In this episode of the Second Opinion, Christina Farr interviews Dickon Waterfield, president of Lantern to discuss the intricacies of U.S. healthcare costs, particularly the disparity between Medicare and commercial prices. They cover the unsustainable burden on employers to provide healthcare, the evolving nature of digital health solutions, and the market's reaction to recent IPOs in the sector.

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LINKS:
Lantern: https://lanterncare.com/ 

Christina Farr's Second Opinion Newsletter: https://secondopinion.media/ 

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SPONSOR:
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HIGHLIGHTS FROM THE EPISODE:
• The company was previously under the radar despite its size because it lacked traditional digital health investors and operated in the emerging "sensitive excellence" space
• Lantern works by securing lower rates from select providers in exchange for steering patient volume to them, rather than contracting with all providers like traditional insurers
• Commercial insurance pays dramatically more than Medicare for the same procedures - for example, a total knee replacement costs around $45,000 commercially versus $17,000 for Medicare
• About 90% of surgical costs go to the facility, with only 10% split between surgeon and anesthesia fees
• The company built scale over 14 years by starting with local networks and school districts before expanding to national employers
• They typically contract with only one or two providers per market, offering them incremental volume and market share gains
• By waiving patient cost-sharing (like $5,000 out-of-pocket maximums), they incentivize patients to travel to preferred providers
• Proposed Medicaid cuts could affect 10% of Medicaid recipients, forcing more healthcare costs onto employers
• When Medicaid funding decreases, hospitals typically increase commercial rates to compensate for uninsured patients
• Employers are increasingly frustrated with being responsible for 60-70% of Americans' healthcare coverage
• The current system originated post-WWII as a talent competition tool and became normalized as part of total compensation packages
• Only a major economic downturn with high unemployment could potentially break this cycle, as tight labor markets force employers to maintain competitive benefits
• Employers will likely narrow their coverage, offering less rich benefits and more selective networks and formularies
• Cell and gene therapies costing $1-5 million per treatment pose existential threats to employer-sponsored health plans
• There's a reckoning coming for point solutions that don't deliver measurable ROI, with increased scrutiny on clinical evidence and cost reduction
• Digital health companies are held to higher standards than pharmaceuticals, which don't face the same outcome-based payment requirements
• Forward-thinking employers are moving beyond simple cost savings to evaluate programs on multiple parameters including talent retention and clinical outcomes
• A new generation of digital health companies is becoming in-network providers rather than selling directly to employers
• This approach eliminates long sales cycles and complex billing arrangements that characterized earlier digital health companies
• Successful healthcare sales requires understanding buyers' needs and solving their problems rather than just selling solutions
• Founder-led sales remains crucial in early stages because founders can listen more acutely to feedback and pivot quickly

In this episode of Second Opinion, Christina Farr and Lifeforce CEO Dugal Bain-Kim dive into the billion-dollar longevity economy, examining why health optimization became a status symbol and how personal data drives better health decisions than population-level advice.

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LINKS:
Lifeforce: https://www.mylifeforce.com/ 

Christina Farr's Second Opinion Newsletter: https://secondopinion.media/ 

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FOLLOW:
https://www.linkedin.com/in/dugal-bain 
https://www.linkedin.com/in/christinafarr/ 

