"Second Opinion" with Christina Farr, Ash Zenooz MD & Luba Greenwood JD

This week on Second Opinion, Christina Farr and Luba Greenwood discuss the acquisition of 23andMe by Regeneron, the involvement of Hims and Hers in the GLP-1 market, and two significant IPOs in the digital health sector. — 📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess   —SPONSOR:🏋🏻‍♀️Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion  using code SECONDOPINION at checkout. —LINKS: Christina Farr's Second Opinion Newsletter: https://secondopinion.media/  —FOLLOW:https://www.linkedin.com/in/christinafarr/ https://www.linkedin.com/in/lubagreenwood/  —TIMESTAMPS:(00:00) Preview(00;48) Intro(01:50) Regeneron’s acquisition of 23andMe(11:59) Sponsor: Fatty15(13:19) Hims and Hers: A billion-dollar raise(17:49) Digital health IPOs: Hinge and Omada(23:46) Wrap —HIGHLIGHTS FROM THE EPISODE:• Regeneron acquired 23andMe for $256 million as the genetic testing company was heading toward bankruptcy.• 23andMe struggled because they tried to operate both a consumer business and expensive drug discovery R&D simultaneously without adequate synergy.• The acquisition price represents roughly $20 per person's genetic data, which is considered a good deal for Regeneron given 23andMe's 15 million user database.• Regeneron faces a "patent cliff" where their blockbuster drugs are losing exclusivity, driving the need for new drug discovery capabilities.• The genetic data will help Regeneron with early-stage drug discovery, though combining genetic data with medical records for drug discovery remains scientifically challenging.• Hims & Hers raised another billion dollars, largely boosted by their partnership with Novo Nordisk to distribute Wegovy (a GLP-1 obesity drug).• The GLP-1 market represents an outlier situation where pharma companies are seeking novel distribution channels due to intense competition and previous drug shortages.• Two major digital health IPOs are happening: Hinge Health (physical therapy) went public at under $3 billion valuation (down from $6 billion private valuation) and Omada Health (chronic disease management) filed their S-1.• Hinge Health's profitability and AI integration in virtual physical therapy positioned them well for their IPO, while Omada faces more skepticism due to lack of profitability.• Both companies primarily serve employers and face challenges expanding into Medicare and health plan markets, requiring different sales teams and strategies.• The success of these IPOs will determine whether the IPO window opens for other digital health companies with $100+ million revenue run rates.• The digital health industry desperately needs successful exits that return money to investors, as M&A activity has been slower than expected despite favorable market conditions.      

In this episode of Second Opinion, Christina Farr, Stephen Klasko and Jessica Beegle, discuss the persistent challenges in healthcare despite technological advancements. They explore the integration of AI, the struggle with outdated systems, and the need for aligning incentives to drive meaningful change. — 📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess —SPONSOR:🏋🏻‍♀️Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion using code SECONDOPINION at checkout. —LINKS: SAIL Conference (Symposium on Artificial Intelligence for Learning Health Systems): https://sail.health/ General Catalyst: https://www.generalcatalyst.com/ THL Partners: https://thl.com/  Christina Farr's Second Opinion Newsletter: https://secondopinion.media/  —FOLLOW:https://www.linkedin.com/in/sklasko/ https://www.linkedin.com/in/jessicabeegle/ https://www.linkedin.com/in/christinafarr/  —HIGHLIGHTS FROM THE EPISODE:• Despite 15 years of technological advancement, the industry still struggles with basic issues like API integrations, data silos, and delayed billing systems.• Healthcare has "Star Wars technology" for individual patients but operates with a "Fred Flintstone" delivery system due to misaligned incentives.• Large tech companies and health systems are finally starting to work together more effectively, translating between Silicon Valley innovation and frontline healthcare delivery.• Many health systems operate with disparate EHR systems, making it difficult to implement modern AI solutions without proper data infrastructure.• The core problem isn't technology but rather that people's salaries often depend on maintaining inefficient systems.• Successful AI implementations include mental health prediction tools, clinical trial optimization, and OR scheduling that added 100 new surgeries in one month.• The industry faces commoditization with hundreds of point solutions at conferences, making it difficult to identify truly valuable innovations.• Similar to how it took 50 years for doctors and nurses to work together effectively, healthcare now needs to learn how physicians and AI can collaborate.• Successful AI adoption requires framing tools as augmentation rather than replacement, focusing on removing administrative burdens from clinical work.• Effective implementation involves focusing on the 65% of physicians in the middle (between early adopters and resisters) rather than extremes.• Health systems operating with thin margins or losses need AI solutions that demonstrate clear ROI within 12 months, not just satisfaction metrics.• The industry is moving away from point solutions toward consolidated platforms that address multiple problems simultaneously.• Leading health systems are seeking equity partnerships with technology companies rather than just being customers.• The authors are writing a book about bridging the gap between Silicon Valley tech culture and healthcare delivery.  

