Today's guest is, Dr. Michael Gold, the Chief R&D Officer at Compass Pathways, which is developing a psilocybin treatment for treatment-resistant depression. A neurologist by training, he has spent nearly 30 years developing brain drugs at companies including Bristol-Myers Squibb, GSK and AbbVie.

In this episode, Dr. Gold explains why brain drugs fail so often, even with hundreds of millions of dollars and top scientists behind them. He walks through the structural challenges of neuroscience: limited animal models, subjective outcome measures, and diseases that begin decades before symptoms appear. He also shares why rigorous, high-quality data is an ethical obligation to the patients who volunteer for trials, and how better biomarkers are changing the field’s odds. Finally, he discusses Compass Pathways’ path toward potential FDA approval and how psychedelics could reshape the way psychiatry defines mental illness.

High Quality Data Is the Best Medicine | $1.6b Compass Pathways CRO Dr. Michael Gold

Today's guest is Dr. Jim Min, the founder and CEO of Cleerly, a cardiovascular imaging company using coronary CT and AI to help clinicians detect and understand heart disease earlier.

In this episode, we explore why traditional cardiology has been so symptom-driven and what changes when physicians can directly visualize the plaque causing coronary artery disease. Jim explains why cholesterol levels, stress tests, and calcium scores can miss important aspects of risk, and how Cleerly is trying to move heart care toward a more personalized, disease-based model. We also discuss the company’s clinical trials, the challenge of building reimbursement and adoption around a new standard of care, and what it took for Jim to move from academic research into entrepreneurship. Finally, we talk about the role AI could play in bringing together imaging, biomarkers, genetics, and other data to make cardiovascular prevention more precise.

The End of Symptom-Based Cardiology | $750m Cleerly CEO Dr. James Min

Today's guest is Paul Brient, Chief Product Officer at Athenaheallth, a $17 billion EHR with more than 170,000 clinicians on its network. Paul has spent his entire career getting doctors to actually love the technology they use, from running PatientKeeper for 17 years, to now leading Athena's push to build an AI native EHR.

We start with the origins of the physician friction problem, why doctors adopted robotic surgery overnight but fought the EHR for two decades, and how Meaningful Use turned the highest paid people in the hospital into data entry clerks. From there, Paul walks through the structural misalignment in healthcare software, where the person who builds the product, pays for it, and uses it are three different people, and why Athena's practice level model works differently. We also get into payers, which Paul argues are the most misunderstood players in the system, and how Athena's Moment of Care product brings payer intelligence to the point of care in real time. And finally, the AI native EHR itself, why Paul believes the original EHR was a mistake of metaphor built around a paper chart, and why he thinks this is finally the moment doctors will actually love their software.

How Doctors Became Unit Secretaries | $18B Athenahealth Chief Product Officer Paul Brient

Cardiovascular disease remains the world's leading killer, yet cardiovascular drug development has declined dramatically when compared to other therapeutic areas.

Today, we sit down with Dr. Howard Surks, a cardiologist turned bench scientist turned big pharma leader who left Merck and Sanofi to help build Cardurion Pharmaceuticals from the ground up around a first-in-class heart failure drug. 

In the episode, Howard's discusses journey from studying blood vessel biology at Tufts to running translational medicine programs at two of the world's largest pharma companies: the real tradeoffs between big pharma and biotech, why cardiovascular trials have become so expensive that most companies walked away. We dig into what it actually takes to move a molecule from the lab into patients, and how decades of basic science research became the foundation for Cardurion's PDE9 inhibitor program. 

When Big Pharma Abandoned the Heart | $750m Carduion CSO Dr. Howard Surks

Today's guest, Rachel Werner, is a physician, health economist, and Executive Director of Penn’s Institute of Health Economics whose work explores how healthcare policy can improve care without creating harmful unintended consequences.

In this episode, we discuss why public quality report cards can push providers to avoid high-risk patients. We examine why pay-for-performance often improves the metric being rewarded without meaningfully improving patient outcomes. We also explore the debate over nursing home staffing mandates and the evidence that stronger staffing requirements could save thousands of lives each year. Finally, we discuss why rigorous research does not always translate into policy, and what it takes to build a more evidence-informed healthcare system.

Why Is Good Healthcare Policy So Hard? | UPenn LDI Director Dr. Rachel Werner

Today's guest is Mark Frank is the founder and CEO of SonderMind, one of the largest mental health platforms in the country that helps providers help patients and manage their practices.

