The Future of AI in Healthcare with Hugh Barrigan, Chris Page, and Askash Saraiya
In this eye-opening episode, I sit down with Hugh Barragan, a technologist and CTO based out of Boston, Dr. Chris Page, an anesthesiologist and pain medicine physician, and Dr. Akash Soraya, an emergency medicine physician and angel investor, to tackle one of the most pressing questions in medicine today: has technology made healthcare better or worse? We dive deep into the promise and peril of AI, examining whether electronic medical records have been a net positive despite their frustrations, and what the future holds when AI can diagnose faster and more accurately than any physician. The conversation gets real as we discuss whether AI will replace doctors, who takes accountability when algorithms make mistakes, and whether patients will even care if they are talking to a human or a machine.
Key Highlights
🏥 Technology's Mixed Impact: While EMRs have made information more accessible and eliminated handwriting issues, they have also created overwhelming data overload and shifted optimization toward billing rather than patient care.
💰 The Cost Paradox: Healthcare costs have skyrocketed since the introduction of EMRs, yet life expectancy has remained flat at roughly 80 years for 15 years - suggesting technology has not fundamentally improved population health outcomes.
🤖 AI Will Replace Physicians: Dr. Akash boldly predicts that AI will eventually outperform emergency physicians at diagnosis and hopes it happens soon, while acknowledging the massive workforce displacement this would cause across 15-20% of the U.S. economy.
⚖️ The Accountability Problem: Hugh emphasizes that computers cannot be held accountable for decisions, creating a fundamental challenge as AI becomes capable of autonomous clinical decision-making - someone must remain responsible when things go wrong.
🩺 Trust and Human Connection: Dr. Chris argues that patients will continue wanting human care for a long time, as the rapport and comfort provided by a real physician cannot easily be replicated - though AI may eventually convince people otherwise.
📊 The Revenue Cycle Machine: Only 20% of healthcare costs are actual human labor - the rest is driven by increasingly sophisticated billing optimization, which AI will likely accelerate rather than reduce, making healthcare even more expensive.
🛡️ Malpractice Insurance for AI: The panel predicts that by 2028-2029, insurance companies will begin underwriting malpractice coverage for fully autonomous AI clinicians, though the actuarial curves and liability frameworks remain completely undefined.
🥊 The Coming AI War: Hugh predicts a shadow AI war in healthcare where patient AIs fight billing AIs, insurer AIs battle provider AIs, and costs spiral as a
14 Dec 2025
The Truth About Entrepreneurship Nobody Talks About - Preston Alexander
The Truth About Entrepreneurship Nobody Talks About
In this episode, Dr. Rishad Usmani sits down with Preston Alexander, co-founder of Forward Slash Health, a consultancy helping clinicians reclaim autonomy in medicine. From building furniture and rock climbing in Colorado to launching a medical device startup during the pandemic, Preston’s unconventional path shows how curiosity, grit, and timing can shape a career in healthcare entrepreneurship.
He opens up about his early days as a psychology and philosophy student, his accidental entrance into healthcare, and how witnessing the corporatization of medicine inspired his mission to empower doctors to lead the business side of care. Preston and Dr. Usmani discuss the broken incentives driving U.S. healthcare, why AI might make us forget how to think, and how to balance friction and optionality when building impactful products.
With candor and humor, Preston explores the lessons behind his successes and failures — from cold-calling hospitals during COVID to building a startup that helps physicians regain ownership of their work and their purpose.
Key Highlights:
💡 From Climbing Walls to Boardrooms: How Preston went from rock climbing and furniture making to leading healthcare startups. 📘 Learning by Doing: Why he faked being an “MBA candidate,” accidentally earned the degree, and discovered his love for business strategy. 🏥 Inside the Medical Machine: How working in medical devices revealed the tension between innovation, regulation, and corporate growth. 🚀 Starting Up in a Pandemic: The story of launching a surgical device company in February 2020 — and cold-calling hospitals through lockdowns. 🧠 Taking Back Healthcare: How Forward Slash Health helps physicians rebuild independence and rethink the business of medicine. 🤖 AI and the Death of Thinking: Why Preston is both fascinated and frustrated by artificial intelligence and fears it may make humanity less thoughtful. 🎓 Education and Creativity: Why he believes traditional schooling traps curiosity and how parents can rethink education for the next generation. ⚙️ Friction vs. Optionality: The philosophy behind designing products, systems, and companies that are both user-friendly and purpose-driven.
