Dr. Adam Brown and Dr. Lara Zibners sit down with Allison Komiyama, PhD, RAC, former FDA reviewer, founder of Bluestocking Health, and self-proclaimed "med tech hype woman", to demystify what actually happens when a medical device tries to reach patients.

Allison breaks down PMA pathways, why "the FDA is the big bad hurdle" is only half the story, and why getting cleared is often just the starting line: insurers won't pay, hospitals won't adopt, and promising life-saving tech can quietly shut down within a year.

They dig into AI's real (and overhyped) role in medical devices, why 8 of the last 10 drugs pulled from FDA clearance failed women specifically, and how the same inequality showing up in clinical trials shows up in art museums too.

Plus: summer camp chaos, killer houseplants, and why everyone needs a "food distribution engineer."

What does it take to leave a steady hospital job and build a value-based care company for the most medically complex kids in America?

In this episode, Dr. Adam Brown and Dr. Lara Zibners sit down with Alison — pediatric emergency physician, mom of 4, host of Startup Physicians, and co-founder of Imagine Pediatrics — to trace her path from clinician to telehealth pioneer to founder of a company that now takes full risk for children on Medicaid.

Along the way, they get into the realities of homeschooling four kids through COVID, why complex pediatric care has been ignored by investors for so long, and the analogy that finally explains the broken math of insuring only the sickest kids (hint: it involves teenage boys and car insurance).

Alison also delivers the single best piece of advice we've heard for physician founders: stop polishing the pitch deck and pre-sell the thing that doesn't exist yet. It's how Imagine Pediatrics walked into day one with thousands of patients already under contract — and it's the playbook she now teaches other doctors who want to build.

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.