The Clinical Realist

Dr. Sarah Matt
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Healthcare innovation is broken. We have billion-dollar AI running on 1990s infrastructure. We have startups dying in "Pilotitis." And we have leaders frozen by analysis paralysis. Dr. Sarah Matt (The Clinical Realist) is here to fix the disconnect between the tech stack and the trauma bay. Join Dr. Matt—physician, strategist, and author of The Borderless Healthcare Revolution—as she cuts through the hype to reveal what actually works in modern medicine. No buzzwords. No fluff. Just the raw, unvarnished truth about how to lead, build, and survive in the future of healthcare. If you are tired of the "Star Trek" vision and want the "Clinical Reality," this is your show. Subscribe to The Sarah Matt Briefing for weekly insights on healthcare AI, access strategy, and the business of medicine: https://drsarahmatt.com/newsletter-signup

  1. 3d ago

    Why Clinical Trials Keep Missing the Patients They Are Supposed to Help, with Lisa Sonneborn

    Most clinical trial eligibility criteria are written by people who have never run a site. Lisa Sonneborn has run one for 15 years. She built the first stand-alone clinical trial facility in Upstate New York, focused on Alzheimer's and NASH research. Watched sponsor after sponsor send protocols with visit schedules, lab windows, and exclusion lists that were scientifically defensible and operationally unworkable. She would look at the eligibility section and know within the first three line items whether the trial was designed for the patients or for the data. In 2024, she co-founded Ichor Research in Syracuse: diagnostic trials for cancer, neurodegeneration, metabolic conditions, substance abuse. The markets large CROs do not prioritize. The patients clinical research has historically passed over. In this episode of The Clinical Realist, Dr. Sarah Matt and Lisa Sonneborn cover the specific protocol features that flag a trial was designed without a real site in mind, what the visit-burden dropout math actually looks like at a small independent site, how AI lands in practice at a three-person team in Upstate New York, the case for running diagnostic research in Syracuse, and what a different five-year future for clinical trial access looks like if small independent sites actually win. What you will take away: - The eligibility list red flag that signals a protocol was not designed for real patients - What dropout math looks like at a small site versus what the protocol assumed - How AI is actually used at Ichor Research versus the pitch version - Why small independent sites reach patients that large CROs skip - What Lisa built differently the second time, knowing what she learned from selling the first business Find Lisa: LinkedIn https://www.linkedin.com/in/lisa-sonneborn-ma-lmhc-17047a63/ | Ichor Research https://ichorlifesciences.com Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  2. Jul 15

    The Number That Should Stop You: Building Continuity Before Big Tech Does, with Amy Andrade

    People whose care is scattered across multiple providers, with no single person or system holding the whole picture, have more than double the risk of dying, even after accounting for how sick they already are. Amy Andrade has spent her career on that gap. In this episode of The Clinical Realist, Dr. Sarah Matt talks with Amy Andrade, Co-Founder and Chief Product Officer of Alphiniti and a biomedical data science researcher at Meharry Medical College. Alphiniti is building person-centric data continuity, infrastructure that keeps one person's record connected across health, financial, and legacy systems instead of scattered across every institution they have ever touched. Amy is also an active advisory client, so this conversation flips the mic on a build Sarah has watched from the inside. The conversation covers what continuity looks like as a shipped product rather than a slide in a deck, the split between institutional (B2B) and consumer-facing (B2B2C) buyers, why AI tools built to fix fragmentation can fail silently for the people already falling through the cracks, the middleware critique and where it does and does not hold up, and how a company Alphiniti's size competes for this category before Big Tech, already signaling interest in the same space, claims it. What you will take away: - Why fragmented data carries a measurable mortality cost, not just an inconvenience - What continuity actually means as a product, not a pitch-deck slide - How B2B and B2B2C buyers value the same infrastructure differently - Where the data-continuity-as-middleman critique is fair, and where it isn't - What has to be true for a company like Alphiniti to win this category Find Amy and Alphiniti: alphiniti.com Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  3. Jul 1