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HIGHLIGHTS FROM THE EPISODE:
• The "shadow healthcare system" refers to cash-pay healthcare alternatives where insured people seek services outside traditional insurance coverage.
• This trend results from converging factors: post-COVID cultural shifts, health becoming aspirational/lifestyle status, and new technology enabling accessible longevity services.
• Personalized data from wearables (like Aura rings showing sleep/alcohol impact) motivates behavior change more effectively than general medical advice.
• "N of one" personalized data feels more relevant than population health guidance, though there's risk of "measuring the fun out of life."
• Personal genetic risk (like Alzheimer's predisposition) transforms health behaviors from optional to urgent, particularly around sleep quality.
• A paradox exists where physicians publicly skeptical of longevity medicine privately use interventions like GLP-1 microdosing and seek optimization partners.
• Personal health testing reveals significant issues traditional healthcare misses, including PCOS, scoliosis, and device malfunctions.
• Longevity medicine catches problems early - 26% of members are pre-diabetic, often undiagnosed despite regular annual physicals.
• Continuous monitoring can discover serious conditions like pituitary brain tumors when primary care doctors aren't interested in investigating elevated biomarkers.
• The equity challenge questions how expensive cash-pay services can reach populations who need them most.
• Three customer types emerge: health optimizers, health-motivated people getting back on track, and people wanting complete health reinvention.
• Solutions for broader access include insurance integration and AI-powered tools to reduce costs from $140 to $40 monthly.
• The "dating app problem" asks whether longevity companies lose customers when they successfully improve health.
• Solutions include maintenance vs. optimization modes, targeting 40-60 age demographic where significant bodily changes occur.
• Despite male-focused industry branding, actual customer bases can be gender-balanced (45% female, 55% male).
• Effective messaging balances performance-focused and wellness-focused approaches rather than targeting one gender.
• Longevity medicine includes traditional prevention but adds quality-of-life interventions that create initial motivation and trust for broader health compliance.
• The rebranding question asks whether longevity is simply primordial prevention made more engaging and actionable.
• Supplement safety concerns arise from liver injuries and poor industry regulation, highlighting need for data-driven approaches.
• Most people take too many unnecessary supplements; data-driven supplementation could improve both safety and efficacy.

This week on Second Opinion, Christina Far interviews Courtney Bragg, CEO and co-founder of Fabric Health, about their innovative approach to delivering healthcare services in laundromats. They discuss the challenges and opportunities in the Medicaid system, the importance of building trust and relationships in healthcare, and the critical role of human elements alongside technology.
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SPONSOR:
🏥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.

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LINKS:
Fabric Health: https://fabrichealth.org/

Christina Farr's Second Opinion Newsletter: https://secondopinion.media/

—
FOLLOW:
https://www.linkedin.com/in/cdebragg/ 
https://www.linkedin.com/in/christinafarr/ 

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HIGHLIGHTS FROM THE EPISODE:
• Most healthcare startups chase the obvious markets, but Fabric Health found something different: 32 million Americans spending two hours weekly in laundromats, 70% of them women making healthcare decisions for their families.
• Founder Courtney Bragg's counterintuitive insight: you need "muffins before mammograms" - build genuine relationships before pushing healthcare services on people who've been burned by scams.
• The approach works because it's human-first with tech as an enabler, not the other way around - they integrate with laundromat systems but lead with offering someone a laundry cart.
• After 837 days in laundromats, they learned the hard way that walking up and asking "do you have insurance?" is tone-deaf; real conversations start with Eagles football talk in Philly.
• The results speak for themselves: 27,000 families enrolled, profitable before raising VC money, and hiring directly from the communities they serve.
• The healthcare system is genuinely broken in absurd ways - like sending a blind woman a paper letter asking her to confirm she's still blind to keep her benefits.
• System dysfunction runs deep: kids auto-assigned to different health plans (one mom juggling four), caseworker calls flagged as "scam likely," transportation benefits that stop 2 miles short of available care.
• These aren't technology problems - they're human problems that require understanding real people's lives, not building apps in isolation.
• The Medicaid opportunity is massive and misunderstood: 80 million Americans, nearly half of all births, but VCs avoid it because they think "poor people don't pay enough."
• Political noise around Medicaid cuts is mostly theater - too many hospitals and jobs depend on it, plus "a lot of people who wear red MAGA hats are on Medicaid."
• States are actually begging Fabric to expand because they see results, with Medicaid directors personally requesting their services.
• The real opportunities ahead are in maternal and pediatric care, where states face real financial penalties for missed metrics.
• Courtney's unconventional background in education taught her community organizing - skills most tech founders lack but healthcare desperately needs.
• Her advice for mission-driven founders: "you've gotta be obsessed with what you're building because you care deeply about it" - most startup founders are just chasing trends.

This week on Second Opinion podcast, Christina Farr and Ash Zenooz interview Eric Jon Larsen about the the potential and challenges of AI in healthcare and various industries, debating its role, accuracy, impact on jobs, and future implications for human society.