This week on Second Opinion, Christina Farr and Ash Zenooz interview Stephen Buck, CEO/Co-Founder of Courage Health, a public benefit company providing cancer survival rates to patients and physicians, helping facilitate conversations about living life to the fullest. They talk about the inefficacy of employer-based healthcare, the lack of political bipartisan collaboration, and the rising trend of direct-to-consumer healthcare models. —📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess —SPONSOR:🏋🏻‍♀️Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion using code SECONDOPINION at checkout. —LINKS: Courage Health: https://courage.health/ Stephen Buck (CNBC Healthy Returns): https://www.cnbc.com/2018/03/20/stephen-buck.html  Christina Farr's Second Opinion Newsletter: https://secondopinion.media/—FOLLOW:https://www.linkedin.com/in/christinafarr/ https://www.linkedin.com/in/ashzenooz/ —HIGHLIGHTS FROM THE EPISODE:• Bipartisan collaboration is necessary for meaningful healthcare reform.• Employer-based healthcare creates fundamental misalignments in the American system.• Short employee tenure (2-3 years) eliminates incentives for long-term health investment.• Consumers willingly pay premium prices for convenient, private healthcare services.• Preventive services offered by employers remain largely underutilized.• "Longevity" branding resonates more effectively than traditional "prevention" messaging.• Cultural attitudes vary widely regarding health optimization versus quality of life.• Knowledge gaps exist between specialized medicine and primary care.• AI tools could potentially serve as co-pilots for patients and clinicians.• Consumer education about healthcare system misalignments is essential for self-advocacy.

This week on Second Opinion, we're sharing an episode from Peter Lee's Microsoft Research Podcast with guests Dave deBronkart and Christina Farr. They examine how AI has transformed healthcare since GPT-4's launch two years ago, with Dave and Chrissy sharing insights on patient empowerment through AI tools and the evolving digital health business models in specialized care areas. This episode was originally published in the Microsoft Research Podcast: ⁠https://www.microsoft.com/en-us/research/podcast/the-ai-revolution-in-medicine-revisited-empowering-patients-and-healthcare-consumers-in-the-age-of-generative-ai/?OCID=AIRevolutionPod_SecondOpinion⁠   —📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  — SPONSOR:🏋🏻‍♀️Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion  using code SECONDOPINION at checkout. —LINKS:e-Patient Dave: https://www.epatientdave.com/  Patients Use AI: https://patientsuseai.substack.com/  Meet e-Patient Dave (TED Talk): https://www.ted.com/talks/dave_debronkart_meet_e_patient_dave  “Let Patients Help”: A Patient Engagement Handbook: https://www.epatientdave.com/let-patients-help/ There's about to be a lot of Al capital incineration: https://secondopinion.media/p/there-s-about-to-be-a-lot-of-ai-capital-incineration  A letter to my kids about last week: https://secondopinion.media/p/a-letter-to-my-kids-about-last-week  The AI Revolution in Medicine: GPT-4 and Beyond: https://www.microsoft.com/en-us/research/publication/the-ai-revolution-in-medicine-gpt-4-and-beyond/   Christina Farr's Second Opinion Newsletter: https://secondopinion.media/ —FOLLOW:https://www.linkedin.com/in/peterlee4  https://www.linkedin.com/in/epatientdave/  https://www.linkedin.com/in/christinafarr/    —HIGHLIGHTS FROM THE EPISODE:Dave de Bronkart's Segment:• Diagnosed with stage four kidney cancer in 2007 with 24-week survival expectation.• Online patient community proved crucial to his survival.• Community had treatment knowledge not available in medical literature.• Always verified community information with clinicians before acting.• Sees AI as tool for patients to explore health questions without using doctor's time.• Believes AI won't replace doctors but will help patients solve more issues independently.• Advocates for patient access to their complete medical data. Chrissy Farr's Segment:• AI startups struggle because healthcare systems can't effectively integrate their tools.• Prefers businesses using AI within care delivery over standalone AI tools.• Healthcare tech works best during "high engagement" moments like pregnancy or cancer diagnosis.• Health systems struggle to justify new technology investments.• Women's health is fertile for digital innovation due to multiple engagement points.• Text messaging services offer better experiences than apps.• Many consumers shifting to cash-pay subscription models.• Short employee tenure challenges employer healthcare investments.• Elder care technologies present significant opportunities.• Healthcare change can come from both outside advocates and inside employees.

