No guest this week, just the two besties going deep. Dr. Junaid Kalia and DR GPT™ Harvey Castro step back to ask what actually changed in healthcare AI this fall, and why it matters. They land on two shifts pulling in the same direction. Junaid’s is technical and under-reported: we have started building AI models for machines, not humans, systems that return a calibrated decision and a probability instead of paragraphs of text, running an entire EHR as a “decision machine” in seconds and at a fraction of the cost. Harvey’s is human and personal: the move from reactive to proactive medicine, built around the one metric he argues beats almost everything else, your VO2 max. One of them lost his father to an emergency that started silently years earlier. The thesis that ties it together: the best emergency is the one that never comes.

• Cold open: what if your emergency has already started? (DR GPT™ Harvey Castro)
• The shift: we are building AI for machines, not humans (Junaid)
• Reactive vs proactive medicine, and why it is personal (DR GPT™ Harvey Castro)
• VO2 max: the longevity metric that beats fixing diabetes (DR GPT™ Harvey Castro)
• Men’s health, and why men die sooner (Junaid)
• Self-evolving research agents and “benchmark as teacher” (Junaid)
• Why SaveLife.AI™ now runs its own GPUs (Junaid)
• Decisions, not language: building AI for outcomes (Junaid)
• Warfarin and the EHR as a decision machine (Junaid)
• 600 questions on one chart, in under a second (Junaid)
• The close: take care of your body today (DR GPT™ Harvey Castro)

🖇️ Calibrated “decision” models: System-1-style systems that return a choice and a probability instead of text (product and company names were spoken on-air; verify spelling before citing)

🖇️ Small, knowledge-light models (e.g., the MiniCPM family) as fast decision engines

🖇️ SaveLife.AI™ bringing its own GPUs online

🖇️ VO2 max and cardiorespiratory fitness as a mortality predictor

🖇️ Daily steps and longevity (the 7,500-step discussion)

🖇️ Signal & Symptoms Ep 54 (Dr. Alan Weiss): genetic testing at scale

Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host)

💼 LinkedIn: https://www.linkedin.com/in/junaidkaliamd

🔗 Website: https://www.junaidkalia.com/

📹 YouTube: https://www.youtube.com/@junaidkaliamd

DR GPT™ Harvey Castro, ER Physician (co-host)

💼 LinkedIn: https://www.linkedin.com/in/harveycastromd/

🔗 Website: https://www.harveycastromd.com/

Visit our website: https://signalandsymptoms.com/

Get advisory insights about Healthcare AI, at zero cost: https://junaidkaliamd.substack.com/

Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor and patient relationship. The longevity and fitness points are general wellness information, not a treatment plan; talk to your own clinician before changing exercise or health routines. Views expressed are the hosts’ own and do not represent their employers. No PHI is shared.

The cost of sequencing your genome just fell below $100, so the hard question is no longer “can we test?” It is “should you know what you cannot fix?” That is the tension at the center of this episode, and the panel refuses to give it an easy answer.

Dr. Alan Weiss, Senior Vice President of Clinical Advancement at Banner Health, returns to Signal & Symptoms (his second appearance) for a conversation on genetic testing at scale, hosted by Dr. Junaid Kalia with co-hosts Dr. Isha Mannering, DR GPT™ Harvey Castro, and Edward Marx. Alan tells the story of a colleague, a genuine health specimen, who did a consumer panel and learned she carries risk for a rare, untreatable cancer, turning her overnight into one of the “worried well.” Harvey shares finding his own macular-degeneration gene during a chess game with his grandfather, and later, how CRISPR let a sickle-cell patient climb a mountain. Junaid raises the Apple Watch AFib problem, where a screening tool floods the system faster than it can absorb. Isha holds the line that genetics is still just a tool, and that newborn screening is where universal testing clearly wins. And Alan closes the loop with a confession: offered widespread testing himself, he said no.