    What an Acquirer Is Actually Buying: Exit-Readiness for Healthtech, with Dr. Roxie Mooney

    Most healthtech founders solve a real clinical problem, get piloted in a few systems, and then discover that solving the clinical problem was never the same thing as building a company someone would actually buy. Dr. Roxie Mooney, DBA, has spent her career on that exact gap. In this episode of The Clinical Realist, Dr. Sarah Matt talks with Dr. Roxie Mooney, founder and CEO of Legacy DNA, where she works with midmarket healthtech and pharmacy companies, often private-equity backed, who are twelve to thirty-six months out from an acquisition or a capital event. She holds a Doctorate in Business Administration focused on commercializing healthcare technology. She helped scale BioPlus Specialty Pharmacy from roughly 750 million dollars to 2 billion in revenue, which led to back-to-back acquisitions by Nautic Partners and then Elevance Health, and she has been part of four successful exits. The conversation covers what an acquirer is actually buying, why most healthtech companies are commercially unready long before they think they are, pilotitis from the commercialization side, the first metric a strategic acquirer opens the diligence folder to find, where pharma and healthtech commercial logic split, and what the current deal climate means for a company eighteen months from an exit. What you will take away: - What a strategic acquirer is actually buying, beyond the clinical science - The signs a founder does not yet understand what makes a company acquirable - Why pilotitis is the enemy of exit readiness - The first metric in the diligence folder - A clear read on the current M and A climate for healthtech Find Roxie: LinkedIn https://www.linkedin.com/in/roxiemooney/ | Substack https://healthinnovatorsedge.substack.com | Book: How Health Innovators Maximize Market Success | Company: Legacy DNA (https://legacy-dna.com) Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  4. Jun 24

    AI Is a Power Shift, Not Just a Tool: Dr. Robert Pearl on What Generative AI Actually Changes for Physicians and Health Systems

    Two years ago, every health system was running an AI pilot. Today, most are still running AI pilots. The technology improved dramatically. The deployment gap between what a board approves and what happens in an exam room stayed the same. In this episode of The Clinical Realist, Dr. Sarah Matt talks with Dr. Robert Pearl about what that gap looks like from inside a system that actually closed it. Pearl was CEO of The Permanente Medical Group and Co-CEO of Kaiser Permanente for 18 years, running 22,000 physicians and 103,000 staff while practicing facial plastic surgery. He is now a clinical professor at Stanford GSB and the School of Medicine, and the author of ChatGPT, MD: How AI-Empowered Patients and Doctors Can Take Back Control of American Medicine. The conversation covers the part that does not fit on a conference slide: the honest before-and-after between narrow AI and generative AI, why patients gaining information parity with physicians is a power shift and not just a convenience, the diagnostic error comparison that almost no one in medicine will make publicly, and what it actually takes to close the boardroom-to-care-floor seam before the tools scale past the governance. What you will take away: - The honest clinical difference between the first wave of narrow AI and generative AI in practice (not in press releases) - Why physician resistance to AI second-opinions is about power structure, not just liability or hallucinations - The diagnostic error comparison between AI and physicians, and why the data is not being discussed publicly - What health system boards are being told about AI ROI versus what is actually happening in exam rooms - Where the governance needs to be before the tools scale Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  5. Jun 17

    Why Health Systems Keep Getting Patient Experience Wrong | Amanda Brummitt, FACHE

    Patient experience gets treated as a soft metric. Amanda Brummitt, FACHE, has spent 25+ years in health system operations proving it is a margin lever, a retention lever, and the first thing most AI rollouts ignore.\n\nIn this episode of The Clinical Realist, Dr. Sarah Matt sits down with Amanda Brummitt, Principal of Brummitt Group, to unpack why patient experience is strategy, not sentiment, and what health system leaders get wrong when they bolt AI onto a broken experience.\n\nGuest: Amanda Brummitt, FACHE, Principal, Brummitt Group\nHost: Dr. Sarah Matt, MD, MBA, surgery-trained physician-executive\n\ndrsarahmatt.com | https://calendly.com/sarahmattmd— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  6. Jun 10

