Ditch The Labcoat

Ending the Diagnostic Odyssey: Finding Hidden Rare Disease Patients with Joshua Resnikoff

Joshua Resnikoff was a bench scientist at Harvard's Wyss Institute, surrounded by cutting-edge science. He believed healthcare could solve anything. Then his son started having unexplained recurring fevers. Monthly ER visits. Ice baths to prevent seizures. Years of diagnostic uncertainty. Finally, a diagnosis: PFAPA, a hyper-inflammatory condition so rare only 500 kids in the US have it. The doctor's response? "There's nothing we can do. It's not terminal, so don't worry about it."That was his red pill moment.On this episode of Ditch the Labcoat, Dr. Mark Bonta sits down with Joshua, founder and CEO of Sunstone Health, to explore what happens when families get trapped in the diagnostic odyssey. Joshua built a platform that compresses a seven-year diagnostic journey into 12 weeks by using AI to find hidden rare disease patients buried in insurance claims data.Dr. Bonta and Joshua tackle the hard questions: What happens when doctors don't know what's wrong? Why does the healthcare system fail zebra patients while teaching doctors to only look for horses? And what role does physician attitude play in solving diagnostic mysteries?If you've ever felt dismissed by the healthcare system or wondered whether AI can actually help real patients, this conversation will challenge everything you thought you knew about precision medicine and patient advocacy.Joshua Resnikoff's Website : https://www.sunstonehealth.com/Episode Takeaways1. The diagnostic odyssey for rare diseases averages 7 years—Sunstone compresses it to 12 weeks using AI and insurance claims data.2. "There's nothing we can do" isn't medical reality—it's often a failure of attitude, not knowledge or skills.3. Rare disease families are desperate for answers, making them vulnerable to predatory experimental treatments and unproven therapies.4. Health plans, not patients, are Sunstone's customers—financial incentives align when undiagnosed kids cost insurers millions in repeated ER visits.5. Doctors are taught "when you hear hoofbeats, think horses not zebras"—but 2% of hospital patients are zebras with no diagnosis after 24 hours.6. Genetic testing isn't just about diagnosis—it's about getting specialty guidance back to local doctors so families don't travel hours for care.7. Patient data ownership matters—families should control their genetic reports and medical records, not insurance companies.8. Expanding from genetic epilepsy into autism, familial hypercholesterolemia, and other rare diseases—the goal is to be infrastructure for all non-oncology genetic disease.Episode Timestamps04:11 – The Red Pill Moment: "There's Nothing We Can Do"07:07 – Building Community: From Desperation to Action11:42 – How Sunstone Works: Finding Hidden Patients in Claims Data19:22 – Seven Years to 12 Weeks: Compressing the Diagnostic Odyssey25:17 – Zebras vs. Horses: When Rare Disease Becomes Your Reality33:46 – The Attitude Problem: Why Doctors Give Up on Diagnostic Mysteries37:48 – Medical Desperation: Experimental Treatments and Predatory Care45:38 – The Future: Expanding Beyond Epilepsy into Autism and BeyondDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Is AI Actually Changing Healthcare? with Dr. Joshua Liu

