In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners welcome Dr. Steven Farmer, former senior leader at the Center for Medicare and Medicaid Innovation (and Adam’s husband).

Between playful banter and sharp commentary, the trio dives into the serious business of healthcare regulation: why the U.S. system remains unaffordable, how payment models shape medical practice, and what it really takes to shift toward value-based care. From international adventures to bundled payments, Dr. Farmer shares his unique journey through medicine, policy, and innovation—sprinkled with equal parts humor and frustration.

If you’ve ever wondered how regulation, incentives, and a little bit of “gaming the system” affect the care you receive, this is the episode for you.

Trigger warning: This episode contains discussion of physician mental health and suicide. If this topic is distressing, please consider listening with support nearby or using local mental health resources.

In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with Dr. Stefanie Simmons, Chief Medical Officer of the Dr. Lorna Breen Heroes' Foundation, for an urgent, unfiltered conversation about the mental health crisis in medicine. Timed for National Physician Suicide Awareness Day (September 17), the episode explores why clinicians—especially emergency and critical care providers—face elevated rates of burnout, depression, and suicide; the systemic barriers that keep clinicians from seeking help; and concrete policy and operational changes that can begin to “heal the healers.”

Dr. Simmons explains the Foundation’s work that’s shifting culture and protections for clinicians. The hosts bring personal stories from residency and frontline care to highlight how stigma, intrusive application questions, and unsafe workplace systems drive clinicians away from care. This episode is essential listening for physicians, nurses, hospital leaders, policy makers, and anyone who cares about the future of the healthcare workforce.

Subscribe to Unstable Vitals, share this episode to raise awareness, and consider supporting clinician wellbeing efforts in your organization.

In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners dive into one of the biggest challenges in healthcare today: misaligned incentives. Should our system prioritize profit or patients? How do payment models, public policy, and personal responsibility collide to shape health outcomes?

From fee-for-service vs. value-based care to the impact of public transportation, food policy, and behavioral nudges, Adam and Lara unpack the hidden forces driving both innovation and inequity in modern medicine. Along the way, they share personal stories, debate policy trade-offs, and explore how we can make healthy choices easier, care more accessible, and incentives better aligned, without sacrificing innovation.

If you’ve ever wondered why our healthcare system feels broken (and what it would take to fix it) this episode is for you.

🎧 Listen now to hear:

• Why profit-driven incentives often work against patient health
• How public health policies intersect with economic growth
• The promise and pitfalls of value-based care
• Behavioral nudges and making healthy choices easier
• Why doctors need to understand the business of healthcare

Listen to Part 1 before diving into Part 2.