Resources & Next Steps:
🌐 Visit (https://forwardslashhealth.com)forwardslashhealth.com (http://forwardslashhealth.com) to learn more about their mission. 📲 Connect with Preston Alexander on LinkedIn. (https://www.linkedin.com/in/preston-alexander/)🎧 Explore more episodes of Learning with Rishad (https://podcasts.apple.com/nz/podcast/learning-with-rishad/id1655592441) for deep conversations at the intersection of medicine, AI, and human behavior.
8 Nov 2025
The Longevity Medicine Paradox - Adam Carewe, MD (General Medicine)
Inside the Mind of the “Guinea Pig Generation” and the Future of AI in Healthcare
In this episode, Dr. Rishad sits down with Dr. Adam Carewe, a physician-turned-healthtech innovator who believes we are the “guinea pig generation” in modern medicine. From his beginnings as a college basketball player and math enthusiast to becoming Chief Medical Information Officer at Kaiser Permanente, Adam shares his journey into the world of healthcare technology and startups.
Together, they explore the intersection of medicine, technology, and uncertainty — discussing the limits of what doctors know, the rise of AI-assisted diagnostics, and the ethical challenges of over-testing in modern healthcare. Adam also reflects on his leap from a secure medical leadership position into the startup world, and why he believes the future of medicine lies in automating the routine to preserve the human.
With humility and candor, Adam opens up about mental vs. physical health, longevity hype, and what he’d tell his younger self about taking risks and following instinct.
Key Highlights:
🧬 The Guinea Pig Generation: Why today’s patients and physicians live in an era where data grows faster than understanding. 📊 From Equations to Empathy: How Adam’s background in math and exercise science shaped his systems-thinking approach to patient care. 🤖 The AI Physician Debate: When AI might safely assist or even replace parts of clinical decision-making. 🧠 Mind and Body as One: Why the separation between mental and physical health is outdated and counterproductive. ⚕️ Too Many Tests, Too Little Meaning: How modern diagnostics often outpace interpretation, creating anxiety and unnecessary procedures. 🚀 Taking the Leap: Why Adam left a high-level role at Kaiser Permanente to join a startup, and what he’d tell his younger self about courage and timing.
Resources & Next Steps:
📲 Follow Dr. Adam Carewe on LinkedIn (https://www.linkedin.com/in/adam-carewe) for insights on clinical innovation and healthcare tech. 🎧 Explore more episodes of Learning with Rishad (https://podcasts.apple.com/nz/podcast/learning-with-rishad/id1655592441) for deep conversations at the intersection of medicine, AI, and human behavior. 🧠 Read about AI in clinical decision-making in publications like NEJM Catalyst or PubMed. 💡 Learn more about General Medicine, the startup Adam joined after leaving Kaiser Permanente.
Episode Breakdown:
00:00 We Are the Guinea Pig Generation
00:51 Adam’s Early Journey
05:20 When Tech Meets Medicine
08:41 Will AI Replace Doctors?
10:46 ChatGPT & Health Data
15:05 Mind vs. Body
19:17 The Longevity Paradox
24:15 Too Much Testing, Too Little Clarity
29:19 Whole-Body MRI & Overdiagnosis
34:33 Tracking Everything
38:05 Fixing the System
40:36 Final Reflection
Reach and audience
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YouTube views
13,326
Score snapshot 15 Sept 2025
Spotify
5.0 / 5
1 ratings
Podcast Authority Score: 32 / 100
A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.
Quality
22
Social presence
0
YouTube
76
Engagement
27
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