Out of Patients with Matthew Zachary

Jessica Federer built her career inside the rooms where science, money, and power collide. As the first female Chief Digital Officer at Bayer, she helped steer a 120,000 person global company through the rise of digital medicine while confronting a harder truth: women were excluded from U.S. clinical trials until 1993.In this conversation, she explains how decades of “first in man” research shaped drug development, why women experience side effects at nearly 2x the rate of men, and how guidance on sex based differences did not arrive from the FDA until December 2025.  She shares what it means to sit on a Yale Institutional Review Board, why clinical trial stipends over $3,000 get taxed, and why she believes participants deserve tax credits instead. From GLP 1 profits to $40,000,000 women’s health funds that barely move the needle, this episode names the gaps and the opportunity hiding inside them.  RELATED LINKSJessica Federer on LinkedInJessica Federer on InstagramYale School of Public HealthHealth of Women Investor SummitFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email [email protected] Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr Eugene Manley grew up in Detroit in the 1980s cycling through emergency rooms 20 to 30 times a year with asthma and anaphylaxis while hospital staff talked past his family and buried them in paperwork they could not decode. He responded by earning a BS in mechanical engineering an MS in biomedical engineering and a PhD in molecular biology cell biology and biochemistry. Along the way he tore his ACL training for a jiu jitsu black belt worked 86 straight days in a lab during his doctorate and learned how academic and clinical systems punish people who refuse to shrink.In this episode Manley walks through a recent post surgery ordeal at Mount Sinai Queens where staff falsified records attempted an illegal discharge and nearly sent him home on the wrong blood thinner. He explains how medical racism shows up in charts staffing and decision making and why measurable equity fails without accountability. Listeners hear how his STEMM and Cancer Health Equity Foundation builds pipelines for underrepresented students challenges clinical trial design and teaches patients how to protect themselves when institutions lie.  RELATED LINKSEugene Manley JrSTEMM and Cancer Health Equity FoundationVillage VoiceLUNGevity FoundationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email [email protected] Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Jenny Opalinski has spent more than a decade inside hospitals where people lose the ability to speak, breathe, swallow, and sometimes survive. A medical speech language pathologist by training, she worked in ICU, neuro rehab, and long term acute care settings, including a Level 1 trauma center, where she watched clinicians absorb 10 to 15 traumatic events in a single shift and then get told to move the crash cart faster next time.That lived reality pushed her to co found The Wellness Shift, an advocacy and education platform focused on healthcare worker burnout, suicide, and assault. In this conversation, Opalinski walks through the moment that changed everything for her: standing in a hospital hallway listening to a family wail after a failed code, followed by a debrief that addressed logistics and ignored grief entirely.She also explains how that work led to Humanity Rx, her podcast about the human cost of medicine, and Dragon’s Breath: Calming Tricks for Big Feelings, a children’s book that translates evidence based breathing and regulation strategies into language kids can actually use. The episode covers moral injury, time scarcity, false wellness, respiratory muscle training, and why empathy keeps getting treated as an optional expense instead of clinical infrastructure.RELATED LINKSJenny Opalinski on LinkedInHumanity Rx PodcastFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email [email protected] Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Fitz Koehler is a fitness expert, race announcer, author, and breast cancer survivor whose career spans decades of helping people move, train, and live healthier lives. After earning a master’s degree in exercise and sport sciences, she built the Fitzness brand, launched the Morning Mile school fitness program, and became one of the country’s most recognizable voices at endurance events before cancer abruptly shifted the conversation.  She spent 15 months enduring chemotherapy, surgery, and radiation after discovering breast cancer shortly after receiving a clean mammogram. She kept traveling, announcing races, and working through treatment while watching the body she had spent a lifetime building become weaker by the week. Instead of asking why cancer happened, she focused on the only things she believed remained under her control: movement, nutrition, sleep, and mental health.  The conversation explores where personal agency ends and biology takes over. Koehler argues that exercise is not about chasing perfection or preventing every diagnosis. It is about building physical reserve before illness arrives and preserving strength, mobility, and independence during treatment. She rejects wellness snake oil, fad supplements, and miracle cures in favor of practical habits rooted in exercise science and lived experience.  The discussion also confronts a harder truth. Koehler did everything “right” and still developed cancer. That tension becomes the center of the episode. Fitness cannot eliminate randomness, but it can influence how people experience treatment, recover from surgery, and reclaim their lives afterward. The conversation moves beyond motivation and into survivorship, exercise oncology, cancer rehabilitation, evidence-based nutrition, and the limits of individual control inside a healthcare system that often tells patients what they should do without showing them how to do it.  Along the way, the conversation wanders through kickboxing, Cinnabon, Jean-Claude Van Damme, chocolate-covered Cheetos, Jerry Seinfeld playing during chemotherapy stretches, and why the simplest advice is often the hardest to follow. Beneath the humor sits a larger argument: preparing the body for hardship is not about living forever. It is about living better when life inevitably gets difficult.  RELATED LINKSFitz Koehler⁠Fitzness⁠The Morning Mile⁠You. Supercharged!⁠My Noisy Cancer Comeback⁠Your Healthy Cancer Comeback⁠UF Health Cancer Center⁠American College of Sports Medicine Exercise Is Medicine⁠FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email [email protected] Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Jeremy Heffner, MD, FACS is a board-certified trauma surgeon, former Chair of Surgery at Lima Memorial Health System, and cofounder of Surgery Unified, one of the largest physician-led communities in surgery. His perspective carries weight because he has spent decades inside operating rooms, hospital leadership, physician culture, and the growing collision between medicine and corporate healthcare. He grew up in a blue-collar Ohio family of firefighters, railroad workers, police officers, and tradespeople. Medicine represented something rare: a career that combined service, stability, and purpose. He pursued engineering, earned his medical degree, completed trauma surgery fellowship training at the University of Michigan, and entered a profession that taught physicians to sacrifice themselves for patients.Then the rules changed.This conversation traces the gap between the medicine physicians were trained to practice and the healthcare industry that emerged around them. Administrative burden expanded. Insurance companies gained influence over treatment decisions.  Prior authorization became routine. Hospital systems consolidated. Physicians retained responsibility for outcomes while losing authority over the conditions required to achieve them.Heffner describes watching colleagues struggle with burnout, moral injury, PTSD, and growing frustration with a system that increasingly inserts business incentives between clinicians and patients. He explains why younger physicians are entering medicine with a level of visibility that previous generations never had. They see the paperwork, the denials, the loss of autonomy, and the personal cost before they ever finish training.The discussion moves beyond physician dissatisfaction and into the broader consequences for patients. When insurers delay care, hospitals absorb costs, clinicians absorb stress, and patients absorb uncertainty. The financial incentives remain intact while trust erodes across every level of the healthcare system.At its core, this episode examines what happens when a profession built around service finds itself operating inside an industry built around extraction. The result affects physicians, nurses, caregivers, and every patient forced to navigate the consequences.RELATED LINKSJeremy Heffner⁠Surgery Unified⁠SurgeOn⁠University of Michigan Department of Surgery⁠KevinMD⁠Suck It Up Buttercup⁠FEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email [email protected] Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.