• Cold open: CRISPR, and a gene you cannot unknow
• A gene you can’t unknow
• Welcome back Dr. Alan Weiss: genetics, genomics, and AI
• A grandfather, chess, and a risk gene (DR GPT™ Harvey Castro)
• The cost just fell below $100 02:08 The “worried well”: a healthy colleague, a frightening result
• Information vs wisdom: knowing what NOT to do
• Pharmacogenomics: the codeine metabolizer example
• Offer it, or patients get it elsewhere (Edward Marx)
• The Apple Watch AFib problem
• Genetics is still just a tool (Dr. Isha Mannering)
• Does knowing your risk change behavior? The back-pain paradox
• CISPR let a sickle-cell patient climb a mountain (DR GPT™ Harvey Castro)
• Newborn screening: where testing clearly wins
• “I was offered testing, and I said no”

🖇️ The sub-$100 genome and the falling cost curve of sequencing

🖇️ Pharmacogenomics: the fast-metabolizer / codeine safety example

🖇️ The Apple Watch AFib screening surge and screening-to-diagnostic capacity

🖇️ CRISPR and sickle cell disease

🖇️ State-mandated newborn screening and the move toward genomic newborn screening

🖇️ Signal & Symptoms Ep 52 (Dr. Alan Weiss, first appearance): the empathy debate

Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host)

💼 LinkedIn: https://www.linkedin.com/in/junaidkaliamd

🔗 Website: https://www.junaidkalia.com/

📹 YouTube: https://www.youtube.com/@junaidkaliamd

Dr. Isha Mannering (co-host)

💼 LinkedIn: https://www.linkedin.com/in/isha-mannering

DR GPT™ Harvey Castro, ER Physician (co-host)

💼 LinkedIn: https://www.linkedin.com/in/harveycastromd/

Edward Marx, CEO, Advisor (co-host)

💼 LinkedIn: https://www.linkedin.com/in/edwardmarx/ 🔗 Website: https://www.marxadvisory.com/

Special Guest:

Dr. Alan M. Weiss, MD, MBA, FACP, Senior Vice President of Clinical Advancement, Banner Health (physician-informaticist; former CMIO)

💼 LinkedIn: https://www.linkedin.com/in/dralanmweiss/

Visit our website: https://signalandsymptoms.com/

Get advisory insights about Healthcare AI, at zero cost: https://junaidkaliamd.substack.com/

Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor and patient relationship. Views expressed by the guest and co-hosts are their own and do not represent their employers. Genetic and screening decisions should be made with a qualified clinician and, where appropriate, a genetic counselor. No specific company or test is endorsed. No PHI is shared.

“Medicine is fundamentally a relationship, and I don’t think AI replaces that.” That is where Dr. Alan Weiss plants his flag, seconds before Dr. Junaid Kalia throws down the provocation the whole episode circles: what if 65% of patients soon get 85% of their primary care through AI agents? This is the empathy debate, and it is not the one you expect.

Dr. Alan Weiss, Senior Vice President of Clinical Advancement at Banner Health and a physician-informaticist who describes himself as “a nerd turned doctor, gone back to being a nerd,” joins host Dr. Junaid Kalia with co-hosts Dr. Isha Mannering, DR GPT™ Harvey Castro, and Edward Marx. Together they work through the uncomfortable middle of the AI-versus-doctor question: the crushing admin load AI could lift, the timeline for when it actually will, the danger of trusting a model that quietly misses a sepsis case, and the studies suggesting AI can already sound more empathetic than a physician. It ends on a story that will stay with you: an AI that remembered a patient loved soccer, and comforted her about missing the World Cup, better than most humans would have.

[00:00] Cold open: “medicine is a relationship” vs “65% of care through AI agents”

[00:46] Meet Dr. Alan Weiss: “a nerd turned doctor, gone back to being a nerd”

[01:16] What still drives him, and AI as augmentation, not replacement

[02:04] Dr. Isha Mannering on pediatrics and the joy in medicine

[02:55] The admin crush: documentation, billing, and the inbox

[04:17] When will AI actually handle it? The timeline (refills, 2029, the Utah pilot)

[05:28] The liability tipping point

[05:53] What if you disagree with the AI? Alan on the sepsis it can miss

[06:33] Can AI fake empathy? Genuine connection vs mimicry

[06:53] Ambient AI that hears 100 emotions in your voice

[07:33] Fatigue vs empathy: why a clinician’s energy runs out (Alan)

[08:40] The World Cup moment: when AI out-empathized the doctor (Edward Marx)

🖇️ JAMA Internal Medicine (2023): AI chatbot responses rated more empathetic than physicians’

🖇️ The Epic Sepsis Model shortfall: an AI that missed most sepsis cases in external validation

🖇️ Ambient AI scribes: hearing “100 emotions” in a clinician’s voice, and easing documentation

