In this episode of Precision Medicine Made Simple, we welcome back Dr. Yelena Bykhovskaya, the Chief Scientific Officer at Biography Health, for a deep dive into polygenic risk scores (PRS) and their emerging role in precision medicine. Dr. Bykhovskaya breaks down the complexities of genetics and its application in clinical practice, focusing on how polygenic risk scores can be used to assess an individual's risk for common complex diseases.

We discuss the evolution of genetics in healthcare, how PRS differs from monogenic testing, and why the accuracy and predictive power of these scores are becoming increasingly important. We also address some of the challenges in applying PRS across different populations and the future potential of genetic risk scores in personalized healthcare.

Key Takeaways:

• Polygenic risk scores are a powerful tool for assessing genetic predisposition to complex diseases like heart disease, Alzheimer’s, and more.
• PRS are calculated using multiple genetic variants, not just one, making them useful in understanding complex traits.
• While still evolving, PRS are becoming more accurate, especially with the incorporation of data from diverse populations.
• Understanding PRS can help prevent diseases before they manifest, offering proactive healthcare solutions.
• The challenges and benefits of integrating PRS into clinical practice, and how the field is rapidly advancing.

In This Episode:

• [00:00] Introduction to polygenic risk scores and their relevance in precision medicine
• [05:00] How the Human Genome Project and next-generation sequencing revolutionized genetics
• [10:00] Explaining the difference between monogenic and polygenic diseases
• [15:00] The limitations of current PRS models and how they’re improving over time
• [20:00] Why PRS is especially useful for assessing cardiovascular risk and other common conditions
• [25:00] The impact of ancestral diversity on PRS and how researchers are making improvements
• [30:00] What it takes for PRS to move from research to clinical use
• [35:00] The potential for PRS to inform more personalized treatment plans
• [40:00] Dr. Bykhovskaya’s personal experience with blood pressure medication and how PRS could have helped
• [45:00] How precision medicine is changing the way we think about healthcare

Notable Quotes:

• “Polygenic risk scores are not just about predicting the future, they’re about empowering people to take control of their health today.” – Dr. Yelena Bykhovskaya
• “You can't just focus on a single gene; it's about the whole picture, understanding how multiple genetic factors contribute to disease risk.” – Dr. Yelena Bykhovskaya
• “Genetics is a moving field, and as we gather more data, the accuracy and usefulness of PRS will continue to improve.” – Dr. Yelena Bykhovskaya
• “Personalized medicine is about understanding you as an individual and tailoring healthcare to your specific needs, not just your symptoms.” – Dr. Yelena Bykhovskaya

Our Guest

Dr. Yelena Bykhovskaya is the Chief Scientific Officer at Biography Health, where she...

In this episode of Precision Medicine Made Simple, we’re joined by Dr. Rich Joseph, a physician with a rare blend of expertise as both a strength and conditioning specialist and a competitive athlete. Dr. Joseph is the founder of VIM Medicine and the Board Chair of Vital Connections. He’s also a faculty member at Harvard Medical School and Brigham and Women’s Hospital, where he focuses on preventive medicine.

Dr. Joseph’s unique approach integrates performance medicine, which he defines as the capacity to bring energy and attention to what matters most in life. His philosophy blends athletic mindset and proactive health practices to help people achieve peak performance in all aspects of life—physical, mental, and emotional.

In this episode, we dive into his journey from athlete to physician, how he started VIM Medicine, and how performance medicine can optimize health and longevity. We also discuss the importance of mindset, recovery, and behavior in achieving long-term wellness.