AI is everywhere in healthcare conversations. This episode asks the more uncomfortable question: what is it actually doing in real hospitals, with real patients, and real constraints?Dr. Mark Bonta sits down with Dr. Joshua Liu, Co-Founder and CEO of SeamlessMD, for a clinician-first, workflow-grounded conversation about where AI delivers value today, where it still falls apart, and why “smart” tools often die quietly at implementation.They unpack why the most immediate wins are not futuristic diagnostics. They are the unglamorous bottlenecks that drain clinical bandwidth: documentation, forms, referrals, and the administrative sprawl that keeps teams stuck in the note instead of at the bedside. From there, the conversation turns to a core systems problem: insight without protocol. A model can predict risk. But if no one knows what to do with the number, nothing changes.You’ll also hear a clear breakdown of “AI agents,” why trust matters more than technology, and how digital care journeys can reduce anxiety, shorten length of stay, and catch post-discharge issues earlier without flooding clinicians with noise.If you are a CMIO, CIO, clinical operations leader, surgical program director, or anyone tired of alert fatigue and “model theater,” this episode will feel uncomfortably familiar in the best way.Dr. Joshua Liu Website https://www.seamless.md/Episode Takeaways1. AI’s First Impact Is Administrative, Not Diagnostic — The biggest gains today are in documentation, forms, and workflow relief, not autonomous clinical decision-making.2. Insight Without Protocol Is Noise — A risk score means nothing unless a care team has defined what to do with it.3. Healthcare Moves at the Speed of Trust — Technology adoption depends less on capability and more on clinician confidence and governance.4. AI Agents Shift from Answers to Action — Moving from chat-based support to systems that execute tasks will redefine clinical workflow.5. Eighty Percent of Patient Concerns Are Low Risk — Smart triage and education can filter noise and reduce unnecessary visits.6. Digital Care Journeys Reduce Variation — Personalized, just-in-time guidance lowers anxiety, shortens length of stay, and reduces readmissions.7. Integration Determines Survival — Tools that do not fit directly into existing EMRs and workflows will not scale.8. Execution Beats Hype — The future of AI in healthcare will be shaped by implementation, not model sophistication.Episode Timestamps01:52 – AI Boom or Bust: What Actually Changes Care03:23 – Predictive Analytics vs Documentation: The Real “Low Hanging Fruit”12:19 – What Is an AI Agent: Chatbot vs Agentic AI16:39 – The Biggest Barrier: Trust, Not Just Privacy22:27 – Why Joshua Chose Startups Over Residency: SeamlessMD Origin Story25:55 – Building Digital Care Journeys: From Surgery to “Birth to Death”30:17 – AI Inside Patient Journeys: Answers Grounded in Vetted Protocols42:03 – The Next Decade: Computer Vision, Robotics, and Physical AIDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Reclaim Your Balance: The Neuroscience of Aging Well with Dan Metcalfe

Welcome back to Ditch the Labcoat for our 100th episode. Today we tackle a challenge that touches millions yet remains widely misunderstood: falls and balance loss in aging adults.Host Dr. Mark Bonta sits down with Dan Metcalfe, Founder and CEO of Born SuperHuman and Total Balance Company, to challenge the dangerous assumption that falling is just "part of getting older." They reveal how falls are actually the number one cause of death in older adults, not because bodies weaken, but because the brain-to-body connection deteriorates when we stop challenging our neurological systems. Dan shares groundbreaking insights from training over 70,000 people, explaining why traditional strength training misses the mark and how proper balance work can add eight years of quality life.Drawing from his own journey from paralysis after a stage accident to competing in Ironman races following partial brain death, Dan explains the neuroscience behind balance, fear, and movement. He breaks down how the cerebellum, the pyramis, and neuroplasticity work together, why "muscle memory" is actually neuron memory, and how mental rehearsal can be as powerful as physical practice. Most importantly, he offers practical, accessible strategies anyone can use to prevent falls and reclaim independence.Dr. Metcalfe shares transformative stories, from Bob Eubanks going from wheelchair-bound to running at 79, to his own mother returning to line dancing after a stroke. They explore why static balance tests fail us, how fear creates the very falls we're trying to avoid, and why playing like a kid again might be the most powerful longevity tool we're ignoring.If you've ever worried about losing your independence, watched a loved one shuffle in fear, or wondered whether aging really means slowing down, you won't want to miss this evidence-based, hope-filled conversation.Dan Metcalfe's Links : http://totalbalancecompany.com/ & https://bornsuperhuman.com/Episode Takeaways1. Falls Are Preventable, Not Inevitable – Falls are the number one cause of death in older adults, but they're caused by lost brain-body connection, not aging itself.2. Balance Is Brain-Led, Not Body-Built – Traditional strength training misses the point. Balance comes from neurological pathways, not muscle strength.3. Muscle Memory Doesn't Exist – What we call muscle memory is actually neuron memory. The brain fires signals to muscles through repetitive neural pathways.4. Fear Creates the Falls We're Trying to Avoid – The pyramis in the cerebellum holds movement fear memories, causing the cautious shuffle that increases fall risk.5. Static Balance Tests Are Misleading – Standing on one leg without moving only uses three brain regions. Real balance requires dynamic movement engaging 18+ brain areas.6. Better Balance Adds Eight Years of Quality Life – French study of 1,300 women proved those in the top 30% for balance lived eight years longer with better function.7. Play Like a Kid to Age Well – Swinging, hopping, side-stepping, and playful movement maintain the neurological connections built in childhood.8. We're Born to Heal at Any Age – From Olympic athletes to centenarians, the brain's ability to rewire through neuroplasticity never stops if we challenge it.Episode Timestamps02:03 – Falls: The Silent Epidemic in Aging04:02 – Balance Isn't About Age, It's About Brain Connection06:41 – From Paralysis to Performance: Dan's Story11:39 – The Muscle Memory Myth: It's All Neurons16:40 – The Pyramis and Fear: How Your Brain Stops You26:06 – Visualization and Mental Rehearsal Power33:52 – Prevention Over Treatment: Move Like a Kid Again50:54 – Born to Heal: Unlocking Your Superhuman PotentialDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Neuroplastic Recovery: Up Close and Personal with Nora Rodden

