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Unstable Vitals

Unstable Vitals

By: Dr. Adam Brown and Dr. Lara Zibners
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Welcome to Unstable Vitals, where healthcare experts Dr. Adam Brown and Dr. Lara Zibners navigate the ever-evolving healthcare landscape. Adam, an emergency physician, professor, and founder of ABIG Health, brings a wealth of leadership experience and expertise in healthcare strategy and DEI. Lara, a nationally recognized educator and co-founder of Calla Lily Clinical Care, combines clinical insights with business expertise to address the industry's most pressing challenges.

In each episode, Adam and Lara break down complex topics, offering practical insights and clarity in the often unstable world of healthcare. From policy shifts to healthcare economics, they provide the knowledge you need to navigate today's healthcare system.

Tune in for fresh perspectives, expert analysis, and a dose of reality in every episode!

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Episodes
  • The Safety Net You've Never Heard Of: Inside America's FQHCs with Dr. Rui Ariyapala
    Jun 9 2026

    What if there were a network of clinics quietly delivering full-suite care — primary care, dental, behavioral health, pharmacy, prenatal, mobile units — to anyone who walks in, regardless of their ability to pay? Spoiler: there is, and most Americans have no idea it exists.

    Adam and Lara sit down with Dr. Rui Ariyapala, Associate Chief Medical Officer at Piedmont Health Services and a public health physician trained across New Zealand, the UK, and the US, to unpack the Federally Qualified Health Center model, a 55-year-old experiment in keeping vulnerable patients out of the ED and inside coordinated, value-based care.

    Along the way: why a father walked out of his child's cancer diagnosis, how $4,500 of NHS coverage stacks up against $26,000 a year in US premiums and what it actually takes to move a system built on sick-care toward real prevention.

    Plus: Gary the Word Bird, Ginger Spice at the London Zoo, and a proposal hidden inside an escape room.

    A conversation about the parts of US healthcare that are working and the upstream shifts that could fix the parts that aren't.

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    49 mins
  • The Women's Health Funding Gap: Why Nobody Opposes It but Nothing Gets Done with Kathryn Schubert
    May 26 2026

    Endometriosis affects as many women as diabetes. Diabetes research gets $1 billion a year from NIH. Endometriosis gets $28 million. That kind of gap doesn't exist because people are against women's health research, it exists because it hasn't been made a priority.

    In this episode, Dr. Adam Brown and Dr. Lara Zibners sit down with Kathryn Schubert, President & CEO of the Society for Women's Health Research, to unpack why the women's health funding gap persists, how policy actually gets shaped behind the scenes in Washington, and what it's going to take to close the gap for good.

    Kathryn shares her journey from Capitol Hill scheduler to registered lobbyist to leading one of the longest-standing organizations fighting for women's health equity. Along the way, we get into the real role lobbyists play in healthcare policy (it's not what you think), how advocates tailor their message to move lawmakers on both sides of the aisle, the history of excluding women from clinical trials — and the assumptions that made it seem reasonable at the time, navigating women's health advocacy in a politically charged environment, and why the private sector is finally waking up to women's health as a market opportunity.

    This conversation will change how you think about where health policy comes from and who's actually moving it forward.

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    46 mins
  • Ringworm, MRSA & Broken Buckles: The PPE Problem Nobody's Talking About w/ Justin McKay
    May 12 2026

    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


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    47 mins
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