• The concept of performance medicine and its relevance to overall well-being.
• How performance-based healthcare goes beyond disease treatment to emphasize proactive, personalized care.
• The importance of behavioral grounding and experimentation in health optimization.
• How to use performance metrics like VO2 max and strength to monitor and improve health.
• The evolution of health insurance and its role in a more proactive, patient-centered care model.
• The growing field of longevity and the need for more balance in the conversation around aging

• [00:00] Introduction to Dr. Rich Joseph’s approach to performance medicine
• [05:15] Transitioning from athletic training to a medical career
• [10:00] The importance of a mindset focused on progress over perfection
• [14:30] Starting VIM Medicine and the integration of exercise into healthcare
• [20:00] The role of recovery and mindset in optimizing longevity
• [25:00] Exploring peptides, supplements, and managing the noise in health trends
• [30:00] Biomarkers: What should you focus on for long-term health?
• [35:00] The difference between functional medicine, longevity medicine, and personalized care
• [40:00] Vital Connections and the effort to address healthcare inequities in Boston
• [45:30] Dr. Joseph’s vision for the future of healthcare and his practice’s growth

• “Health is an asset, something you have to strategically manage and invest over the long term.” – Dr. Rich Joseph
• “You can’t just treat the symptoms; you have to optimize performance to live well.” – Dr. Rich Joseph
• “Prevention is not sexy, but performance is something everyone can get behind.” – Dr. Rich Joseph
• “You have to pair stimulus with recovery to create adaptation.” – Dr. Rich Joseph

Dr. Rich Joseph is a Harvard-trained internist, founder of VIM Medicine, and Chief Medical Officer at Restore Hyper Wellness. With a background in strength and conditioning, he has created a unique model of Performance Medicine that combines athletic principles with healthcare. His approach emphasizes proactive health strategies, personalized wellness, and performance optimization. Dr. Joseph also leads Vital Connections, a nonprofit focused on improving health equity and community well-being.

Dr. Rich Joseph

• https://www.linkedin.com/in/rich-joseph-md-mba-61448b33a/

Most of today’s healthcare still treats problems after they happen. Dr. Leroy Hood thinks that needs to change. In this episode of Precision Medicine Made Simple, he explains how genomics, regular health tracking, and AI can shift the focus to preventing disease before it starts.

Dr. Hood is one of the scientists who helped build the automated DNA sequencer that powered the Human Genome Project. He also founded the Institute for Systems Biology. He has worked across research, government, and healthcare to push ideas that were unpopular at the time but are now standard practice.

You’ll hear how he went from a professor at Caltech to building new departments, starting research institutes, and working with governments around the world to change how healthcare works.

He also explains the idea of P4 medicine: predictive, preventive, personalized, and participatory care and why most of the healthcare system isn’t built to support it yet.

• Seven shifts that shaped Dr. Hood’s career and could change medicine
• Why most healthcare money goes to chronic disease and how to cut that
• How genome and phenome data can find diseases years before symptoms
• What polygenic risk scores mean for different ethnic groups
• How AI helps doctors create personalized care plans
• How useful data can slow aging, prevent Alzheimer’s, and support your health
• Why chasing profits slows down U.S. healthcare
• How kids in Seattle learn to manage their own health
• Why commercial insurance may fail if it doesn’t adapt
• How Tom Brady trained his brain to last longer and how you can apply that

• [00:00] Introduction to Dr. Leroy Hood's journey
• [01:49] The evolution of precision medicine
• [03:11] Introducing Dr. Leroy Hood
• [04:41] Dr. Hood's early career and challenges
• [06:43] The birth of systems biology
• [08:20] Pioneering cross-disciplinary research
• [10:56] The Human Genome Project
• [13:49] Establishing systems biomedicine
• [22:51] The Luxembourg initiative
• [23:45] Data-driven health insights
• [30:42] Challenges with polygenic risk scores
• [31:42] Ancestry and genetic variants
• [32:52] Pharmacogenomics and drug response
• [33:16] Rare diseases and carrier status
• [34:57] Lifestyle genetics and athletic injuries
• [36:18] Actionable possibilities in genomics
• [38:27] Economic impact of chronic disease prevention
• [39:04] Obstacles to deep health analysis
• [40:48] Advancements in personalized medicine
• [45:50] The future of health care and AI
• [56:15] Brain health and cognitive function
• [59:39] Conclusion and future topics

• [00:00:39] "I decided “Big Data” was necessary to deconvolute the complexity of human biology. But the instrumentation for “Big Data” didn't exist at that point in time." — Dr. Leroy Hood
• [00:11:41] "The big science of the genome project revolutionized so many fields of biology in profound ways that it's really quite remarkable." — Dr. Leroy Hood
• [00:12:15] "The Human Genome absolutely transformed our understanding of how we can think about human biology." — Dr. Leroy Hood
• [00:13:39] "If you really want to have fun with science, you can't do it at a place where people are criticizing two of the major thrusts in your laboratory." — Dr. Leroy Hood
• [00:44:14] "Over the last 40 years, Americans extended their lifespan by 10 years. They didn't expand their health span by a single year." — Dr. Leroy...