🖇️ Wearables, the admin inbox, and the “augment, don’t replace” thesis

Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host) 💼 LinkedIn — https://www.linkedin.com/in/junaidkaliamd

🔗 Website — https://www.junaidkalia.com/

📹 YouTube — https://www.youtube.com/@junaidkaliamd

Edward Marx, CEO, Advisor (co-host)

💼 LinkedIn — https://www.linkedin.com/in/edwardmarx/

🔗 Website — https://www.marxadvisory.com/

📹 YouTube — https://www.youtube.com/@EdwardMarx

DR GPT™ Harvey Castro, ER Physician, #DrGPT™ (co-host)

💼 LinkedIn — https://www.linkedin.com/in/harveycastromd/

🔗 Website — https://www.harveycastromd.com/

Visit our website: https://signalandsymptoms.com/

Dr. Isha Mannering (co-host)

💼 LinkedIn: https://www.linkedin.com/in/isha-mannering

Special Guest:

Dr. Alan M. Weiss, MD, MBA, FACP, Senior Vice President of Clinical Advancement, Banner Health (physician-informaticist; former CMIO)

💼 LinkedIn: https://www.linkedin.com/in/dralanmweiss/

Visit our website: https://signalandsymptoms.com/

Get advisory insights about Healthcare AI, at zero cost: https://junaidkaliamd.substack.com/

Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor and patient relationship. Views expressed by the guest and co-hosts are their own and do not represent their employers. AI tools discussed are decision-support with a clinician in the loop, not autonomous or cleared diagnostic devices. No PHI is shared.

Technology keeps getting built for clinicians and too often without them. This episode of Signal & Symptoms is about closing that gap. Dr. Junaid Kalia is joined by co-hosts Ed Marx, DR GPT™ Harvey Castro, and now officially on the roster Dr. Isha Mannering, with guest Dr. Ryan Walsh, Chief Medical Information Officer at Memorial Hermann. Ryan calls his path “the Forrest Gump of health IT”: a family physician and residency educator who raised his hand when someone asked “does anyone know about computers?” and ended up double-board-certified as a “human + machine” leader.

The conversation is a working clinician’s field guide to living with AI: what actually excites a CMIO right now, how to de risk AI so you can use it without getting burned, why residents trust an AI summary inside Epic more than an outside source (and why that’s dangerous), and the med-legal reality that governance and law are being outpaced by the technology. Ed lands the episode’s sharpest line that the real leading cause of preventable death in a hospital might not be sepsis, but governance that keeps good tools out. Ryan’s answer isn’t to skip the guardrails: it’s a physician-led clinical AI governance council, piloting carefully, and refusing to throw the baby out with the bathwater “but we do need to test the bathwater.”

[00:00] “nothing is foolproof,” and the EHR-trust trap

[00:21] Welcome + meet Dr. Ryan Walsh (CMIO, Memorial Hermann), Isha joins as co-host

[00:57] The “Forrest Gump of health IT” origin story

[02:03] What excites a CMIO now: the tech finally catching up

[03:23] AI as a thinking partner

[04:42] “All technology is deflationary” (Junaid)

[05:02] Advice for clinicians: use it, learn the limits, de-risk it

[06:29] Do residents trust AI? The EHR summary surprise

[07:43] Fear, soul, and choosing love over 150 years of tech (Ed)

[08:13] The bridge: balance, not sides (Isha)

[08:42] Med-legal reality + the clinical AI governance council

[09:29] “The real leading cause of preventable death? Governance.”

[10:07] Don’t throw the baby out with the bathwater test the bathwater

🖇️ Dr. Ryan Walsh — CMIO, Memorial Hermann Health System; family physician + informaticist (“human + machine”)

🖇️ Memorial Hermann’s overarching clinical AI governance council

🖇️ AI summaries inside the EHR (Epic) — and the automation-bias / implicit-trust risk

🖇️ 21st Century Cures Act era of health data + interoperability Connect with us:

Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host) 💼 LinkedIn — https://www.linkedin.com/in/junaidkaliamd

🔗 Website — https://www.junaidkalia.com/

📹 YouTube — https://www.youtube.com/@junaidkaliamd

Edward Marx, CEO, Advisor (co-host)

💼 LinkedIn — https://www.linkedin.com/in/edwardmarx/

🔗 Website — https://www.marxadvisory.com/

📹 YouTube — https://www.youtube.com/@EdwardMarx

DR GPT™ Harvey Castro, ER Physician, #DrGPT™ (co-host)