In this episode, we unpack why the mental health care system has lacked the basic infrastructure that exists in nearly every other healthcare vertical. Mark walks through the provider side, where therapists are forced to become small business operators just to deliver care, and the patient side, where insurance directories are functionally broken and subjective screening tools like the PHQ-9 leave massive gaps in understanding. We explore how SonderMind is building an integrated system of care that captures what happens between sessions to give therapists better information and patients better outcomes. T

An Operating System for Mental Healthcare | $1B+ SonderMind CEO Mark Frank

Today we speak with Jonathan, co-founder of Paradigm Health, a startup which has raised over $350m+ to is build the infrastructure behind clinical trials in order to make them quicker and more accessible.

Jonathan walks us through his path from a UChicago neuroscience lab to dropping out of Stanford to launch CyApps, one of the earliest precision medicine companies. We dig into why US trial capacity is fundamentally broken — why oncology needs three times the current bandwidth, why studies are moving to China, and why providers (not patients) are the real recruitment bottleneck. Jonathan breaks down Paradigm's playbook across trial design, site selection, LLM-native patient matching, and real-time data collection, and how they "hacked" the cold start problem through aggressive fundraising and acquisitions like Flatiron's clinical research unit. We close on what keeps him up at night: the risk of the US losing its edge in clinical innovation, and the AI wave he believes can help us win it back.

Rewriting the Clinical Trial Paradigm | $500m Paradigm Health Co-Founder Jonathan Hirsch

Today's guest is Jason Rhodes, a partner at Atlas Venture and serial biotech entrepreneur who took Dyne Therapeutics ($2B+) and Epizyme ($5B+) through their IPOs, co-founded Disarm Therapeutics (acquired by Eli Lilly), and spent years on the leadership team at Alnylam Pharmaceuticals helping pioneer RNAi therapeutics.

In this episode, Jason breaks down over three decades of biotech evolution. We trace how pharma went from fully vertically integrated to increasingly dependent on biotech for its pipeline, and why that inversion reshaped the entire industry. Jason introduces what he calls the paradox of plenty, as the barriers to building biotech companies come down and innovation pours in from China, AI, and maturing capital markets, the flood of competition makes it harder than ever to be first or best in class. We get into how Atlas navigates that by building companies from scratch, spending $2 million to test whether the science even replicates before pouring in real capital. It's a wide-ranging conversation on where biotech has been, where it's going, and why the biology is always immutable.

Pharma's Paradox of Plenty in Biotech | Atlas Venture Partner Jason Rhodes

In this episode, we speak with Dr. Atul Gupta, a professor at the Wharton School, about the role of free markets in healthcare, along with the broader tradeoffs between quality and efficiency.

We start by discussing how information asymmetry, third-party payment, and limited competition make it difficult for the “invisible hand” to function in healthcare. Dr. Gupta then walks through his research on hospital readmission penalties, showing how financial incentives can improve care while also creating room for hospitals to game the metrics. We also explore the trade-offs behind hospital privatization and consolidation, including how efforts to make hospitals more efficient or profitable can affect prices, staffing, safety-net access, and patient outcomes. Finally, we examine private equity’s role in healthcare and what better regulation, transparency, and quality-linked incentives could look like in the future.

Why Free Markets Break in Healthcare | Wharton Professor Dr. Atul Gupta

Today's guest is Dr. Richard Carmona, the 17th Surgeon General of the United States, a trauma surgeon, public health leader, former hospital executive, and decorated Army Special Forces medic.

In this episode, we explore how Dr. Carmona’s early life, military service, and medical career shaped his understanding of healthcare as far more than what happens inside a hospital. He discusses building Arizona’s regional trauma system, turning around a public hospital, and why prevention, health literacy, and trust are central to improving outcomes. We also dive into the politicization of public health, from tobacco and vaccines to the growing confusion around scientific institutions today. Dr. Carmona explains why the Surgeon General’s role should be nonpartisan, grounded in science, and focused on helping the public make better health decisions. At its core, this conversation is about what happens when science, politics, and trust collide, and what it will take to rebuild confidence in American healthcare.

The Collapse of Trust in Public Health | U.S. Surgeon General Dr. Richard Carmona

Nikhil Reddy (@nikhilrxddy) · Zencastr

Nikhil Reddy (@nikhilrxddy)

Discover where healthcare is headed with The Healthcare Theory. Through recurring mini-series, we unpack everything from health policy to life sciences and digital health. Tune in every week for insightful conversations with founders, researchers, and industry experts that are shaping the future of healthcare.

The Healthcare Theory Podcast