What does it really take to solve the medical mysteries most doctors dismiss? In this episode of Precision Medicine Made Simple, we sit down with Dr. Hengameh Monsef, DO, an internal medicine physician trained in high-acuity care, now reinventing how we treat chronic and complex illness through concierge precision medicine at Ascending Medicine.

She shares her journey from Iran to the U.S., from frustrated hospitalist to data-powered detective. We dive into how whole genome sequencing, pharmacogenetics, and old-school osteopathic wisdom come together in her practice and why some of the most impactful tools, like lymphatic drainage and myofascial release, are still off the radar in mainstream care.

This is a must-listen for clinicians rethinking their practice, patients frustrated by the status quo, and anyone curious about the intersection of science, culture, behavior, and care.

• Why Dr. Hengameh Monsef left the hospital system after 20 years
• The surprising science behind “alternative” practices like lymphatic drainage and fascia work
• How she balances whole genome data with patient preference, culture, and compliance
• What AI can’t replace in clinical decision-making (yet)
• Why pharmacogenetics saves lives and should be routine, not optional
• How concierge medicine works and why younger doctors shouldn’t rush into it
• The role of genetics in mental health, depression, and drug sensitivity
• What needs to change in politics and insurance for precision medicine to scale

• [00:00] Introduction to experience in medicine and AI
• [00:54] Welcome to Precision Medicine Made Simple
• [02:17] Meet Dr. Hengameh Monsef
• [03:25] Dr. Monsef' journey to medicine
• [07:06] The philosophy of osteopathic medicine
• [10:08] Challenges and rewards of concierge medicine
• [18:01] Personalized medicine and patient care
• [23:06] Exploring holistic and alternative therapies
• [27:53] The dangers of sitting: why movement matters
• [29:15] Holistic lifestyle interventions for chronic diseases
• [29:51] Personalized medicine: the role of whole genome sequencing
• [30:28] Understanding genetic variants and chronic conditions
• [32:07] Acupuncture and genetic differences
• [33:11] Screening for mental health issues
• [34:23] Genetic links to depression and anxiety
• [34:49] The importance of pharmacogenetics
• [36:47] Challenges in traditional medicine and the role of AI
• [40:10] The future of personalized medicine and patient empowerment
• [46:49] Insurance companies and market forces
• [48:56] The role of patients in shaping healthcare
• [56:16] Advice for female immigrant physician entrepreneurs
• [57:00] Conclusion and contact information

• [08:38] "I think the more data we have, it's going to direct medicine to maybe a different route that are currently being taught in traditional medical schools." — Dr. Hengameh Monsef
• [10:54] "When you become a physician, just that career is dedication. So I feel I'm dedicated to the patient. So it makes it even harder to balance family." — Dr. Hengameh Monsef
• [11:23] "Why concierge medicine is growing is by just the fact that you're concierge, you tend to keep lower numbers. By lower numbers, you decrease the number of emergencies that could happen in a day." — Dr. Hengameh Monsef
• [13:25] "If you're graduating early, it's not a good idea to do concierge medicine because you have to put some experience that, that learning that comes with experience." —Dr. Hengameh Monsef
• [56:16] "I think first generation immigrant automatically most of them...

What if your doctor could predict what will kill you—before it ever becomes a problem? In this episode of Precision Medicine Made Simple, we dive into the evolving landscape of longevity medicine and health AI with Dr. Hillary Lin, Stanford-trained internist, former oncologist, and co-founder of CareCore—a platform empowering wellness creators and brands to offer doctor-supervised, data-driven care.

