In this episode of Unstable Vitals, we sit down with Mac Deford, former local government attorney, community advocate, and congressional candidate from South Carolina. From his time in the Coast Guard to his work in behavioral health and affordable housing, Mac has seen firsthand how policy decisions ripple through people’s lives.

We talk about what inspired him to run for Congress, the realities of healthcare and housing access in South Carolina, and why public service still matters, even when the system feels a little… unstable.

In this episode of Unstable Vitals, Dr. Lara Zibners and Dr. Adam Brown welcome Alison Fragale, organizational psychologist, professor, and author of Likeable Badass, to talk about the science of respect, influence, and why women in leadership still face steep uphill battles.

From trading nail files for shoes to unpacking why “likeable” and “badass” aren’t opposites, this conversation dives into how gender bias shapes pay, leadership, and culture, and what can be done to change it.

Alison breaks down the psychology behind earning respect and why bias isn’t just a “men vs. women” problem. Lara and Adam bring it home with real-world reflections on mentorship and what it means to balance warmth and authority in a system that often rewards the opposite.

Smart psychology, unfiltered honesty, and a little bit of chaos the Unstable Vitals way.

In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with orthopedic surgeon, researcher, and author Dr. Jocelyn Wittstein. Together, they dig into an often-overlooked area of medicine: bone and joint health as the foundation for long-term wellness.

Dr. Wittstein shares insights from her new book, The Complete Bone and Joint Health Plan, exploring why osteoporosis and arthritis are more than “aging problems” — they’re critical, preventable drivers of disability that ripple into cardiovascular health, cognitive decline, and overall quality of life. The conversation covers:

• Why mobility is medicine and how preventing fractures protects independence.
• The evidence (and myths) behind supplements like glucosamine, collagen, and more.
• How proactive, cross-specialty care (from hormone therapy to strength training) can reduce complications and extend healthy years.
• Dr. Wittstein’s journey as one of the 6% of women in orthopedics, and how her perspective shapes both her practice and her advocacy for women’s health.

Blending humor, real-life stories, and evidence-based strategies, this episode shines a light on the connection between musculoskeletal health and the stability of our entire healthcare system.

In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners welcome Dr. Steven Farmer, former senior leader at the Center for Medicare and Medicaid Innovation (and Adam’s husband).

Between playful banter and sharp commentary, the trio dives into the serious business of healthcare regulation: why the U.S. system remains unaffordable, how payment models shape medical practice, and what it really takes to shift toward value-based care. From international adventures to bundled payments, Dr. Farmer shares his unique journey through medicine, policy, and innovation—sprinkled with equal parts humor and frustration.

If you’ve ever wondered how regulation, incentives, and a little bit of “gaming the system” affect the care you receive, this is the episode for you.

Trigger warning: This episode contains discussion of physician mental health and suicide. If this topic is distressing, please consider listening with support nearby or using local mental health resources.

In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with Dr. Stefanie Simmons, Chief Medical Officer of the Dr. Lorna Breen Heroes' Foundation, for an urgent, unfiltered conversation about the mental health crisis in medicine. Timed for National Physician Suicide Awareness Day (September 17), the episode explores why clinicians—especially emergency and critical care providers—face elevated rates of burnout, depression, and suicide; the systemic barriers that keep clinicians from seeking help; and concrete policy and operational changes that can begin to “heal the healers.”

Dr. Simmons explains the Foundation’s work that’s shifting culture and protections for clinicians. The hosts bring personal stories from residency and frontline care to highlight how stigma, intrusive application questions, and unsafe workplace systems drive clinicians away from care. This episode is essential listening for physicians, nurses, hospital leaders, policy makers, and anyone who cares about the future of the healthcare workforce.

Subscribe to Unstable Vitals, share this episode to raise awareness, and consider supporting clinician wellbeing efforts in your organization.

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.