💼 LinkedIn — https://www.linkedin.com/in/harveycastromd/

🔗 Website — https://www.harveycastromd.com/

Visit our website: https://signalandsymptoms.com/

Special Guest:

Dr. Ryan Walsh — Chief Medical Information Officer, Memorial Hermann Health System

💼 LinkedIn — https://www.linkedin.com/in/ryanwalshmd/

Visit our website: https://signalandsymptoms.com/

Get advisory insights about Healthcare AI — at zero cost: https://junaidkaliamd.substack.com/

Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor–patient relationship. Views expressed are Their own and do not represent the employer. Tools and methods discussed are decision-support and research infrastructure with a clinician in the loop — not autonomous or cleared diagnostic devices. No PHI is shared.

“AI alone is very rarely the real breakthrough.” That’s how Dr. Agata Krasoń a Senior Clinical & Imaging Data Scientist at Roche, joining from Switzerland opens the conversation, and it reframes the entire episode. The breakthrough, she argues, happens when the right data, the right model, the workflow, the validation, and the clinical decision are all connected. The model is the easy part.

In this episode of Signal & Symptoms, Dr. Junaid Kalia and co-host Ed Marx dig into the unglamorous middle layer where medical imaging actually becomes clinical AI: data standardization, harmonization, and the FAIR foundations that decide whether a model can be trusted at all. Agata makes the case for starting with the decision, not the model; Junaid shares how SaveLife.AI™’s “VisionOps” flywheel compressed grounded-data prep from months to hours; and Ed brings the hard governance truth in his words, when we don’t share the right data, “people die, and that’s criminal.” They close on precision medicine, the AI “mirage” (models that fake the read), planning one year instead of five, and why patients should own their health data like a bank account.

[00:00] “AI alone is rarely the real breakthrough”

[00:47] Welcome + meet Agata Krasoń (Roche, Switzerland)

[01:35] Start with the decision, not the model

[02:58] Work backwards from the problem (Ed Marx)

[03:29] Data standardization: the foundation you build the house on

[04:23] VisionOps & the AI flywheel months to hours

[05:32] Precision medicine: the right therapy for the right patient

[06:06] The “mirage”: when AI fakes the read

[06:58] Plan one year, not five

[07:36] Switzerland vs. the US: 500+ EMRs, no single data source

[08:48] Regulation, data-sharing, and who really drives the rules

[09:15] Own your health data like your bank account (+ the $500 private-AI box)

🖇️ Agata Krasoń’s May 2026 LinkedIn post — “AI alone is never the real breakthrough”

🖇️ FAIR data principles (Findable, Accessible, Interoperable, Reusable)

🖇️ SaveLife.AI™ “VisionOps” — Vision-Language Model (VLM) analysis pipeline

🖇️ Sergey Brin, paraphrased — “If you cannot measure it, you cannot improve it”

🖇️ The imaging-AI “mirage” — foundation models producing reads without truly using the image

🖇️ Signal & Symptoms Ep 33 (Martin Willemink) — radiology AI

Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host) 💼 LinkedIn — https://www.linkedin.com/in/junaidkaliamd

🔗 Website — https://www.junaidkalia.com/

📹 YouTube — https://www.youtube.com/@junaidkaliamd

Edward Marx, CEO, Advisor (co-host)

💼 LinkedIn — https://www.linkedin.com/in/edwardmarx/

🔗 Website — https://www.marxadvisory.com/

📹 YouTube — https://www.youtube.com/@EdwardMarx

DR GPT™ Harvey Castro, ER Physician, #DrGPT™ (co-host)

💼 LinkedIn — https://www.linkedin.com/in/harveycastromd/

🔗 Website — https://www.harveycastromd.com/

Visit our website: https://signalandsymptoms.com/

Special Guest:

Dr. Agata Krasoń — Senior Clinical & Imaging Data Scientist, Roche (Basel, Switzerland)

💼 LinkedIn — https://www.linkedin.com/in/agatakrason

Visit our website: https://signalandsymptoms.com/

Get advisory insights about Healthcare AI — at zero cost: https://junaidkaliamd.substack.com/

Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor–patient relationship. Tools and methods discussed are decision-support and research infrastructure with a clinician in the loop — not autonomous or cleared diagnostic devices. No PHI is shared.