In this episode of Ditch the Labcoat, Dr. Mark Bonta does something different. For the first time on the podcast, he speaks with a former patient.Nora Rabah Rodden joins the show not as a clinician, but as someone who lived for years with debilitating symptoms that medicine couldn't explain or fix. Despite normal tests and repeated reassurance, her pain, GI symptoms, fatigue, and nervous system distress persisted. What she encountered instead was a gap in care. Not a lack of effort, but a lack of framework.Nora shares how learning about neuroplasticity and nervous system patterning finally gave her symptoms context. Not imagined. Not psychological. Learned, reinforced, and reversible. That experience became the foundation for why she later co-founded Nervana.Together, they explore why so many patients are dismissed once serious disease is ruled out, how threat signaling and conditioned responses can keep the body stuck in symptoms, and why telling patients “nothing is wrong” is often the most harmful message of all. The conversation breaks down the science of neuroplastic recovery in plain language, while staying honest about its limits and responsibilities.This episode is about what happens when medicine runs out of explanations, and what becomes possible when we stop treating unexplained symptoms as a dead end and start treating the nervous system as something that can learn, adapt, and heal.Nora's Link : https://www.trynervana.com/Episode Takeaways 1. Patient Experience Matters: Normal tests do not equal normal lives. Symptoms can persist even when disease is ruled out.2. Neuroplastic Symptoms Are Real: Learned nervous system patterns can drive pain, GI distress, fatigue, and insomnia without structural damage.3. “Nothing Is Wrong” Is Harmful: Reassurance without explanation often deepens fear, confusion, and isolation.4. Symptoms Can Be Learned and Unlearned: The brain adapts quickly, for better or worse, and those patterns are reversible.5. This Is Not Psychosomatic: Neuroplastic recovery is grounded in neuroscience, not imagination or positive thinking.6. Awareness Changes Identity: When patients stop identifying with symptoms, recovery often begins.7. Recovery Is Gradual, Not Dramatic: Progress usually looks subtle, steady, and cumulative rather than sudden.8. Lived Experience Can Build Better Care: Nora’s recovery is why Nervana exists, to close the gap medicine often leaves behind.Episode Timestamps04:18 – Why This Episode Is Different: The First Patient Voice08:36 – When Tests Are Normal but Symptoms Are Not13:09 – The Gap Between Disease and Dysfunction18:52 – Neuroplasticity Explained Without the Jargon24:35 – Why “Nothing Is Wrong” Can Be Harmful30:13 – How the Nervous System Learns Symptoms36:56 – What Recovery Actually Looks Like in Practice43:14 – Turning Lived Experience Into a Care FrameworkDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. 