This week on Second Opinion, Christina Farr and Ash Zenooz interview Seraphina Therapeutics CEO Steph Venn-Watson, unpacking why men dominate the longevity space, the cellular secrets of aging, and C15:0’s potential to boost health. —📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  —SPONSOR:🏋🏻‍♀️ Strengthen your cells from the inside-out with Fatty15, a pure C15:0 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion using code SECONDOPINION at checkout. 🏥 Thatch makes it easy to give your team great healthcare. Save ~$1620 per employee yearly while giving them customizable plans. Visit https://thatch.ai/HR  for a demo and receive a $100 gift card. —LINKS:  The Longevity Nutrient: https://www.amazon.com/Longevity-Nutrient-Unexpected-Holds-Healthy/dp/1668063549 Subscribe to Second Opinion Newsletter: https://secondopinion.media/  —FOLLOW:https://www.linkedin.com/in/stephanievennwatson/https://www.linkedin.com/in/christinafarr/ https://www.linkedin.com/in/ashzenooz/  —HIGHLIGHTS FROM THE EPISODE: Christina Farr, Ash Zenooz and Seraphina Therapeutics CEO Stephanie Venn-Watson explore women's perspectives on longevity versus the male-dominated "influencer" space in this field. Stephanie explains that traditional "longevity" focused on living forever doesn't resonate with most women, who instead want quality years. Stephanie reveals concerning data that people born after 1990 are showing aging-related diseases at younger ages than previous generations. While studying Navy dolphins, Stephanie's team discovered that a molecule called C15:0 (pentadecanoic acid) was linked to healthier aging. C15:0 is a saturated fat primarily found in dairy fat, which has been significantly reduced in American diets since 1977 dietary guidelines. The 1977 congressional guidelines recommended decreasing saturated fat intake, leading to widespread adoption of low-fat dairy. This dietary shift doubled down in the 1990s when pediatricians began recommending switching children from whole milk to low-fat milk at age two. People born since the 1990s have grown up in what Stephanie calls a "C15:0 deficient world." The good news is that C15:0 supplementation can help reverse some of these conditions according to clinical trials. C15:0 levels can also be increased through diet (especially grass-fed dairy), exercise, and consuming fiber.

In this episode of Second Opinion, hosts Christina Farr, Ash Zenooz, and Luba Greenwood discuss the latest trends in healthcare, including conferences, the economic impact on health tech and biotech sectors, the potential for AI to reduce administrative burdens, and the dynamics of the IPO market.—📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  —SPONSORS:🏋🏻‍♀️ Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at http://fatty15.com/secondopinion using code SECONDOPINION at checkout. 👩‍⚕️ Hot flashes, insomnia, brain fog? You don't have to accept these as just another part of aging. Midi Health is the virtual care clinic for women navigating midlife hormonal transition, offering FDA-approved medications, supplements and lifestyle coaching - all covered by insurance. Visit https://joinmidi.com to book your virtual visit today.—LINKS: Health Evolution Summit (HES): https://www.healthevolution.com/summit/ Adoption of Artificial Intelligence in Healthcare Delivery Systems: Early Applications and Impacts (PHTI research): https://phti.org/ai-adoption-early-applications-impacts/ —FOLLOW:https://www.linkedin.com/in/christinafarr/https://www.linkedin.com/in/lubagreenwood/ https://www.linkedin.com/in/ashzenooz/—HIGHLIGHTS FROM THE EPISODE: The economy is currently experiencing significant turbulence, with biotech stocks particularly affected by recent market conditions. Tariffs are causing severe economic uncertainty, especially impacting pharmaceuticals since India and China make up more than half of the US generic drug supply. The pharmaceutical industry relies heavily on global sourcing, making it particularly vulnerable to tariff impacts that will likely increase costs for consumers. The hosts expressed frustration that healthcare organizations weren't better prepared for tariffs given that they were a central policy point for the Trump administration. A recent report on AI scribing technologies in healthcare revealed mixed results regarding cost savings, with many health systems seeing no actual cost reduction despite improvements in physician satisfaction. Luba argued that hospitals' resistance to reducing administrative bloat is a key reason why AI hasn't led to cost savings in US healthcare. Countries like Singapore and Korea have successfully implemented AI in hospitals to reduce administrative staff while maintaining focus on clinical care. CMS recently announced a significant five percent payment increase for Medicare Advantage plans for 2026, injecting approximately $25 billion into insurers. The hosts expressed concern about potential reduced federal spending on Medicaid under the current administration. Hinge Health, poised to be the first major digital health IPO in years, is now reportedly reconsidering due to economic uncertainty. The success or failure of Hinge Health's IPO could have significant implications for funding across the entire digital health sector. Peter Marks, the FDA's vaccine chief, recently left, sending shockwaves through the biotech industry. China is gaining dominance in biotech development largely due to lower regulatory hurdles that allow much faster clinical trial progression compared to the US. Ash emphasized the need for better FDA-CMS coordination, noting that it typically takes 17 years from innovation to patient access partly because CMS coding delays follow FDA approvals.

