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The Clinical Realist

The Clinical Realist

By: Dr. Sarah Matt
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Healthcare innovation is broken. We have billion-dollar AI running on 1990s infrastructure. We have startups dying in "Pilotitis." And we have leaders frozen by analysis paralysis.

Dr. Sarah Matt (The Clinical Realist) is here to fix the disconnect between the tech stack and the trauma bay.

Join Dr. Matt—physician, strategist, and author of The Borderless Healthcare Revolution—as she cuts through the hype to reveal what actually works in modern medicine. No buzzwords. No fluff. Just the raw, unvarnished truth about how to lead, build, and survive in the future of healthcare.

If you are tired of the "Star Trek" vision and want the "Clinical Reality," this is your show.

Subscribe to The Sarah Matt Briefing for weekly insights on healthcare AI, access strategy, and the business of medicine: https://drsarahmatt.com/newsletter-signup

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Episodes
  • Culture Breaks First, with Julie Tuel

    Culture Breaks First, with Julie Tuel
    Oct 14 2026
    Virtual nursing gets sold to hospital boards as a staffing patch. Put a camera in the room, put an experienced nurse behind it, and the math on the slide works. Almost nobody in that boardroom asks the question that decides whether it works on the actual unit: what does this do to a shift in week three? Julie Tuel is System Vice President of Nursing Care Transformation and Clinical Digital Care at CommonSpirit Health, a system with more than 2,200 care sites across 24 states. As of CommonSpirit's March 2026 reporting the virtually integrated care model covered 1,075 beds, on the way to roughly 3,000. She is a critical care and stroke nurse by training, and she has spent this stretch of her career on the unglamorous part of the work: taking virtually integrated care from a concept that presents well to a care model that survives contact with a real med-surg floor and real nurses who did not ask for it. Dr. Sarah Matt asks for the first 90 days, not the strategic vision. Tuel's answer is that there is no system-level first 90 days at all. Every hospital and every unit is run as its own project, because the thing that breaks first when you scale a care model is not the technology and not the workflow. It is the culture, and a standard pushed out uniformly will hold for a quarter and then stop holding. On outcomes, Tuel gives numbers and then does something unusual with them. CommonSpirit has measured a 43 percent reduction in first-year RN voluntary turnover, and she immediately says it is not all attributable to virtually integrated care: it also reflects the nurse residency program and local and national nursing leadership. The program has also measured a 37 percent reduction in CAUTIs and CLABSIs and a 20 percent increase in nursing communication scores on HCAHPS. Other things covered: why CommonSpirit's model is deliberately not an admissions, discharges, and transfers model, and what changes when the virtual nurse is part of the care team instead

    —

    Resources & Links:

    📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers.

    💼 Work with Dr. Matt:
    Looking for a keynote speaker or strategic advisor?
    Visit: drsarahmatt.com

    🔗 Connect on Social:
    LinkedIn: https://www.linkedin.com/in/sarahmattmd/
    YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist

    📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup

    —
    Disclaimer:
    The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.
    Show More Show Less
    26 mins
  • What a Medical Bill Actually Is, with Amy Stillman

    What a Medical Bill Actually Is, with Amy Stillman
    Oct 7 2026
    The encounter ends, the patient goes home, and then a bill arrives. Amy Stillman argues that a medical bill is not a payment reminder. Patients frequently do not understand what happened to them, what they owe, or what they are supposed to do next, and the bill lands after the frightening part is already over. Stillman is Chief Product Officer at Cedar, where she has run product, design, research, and data science since 2019. She is an industrial designer by training, not an engineer and not a revenue cycle specialist, which turns out to matter. She and Dr. Sarah Matt cover where Cedar sits among payers, EHRs, and clearinghouses, and why a patient should not be reduced to a single true or false signal from one system. Much of the conversation is about Cora, Cedar's AI agent, which Stillman says resolves about 40 percent of its calls, and which is designed against three measures at once: cost to serve, resolution rate, and patient satisfaction. She makes the case for tracking resolution rather than collection, since the right outcome may be a corrected insurance record, a Medicaid redetermination, financial aid, or a discount paired with a payment plan. She also names the group Cedar finds hardest to help: patients just above the financial aid cutoff, called ALICE by United Way, asset limited, income constrained, but employed. Find Amy: cedar.com | linkedin.com/in/amystillman

    —

    Resources & Links:

    📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers.

    💼 Work with Dr. Matt:
    Looking for a keynote speaker or strategic advisor?
    Visit: drsarahmatt.com

    🔗 Connect on Social:
    LinkedIn: https://www.linkedin.com/in/sarahmattmd/
    YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist

    📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup

    —
    Disclaimer:
    The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.
    Show More Show Less
    26 mins
  • What Longitudinal Data Actually Contains, with Shashi Shankar

    What Longitudinal Data Actually Contains, with Shashi Shankar
    Sep 30 2026
    Start with a number. In a registry of about 6,000 patients on GLP-1 medications, roughly 45 percent have taken two or more versions of the drug, most often moving from semaglutide to tirzepatide. The largest published study, about 127,000 adults, puts 12-month switching closer to 20 percent. Nobody can fully verify either figure, because no single system holds the whole record. Shashi Shankar spent nearly a decade at Genentech working on real world data before co-founding Novellia, where he is chief executive. The product pulls a patient's records out of every patient portal they have ever logged into, across roughly 25 years of care. Biopharmaceutical researchers pay for de-identified access. Patients never pay at all. He and Dr. Sarah Matt walk through where records actually fragment: community clinic to lab to academic specialist, and inside a single health system when the hub and the community site sit two hours apart. Shankar describes the load carried by family caregivers, and explains why he considers tokenized data brokerage a poor substitute, with each join between data sets hitting at 15 to 20 percent and leaving a snapshot frozen in time. Matt presses on the part still unsolved: the record reaches the patient, and it still does not reach the prescriber. Find Shashi: novellia.com | search his name with Novellia on LinkedIn

    —

    Resources & Links:

    📖 Get the Book: "The Borderless Healthcare Revolution" is available now on Amazon and major retailers.

    💼 Work with Dr. Matt:
    Looking for a keynote speaker or strategic advisor?
    Visit: drsarahmatt.com

    🔗 Connect on Social:
    LinkedIn: https://www.linkedin.com/in/sarahmattmd/
    YouTube: https://www.youtube.com/@DrSarahMatt-ClinicalRealist

    📧 Subscribe to The Briefing: drsarahmatt.com/newsletter-signup

    —
    Disclaimer:
    The views expressed on this podcast are those of Dr. Sarah Matt and her guests. They do not necessarily reflect the official policy or position of any affiliated institutions. This content is for informational and educational purposes only and does not constitute medical advice or a professional consulting relationship.
    Show More Show Less
    33 mins
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