Dr. Adam Cifu is a general internist and professor at the University of Chicago, co-author of Medical Reversal, and co-founder of Sensible Medicine, one of the most widely read independent medical publications in the country. He sees patients daily, teaches the next generation of physicians, and writes about the gap between medical consensus and medical evidence.

In this conversation with Shannon Lantzy, Dr. Cifu breaks down what medical reversal actually means and why hormone replacement therapy is one of the most instructive examples of how medicine gets things wrong. He shares his nuanced take on CGMs, AFib detection, wearables, and blood pressure monitoring, and explains why the same device can be genuinely helpful for one patient and harmful for another. He also reflects on what evidence-based regulation should look like, what he hopes changes at FDA, and why primary care is still the most important relationship in medicine.

Timestamps: 

[00:00:00] Introduction and Dr. Cifu's background

[00:01:44] Deciding to become a doctor

[00:03:08] What other career he might have had

[00:04:40] Writing, publishing, and the piece that changed everything

[00:05:40] What his practice actually looks like

[00:07:32] Why Sensible Medicine is a group publication

[00:10:16] Finding Sensible Medicine through Marty Makary's book

[00:11:28] What medical reversal means

[00:12:40] Hormone replacement therapy as the defining case

[00:15:40] Shannon's personal experience and the gap in clinical practice

[00:17:00] When turning healthy people into patients goes wrong

[00:20:20] The Oura ring and what biofeedback actually teaches

[00:22:04] Should daily burden be measured? Dr. Cifu pushes back

[00:24:08] When data doesn't help

[00:26:44] N of one trials and personalized medicine

[00:32:48] Technology in primary care: entering with trepidation

[00:34:28] Stenting and the cautionary tale of extrapolation

[00:38:28] Early adopters as beta testers

[00:39:16] What a clinic day actually looks like

[00:43:12] The Whoop blood pressure controversy

[00:46:32] AFib detection: who it helps and who it harms

[00:49:40] A hypothetical 82-year-old, Apple Watch data, and a caregiver's anxiety

[00:51:32] When information helps patients and when it makes things worse

[00:53:24] Adam Cifu AI: the case for and against

[00:57:24] When a test won't change management

[01:00:44] Hopes for FDA and evidence-based regulation

[01:04:00] Medical devices and the surgical reversal risk

[01:07:04] Rapid fire questions

Follow Shannon and Adam:

Connect with Shannon: 

LinkedIn: https://www.linkedin.com/in/shannonlantzy/

Website: https://www.shannonlantzy.com/

Connect with Adam: 

LinkedIn: https://www.linkedin.com/in/adam-cifu-bbb8ba206/

Website: https://www.sensible-med.com/