Dr. Lin shares her personal journey from frustration with traditional medicine to building one of the most forward-thinking longevity platforms today. She discusses how we can sift through misinformation, integrate wearables, genetics, and proteomics, and balance the promise of AI with the human art of medicine.

If you're interested in the intersection of tech, behavior change, and personalized healthcare—or you're a clinician navigating this fast-changing world—this episode is a must-listen.

• Why Dr. Lin walked away from oncology—and what that revealed about the limits of traditional medicine
• How AI is helping doctors make sense of overwhelming health data (without replacing the human touch)
• Why behavior change—not biomarkers—is still the hardest challenge in longevity care
• What whole genome sequencing and proteomics are uncovering about health risk (and why family history still matters)
• How mental health is shaped by biology, not just emotions—and what that means for future treatments
• Why “more data” isn’t always better—and how the art of medicine guides what we actually do with it
• How CareCore is bringing doctor-backed longevity tools to wellness creators, gyms, and health brands
• Why longevity medicine must balance innovation with scientific rigor—and where influencers can help or hurt

• [00:00] Dr. Lin’s background and intro to the show
• [01:02] Leaving traditional medicine: oncology frustrations
• [07:07] Curiosity, questioning incentives, and systemic change
• [14:30] Wearables, data overwhelm, and near-future care
• [19:21] Will AI replace doctors? Not likely—here’s why
• [25:27] Behavior change, accountability, and lifestyle compliance
• [28:40] Why common advice still matters—but needs personalization
• [32:56] Dr. Lin’s take on Brian Johnson’s biohacking movement
• [36:33] The importance of community and mental health in longevity
• [43:39] Gut-brain connection and biological drivers of mental health
• [47:01] How to build a personalized longevity baseline
• [50:23] Genomics vs. real-world outcomes: a case study in family history
• [55:44] AI-enabled care and the future of CareCore
• [59:20] Influencer health, B2B partnerships, and responsible content

• [01:02] "I realized somewhere along the way that I couldn't be a doctor in today's system and do the things that I hope to do. You have to maintain the mind of a child always in that you're asking why?" — Dr. Hillary Lin
• [01:38] "Behavior change is the number one, most important and hardest thing to achieve. I think the art part of medicine is really knowing what to do with incomplete knowledge." — Dr. Hillary Lin
• [08:09] "The curiosity was so important because it makes you push past a lot of deterrence... you have to really dig past that by continuously asking, well, why is it that way?" — Dr. Hillary Lin
• [21:46] "I think there will always be a place for doctors slash healers. And the reason is humans love other humans." — Dr. Hillary Lin
• [29:48] "I think the art part of medicine is really knowing what to do with incomplete knowledge.I always say start with figuring out what will kill you first.”— Dr. Hillary Lin
• [34:55] "I think people should be re-energized about lifestyle changes. It's not new, but if he makes it seem like it's new, then cool, that's...

In this episode of Precision Medicine Made Simple, hosts Dr. William Stanford and Taylor Cu sit down with Dr. Genise Fraiman, founder of Ascending Medicine and a trailblazer in concierge care. With over two decades of experience—from co-founding one of Cedars-Sinai’s top hospitalist groups to mentoring young physicians—Dr. Fraiman shares her personal and professional evolution toward a more human, proactive approach to medicine.

Together, they unpack the pressures of traditional practice, the emotional toll of hospital work, and Dr. Fraiman’s deeply personal experience navigating breast cancer risk without the genomic tools we now have at our fingertips. She also reveals how treating sleep apnea transformed her own health—and why even “healthy” patients shouldn’t ignore it.

This candid, wide-ranging conversation explores the promise (and pitfalls) of AI in healthcare, the art of vetting medical information, and what it really takes to start a concierge or precision-focused practice today. At its core, this episode is about reimagining the doctor-patient relationship—and reclaiming time, trust, and tailored care.

