Shows / The Clinical Realist
The Clinical Realist
Healthcare innovation is broken. We have billion-dollar AI running on 1990s infrastructure. We have startups dying in "Pilotitis." And we have leaders frozen by analysis paralysis.
Dr. Sarah Matt (The Clinical Realist) is here to fix the disconnect between the tech stack and the trauma bay.
Join Dr. Matt—physician, strategist, and author of The Borderless Healthcare Revolution—as she cuts through the hype to reveal what actually works in modern medicine. No buzzwords. No fluff. Just the raw…
Episodes
- The Clinical Realist
The Trust Slide Is Aimed at the Wrong Target, with Dr. Fatih Mehmet Gul
Every AI vendor deck has a slide about building trust in the algorithm. Dr. Fatih Mehmet Gul thinks it's aimed at the wrong target. The thing eroding isn't…
The Clinical RealistCulture Breaks First, with Julie Tuel
Virtual nursing gets sold to hospital boards as a staffing patch. Put a camera in the room, put an experienced nurse behind it, and the math on the slide…
The Clinical RealistWhat a Medical Bill Actually Is, with Amy Stillman
The encounter ends, the patient goes home, and then a bill arrives. Amy Stillman argues that a medical bill is not a payment reminder. Patients frequently do…
The Clinical RealistWhat Longitudinal Data Actually Contains, with Shashi Shankar
Start with a number. In a registry of about 6,000 patients on GLP-1 medications, roughly 45 percent have taken two or more versions of the drug, most often…
The Clinical RealistWho Gets to Say No in Health IT, with Anthony Guerra
Anthony Guerra has asked roughly the same question about 600 times. He founded Health System CIO in 2010 and has covered health information technology since…
- The Clinical Realist
Agency Is Neurological Before It's Philosophical, with Kris Nessa and Erica Olenski
You cannot will your way to better healthcare outcomes. Agency, it turns out, is not a mindset problem: it is a neurological one, a design one, and a systems…
- The Clinical Realist
Trust Debt: The Bill Comes Due at Renewal, with Arvita Tripati
Somewhere in your organization there is an AI tool in year two of its contract, performing worse than the day you signed. The model did not change. Your…
The Clinical RealistYour Women's Health Strategy Is Labor and Delivery and a Mammogram, with Priya Bathija
Ask a health system CEO about their women's health strategy and you will hear two things. Labor and delivery. Mammography. Then they wipe their hands, and the…
- The Clinical Realist
Why Clinical Trials Keep Missing the Patients They Are Supposed to Help, with Lisa Sonneborn
Most clinical trial eligibility criteria are written by people who have never run a site. Lisa Sonneborn has run one for 15 years. She built the first…
- The Clinical Realist
The Number That Should Stop You: Building Continuity Before Big Tech Does, with Amy Andrade
People whose care is scattered across multiple providers, with no single person or system holding the whole picture, have more than double the risk of dying…
- The Clinical Realist
What an Acquirer Is Actually Buying: Exit-Readiness for Healthtech, with Dr. Roxie Mooney
Most healthtech founders solve a real clinical problem, get piloted in a few systems, and then discover that solving the clinical problem was never the same…
- The Clinical Realist
AI Is a Power Shift, Not Just a Tool: Dr. Robert Pearl on What Generative AI Actually Changes for Physicians and Health Systems
Two years ago, every health system was running an AI pilot. Today, most are still running AI pilots. The technology improved dramatically. The deployment gap…
- The Clinical Realist
Why Health Systems Keep Getting Patient Experience Wrong | Amanda Brummitt, FACHE
Patient experience gets treated as a soft metric. Amanda Brummitt, FACHE, has spent 25+ years in health system operations proving it is a margin lever, a…
- The Clinical Realist
The Other Side of the Table: What Academic Health Systems Actually Need From Health Tech
Dr. Marschall Runge, MD, PhD, Dean of the University of Michigan Medical School and CEO of Michigan Medicine, sits across the table from health tech founders…
The Clinical RealistWhen the Algorithm Is a Device: AI, the FDA, and the Question Almost Nobody Is Asking
