only surviving but posting strong margins. They’re lean, tech-forward, and operationally disciplined, proving that small can be powerful when run like a high-performing business.

All around you, Healthcare leadership continues to lean on familiar solutions: more education, more empowerment, more reminders to improve adherence. It sounds polite,nonthreatening, and promising. But it’s also a comfortable excuse that obscures a deeper, systemic failure. Because the truth is: medication adherence—our most basic measure of patient engagement—remains stubbornly low. Despite decades of well-meaning interventions, the problem persists. This isn’t a patient failure. It’s a system failure. 

Modern Primary Care Diagnostic Sequences; Why the Future of Care Hinges on Faster, Smarter Diagnostics. Traditionally, and still in many practices today, some of the most important parts of a primary care visit happen after the patient leaves the exam room. Diagnosis is often delayed, follow-up decisions are disconnected from the visit itself, and early opportunities for intervention can be missed. The diagnostic sequence may be the least celebrated yet the most essential part of a primary care visit. Whether it’s a healthy 25 year old seeking reassurance or a 45 year old at risk for diabetes, the pattern is the same: see the doctor, get the labs, wait for results, then discuss what it all means. This four step routine isn’t just tradition, it’s the structure payers recognize, the basis on which health system workflows are built, and the process clinicians rely on to deliver care.

As demand for GLP-1 drugs like Ozempic and Wegovy soars, a parallel market for compounded versions has emerged — one that’s largely unregulated and increasingly risky. This episode examines how gaps in oversight, aggressive marketing, and blurred lines between compounding and manufacturing expose patients to safety concerns and strain the health system. We explore why compounded GLP-1s are more than a niche issue, highlighting how they fit a recurring pattern where regulation lags behind fast-moving markets.

Medicaid and Medicare Advantage may seem like programs for specific groups, but the choices made in these public plans ripple across the entire insurance system. This episode explores how coverage churn, capped benefits, and financing reforms in public programs ultimately shape commercial premiums, provider networks, and patient access for everyone. We unpack why what starts in Medicaid and Medicare Advantage rarely stays there, and how those shifts end up reshaping all of our coverage.

Primary care consolidation is changing how patients experience — and pay for — everyday healthcare. This episode examines how ownership, pricing, and place intersect to drive up costs, with research from The Journal of the American Medical Association showing that hospital and private equity–affiliated practices charge more without delivering clear quality gains. We unpack what this hidden shift means for patients, insurers, and the future of affordable primary care.

Firearms have become the leading cause of death among U.S. children and teens, yet unlike cars, toys, or even e-cigarettes, they remain exempt from basic consumer safety regulation. This episode explores the public health and economic costs of treating guns as constitutionally protected products rather than consumer goods, drawing on recent research and commentaries from The Journal of the American Medical Association (JAMA) and JAMA Health Forum. We highlight what a true public health approach could look like (from child locks to smart-gun technology) and why closing this regulatory gap could save lives and reduce systemwide costs.

Patients are no longer entering care through the doors traditional health systems control. This episode explores how retail brands, pharma platforms, and digital experiences are becoming the new “front doors,” transferring trust and reshaping where care journeys begin. We look at what this shift means for partnerships, brand equity, and how healthcare organizations must adapt to stay relevant at the first point of engagement.

Rising clashes between hospitals and insurers are exposing outdated fee-for-service infrastructure. As payer–provider clashes surge, healthcare infrastructure is under pressure. We unpack what’s fueling these disputes, how they impact patients, and why flexible platforms may be the key to moving forward.

From weight loss buzz to healthcare infrastructure, GLP-1 drugs started as diabetes treatments but are now reshaping weight loss, care delivery, and consumer markets. In this episode, we explore how they have become more than medicine, driving new business models, digital access points, and patient expectations, featuring insights from leaders across health plans, startups, and strategy firms.