    The Other Side of the Table: What Academic Health Systems Actually Need From Health Tech

    Dr. Marschall Runge, MD, PhD, Dean of the University of Michigan Medical School and CEO of Michigan Medicine, sits across the table from health tech founders every day. In this episode, he shares the institutional reality that most health tech companies never see: what it actually takes for an academic medical center to say yes. Not the demo. Not the pilot. The governance questions, the budget structures, the clinical workflow realities, and the leadership calculus that decides whether a tool survives past the first quarter. If you build for health systems, or you are trying to scale inside one, this is the conversation that explains why the buyer behaves the way they do.— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

  7. May 27

    When the Algorithm Is a Device: AI, the FDA, and the Question Almost Nobody Is Asking

    The AI tool you bought last quarter, the one bundled into your EHR upgrade, the one your hospital piloted on your unit. Was it cleared by the FDA as a medical device? Most physicians do not know the answer. The vendor's pitch deck almost certainly did not lead with it. And the answer matters, because once an algorithm crosses into FDA medical device territory, the rules that govern what it can claim, how it has to perform, who is liable when it fails, and what evidence the manufacturer had to produce before it reached your practice change categorically. In this episode of The Clinical Realist, Dr. Sarah Matt walks listeners through three questions: when is an AI tool a medical device, what do the three FDA approval pathways actually mean about the evidence behind a product, and what does professional liability look like when the algorithm is the one making the call. What you will take away: - When a clinical AI tool crosses the line into FDA-regulated medical device territory - What 510(k), De Novo, and PMA clearance pathways actually say about the evidence behind a product - Why the word cleared is doing enormous amounts of work in this industry - What changes for physicians, procurement teams, and health system leaders when the algorithm is making the call Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

    When the Algorithm Is a Device: AI, the FDA, and the Question Almost Nobody Is Asking

  8. May 20

    The Economics Nobody Taught You in Medical School

    Medical school teaches you pathophysiology, pharmacology, and clinical reasoning. It does not teach you how the money actually works. In this episode, Dr. Sarah Matt breaks down the economic structures that govern every clinical decision, every technology purchase, and every AI pilot that dies in a committee room: who pays, who decides, who uses, and why those three people are almost never the same person. What you will take away: - The user / decider / payer split and why it explains nearly every failed health-tech deal - How the RVU system shapes physician behavior and silently resists AI adoption - Why value-based care is harder to execute than the architects planned for - The practical questions buyers, vendors, and physicians should be asking before any AI deployment If you want to understand why healthcare moves so slowly, start here. Book a Discovery and Clarity Session: https://calendly.com/sarahmattmd Subscribe to The Sarah Matt Briefing: https://drsarahmatt.com/newsletter-signup— Resources & Links: 📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers. 💼 Work with Dr. Matt: Looking for a keynote speaker or strategic advisor? Visit: drsarahmatt.com 🔗 Connect on Social: LinkedIn: https://www.linkedin.com/in/sarahmattmd/ YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist 📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup   — Disclaimer: The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.

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About

Healthcare innovation is broken. We have billion-dollar AI running on 1990s infrastructure. We have startups dying in "Pilotitis." And we have leaders frozen by analysis paralysis. Dr. Sarah Matt (The Clinical Realist) is here to fix the disconnect between the tech stack and the trauma bay. Join Dr. Matt—physician, strategist, and author of The Borderless Healthcare Revolution—as she cuts through the hype to reveal what actually works in modern medicine. No buzzwords. No fluff. Just the raw, unvarnished truth about how to lead, build, and survive in the future of healthcare. If you are tired of the "Star Trek" vision and want the "Clinical Reality," this is your show. Subscribe to The Sarah Matt Briefing for weekly insights on healthcare AI, access strategy, and the business of medicine: https://drsarahmatt.com/newsletter-signup

Information

  • Creator
    Dr. Sarah Matt
  • Years Active
    2026
  • Episodes
    24
  • Rating
    Clean
  • Copyright
    © 2026 The Clinical Realist
  • Show Website
    The Clinical Realist