Michael Osterholm, PhD, MPH, one of the world’s leading experts on infectious disease threats and pandemic preparedness, joins The Future of Medicine for a wide-ranging conversation about COVID-19, vaccines, airborne transmission, public trust, and what the world must do before the next pandemic arrives.

Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota and has spent nearly five decades investigating outbreaks and advising public officials. In this episode, he reflects on the experiences that first inspired him to become a “medical detective,” including an unusual outbreak linked to thyroid tissue entering the food supply through hamburger meat.

The conversation then turns to COVID-19 and the lessons that remain unresolved. Osterholm explains why he believes the United States needs an independent, nonpartisan review of its pandemic response—one focused on identifying what worked, what failed, and how changing evidence shaped decisions about schools, hospitals, masking, and public gatherings.

“The pandemic clock is ticking,” Osterholm says. “We just don’t know what time it is.”

He also discusses why public health guidance must be able to evolve. As Osterholm puts it, “Science is not truth. Science is the pursuit of truth.” New variants, new evidence, and changing risks do not necessarily mean earlier recommendations were made in bad faith; they reflect the reality of responding to a rapidly developing threat.

Watch the full conversation to learn what COVID-19 revealed about the strengths and weaknesses of modern public health—and how science, vaccines, and more honest communication could help the world respond differently next time.

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Dr. Michelle Mello, professor of law and health policy at Stanford University, joins The Future of Medicine for a conversation about one of the most frustrating and consequential parts of American healthcare: prior authorization. For many patients and clinicians, prior authorization is the process behind the letter saying an insurance company will not cover a medication, procedure, or service unless additional criteria are met. As Dr. Mello explains, this system is already difficult, time-consuming, and often painful for patients and care teams. Now, artificial intelligence is beginning to reshape how these decisions are made.

In this episode, Dr. Mello and host Dr. Euan Ashley discuss how insurers and healthcare systems are using AI in prior authorization, billing, appeals, and utilization management. AI may be able to speed up routine approvals and reduce administrative burden, but it also raises serious questions about transparency, bias, accountability, and whether patients are being protected from wrongful denials.

The conversation explores what Dr. Mello describes as an “arms race” of AI systems, with insurers using technology to evaluate requests and health systems using their own tools to identify denials most likely to be overturned and draft stronger appeal letters. She also explains why appeals matter: a large share of insurance denials can be reversed, but many health systems do not have enough staff to appeal every case.

Together, Dr. Mello and Dr. Ashley consider what responsible AI governance should look like in healthcare, why simply banning AI may not solve the underlying problems, and how AI could be used in ways that support patients, clinicians, and fairer decision-making. They also discuss the need for greater transparency from insurers, the role of private governance, and why academic medical centers have a responsibility to help shape the safe and ethical use of these tools.

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Dr. Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases and one of the nation’s most influential public health leaders, joins Stanford Department of Medicine’s The Future of Medicine for a conversation with Dr. Euan Ashley about science, service, public trust, and the future of public health.

In this episode, Dr. Fauci reflects on his early career as a physician-scientist, the first years of the HIV/AIDS epidemic, the creation of PEPFAR, the scientific foundation behind COVID-19 vaccines, and the challenge of communicating evidence in an era of misinformation.

Together, Dr. Fauci and Dr. Ashley discuss what it means to lead with integrity when the stakes are high, and why long-term investment in science remains essential for pandemic preparedness and medical progress.

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Dr. Christopher J.L. Murray — health economist at the University of Washington, physician, and founder of the Global Burden of Disease framework — joins The Future of Medicine to discuss what decades of data across 204 countries reveal about human health, and where it's headed by the end of this century.

Dr. Murray's Global Burden of Disease project involves 19,000 collaborators in 167 countries and has produced more than 5,000 published papers. In this conversation, he explains what that data shows: remarkable progress on childhood infectious disease and HIV, a profound global shift toward chronic conditions like heart disease, diabetes, and chronic kidney disease, and a mental health crisis — rising steadily for over a decade — whose causes experts still actively debate.

He also discusses why the widely circulated claim that American obesity rates had flattened is likely a statistical artifact, what the data projects for the coming decades (including diabetes overtaking heart disease as the world's leading cause of death), and the compounding health crisis facing the Sahel as population growth, poverty, and climate change converge.

The conversation closes on the Lancet Commission on existential and catastrophic risks — a project Dr. Murray helped initiate that takes a data-driven look at long-range threats to humanity, from AI and synthetic biology to nuclear risk, out to 2100.

It's a rare conversation that takes a long, honest look at the future — and doesn't flinch.

