Unstable Vitals

Ringworm, MRSA & Broken Buckles: The PPE Problem Nobody's Talking About w/ Justin McKay

You put on a lead apron and assume it's keeping you safe. But what if it's carrying MRSA, ringworm, and nearly 10 times the bacteria of a gas station pump handle? Even worse, what if nobody's required to clean it? Justin McKay, founder of RadCare Services, joins Dr. Adam Brown and Dr. Lara Zibners to share how a ringworm infection, a torn-up apron on his first day in the OR, and a year of quietly studying hospitals across the country led him to build something the healthcare industry didn't even know it needed: a full-service lead apron cleaning, repair, and compliance program. In this episode, we dig into the disgusting (and dangerous) reality of radiation protection garments in U.S. hospitals from blood and fecal-stained aprons going right back on the rack, to a culture study that found MRSA on the majority of aprons tested. Justin shares the moment a skeptical surgical director called his pitch "snake oil," so he tested her busiest surgeon's apron on the spot. The results were jaw-dropping. We also talk about the uphill battle of building a business around a problem no one is required to fix, why financial incentives in healthcare make or break innovation, and what gives Justin hope for the future of medicine. In this episode: * Why hospital lead aprons are virtually unregulated for cleanliness in the U.S. * The ATP test that proved aprons are nearly 10x dirtier than gas pump handles * How a 2017 lawsuit tied defective PPE to cancer deaths among OR staff * The founder's journey: quitting a VP of sales job, two years without a paycheck, and bootstrapping a new business Follow Unstable Vitals: LinkedIn [https://www.linkedin.com/company/theunstablevitals] Instagram [https://www.instagram.com/theunstablevitals/] Youtube [https://www.youtube.com/@UnstableVitals]

The NHS Up Close: Emergency Care and Lessons from Across the Pond With Robert Pinate

In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners are joined by a very special guest, Lara's husband, Robert Pinate, a nurse consultant with over 30 years in UK emergency medicine. Rob helps emergency departments rethink outdated workflows and improve patient flow. The conversation dives into how the NHS actually works from its funding model and workforce of to the freedom clinicians feel when billing isn't part of the equation. Rob breaks down the rapid assessment and treatment model he champions, the culture shock of implementing America's Epic EHR in a system that doesn't bill, and what it's like walking into struggling hospitals that feel like they've regressed. The trio explores the sobering parallels between the NHS's decline after years of austerity and the growing cracks in the U.S. system, from Medicare cuts to frontline burnout. But it's not all doom. Rob shares where he's seeing improvement and makes the case that sometimes all it takes is pulling the right people off the floor, handing them a blank sheet of paper, and asking: how can we do this better?

Saving the Independent Practice: How One Company Is Trying to Stop Healthcare's Consolidation Crisis

What happens when a Canadian finance guy with zero healthcare experience decides to take on one of the most broken systems in the world? You get Alex Barrett, co-founder and CEO of Meroka, and a genuinely different perspective on why independent medicine is dying and what can actually be done about it. In this episode, Drs. Lara Zibners and Adam Brown sit down with Alex to unpack the real force behind healthcare consolidation, and it's not the "silver tsunami" you keep hearing about. CMS reimbursement rates have been essentially flat since 2002 while costs have surged, making the business model of running an independent practice quietly unsustainable for thousands of physicians across the country. Alex shares how Meroka is building a third exit path for retiring physicians, one that keeps practices out of private equity hands and transfers ownership to the staff who actually do the work. But the conversation goes deeper: Why does the only OB delivering babies in a 100-mile radius in rural West Virginia still have no negotiating power? Why are non-compete clauses one of the biggest hidden barriers to independent medicine? And is the system so broken it simply can't be fixed? Spoiler: Alex doesn't think so. Listen now.

Season 2: We're Back. And Healthcare Is Still a Mess

Dr. Adam Brown and Dr. Lara Zibners are back for Season 2 of Unstable Vitals, and they're wasting no time. After catching up on life, including Laura's Arctic Circle dog sledding adventure, Adam's new London life, Calla Lily's first Big Pharma partnership, and a spirited rant about Yorkshire pudding, the duo lays out their ambitious plan for the season ahead. This episode introduces the "Five P's" framework that will guide Season 2: Politicians/Policymakers, People (patients), Providers, Payers, and Producers. They argue that fixing America's broken healthcare system requires engaging all five groups, and they plan to do exactly that through conversations with health tech founders, clinical innovators, device executives, regulators, and investors. From the cost of estrogen gel in Europe vs. the U.S. to why walking to the grocery store might be better healthcare policy than anything coming out of Washington, this season promises to be equal parts hilarious and eye-opening. Topics covered: * The "Five P's" of healthcare: the season's guiding framework * Public transportation, walkability, and downstream population health * Lifestyle medicine and transatlantic perspectives on healthcare costs * A preview of Season 2 guests and episodes * What Adam and Lara have been up to since last season Follow Unstable Vitals on LinkedIn to stay connected.

Season 1 Finale: Unstable Vitals 2025 Year in Review

In this special year-end episode of Unstable Vitals, Dr. Lara Zibners and Dr. Adam Brown reunite for their funniest, most unfiltered conversation yet. From GLP-1 mania to AI hype, from the workforce crisis to the seismic impacts of the 2025 election, Lara and Adam break down the five biggest healthcare stories of the year, with the honesty and occasional oversharing you’ve come to expect. Along the way, they revisit their favorite moments from Season 1, reflect on personal wins, and look ahead to what excites and terrifies them most about 2026.  They also talk negotiations, vaccine misinformation, reproductive rights, and why you should always travel with spare underwear. Lara and Adam close out 2025 exactly the way they started it: unstable, opinionated, and determined to make healthcare a little less chaotic, one candid conversation at a time.