• The untold toll of hospital-based medicine—and why Fraiman finally left it behind
• What concierge care actually looks like in practice (and why it matters)
• Why time is the most underrated tool in patient care
• Dr. Fraiman’s decision to undergo a prophylactic mastectomy—and the missing genomic data that could’ve changed it all
• How sleep apnea affects even lean, fit patients—and how CPAP changed her health
• What patients should know about supplements, pseudoscience, and AI misinformation
• How to vet a personalized medicine provider—and why the right “fit” matters more than ever
• Dr. Stanford’s bold prediction: commercial health insurance will collapse within 10 years

• [00:00] Introduction and initial questions
• [00:59] Welcome to the podcast
• [01:07] Guest introduction: Dr. Genise Fraiman
• [01:55] Early career and meeting Dr. Stanford
• [04:07] Building a hospitalist group
• [04:34] Transition to concierge medicine
• [05:52] Challenges and rewards of concierge medicine
• [07:13] Personalized patient care
• [13:50] Proactive vs. reactive medicine
• [19:47] Personal health journey and genetic risks
• [29:48] Sleep study reflections
• [30:11] Challenges and adjustments with CPAP
• [31:21] Exploring alternative treatments
• [33:00] Navigating medical information and supplements
• [38:02] The role of AI in healthcare
• [42:44] Starting a concierge medical practice
• [46:58] Insurance and healthcare costs
• [52:32] Privacy concerns with genetic testing
• [55:28] Finding the right medical provider
• [57:42] Conclusion and contact information

• [07:28] "What I found is I've been on all sides. I've been the patient, I've been the physician, I've been the family member. And it's a really horrible feeling to feel helpless in any of those situations."— Dr. Genise Fraiman

• [14:33] “I think we were taught to be really great at being reactive physicians. But if we can take that same knowledge and be proactive—change the trajectory—that’s the name of the game.” — Dr. Genise Fraiman

• [24:53] “If I had the genetic information then that I have now, the decision around my mastectomy would’ve been far less agonizing.” — Dr. Genise Fraiman

• [27:50] “I failed my sleep study miserably… and I’m 5’3”, fit, and healthy. You can’t ignore the data.” — Dr. Genise Fraiman

Founder of Ascending Medicine, Dr.Fraiman brings...

We’re living in the age of health data overload—but how do you turn all those insights into real-life transformation? This episode of Precision Medicine Made Simple features Dr. Daniel Stickler, former vascular surgeon turned systems medicine pioneer, who’s leading the charge in longevity, AI-powered diagnostics, and cutting-edge clinical tools.

In this candid conversation with hosts Dr. Stanford and Taylor, Dr. Stickler opens up about the moment he walked away from surgery for good—and how it led to building an entirely new model of medicine. From continuous glucose monitors to full genome sequencing, from peptides to personalized AI agents, Dr. Stickler shares the emerging tools that are empowering both doctors and patients to move from disease management to proactive health optimization.

Whether you're a healthcare provider, tech innovator, or simply a wellness-curious listener, this episode will challenge your assumptions and give you a vision for the future of truly personalized care.

• Why most modern medicine is built around postponing death, not optimizing life
• How wearables like Garmin and UltraHuman reveal individual patterns (and change behavior fast)
• The overlooked power of epigenetics—and why lifestyle still rules your genes
• What peptides like BPC-157 and GLP-1 analogs are doing for healing, inflammation, and gut health
• How Dr. Stickler uses AI to process patient data and create 50-page system-based care plans in minutes
• Why “root cause” medicine might be an outdated myth—and what’s next

• [00:00] Introduction
• [00:14] Guest introduction: Dr. Daniel Stickler
• [01:00] Dr. Stickler's journey into medicine
• [03:19] Integrating wearable technology in medicine
• [05:39] The impact of wearables on patient care
• [12:38] Genetics and epigenetics in medicine
• [22:21] Systems-based medicine explained
• [27:08] The role of peptides in modern medicine
• [30:58] Introduction to GLP-1 peptides
• [31:30] Benefits and fine-tuning of semaglutide
• [32:35] Exploring BPC-157 for recovery
• [33:51] Oral vs. injectable BPC-157
• [35:05] Potential downsides of BPC-157
• [36:44] Wearable technology and recovery
• [38:19] The future of medicine: AI and personalized care
• [56:17] The role of physicians in the AI era
• [57:17] Concerns about over-reliance on technology
• [58:46] Recommended resources for providers and patients
• [01:01:19] FDA's role in approving medical advancements
• [01:03:42] Exosomes and young plasma therapy potential

Dr. Daniel Stickler is the Co-Founder and Chief Medical Officer of Apeiron Zoh and Mosaic Biodata, where he integrates wearable tech, AI, peptides, genetics, and systems thinking into personalized healthcare. A former high-volume surgeon, he now trains clinicians globally in longevity and performance medicine. He's also an advisor to Google and a recognized thought leader in human enhancement and optimization.