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Dr. Samuel Klein, Division Chief and William H. Danforth Professor of Medicine and Nutritional Science at Washington University Medicine, joins The Future of Medicine for a conversation about obesity, metabolism, insulin resistance, and the revolution sparked by GLP-1 medications like Ozempic.

In this episode, Dr. Klein explains why obesity is far more biologically complex than many people realize — and why some individuals with obesity remain metabolically healthy while others develop diabetes, heart disease, and fatty liver disease.

The conversation explores how fat functions not only as stored energy, but also as an active endocrine organ that communicates with the rest of the body through hormones and inflammatory signaling molecules. Dr. Klein discusses visceral fat, insulin resistance, inflammation, and why procedures like liposuction do not produce the same metabolic benefits as weight loss through diet, surgery, or GLP-1 medications.

Dr. Klein also reflects on the unexpected rise of GLP-1 therapies, including how medications originally developed for diabetes transformed obesity treatment and may hold broader implications for cardiovascular disease, addiction, and other chronic conditions.

Together, Dr. Klein and Euan Ashley discuss the future of metabolic medicine, precision approaches to obesity care, and why understanding metabolism may reshape the future of healthcare itself.

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In this episode of the Future of Medicine, we welcome Dr. Robert Wachter, physician, author, and chair of medicine at the University of California, San Francisco, for a conversation about artificial intelligence, healthcare, and the future of medicine.

Dr. Wachter reflects on how the digitization of healthcare reshaped modern medicine — and why many of the frustrations clinicians experience today, from burnout to endless documentation, emerged during the first wave of the electronic health record revolution.

The conversation explores why large language models like ChatGPT feel fundamentally different from earlier healthcare technologies, and how AI may finally help medicine move beyond the limitations of current electronic health records. Dr. Wachter discusses the promise of AI scribes, clinical copilots, patient-facing tools, and digital assistants that can help clinicians synthesize information, reduce administrative burden, and improve access to expertise.

At the same time, he examines the risks of overtrusting AI systems, including hallucinations, deskilling, automation bias, and the challenge of keeping humans engaged when machines are right most (but not all) of the time.

Together, Dr. Wachter and Euan Ashley discuss empathy, medical education, patient trust, and what happens when technology begins to act increasingly human.

Looking ahead, Dr. Wachter shares why he remains optimistic about AI in medicine — and why the next few years could fundamentally reshape how healthcare is delivered around the world.

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In this episode of the Future of Medicine, we welcome Crystal Mackall, the Ernest and Amelia Gallo Family Professor and founding director of the Stanford Center for Cancer Cell Therapy at Stanford, for a conversation on CAR T-cell therapy, pediatric cancer, and the future of biologic medicine.

Dr. Mackall reflects on her path from a working-class town in Ohio to becoming one of the world’s leading pioneers in cancer immunotherapy. She shares how early experiences with cancer shaped her interest in medicine, and how decades of research eventually helped lay the groundwork for today’s advances in engineered cell therapies.

The conversation explores the evolution of CAR T-cell therapy, including the challenges of treating solid tumors and why many promising therapies can take decades to become reality.

Looking ahead, Dr. Mackall shares her perspective on the future of medicine, including the growing role of RNA therapeutics, gene delivery, and in vivo cell engineering. She explains why the next generation of therapies may involve programming the body directly, rather than manufacturing treatments outside of it.

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In this episode of The Future of Medicine, we welcome Stephen Quake, a bioengineer, physicist, and serial entrepreneur whose innovations have transformed how we measure biology and deliver care.

Dr. Quake shares how his early fascination with building and experimentation led him from physics into biology, where he helped pioneer microfluidics, enabling the automation of complex biological experiments. He reflects on founding multiple companies to bring these technologies into real-world use, reshaping research and diagnostics.

The conversation explores the development of noninvasive prenatal testing (NIPT), a breakthrough that allows doctors to detect chromosomal conditions using a simple blood draw instead of invasive procedures. Dr. Quake explains the key insight behind this advance: counting DNA molecules, and how it has since impacted millions of pregnancies worldwide.

They also discuss the early days of genome sequencing, including Dr. Quake’s decision to sequence his own genome and what it revealed about the future of personalized medicine. From there, the conversation expands into liquid biopsies, transplant monitoring, and early cancer detection, highlighting how blood-based diagnostics are transforming how we detect and manage disease.

Looking ahead, Dr. Quake shares his perspective on the next frontier: using advanced molecular tools and AI to detect disease earlier, understand human biology more deeply, and ultimately reshape the practice of medicine.

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Call to action: If you enjoy The Future of Medicine, subscribe for more conversations with leading scientists shaping the next era of healthcare. Please rate and review the podcast to help others discover these important discussions. Share with friends and colleagues who are curious about how science becomes medicine.