Lifestyle Changes to Prevent Chronic Disease: Real Talk with Dr. Ford Brewer

Dr. Ford Brewer’s story is not about hacks or shortcuts. It is about a physician who left the adrenaline of the emergency department to confront a quieter, more uncomfortable reality. Most of the heart attacks and strokes he saw should never have happened. At Hopkins, in public health, and later in his own practice, he realized how profoundly our future health is shaped by habits that feel small in the moment and by metabolic problems that remain invisible for decades.In this conversation, we unpack what “test, do not guess” really looks like in real life. We talk about the epidemic of undiagnosed prediabetes, why fasting glucose and A1C miss so much disease, and how an old school oral glucose tolerance test can reveal what is really happening under the surface. Dr. Brewer explains continuous glucose monitors, why leg muscle acts like an internal safety valve for high blood sugar, and how small “exercise snacks” can protect you more than heroic gym bursts. We dig into the GLP 1 craze, the politics of food guidelines, and the uncomfortable reality that some systems profit from people staying sick.So whether you are a clinician, a patient who has been told your labs are “fine,” or someone who simply wants to stay out of the cath lab in your 50s, this episode is a sharp reset. It will change how you think about carbs, muscle, and “normal aging,” and it will give you tangible ways to take back agency over your metabolism. Plug in and see what happens when prevention stops being boring advice and becomes a clear plan for protecting the decades ahead.Ford Brewer MD MPH's Links : YouTube : https://www.youtube.com/channel/UCmoEsq6a6ePXxgZeA4CVrUw  Website : https://drfordbrewermd.com/Episode Takeaways 1. Building Better Habits – Long term health depends far more on daily routines than on motivation or willpower. Action beats intention every time.2. Discomfort Drives Growth – Improvement requires stepping outside comfort zones. Sustainable prevention often starts with doing what you do not feel like doing.3. Prevention Is Undervalued – Preventive medicine is dismissed as boring, yet most chronic disease stems from issues that could have been avoided years earlier.4. Prediabetes Is Everywhere – With half the population showing signs of impaired glucose control, early metabolic testing should be a universal priority.5. A1C Is Not Enough – Standard labs miss a large percentage of metabolic disease. Old school glucose tolerance testing reveals problems long before symptoms appear.6. CGMs Change Behavior – Real time glucose feedback helps people finally understand how food and activity affect their bodies and motivates true habit change.7. Muscle Protects Metabolism – Strong, active leg muscles act as metabolic engines that help control glucose spikes and support long term vascular health.8. Food Systems Shape Disease – Big Food, outdated guidelines, and institutional incentives influence what people eat and directly contribute to chronic illness.Episode Timestamps 00:02:32 — Meet Dr. Kang Hsu, Chief Medical Officer of Canary Speech00:03:44 — How voice became medicine: the story behind Canary Speech00:04:29 — Why this conversation matters to clinicians and patients alike00:05:05 — Making science accessible: breaking down complex ideas00:06:59 — Behind the mic: how each episode comes together00:07:59 — Keeping it real: refining, revising, and staying authentic00:09:00 — Can your voice reveal your health? The rise of vocal biomarkers00:13:00 — From telehealth to wearables: real-world applications00:19:00 — The uphill climb: innovation vs. healthcare resistance00:25:00 — The road ahead: what the future of voice in medicine could look like00:31:00 — Closing thoughts and a glimpse into what’s nextDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.    Disclosures: Ditch The Lab Coat podcast is produced by (soundsdebatable.com) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.