• Apeiron Center
• LinkedIn
• Substack

• Captivate.FM
• LinkedIn

The Former ER Doctor Challenging How We Practice Medicine w/Dr. Sukhjit "Sarge" Takhar

Primary-MD.com

Email: drtakhar@primary-md.com

Takeaways

• Dr. Takhar emphasizes the importance of understanding the patient as a person.
• Concierge medicine allows for more personalized and attentive care.
• The healthcare system often limits the time doctors can spend with patients.
• AI can assist in healthcare but cannot replace the human connection.
• Precision medicine focuses on individual patient needs rather than population averages.
• The integration of advanced diagnostics is crucial for effective patient care.
• Healthcare professionals must navigate the challenges of the current system.
• There is a growing need for democratization of advanced medical care.
• Patients should be encouraged to take an active role in their health decisions.
• The future of medicine will likely involve more personalized and preventive approaches.

Summary

In this episode of the Precision Medicine Made Simple podcast, hosts Taylor Cu and Dr. William P. Stanford engage with Dr. Sukjit "Sarge" Takhar, a pioneer in concierge medicine. They discuss the evolution of healthcare, the challenges faced by practitioners, and the importance of personalized patient care. Dr. Takhar shares his journey from traditional medicine to a more individualized approach, emphasizing the role of advanced diagnostics and the integration of AI in healthcare. The conversation highlights the need for a human connection in medicine, the significance of understanding patient backgrounds, and the future of precision medicine as it becomes more accessible and affordable. The episode concludes with advice for aspiring medical entrepreneurs and a discussion on the intersection of science and patient care.

Chapters

00:00 The Journey Begins: Personal Stories and Connections

02:32 From Traditional Medicine to Concierge Care

06:36 The Shift Towards Precision Medicine

10:50 Challenges and Opportunities in Healthcare

14:57 The Future of Health Monitoring and Diagnostics

25:57 Vitalist Bay: A Progressive Longevity Conference

26:23 Buyer Beware: Navigating Longevity Medicine Hype

27:37 Understanding Conflicts of Interest in Longevity Research

28:30 Metabolic Health: The Crisis and Its Implications

29:57 The Role of Direct-to-Consumer Tests in Health Decisions

31:42 Precision Medicine: Personalizing Health Strategies

33:21 AI in Medicine: The Human Advantage

35:33 The Evolution of AI in Healthcare

37:31 AI and Human Connectivity in Medicine

39:58 The Future of AI in Patient Care

47:53 Navigating AI Regulations in Healthcare

50:33 Advice for Aspiring Medical Entrepreneurs

51:19 The Challenges of Building a Practice

53:00 Staying Current in Medicine

56:20 The Importance of Precision Medicine

01:01:25 Personalized Health Recommendations

01:07:55 Building Trust with Patients

01:13:43 Navigating the Landscape of Health Claims

01:16:14 PMMS - New Outro - No Music.mp4

Dr. William Stanford MD PHD FACP

drstanford@bhipm.com

Dr. William Stanford is co-founder of Biography Health. He began his career as a mechanical and aerospace engineer at Texas Instruments in 1982 while also pursuing his interest in aviation as a flight instructor and commercial pilot. In 1991, he pivoted into biomedical science and subsequently completed the combined M.D./Ph.D. physician-scientist training program at the University of California, Los Angeles, in 1998 and an internal medicine residency at UCLA in 2001. He is board-certified in internal medicine and is a Fellow of the American College of Physicians.

A pioneer in the field of...