Mission Before Monetisation: Building MDCalc Over 20 Years with Graham Walker and Joe Habboushe

Carl Byers joins Tom and Christina to unpack what’s actually changing in healthcare as AI moves from hype to real world application. From the “failure of imagination” phase of AI to the reality of investor expectations, Carl shares how he evaluates companies in a market where capital is no longer free and technology is increasingly commoditised. The conversation moves between venture dynamics, digital health’s overinflated past, and what it really takes to build something with durable value in healthcare. It also expands beyond AI. From GLP-1s reshaping metabolic health to the limits of behaviour change, the discussion explores where real impact is likely to come from in the next 5, 10 and 20 years and whether the future of healthcare is driven by software, drugs, or a combination of both. Key Themes

Tom and Christina sit down with AI researcher, Oxford academic and health equity advocate Maxine Mackintosh for a conversation about bias, power and what happens when healthcare innovation grows up. They explore why the era of “sparkly innovation” in the UK has given way to hard questions about evidence and cost-effectiveness, how AI scribes became one of the first technologies clinicians actively pulled into practice, and why bias in AI isn’t just about models — it’s about the entire pipeline from data collection to post-market surveillance. From genomics datasets skewed toward European ancestry to language, culture and translation, Maxine makes the case that AI can both amplify inequity and create new opportunities for debiasing. The episode closes on a wider lens: billionaire influence, concentrated power, and why introducing friction — not removing it — might be key to preserving humanity in an automated future. Key Themes

Daniel Kraft joins Tom and Christina for a conversation that moves from BioBERT to space medicine, from longevity hype to embryo screening ethics, and from full-body MRIs to the future of medical education. Daniel frames AI as a super convergence (slowly, then all at once) where genomics, multimodal data, computational biology and intelligent agents are beginning to connect. The episode explores the tension between optimism and skepticism: stem cell tourism and snake oil, incidentalomas and anxiety, precision oncology and digital twins. It lands on a new model of future healthcare which is continuous, personalized and insight-driven. Where clinicians are augmented by intelligent systems and freed to focus on judgment, empathy and human connection. Key Themes:

Stephen Klasko’s career doesn’t follow a straight line. From disc jockey, to OB-GYN, medical school dean, health system CEO, and venture investor, this unconventional arc is what gives him the vantage point to dissect American healthcare not as a critic on the sidelines, but as someone who has run one of the largest academic health systems in the country and tried to change it from the inside. This conversation moves from maternal health inequities and malpractice pressures to employer sponsored insurance, perverse financial incentives, and why the U.S. spends more than any other country while outcomes lag. Klasko reflects on leading Thomas Jefferson University, redesigning incentives around health inequities, partnering with venture, and why technology alone won’t fix a system built around sick care. He argues for training a different kind of clinician, rethinking insurance at the state level, and even launching a “911 Commission for Healthcare” to confront structural failure head-on. Key Themes & Topics:

For decades, medicine rewarded stability, hierarchy and certainty. Now, a growing subset of clinicians are stepping away from traditional pathways to build companies, invest in startups and reshape healthcare from the inside. Dr Tom and Christina Farr, sit down with Rebecca Mitchell to unpack what’s changed. From “burning the boats” and letting medical licenses expire, to building venture firms powered by frontline clinicians, this conversation explores why medicine is producing a new archetype: the clinician founder. They examine founder psychology, product led growth in healthcare, storytelling as a strategic advantage, and why the next era of healthcare innovation may be led by doctors who want more agency, not an escape route. Key Themes & Topics: