In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners dive into one of the biggest challenges in healthcare today: misaligned incentives. Should our system prioritize profit or patients? How do payment models, public policy, and personal responsibility collide to shape health outcomes?

From fee-for-service vs. value-based care to the impact of public transportation, food policy, and behavioral nudges, Adam and Lara unpack the hidden forces driving both innovation and inequity in modern medicine. Along the way, they share personal stories, debate policy trade-offs, and explore how we can make healthy choices easier, care more accessible, and incentives better aligned, without sacrificing innovation.

If you’ve ever wondered why our healthcare system feels broken (and what it would take to fix it) this episode is for you.

🎧 Listen now to hear:

• Why profit-driven incentives often work against patient health
• How public health policies intersect with economic growth
• The promise and pitfalls of value-based care
• Behavioral nudges and making healthy choices easier
• Why doctors need to understand the business of healthcare

Listen to Part 1 before diving into Part 2.

Why is the U.S. healthcare system so expensive, yet so ineffective? In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners dive deep into the tangled web of patients, profits, and misaligned incentives driving instability in American healthcare.

From skyrocketing medical school debt and low primary care reimbursements to insurance company profits and hospital billing practices, Adam and Lara expose the financial forces shaping how (and if) patients receive care. They compare the U.S. system to models in the U.K. and Europe, exploring why Americans pay more but live shorter, less healthy lives.

This episode tackles big questions, like:

• Why do we prioritize treating illness over preventing it?
• How do insurance companies profit while patients struggle with medical bills?
• What does “health” actually mean and who gets to decide?
• Can we fix a system where profit often outweighs patient care?

If you’ve ever wondered why navigating healthcare feels so complicated, or why the U.S. spends more per person on healthcare than any other developed nation but ranks lower in life expectancy, this conversation is a must-listen.

Residency: the rite of passage every doctor must survive before practicing on their own. But is the system built to train (or to break) young physicians?

In this episode of Unstable Vitals, Dr. Laura Zibners and Dr. Adam Brown sit down with Dr. Jared Dashevsky, a resident physician at Mount Sinai and founder of Healthcare Huddle, to unpack the realities of residency and what it reveals about the larger instability in U.S. healthcare.

From 80-hour work weeks and six-figure medical school debt to the high-stakes “Match” process and the infamous July 1st turnover, we dive into the pressures that shape doctors before they even become attendings. Jared shares his perspective as a third-year resident, new father, and healthcare communicator, offering an unfiltered look at the sacrifices, frustrations, and occasional absurdities of residency life.

Along the way, we ask:

• Is the residency system outdated?
• How do pay disparities and debt burden destabilize medicine?
• What changes could make training more sustainable for doctors and the patients they serve?

Whether you’re in medicine, thinking about it, or just want to understand what’s behind the curtain, this conversation exposes the cracks in the system and why they matter for all of us.