In this episode, Christina Farr sits down with Dr. Jeff Wessler, cardiologist and CEO of Heartbeat Health, about the challenges of behavior change in cardiology, the role of technology in health, the importance of preventative measures, and the emerging trend of longevity-focused health interventions. —📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  —SPONSORS:🏋🏻‍♀️ Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion using code SECONDOPINION at checkout. 👩‍⚕️ Hot flashes, insomnia, brain fog? You don't have to accept these as just another part of aging. Midi Health is the virtual care clinic for women navigating midlife hormonal transition, offering FDA-approved medications, supplements and lifestyle coaching - all covered by insurance. Visit https://joinmidi.com to book your virtual visit today.—LINKS: Heartbeat Health: https://www.heartbeathealth.com/ Why is longevity suddenly so hot?: https://secondopinion.media/p/why-is-longevity-suddenly-so-hot —FOLLOW:https://www.linkedin.com/in/jeffrey-wessler/ https://www.linkedin.com/in/christinafarr/—HIGHLIGHTS FROM THE EPISODE: Heartbeat Health is a large medical group with cardiologists and other practitioners providing telehealth and remote diagnostics across the US. Jeff is skeptical about technology's role in behavior change for cardiovascular health, noting that despite more tech, outcomes in cardiovascular disease have worsened. Jeff explains that heart attacks are largely predictable, contrary to popular belief that they are random events. Modern diagnostic technology can identify risk factors and provide feedback loops that show whether interventions like diet and exercise are working. The longevity trend represents a shift from the traditional model where doctors simply tell patients to improve their lifestyle to one where patients can test interventions and see measurable results. Jeff identifies different types of prevention: primordial (preventing risk factors), primary (preventing heart attacks in those with risk factors), secondary (preventing subsequent heart attacks), and tertiary (reducing complications). Current longevity programs reach thousands when they need to reach millions to make a meaningful impact on cardiovascular outcomes.

