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The Clinical Realist
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
Episodes
17 episodes
The Economics Nobody Taught You in Medical School
Medical school teaches you pathophysiology, pharmacology, and clinical reasoning. It does not teach you how the money actually works. In this episode, Dr. Sarah Matt breaks down the economic structures that govern every clinical decision, every t...
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The Patient We Never Designed For (Live from Cornell Ithaca, Extended Cut)
Recorded live at Cornell Ithaca. This is the extended cut of Dr. Sarah Matt's keynote on the central design flaw in modern healthcare: a system optimized for an "average" patient who does not exist.When you build clinical work...
Sunk Cost, Vendor Lock, and the AI Tools Health Systems Can't Let Go Of
Most clinical AI governance frameworks tell you how to evaluate tools before you deploy them. Nobody talks about how to exit a tool that is not working. In this episode, Dr. Sarah Matt walks through the anatomy of sunk cost bias in health system ...
The Q2 Governance Problem: When AI Goes Live Without a Safety Net
Most health systems that deployed clinical AI in Q1 are now six to eight weeks post-launch and starting to see the governance gap. Dr. Sarah Matt explains what the gap looks like in production, why retrofitting governance is more expensive than bu...
The Pilot Trap: What Health Systems Get Wrong About Implementation
Your pilot worked. You got approval to scale. Six weeks into full implementation, something is wrong: not catastrophically wrong, just wrong enough to make you wonder whether "it worked in the pilot" meant anything at all. In this episode, Dr. Sa...
The Wrong Diagnosis: Why Health Systems Keep Failing at AI
Most health systems that fail at clinical AI adoption are not failing because the tool is bad. They are failing because they diagnosed the problem wrong before they ever touched a vendor pitch. In this episode, Dr. Sarah Matt breaks down the co...
The 90% Problem: Why Clinical AI Pilots Don't Scale
You ran the pilot. The AI worked. The clinicians loved it. The outcomes were solid. Then you tried to roll it out system-wide and it fell apart. This is the 90% problem, and it is not a technology problem. It is an adoption problem. In this episo...
What Hospital Boards Get Wrong About Healthcare AI And Why It Matters to You
Health system boards are approving eight-figure AI investments without a governance framework that tells them what they are actually approving. They are receiving technology presentations. What they need are risk assessments.In this episode, Dr. S...
What Physicians Actually Need to Know About AI Contracts Before They Sign Anything
A physician executive signed a clinical validation form. Eleven months later, she was the one accountable in peer review after an AI-assisted recommendation contributed to a delayed diagnosis. She had not read the indemnification clause. Almost no...
The Physician's Role in AI Procurement: Accountability Before Authority
When an AI tool causes a patient harm, who gets called into the review meeting?In almost every health system, the answer is the physician. The same physician who was brought into the procurement conversation as a validator after the vend...
Why Most Health Systems Will Fail at AI — And It's Not the Technology
Health systems are signing AI contracts they cannot govern. That is the real problem. Not the technology.In this episode, Dr. Sarah Matt, physician executive and healthcare strategy advisor, breaks down the three governance layers where ...
Ep 6: Taco Bell vs. Steakhouse Dilemma: Why Healthcare Economics is Broken
In this episode of The Clinical Realist, Dr. Sarah Matt takes a deep dive into the confusing and often contradictory world of healthcare economics. Using a surprisingly relatable analogy—the price of a taco—she explains why the "castle...
Ep 5: The Question Nobody Asks at Healthcare Conferences
Seven thousand healthcare leaders will walk into ACHE 2026 next week. Adam Grant opens. Brene Brown closes. Hundreds of sessions on AI, strategy, and leadership will fill every ballroom.Here is the question that will not be on any panel ...
Ep 4: The Virtual Care Illusion - Why Video Visits Aren't the Revolution We Need
In this episode of The Clinical Realist, Dr. Sarah Matt challenges the common misconception that video visits are the pinnacle of virtual care. Drawing from her extensive experience as a surgeon and health technology strategist, she ar...
Ep 3: The Illusion of Balance: Embracing the "Tilt" in Leadership and Life
In this deeply personal and practical episode, Dr. Sarah Matt—surgeon, CEO, and author—dismantles one of the most destructive myths sold to modern leaders: the concept of work-life balance. Drawing on her unique perspective at the...
Ep 2: Star Trek vs. The Flintstones: The Reality of Hospital Tech
Are you trying to run Star Trek software on Flintstones infrastructure?In this episode of The Borderless Healthcare Revolution, Dr. Sarah Matt—the Clinical Realist—dissects the massive gap between what the technology indu...