The AI tool you bought last quarter, the one bundled into your EHR upgrade, the one your hospital piloted on your unit. Was it cleared by the FDA as a medical…
- The Clinical Realist
The Economics Nobody Taught You in Medical School
Medical school teaches you pathophysiology, pharmacology, and clinical reasoning. It does not teach you how the money actually works. In this episode, Dr…
- The Clinical Realist
The Patient We Never Designed For (Live from Cornell Ithaca, Extended Cut)
Recorded live at Cornell Ithaca. This is the extended cut of Dr. Sarah Matt's keynote on the central design flaw in modern healthcare: a system optimized for…
- The Clinical Realist
Sunk Cost, Vendor Lock, and the AI Tools Health Systems Can't Let Go Of
Most clinical AI governance frameworks tell you how to evaluate tools before you deploy them. Nobody talks about how to exit a tool that is not working. In…
- The Clinical Realist
The Q2 Governance Problem: When AI Goes Live Without a Safety Net
Most health systems that deployed clinical AI in Q1 are now six to eight weeks post-launch and starting to see the governance gap. Dr. Sarah Matt explains what…
- The Clinical Realist
The Pilot Trap: What Health Systems Get Wrong About Implementation
Your pilot worked. You got approval to scale. Six weeks into full implementation, something is wrong: not catastrophically wrong, just wrong enough to make you…
- The Clinical Realist
The Wrong Diagnosis: Why Health Systems Keep Failing at AI
Most health systems that fail at clinical AI adoption are not failing because the tool is bad. They are failing because they diagnosed the problem wrong before…
- The Clinical Realist
The 90% Problem: Why Clinical AI Pilots Don't Scale
You ran the pilot. The AI worked. The clinicians loved it. The outcomes were solid. Then you tried to roll it out system-wide and it fell apart. This is the…
- The Clinical Realist
What Hospital Boards Get Wrong About Healthcare AI And Why It Matters to You
Health system boards are approving eight-figure AI investments without a governance framework that tells them what they are actually approving. They are…
- The Clinical Realist
What Physicians Actually Need to Know About AI Contracts Before They Sign Anything
A physician executive signed a clinical validation form. Eleven months later, she was the one accountable in peer review after an AI-assisted recommendation…
- The Clinical Realist
The Physician's Role in AI Procurement: Accountability Before Authority
When an AI tool causes a patient harm, who gets called into the review meeting? In almost every health system, the answer is the physician. The same physician…
- The Clinical Realist
Why Most Health Systems Will Fail at AI — And It's Not the Technology
Health systems are signing AI contracts they cannot govern. That is the real problem. Not the technology. In this episode, Dr. Sarah Matt, physician executive…
- The Clinical Realist
Ep 6: Taco Bell vs. Steakhouse Dilemma: Why Healthcare Economics is Broken
In this episode of The Clinical Realist, Dr. Sarah Matt takes a deep dive into the confusing and often contradictory world of healthcare economics. Using a…
- The Clinical Realist
Ep 5: The Question Nobody Asks at Healthcare Conferences
Seven thousand healthcare leaders will walk into ACHE 2026 next week. Adam Grant opens. Brene Brown closes. Hundreds of sessions on AI, strategy, and…
- The Clinical Realist
Ep 4: The Virtual Care Illusion - Why Video Visits Aren't the Revolution We Need
In this episode of The Clinical Realist, Dr. Sarah Matt challenges the common misconception that video visits are the pinnacle of virtual care. Drawing from…
- The Clinical Realist
Ep 3: The Illusion of Balance: Embracing the "Tilt" in Leadership and Life
In this deeply personal and practical episode, Dr. Sarah Matt—surgeon, CEO, and author—dismantles one of the most destructive myths sold to modern leaders: the…
- The Clinical Realist
Ep 2: Star Trek vs. The Flintstones: The Reality of Hospital Tech
Are you trying to run Star Trek software on Flintstones infrastructure? In this episode of The Borderless Healthcare Revolution, Dr. Sarah Matt—the Clinical…
- The Clinical Realist
Ep 1: The Manifesto
Welcome to the launch of The Clinical Realist. In this first episode, Dr. Sarah Matt lays out the manifesto for 2026. If we want to fix healthcare, we have to…