This week on Second Opinion, Christina Farr interviews Liana Douillet Guzmán, CEO of FOLX, about the healthcare challenges faced by the LGBTQIA+ community. They discuss systemic discrimination, the growing demand for inclusive care, and the importance of patient-centered, community-based healthcare solutions tailored to the unique needs of LGBTQ+ individuals.—📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  🙏 Help shape our show by taking our quick listener survey at https://bit.ly/TurpentinePulse  —SPONSORS:🏥 Thatch makes it easy to give your team great healthcare. Save ~$1620 per employee yearly while giving them customizable plans. Visit https://thatch.ai/HR for a demo and receive a $100 gift card.🏋🏻‍♀️ Strengthen your cells from the inside-out with Fatty15, a pure C15 supplement proven to boost energy, improve sleep, and support metabolic, heart, and liver health – without the downsides of fish oil. Ready to restore your long-term health? Get 15% off your 90-day subscription Starter Kit at https://fatty15.com/secondopinion using code SECONDOPINION at checkout. 👩‍⚕️ Hot flashes, insomnia, brain fog? You don't have to accept these as just another part of aging. Midi Health is the virtual care clinic for women navigating midlife hormonal transition, offering FDA-approved medications, supplements and lifestyle coaching - all covered by insurance. Visit https://joinmidi.com to book your virtual visit today.—LINKS: FOLX Health: https://www.folxhealth.com/ —FOLLOW:https://www.linkedin.com/in/lianaguzman https://www.linkedin.com/in/christinafarr/https://www.linkedin.com/in/lubagreenwood/ https://www.linkedin.com/in/ashzenooz/—HIGHLIGHTS FROM THE EPISODE: FOLX is a virtual clinic providing healthcare specifically for LGBTQIA+ individuals. The current healthcare system was not built for LGBTQIA+ individuals and is often openly discriminatory. 40% of LGBTQIA+ community avoids seeking medical care due to fear of discrimination. 10% of US adult population identifies as queer, while 25%+ of Gen Z identifies as queer. LGBTQIA+ community has higher rates of mental health challenges due to societal stress. Most clinicians graduate with only five hours of LGBTQIA+ training. FOLX started as a direct-to-consumer service for gender-affirming care and expanded to serve the broader LGBTQIA+ community. The company added insurance acceptance and employer partnerships to increase accessibility. The current political climate has created increased demand for FOLX's services. Patient-centered care should value the patient's expertise about their own experience. Liana believes "you can do good and do well at the same time." FOLX positions itself as a smart business decision rather than just a DEI initiative.

Dr. Asima Ahmad, Co-founder and Chief Medical Officer of Carrot, shares her insights as a fertility specialist and entrepreneur. The discussion highlights the urgent need for early fertility education and how technology is revolutionizing access to care. They tackle the rising trend of 'revenge egg freezing' in response to recent job layoffs, examining its implications for equity in fertility treatment. Ahmad emphasizes the importance of mentorship and addresses the shortage of specialists in reproductive health, advocating for accessible solutions.

This week on Second Opinion, we're featuring Christina Farr, Ash Zenooz, and Luba Greenwood's conversation with Sami Inkinen, CEO of Virta Health. They discuss the company's mission to reverse type 2 diabetes and obesity through personalized nutrition and intensive telemedicine.—📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  🙏 Help shape our show by taking our quick listener survey at https://bit.ly/TurpentinePulse  —SPONSOR: 👩‍⚕️ Hot flashes, insomnia, brain fog? You don't have to accept these as just another part of aging. Midi Health is the virtual care clinic for women navigating midlife hormonal transition, offering FDA-approved medications, supplements and lifestyle coaching - all covered by insurance. Visit https://www.joinmidi.com/ to book your virtual visit today.—LINKS: Virta Health: https://www.virtahealth.com/ PHTI: https://phti.org/ Caroline Pearson on Second Opinion: https://www.youtube.com/watch?v=nbo3T654g6c —FOLLOW:https://www.linkedin.com/in/samiinkinen/ https://www.linkedin.com/in/christinafarr/https://www.linkedin.com/in/lubagreenwood/ https://www.linkedin.com/in/ashzenooz/—HIGHLIGHTS FROM THE EPISODE: Sami Inkinen is an "accidental healthcare entrepreneur" who founded Virta Health after discovering he was pre-diabetic despite being a world championship triathlete. Sami's key insight was that "you cannot outrun a bad diet" – excessive processed carbohydrates lead to insulin resistance regardless of exercise level. Virta Health's mission is to reverse type 2 diabetes and obesity in 1 billion people through nutrition, lifestyle changes, and telemedicine support. Virta spent five years running clinical trials that demonstrated they could reverse type 2 diabetes and deliver sustained weight loss (13% at one and two years). They highly individualize treatment plans based on each person's circumstances, whether they're eating from a casino, a 7-Eleven, or McDonald's. Unlike traditional quarterly doctor visits, Virta provides 2-3 interactions daily, monitoring biomarkers and adjusting in near real-time. Their approach doesn't rely on willpower – patients eat to satiety, which is key to long-term success. Patients typically get free access to Virta, with employers or health plans paying because Virta saves them about $600/month per patient. The Peterson Health Technology Institute found Virta was the only digital diabetes program that actually worked. Sami believes the ideal obesity treatment combines nutrition (as first-line defense) with GLP-1 drugs when necessary, not an either/or approach. Virta employs full-time doctors and coaches who form long-term relationships with patients, empowered by software and AI. The company is focusing on scaling their current services, becoming profitable in 2025, and potentially becoming a public company.