Samuel Klein on GLP-1 Revolution, Metabolism, and the Future of Obesity Medicine

Michelle Mello on AI, Insurance Denials, and the Future of Health Policy

Dr. Michelle Mello, professor of law and health policy at Stanford University, joins The Future of Medicine for a conversation about one of the most frustrating and consequential parts of American healthcare: prior authorization. For many patients and clinicians, prior authorization is the process behind the letter saying an insurance company will not cover a medication, procedure, or service unless additional criteria are met. As Dr. Mello explains, this system is already difficult, time-consuming, and often painful for patients and care teams. Now, artificial intelligence is beginning to reshape how these decisions are made. In this episode, Dr. Mello and host Dr. Euan Ashley discuss how insurers and healthcare systems are using AI in prior authorization, billing, appeals, and utilization management. AI may be able to speed up routine approvals and reduce administrative burden, but it also raises serious questions about transparency, bias, accountability, and whether patients are being protected from wrongful denials. The conversation explores what Dr. Mello describes as an “arms race” of AI systems, with insurers using technology to evaluate requests and health systems using their own tools to identify denials most likely to be overturned and draft stronger appeal letters. She also explains why appeals matter: a large share of insurance denials can be reversed, but many health systems do not have enough staff to appeal every case. Together, Dr. Mello and Dr. Ashley consider what responsible AI governance should look like in healthcare, why simply banning AI may not solve the underlying problems, and how AI could be used in ways that support patients, clinicians, and fairer decision-making. They also discuss the need for greater transparency from insurers, the role of private governance, and why academic medical centers have a responsibility to help shape the safe and ethical use of these tools. Thank you for listening! Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.

Anthony Fauci on the Lessons of HIV/AIDS, COVID-19, and The Future of Pandemic Preparedness

Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and one of the nation’s most influential public health leaders, joins Stanford Department of Medicine’s The Future of Medicine for a conversation with Dr. Euan Ashley about science, service, public trust, and the future of public health. In this episode, Dr. Fauci reflects on his early career as a physician-scientist, the first years of the HIV/AIDS epidemic, the creation of PEPFAR, the scientific foundation behind COVID-19 vaccines, and the challenge of communicating evidence in an era of misinformation. Together, Dr. Fauci and Dr. Ashley discuss what it means to lead with integrity when the stakes are high, and why long-term investment in science remains essential for pandemic preparedness and medical progress. Thank you for listening! Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.

Christopher Murray on the Global Burden of Disease and the Hidden Threats Facing Humanity

Dr. Christopher J.L. Murray — health economist at the University of Washington, physician, and founder of the Global Burden of Disease framework — joins The Future of Medicine to discuss what decades of data across 204 countries reveal about human health, and where it's headed by the end of this century. Dr. Murray's Global Burden of Disease project involves 19,000 collaborators in 167 countries and has produced more than 5,000 published papers. In this conversation, he explains what that data shows: remarkable progress on childhood infectious disease and HIV, a profound global shift toward chronic conditions like heart disease, diabetes, and chronic kidney disease, and a mental health crisis — rising steadily for over a decade — whose causes experts still actively debate. He also discusses why the widely circulated claim that American obesity rates had flattened is likely a statistical artifact, what the data projects for the coming decades (including diabetes overtaking heart disease as the world's leading cause of death), and the compounding health crisis facing the Sahel as population growth, poverty, and climate change converge. The conversation closes on the Lancet Commission on existential and catastrophic risks — a project Dr. Murray helped initiate that takes a data-driven look at long-range threats to humanity, from AI and synthetic biology to nuclear risk, out to 2100. It's a rare conversation that takes a long, honest look at the future — and doesn't flinch. Thank you for listening! Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.

Samuel Klein on GLP-1 Revolution, Metabolism, and the Future of Obesity Medicine

Dr. Samuel Klein, Division Chief and William H. Danforth Professor of Medicine and Nutritional Science at Washington University Medicine, joins The Future of Medicine for a conversation about obesity, metabolism, insulin resistance, and the revolution sparked by GLP-1 medications like Ozempic. In this episode, Dr. Klein explains why obesity is far more biologically complex than many people realize — and why some individuals with obesity remain metabolically healthy while others develop diabetes, heart disease, and fatty liver disease. The conversation explores how fat functions not only as stored energy, but also as an active endocrine organ that communicates with the rest of the body through hormones and inflammatory signaling molecules. Dr. Klein discusses visceral fat, insulin resistance, inflammation, and why procedures like liposuction do not produce the same metabolic benefits as weight loss through diet, surgery, or GLP-1 medications. Dr. Klein also reflects on the unexpected rise of GLP-1 therapies, including how medications originally developed for diabetes transformed obesity treatment and may hold broader implications for cardiovascular disease, addiction, and other chronic conditions. Together, Dr. Klein and Euan Ashley discuss the future of metabolic medicine, precision approaches to obesity care, and why understanding metabolism may reshape the future of healthcare itself. Thank you for listening! Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.

Robert Wachter on the Digital Doctor, the Trust Gap, and Medicine's Next Giant Leap

In this episode of the Future of Medicine, we welcome Dr. Robert Wachter, physician, author, and chair of medicine at the University of California, San Francisco, for a conversation about artificial intelligence, healthcare, and the future of medicine. Dr. Wachter reflects on how the digitization of healthcare reshaped modern medicine — and why many of the frustrations clinicians experience today, from burnout to endless documentation, emerged during the first wave of the electronic health record revolution. The conversation explores why large language models like ChatGPT feel fundamentally different from earlier healthcare technologies, and how AI may finally help medicine move beyond the limitations of current electronic health records. Dr. Wachter discusses the promise of AI scribes, clinical copilots, patient-facing tools, and digital assistants that can help clinicians synthesize information, reduce administrative burden, and improve access to expertise. At the same time, he examines the risks of overtrusting AI systems, including hallucinations, deskilling, automation bias, and the challenge of keeping humans engaged when machines are right most (but not all) of the time. Together, Dr. Wachter and Euan Ashley discuss empathy, medical education, patient trust, and what happens when technology begins to act increasingly human. Looking ahead, Dr. Wachter shares why he remains optimistic about AI in medicine — and why the next few years could fundamentally reshape how healthcare is delivered around the world. Thank you for listening! Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.