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SPONSOR:
🏥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:
Eric Jon Larsen (Towerbrook): https://www.towerbrook.com/our-team/eric-jon-larsen/ 
The 'creepy Facebook AI' story that captivated the media: https://www.bbc.com/news/technology-40790258 
Genesis: Artificial Intelligence, Hope, and the Human Spirit: https://www.amazon.com/Genesis-Artificial-Intelligence-Human-Spirit/dp/0316581291 
John Maynard Keynes’s  Economic Possibilities for our Grandchildren: https://www.econ.yale.edu/smith/econ116a/keynes1.pdf 

Christina Farr's Second Opinion Newsletter: https://secondopinion.media/ 

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FOLLOW:
https://www.linkedin.com/in/eric-larsen-a4a0461/ 
https://www.linkedin.com/in/ashzenooz/ 
https://www.linkedin.com/in/christinafarr/ 

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HIGHLIGHTS FROM THE EPISODE:
• Christina Farr tested AI on financial filings - it produced 5-hour analysis in 2 minutes but with 5% inaccuracies requiring 2 hours to verify, raising the question of whether we should wait for 100% accuracy before relying on AI
• Eric Larsen argues AI represents a "speciation event" - unlike previous technologies that augmented human capabilities, AI will replace cognitive work entirely as we create "non-biological intelligence" superior to humans
• Healthcare faces a perfect storm: medical knowledge now doubles every 73 days (vs 50 years in 1950), 2.3 million biomedical studies published annually, and humans already exceed ability to process medical knowledge
• AI shows superior empathy in healthcare - people tell truth to chatbots but lie to humans to avoid embarrassment, and chatbots provide infinite patience compared to overworked physicians
• China announced first AI hospital with 26 specialties testing 10,000 synthetic patients with higher diagnostic accuracy than human doctors, while US regulatory barriers slow adoption
• Counterintuitive prediction: high-cognition jobs (doctors, lawyers, consultants) will be disrupted before physical jobs due to "Moravec's Paradox" - algorithms mastered chess and Go but struggle with basic motor skills
• The healthcare narrative that "AI won't replace doctors, but doctors using AI will replace those who don't" is a "bedtime story" - real trajectory points toward AI systems exceeding human diagnostic capabilities
• Economic transformation ahead includes potential 30% annual productivity improvements, massive deflation as AI drives costs toward zero, and need for new social redistribution policies
• Larsen advises next generation to "learn for agility" - study humanities plus STEM, become "cybernetic" human-machine collaborators, and develop AI proficiency as core mental operating system
• Critical window exists to shape AI development before it achieves "escape velocity" through automated AI research, creating infinitely replicable researchers sharing a "hive mind" of knowledge

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.

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SPONSOR:
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LINKS:
Christina Farr's Second Opinion Newsletter: https://secondopinion.media/ 

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FOLLOW:
https://www.linkedin.com/in/christinafarr/ 
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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

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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.

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🏋🏻‍♀️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.

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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/ 

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FOLLOW:
https://www.linkedin.com/in/sklasko/ 
https://www.linkedin.com/in/jessicabeegle/ 
https://www.linkedin.com/in/christinafarr/ 

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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.

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🏋🏻‍♀️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.

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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/

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FOLLOW:
https://www.linkedin.com/in/christinafarr/ 
https://www.linkedin.com/in/ashzenooz/ 

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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  

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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.

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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/

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FOLLOW:
https://www.linkedin.com/in/peterlee4  
https://www.linkedin.com/in/epatientdave/  
https://www.linkedin.com/in/christinafarr/  

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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.

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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/ 

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FOLLOW:
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https://www.linkedin.com/in/christinafarr/ 
https://www.linkedin.com/in/ashzenooz/ 

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HIGHLIGHTS FROM THE EPISODE:

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.

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📰 Be notified early when Turpentine drops new publication: https://www.turpentine.co/exclusiveaccess  

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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/

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FOLLOW:

https://www.linkedin.com/in/christinafarr/

https://www.linkedin.com/in/lubagreenwood/ 

https://www.linkedin.com/in/ashzenooz/

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HIGHLIGHTS FROM THE EPISODE: