Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Otello Stampacchia is today’s guest on The Long Run.
Otello is the founder and managing director of Omega Funds. It’s a transatlantic biotech venture firm with offices in Boston and Geneva, Switzerland. He’s a native of Italy and you might say a true international businessman, deeply rooted in the issues startups face in various geographies around the world.
Otello Stampacchia, founder and managing partner, Omega Funds
This conversation stems from the current moment of geopolitical disruption, and what Europe can do to become a more dynamic player in this key industry of the 21st century. The US federal government has been pressuring big companies to invest more in the US or else face crushing tariffs. China has emerged as an aggressive low-cost, high-speed, high-quality rival.
Europe runs the risk of being caught in the middle and further marginalized in several key industries of the future, including biotech. The present state of affairs isn’t great. Only 7 percent of venture capital for biotech startups goes to European companies – compared with 63 percent for the US – according to one recent analysis.
Otello is concerned. The science is terrific in Europe. The question is how to translate that better into useful products and high-growth companies in Europe.
Otello is spending some of his time on tackling longstanding roadblocks in the financial systems and regulatory systems that hold back Europe’s small to mid-sized companies. He has been integral to the formation of the European Life Sciences Coalition. It’s a group of venture firms such as Omega, Forbion, Novo Holdings and Sofinnova Partners.
This is an interesting conversation about how to create positive conditions through science policy that’s relevant for listeners around the world.
The Long Run is sponsored by:
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Now please enjoy this conversation with Otello Stampacchia on The Long Run.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
The Timmerman Traverse has become a phenomenon in the biotech industry.
Numbers tell part of the story. More than 200 biotech industry leaders have participated since 2019. More than $15 million has been raised to support high-risk/high-reward cancer research, poverty alleviation, and newborn screening for sickle cell disease.
Nonprofit organizations have seen awareness of their work, and their donor networks, increase significantly. Maybe most important of all — participants describe the experience as life changing.
It’s about getting outside, doing something physically and mentally challenging, raising substantial funds for a good cause, and banding together with a team of mission-driven biotech leaders. Lifelong friendships are formed.
For those who are curious, I’d encourage you to watch these short videos.
First, this one from Damon Runyon Cancer Research Foundation focuses on the young cancer researchers who are getting critical resources to launch their careers and explore the frontiers with high-risk/high-reward research.
This next video, created with help from Fuel for Female Founders, captures footage from the Kilimanjaro expedition in February 2026. See what participants say while they’re in the moment on the mountain.
Lastly, this video created by Timmerman Traverse alumna Rosie Rodriguez contains commentary from a few prominent alumni reflecting on the experience months or years later.
Thanks to all of you who have stuck your necks out to participate, to contribute to a friend’s campaign, or to step up as a major corporate sponsor.
If you are interested in participating or contributing to the next Timmerman Traverse for Damon Runyon Cancer Research Foundation, it’s a pair of spectacular day hikes in the Evolution Range of the Sierras near Bishop, CA.
See me for more information. luke@timmermanreport.com.
Timmerman Traverse
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Ken Song is today’s guest on The Long Run.
First things first, this episode was recorded before news broke that Candid Therapeutics went public via a reverse merger with RallyBio. But I must say, that deal was no surprise.
Ken Song, CEO, Candid Therapeutics
Ken was on The Long Run five years ago, in November 2021. At that time, he was CEO of San Diego-based RayzeBio. That company was developed targeted radiopharmaceuticals for cancer. It ended up going public and then was quickly acquired by Bristol Myers Squibb for $4.1 billion in December 2023.
Ken struck me then as someone with good entrepreneurial instincts. He’s back in the arena again with another startup with potential.
This time, he’s CEO of San Diego-based Candid Therapeutics. It’s a startup developing bispecific T-cell engaging antibodies to treat autoimmune diseases. It has raised $370 million in venture capital. The company’s two lead drug candidates are in clinical trials.
Candid is hoping to be part of a wave of innovation in the treatment of autoimmune disease. We’ve seen remarkable results with CAR-T cell therapies in patients with autoimmune disease, who achieve “an immune reset.” That’s a tantalizing result, but one that’s unlikely to scale to the millions of people with autoimmune diseases. Ken and his team are wagering that T-cell engaging antibodies will achieve a similar biological effect, but in a more practical, scalable, and cost-effective shot that comes in a vial.
Before we get started, a word from the sponsors of The Long Run.
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Please enjoy this conversation with Ken Song on The Long Run.
David Shaywitz
Last night I offered some remarks at February’s Boston Health Innovation Night, a monthly gathering of innovators, entrepreneurs, and investors in Boston’s extraordinary biomedical ecosystem, organized by digital health advisor and investor Steven Wardell.
Several people asked whether I’d written the ideas up, which I took as encouragement to share them here (along with a few photos from the event). What follows is a lightly edited version of what I said, followed by a related personal career update/disclosure for readers (tl;dr my passion project is now also my day job).
• • •
Each phase of my career has been shaped by a powerful emerging technology — molecular biology and genetics, stem cells, digital health, and most recently AI. What’s kept me at it is less the technology itself than the intent: trying to figure out how to actually use these tools to help people, and staying preoccupied with whether we really are. And who those people are is changing. Taking care of the sick remains the core of medicine, but the aperture is widening: we’re beginning to ask how these same tools might help all of us live better, not just recover when things go wrong.
Author, with Nicole van Poppel (Cytoreason) and Dr. Jenifer Siegelman (strategic advisor)
A few learnings along the way:
First: technology is enormously enabling. Tools have extraordinary power. Think of the impact of the telescope, the microscope, the microchip, the calculus: all changed the questions we were able to ask of nature. But the key challenge with any powerful new technology — and gen AI is only the latest example — is making sure we leverage it without getting defined by it. The real danger is letting what the tools do well define what we think matters. In healthtech, that means we tend to focus on measuring, quantifying, and optimizing, rather than what might be most important to the people we’re trying to serve. As Kate Crawford astutely reminds us, we must not let the “affordances of the tools become the horizon of truth.”
Second: remarkable progress in the science of aging has highlighted the outsized value of basic lifestyle activities. There’s so much we can do to age better and live healthier. Not zany fads like rejuvenation pods and the like, but basic, common-sense things that tend to reduce what researchers call “inflammaging,” chronic low-grade inflammation associated with problems from cancer to dementia.
Event organizer, digital health investor/advisor Steven Wardell (right).
Obvious examples involve physiology: move regularly — Eric Topol has pointed out that a drug that delivered all the health benefits of exercise would be considered a medical breakthrough. Eat thoughtfully — avoid what nutrition researcher Kevin Hall describes as hyperpalatable, calorie-dense food; there’s lots of good data around the Mediterranean Diet, but common sense applies, and as Zeke Emanuel advises, on special occasions go ahead and eat your ice cream. Also — prioritize sleep; as Matthew Walker and others have taught us, it’s incredibly important.
Unfortunately, the remarkable advances in our ability to measure have led some to turn health into a game of relentless optimization of performance metrics like VO2 and various evolving putative measures of biological aging that may have value at the population level but aren’t yet validated on the individual level. There’s even a rejuvenation Olympics where biohackers compete for best biological aging score.
I’ve always favored a more capacious view of health — and the data seem to support this broader perspective. For example, while physiology is important, so are two other categories: connection/purpose and agency. The Harvard Study of Adult Development, now running over 85 years, has shown that warm relationships predict better cognitive and emotional health decades later. The Northwestern SuperAgers study — examining people in their 80s with memory as sharp as 50-year-olds — found that the single psychological factor distinguishing them from their peers was higher-quality positive relationships. And meta-analyses across more than 300,000 people show that stronger social connections are associated with a 50% increased likelihood of survival. And a higher sense of purpose has also been robustly associated with reduced mortality — there’s actually a great JAMA Network publication showing a dose-response relationship.
Finally, we get to the quality I’m especially captivated by: agency — essentially, your belief that you can impact the world around you. The data linking agency and optimism to better health are striking. Meta-analyses across more than 200,000 people show that higher optimism is associated with roughly a 35% lower risk of cardiovascular events and about 14% lower all-cause mortality — effect sizes in the same neighborhood as traditional risk factors like blood pressure or cholesterol. In the Nurses’ Health Study, women in the top quartile of optimism had nearly 40% lower risk of dying from heart disease or stroke over eight years. More optimistic people also appear to live about 10% longer, with 50-70% greater odds of making it to 85 or beyond. The American Heart Association’s 2021 Scientific Statement in Circulation formally recognized optimism and psychological well-being as cardiovascular health factors with quantified effect sizes, which I guess makes these ideas officially mainstream.
Author, with Alexander Webber (Virus Watcher) and Dr. Marc Herant (Recon Strategy).
Of course, these encouraging associations raise the real question: can we actually cultivate agency, or is it just a trait some people happen to possess? Because changing health behavior is incredibly hard. Angela Duckworth and Katy Milkman ran a massive study –- a “megastudy” — with over 60,000 participants testing dozens of behavioral interventions to boost gym attendance, and none of them worked particularly well — and experts had very little ability to predict which specific interventions would be effective. As Duckworth herself put it, “Behavior change is really *#$@ing hard” – and she’s a MacArthur Genius!
And yet — there are remarkable examples showing it absolutely can be done. Perhaps none more compelling than right here in Boston, just down the street from where we’re standing. The Diabetes Prevention Program, led by my diabetes clinical mentor David Nathan at MGH, demonstrated that a structured lifestyle intervention could reduce the incidence of type 2 diabetes by 58 percent — nearly twice the effect of medication. And the benefits have persisted over 15 years of follow-up. It’s one of the most important prevention studies ever conducted, and, as I see it, it’s all about cultivating agency.
And we’re seeing the same mechanism play out right now in a completely different context. David Kessler — former FDA Commissioner — has described the struggle to lose weight after a lifetime of trying as “a cycle of despair.” What the new GLP-1 medications have done for Kessler and many others, beyond the physiology, is restore the belief that they can actually succeed. That renewed sense of agency can create what I’ve called an “agentic dividend” that, if suitably cultivated, can be applied to other healthy pursuits, like exercising, getting health screenings, reconnecting with family, friends, and community. It has the potential to initiate a virtuous cycle.
Author, with Molly Robb (talent partner) and Steven Wardell (digital health investor/advisor).
One important thing to say about agency before I close. This is emphatically not about “putting on a happy face.” Bad things happen. Terrible things happen. The deeper view of positivity — what Martin Seligman calls flourishing — is a combination of positive emotion, engagement, relationships, meaning, and accomplishment. It’s substantive, not superficial, and as he derisively explains, it’s absolutely not about “merriment.” Optimism can improve your odds, but it’s not a panacea. I think of it more as a resilience tool, one that encourages us to respond constructively and persistently — while being clear that bad outcomes don’t mean you didn’t smile enough. There’s a lot of contingency and bad luck in the world. Sh-t happens.
And that brings me to my final point. It’s precisely because of all that contingency that our ability to cultivate agency matters so much. Agency, as I’ve described it, is the motivational currency of health — the thing that allows us to push through despite the many obstacles and pervasive, ever-present uncertainty. As Seligman wrote in 2021:
“When do we try hard? When do we break out of our sloth and overcome barriers that seem insurmountable? When do we reach for goals that seem unobtainable? When do we persist against the odds? When do we make new, creative departures? These all require Agency — an individual’s belief that he or she can influence the world.”
There’s so much we can’t control — in every setting, everywhere. Our most underappreciated tool for improving our chances of getting the outcomes we want, and even more importantly – for living lives that feel full and capacious and ours — is building our sense of agency, our belief that we can impact the world around us, and coupling that belief with the pragmatic skills and mastery experiences that prove to us, in domains and across domains, that we actually can.
(Reading and resources related to agency and health can be found at KindWellHealth, here.)
• • •
Now to the career update/disclosure I mentioned upfront: I am joining Lore Health as Chief Medical Scientist. In this role, the passion project I’ve pursued (and maintain) at KindWellHealth will now also become my day job: leveraging emerging technology and behavioral science to cultivate agency and improve health at scale.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
One of my favorite Swahili words is “pamoja.” It means together.
The Timmerman Traverse for Damon Runyon Cancer Research Foundation concluded on Feb. 16. We had a memorable experience on Kilimanjaro.
We did it together.
We shared many laughs, and a few tears during our 7-day experience on the highest peak in Africa.
This team had some disappointments. Illness and injury prevented a few members of the team from reaching the summit at 19,341 feet / 5,895 meters.
But there much more to this mountain experience than the summit. We marveled at the stars sparkling in the night skies. We paused to look over the Dendrosenecio kilimanjari, a prehistoric, tree-like plant that look like something from a Dr. Suess book. They are found only in Kilimanjaro’s moorland zone around 14,000 feet.
We gawked at monkeys jumping from branch to branch in the lush forest zone. We heard gentle taps of rain and snow on our tents, while snug in our sleeping bags. We held onto ancient volcanic rock, made smooth over the years by people who make careful hand and foot placements to continue up the mountain.
We exceeded our $1 million fundraising goal for high-risk / high-reward cancer research with $1,206,402. This is enough to fully fund three young scientists for the next four years through the Damon Runyon Cancer Research Foundation. Our hard work on fundraising will advance cancer research for future generations.
This team rose to the challenge of doing something larger than ourselves.
The physical and emotional challenge was no small thing. We covered a little more than 40 miles over rugged, uneven, uphill and downhill terrain. When individuals struggled with altitude symptoms, our group rallied in support — a sip of water, a tasty snack, or a hug.
The camaraderie was special. There’s something deeply human about getting outside, with a group, pushing ourselves hard mentally and physically toward a shared goal.
We relaxed after these efforts by telling stories and cracking jokes. We sang and danced with our Tanzanian crew as if no one was watching.
We shared simple pleasures. A cup of tea or coffee in the tent. Afternoon popcorn in the mess tent. A washcloth at the end of a long day. The nourishing slurp of warm carrot and ginger soup.
We paid attention, and offered respect, to our gracious and hard-working Tanzanian hosts.
The bonds formed were strong. At the end of an immersive experience like this, these are the people who will show up at your wedding or your memorial service. Many positive things will undoubtedly spin out from these deep, meaningful relationships.
Please enjoy a few photos from this life-altering experience.
Please subscribe and tell your friends why it’s worthwhile. Quality journalism costs money. When you subscribe to Timmerman Report at $199 per year, you reward quality independent biotech reporting, and encourage more.
Ansu Satpathy is today’s guest on The Long Run.
Ansu is a physician-scientist and an associate professor of pathology and immunology at Stanford University. He’s co-director of the Parker Institute for Cancer Immunotherapy Center at Stanford Medicine, and the co-founder of several startup companies. These include Cartography Biosciences (a cancer drug developer), Santa Ana Bio (a developer of precision autoimmune therapies) and Immunai, which maps the immune system to guide drug discovery.
Ansu Satpathy, associate professor, Stanford University; co-director, Parker Institute for Cancer Immunotherapy at Stanford Medicine
Ansu’s work focuses on using the new tools of biology – ones that gather genomic, proteomic, metabolomic and other comprehensive datasets – down to the level of single immune cells and cancer cells.
He is one of the people using the tools to probe in ever-greater levels of detail, what’s happening in healthy states, diseased states, and what happens at the molecular level before and after patients get experimental treatments.
Scientists in Ansu’s orbit are seeing things that scientists haven’t been able to see before. It’s throwing off all kinds of promising ideas and discoveries. It’s heady stuff.
Before we get started, a word from the sponsor of The Long Run.
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Lastly, planning is underway for the next big Timmerman Traverse for Damon Runyon Cancer Research Foundation. It will be Aug. 2-5 in the High Sierras of Northern California. Join me for a pair of back-to-back day hikes that will deliver spectacular views of peaks in the 13,000-14,000-foot range. If you are physically fit, enjoy the outdoors, and are able to raise significant money for cancer research – ask me for an invitation. luke@timmermanreport.com.
Now, please enjoy this conversation with Ansu Satpathy on The Long Run.
Luke Timmerman, founder & editor, Timmerman Report
Please join me for a spectacular outdoor experience.
It’s the next Timmerman Traverse for Damon Runyon Cancer Research Foundation. This year it will be in the Evolution Range of California’s High Sierras.
We will do an extraordinary pair of back-to-back day hikes. We will test our endurance on high-altitude trails, reaching peaks above 13,000 feet. We’ll marvel at breathtaking views and landscapes.
The funds we raise on this trip will propel the careers of outstanding young scientists in the Damon Runyon Cancer Research Foundation network.
The physical challenge, the mission for cancer research, the fellowship of your peers, and the awe-inspiring natural beauty combine to make this an unforgettable life experience.
This is a trip you will tell your grandkids about when you are 80 years old.
WATCH this for what the Timmerman Traverse program is all about.
THE CHALLENGE: We will cover 25 miles, with 7,200 feet of elevation gain over back-to-back day hikes with some short and non-technical rock scrambles. We will savor some of the most beautiful scenery in North America. These routes are safe. We will not need ropes or technical rock-climbing equipment.
Bishop Pass, elevation 11,972 feet
Piute Pass, elevation 11,423 feet
When: Aug. 2-5, 2026.
Who’s the Team Leader? Luke Timmerman is the founder and editor of Timmerman Report, a leading biotech industry newsletter. Since 2017, the Timmerman Traverse has mobilized the biotech community to give back more than $15 million for cancer research, anti-poverty initiatives, and screening for sickle cell disease.
Where are we staying? Not in a tent. We’ll sleep in comfortable beds each night at Wayfinder Bishop. It’s a boutique hotel in Bishop, CA. (LINK). We’ll take vans to the trailheads each day.
Fundraising: The fundraising minimum is $35,000. You will start your campaign by making a personal contribution of $1,000 to register.
Each hiker is *required* to raise the $35,000 for Damon Runyon Cancer Research Foundation. Many will go above and beyond.
Funds can come from a variety of sources: corporate sponsors, friends and family, business colleagues. You are a talented executive or investor. You know how to prioritize and get things done.
What Will I Do?
Why Damon Runyon? It supports brilliant cancer researchers doing high-risk/high-reward research across the US. Damon Runyon grants allow young scientists to generate data they can leverage into larger sums from others.
Damon Runyon has a keen eye for talent. In its more than 75-year history, its recipients have gone on to win:
Damon Runyon grants have catalyzed many major advances in science, including
Where do the Funds Go? All of the funds we raise (100 percent) go to the young scientists in the Damon Runyon network. Since 2023, Timmerman Traverse campaigns have raised more than $3 million for the Damon Runyon Cancer Research Foundation.
We are betting on brilliant young people with big ideas.
Here’s who the Timmerman Traverse Fellows are, and what they are doing:
The funds you raise will open doors for more outstanding young scientists. Your efforts will enable them to pursue their dreams and hopefully make breakthrough discoveries.
Schedule:
Sunday, Aug. 2. Arrive in Bishop, CA. United Airlines flights from SFO and Denver. 6 pm dinner & team briefing, Wayfinder Bishop.
Monday, Aug. 3. Hike to Piute Pass / Mt. Emerson (elev. 13,210 ft)
Tuesday, Aug. 4. Hike to Bishop Pass / Mt. Goode (elev. 13,085 ft)
Wednesday, Aug. 5. Depart.
What Alumni Are Saying:
Ted Love, immediate past chair of the board, BIO
“Timmerman Traverse is special to me because it brings together adventure, physical challenge, philanthropy and camaraderie with some of the most outstanding people in the biopharma industry.” — Ted Love, immediate past chair of the board, Biotechnology Innovation Organization.
“I made friends for a lifetime with colleagues who shared the goal of raising critical funds for truly innovative cancer research.” – Nagesh Mahanthappa, executive chair, Exo Therapeutics.
“What was completely unexpected was the level of camaraderie that immediately formed in the group – like-minded, interesting and interested, generous and unquitting.” – Nina Kjellson, general partner, Canaan Partners
Vineeta Agarwala, general partner, A16Z Bio & Health
“This is a vibrant community of life science leaders all over the country who love to recharge in the outdoors, meet one another as friends and colleagues, and most importantly, give back to the communities around us.” — Vineeta Agarwala, general partner, Andreesen Horowitz Bio & Health Fund
“Simply the best chance ever to get to know a high-quality group of biotech executives well. And so much more. Consider Luke’s future trips if you love the industry and hate cancer.” — Bob More, partner, Alta Partners
Expenses: You will be personally responsible for the following:
Key Dates:
Who’s on the TT Sierras Team?
I hope you can join us for this once-in-a-lifetime experience.
Ready to sign up? Email luke@timmermanreport.com
L to R: Henry Kilgore, Luke Timmerman, and Will Chen on Kilimanjaro, Feb. 2024. Henry and Will are Damon Runyon Fellows who participated in the inaugural Timmerman Traverse for Damon Runyon on Kilimanjaro, Feb. 2024.
Gear check is when it starts getting fun and getting real.
Our team of 21 hikers has arrived in Tanzania and gotten all our gear sorted. We’ll start the trek on Kilimanjaro Feb. 10. Then we spend the next seven days together on the trails to the top of the highest peak in Africa, elevation 19,341 feet / 5,895 meters.
We are getting to know each other over meals. We’re cracking jokes. We’re soaking up the warm and welcoming atmosphere of the Tanzanian people.
It’s time to slow down and savor these days. We’ve put in months of hard work getting physically and mentally ready, and tapping our networks to raise $1.2 million for high-risk / high-reward cancer research through the Damon Runyon Cancer Research Foundation.
Thanks to all of you who contributed. If you haven’t yet contributed, there’s still time to do so here at Qgive. You can also follow our day-to-day progress on the mountain here.
Enjoy a few photos from Orientation Day in Arusha.
Timmerman Traverse for Damon Runyon Cancer Research Foundation 2026 Kilimanjaro team.
David Shaywitz
“There are decades where nothing happens; and there are weeks where decades happen,” said Lenin, probably never. It’s also a remarkably apt characterization of the last year in generative AI (genAI) — the last week in particular — which has seen the AI landscape shift so dramatically that even skeptics are now updating their priors in a more bullish direction.
In September 2025, Anthropic, the AI company behind Claude, released what it described as its most capable model yet, and said it could stay on complex coding tasks for about 30 hours continuously. Reported examples including building a web app from scratch, with some runs described as generating roughly 11,000 lines of code. In January 2026, two Wall Street Journal reporters who said they had no programming background used Claude Code to build and publish a Journal project, and described the capability as “a breakout moment for Anthropic’s coding tool” and for “vibe coding” — the idea of creating software simply by describing it.
Around the same time, OpenClaw went viral as an open-source assistant that runs locally and works through everyday apps like WhatsApp, Telegram, and Slack to execute multi-step tasks. The deeper shift, though, is architectural: the ecosystem is converging on open standards for AI integration. One such standard called MCP — the “USB-C of AI” — is now being downloaded nearly 100 million times a month, suggesting that AI integration has moved from exploratory to operational.
Markets are watching the evolution of AI agents into potentially useful economic actors and reacting accordingly. When Anthropic announced plans to move into high-revenue verticals — including financial services, law, and life sciences — the Journal headline read: “Threat of New AI Tools Wipes $300B Off Software and Data Stocks.”
Economist Tyler Cowen observed that this moment will “go down as some kind of turning point.” Derek Thompson, long concerned about an AI bubble, said his worries “declined significantly” in recent weeks. Heeding Wharton’s Ethan Mollick — “remember, today’s AI is the worst AI you will ever use” — investors and entrepreneurs are busily searching for opportunities to ride this wave.
Some founders are taking their ambition to healthcare and life science, where they see a slew of problems for which (they anticipate) genAI might be the solution, or at least part of it. The approach one AI-driven startup is taking towards primary care offers a glimpse into what such a future might hold (or perhaps what fresh hell awaits us).
There is genuine crisis in primary care. Absurdly overburdened and comically underpaid, primary care physicians have fled the profession in droves — some to concierge practices where (they say) they can provide the quality of care that originally attracted them to medicine, many out of clinical practice entirely. Recruiting new trainees grows harder each year.
What’s being lost is captured with extraordinary power by Dr. Lisa Rosenbaum in her NEJM podcast series on the topic. In a companion essay, Rosenbaum documents the measurable consequences when patients lose a primary care physician: a rise in mortality, emergency room visits, and hospitalizations, all in proportion to the relationship’s duration — suggesting, as she writes, “that the relationship itself conferred health benefits.” Worse, more than three quarters of patients never form a new PCP relationship after losing one.
But Rosenbaum’s deepest concern isn’t statistical. It’s about what she calls the “good doctor” phenotype — not a skill set but a style. She describes a physician whose hallmark was assuming responsibility for the totality of his patients’ problems. When Rosenbaum was caring for one of his hospitalized patients, the patient insisted she update the doctor, explaining simply: “He will want to know.” For Rosenbaum, having your patients intuit that you would want to know — far more than any quality metric — constitutes the essence of being a good doctor. A “culture without a vision of the good doctor,” she warns, “is a profession without a soul.”
Her darkest worry: the system may morph into “some artificial-intelligence-enhanced triage system devoid of a relational core.”
Which is almost exactly what physician-entrepreneur Muthu Alagappan, co-founder of Counsel Health, aspires to deliver — for the sake of patients. His starting point: 100 million Americans don’t have a relationship with a doctor, good or otherwise. The relational ideal Rosenbaum celebrates is already inaccessible to vast swaths of the population.
At Counsel Health — recently backed by a $25M Series A from GV and Andreessen Horowitz — AI handles the upfront information gathering and initial clinical reasoning, functioning, as Alagappan puts it, like “an extremely smart medical resident that is reasoning along with them, serving up the plan and allowing them to approve or deny in a single click.” Doctors see 15 to 20-plus patients per hour. The vision: primary care visits costing less than a dollar.
As Alagappan sees it “It’s hard to fathom a cognitive aspect of the practice of medicine in primary care that a technology system is just not better suited to do than the human brain.”
He acknowledges that humans may still be necessary for pesky, hands-on tasks like wrapping an ankle or administering a vaccine, but beyond these, he seems to believe, the future belongs to the machines. He anticipates “regulation will ease and improve so that the AI can do more and more.”
In Utah, the approach pursued by a startup called Doctronic suggests such regulatory change may be closer than we think. The company’s AI prescribes renewals without a physician in the loop for 190 routine medications, at $4 per script — with a malpractice insurance policy covering the AI system itself, and escalation and oversight safeguards. Expansion is already contemplated to states like Texas, Arizona and Missouri, with a national roll-out under consideration as well.
As AI capabilities compound rapidly, there is tremendous temptation to apply them wherever they fit most naturally. Without intentionality, this approach risks quietly redefining disciplines by the tasks the technology performs well. Because AI can efficiently process symptoms, match protocols, and renew prescriptions, we might start to define medicine as these specific tasks — in much the same way that because we can measure steps, sleep scores, and VO2 max, we’re tempted to define health as the optimization of dashboard metrics. As Kate Crawford astutely warned, we must not let the “affordances of the tools become the horizon of truth.”
This tension extends to biopharma R&D as well. Here, efforts to leverage AI have succeeded in limited domains with dense data and established benchmarks, but have struggled where the critical data are scarce, highly conditional, or both — as Andreas Bender, in particular, has eloquently discussed.
We’re always tempted to look where the light is. But difficult as it can be to maintain focus on what actually matters, rather than what technology most readily delivers, it can be done.
For some time now, I’ve argued — in this space, at KindWellHealth, and elsewhere — that genuinely enhancing human flourishing requires attention to three broad dimensions: physiology (movement, nutrition, recovery, preventive screening), agency (your belief in your ability to shape a better future), and connection (the value of meaningful relationships and purposeful pursuits).
The news that caught my attention recently was that someone independently built a business around exactly this framework. Unbound, a UK-based preventive health company operating from a single just-opened location in London’s Shoreditch, describes itself as “built on the belief that physical, mental and social health are inseparable.”
Several design choices distinguish Unbound from the optimization-culture norm. They measure connectedness alongside biomarkers — literally assessing social connection as a clinical input. Their medical director, Dr. Elliott Roy-Highley, frames health as “not merely the result of internal cellular mechanics, but an emergent property of social integration, purpose, and communal regulation.” A coffee shop replaces the waiting room; community circles, run clubs, and art exhibitions aren’t wellness window-dressing but structural commitments – the social environment is treated as meaningful part of the intervention.
Perhaps most distinctive is a post-assessment “future self” exercise — an evidence-backed positive psychology intervention that asks participants to envision their optimal future self and identify personal barriers to achieving that vision. By strengthening the psychological connection between present and future selves, the exercise enhances goal clarity, self-efficacy, and motivation for behavior change. This process works through narrative mechanisms — imagining, evaluating, and orienting toward personally meaningful goals –that translate assessment insights into actionable health strategies.
Crucially, Unbound doesn’t reject measurement and technology. They offer a companion app for extending connection and tracking recommendations beyond the clinic; their assessments integrate blood work and physical performance testing alongside the emotional and social components. As Unbound puts it: “Yes, we use tools like clinical testing — but not as a way to measure your worth or push you to chase perfection. We use them to guide and support a much bigger goal: helping you live the life you want, with clarity and confidence.” The intent: leverage science and technology with intentionality, pointing them where they should be aimed, rather than where they are most inclined to go.
Of course, there’s a large gap between a compelling concept and improved health. It’s possible Unbound will prove to be savvy wellness marketing aimed at motivated, affluent urbanites. The people who walk into a trendy Shoreditch health studio are already relatively motivated and likely already drawn to purposeful engagement. The evidence that the program actually improves health, while theoretically grounded, remains to be seen.
But the interest Unbound has attracted reveals a substantial appetite for something beyond relentless metric optimization — and there’s little in their approach that seems especially proprietary. The same foundational principles — deepen connection, develop agency, attend (with compassion) to physiology — all could be applied at scale by incumbents and digital platforms. Peloton, for instance, has the community infrastructure and the user engagement; what it lacks is a framework that extends beyond leaderboards and performance dashboards toward something that might help users not just perform but flourish.
GenAI is advancing at a pace that would have seemed fantastical even a year ago; the developments of the last few weeks have forced even seasoned skeptics to recalibrate. There is tremendous incentive — and good reason — to ride this technology wave toward compelling opportunities like the crisis in primary care. But as these capabilities compound, the central challenge will be ensuring the technology serves what patients and people actually need, rather than allowing those needs to be defined by what the technology most readily delivers. The risk of essentially reducing health to what can be optimized by technology is real, as so many tech-powered companies in healthcare, biotech, and fitness demonstrate. But it is also possible to leverage technology in service of a more complete and less reductive vision — attending to physiology, agency, and genuine human connection — as Unbound suggests, and hopefully, many others pursue.
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Alex Harding, CEO, stealth biotech startup
I should start by saying that I am currently the CEO of a platform company. (We’re not talking publicly about what we’re doing yet.)
Yes, I recognize the contradiction between the headline of this piece and my own career choice. No, I don’t like calling it a platform company—even if that’s what it is.
There are a few different species of platform companies. The classic form (and the type I’m focused on here) is a drug technology platform, like the CRISPR gene editing companies or Alnylam, the leading siRNA company. These companies have a core technology incorporated into the drugs they aim to make.
There are also assay platform companies, which develop an assay to screen or characterize molecules. Vertex, for example, developed an assay platform to detect expression and localization of the CFTR chloride channel, which became a powerful engine to discover drugs for cystic fibrosis.
And there are companies where the platform is its expertise in a disease area. Disc Medicine, a company specialized in benign hematology, is able to use its hematology expertise to develop molecules in ways that other companies hadn’t thought of, because of its specialized knowledge in that disease area.
Platforms are great when they do what they’re supposed to, which is to create an efficient engine that generates multiple valuable programs using the same underlying technology or capability.
The problem is when that platform becomes the focal point of the company, instead of the programs it is supposed to generate. Many platform companies spend over $50 million and 3-4 years—sometimes much more—just to get to their first development candidate, the first molecule with the potential to go into a clinical trial.
These companies hire large scientific teams dedicated to the platform. Those teams do spectacular science. They publish papers in Science and Nature. Sometimes, they even make meaningful progress that the whole field benefits from.
But, too often, that progress comes at an enormous cost, without enough tangible output of the currency biotechnology companies deal in: molecules. That is, drug molecules on the path to demonstrating clinical proof of concept, on the path to becoming medicines. Instead, these platform companies exist for the sake of the platform.
The rationale for a platform company hinges on the notion that once the technical hurdles of the platform are cracked with a first program, a dam will break and there will be a flood of additional programs, justifying the upfront investment in the platform. Very often, however, the dam never breaks. After pouring $50 million or 100 million to get a first program into clinical trials, a platform company has a valuation of over $200 million and a crop of investors who are fatigued and reluctant to invest more behind preclinical programs. In some cases, the second or third programs intended to be churned out by a technology platform do not have such a compelling product profile as the lead program.
All too often, the promised flood of new programs never materializes. Instead, the company has poured money into a platform and only has a lead program to show for it. The lofty valuation, predicated on the broader pipeline potential, is hard to justify with a single asset, and the company will struggle to raise additional capital.
This is a story that has been written and rewritten all too often in biotechnology.
The label ‘platform company’ grates on me when people use it to describe the company I’m helping to build. They are not wrong—we do have a technology platform. But I prefer to think of ourselves as a pipeline company. We have a technology platform oriented to producing new programs, new molecules that have the potential to become medicines.
The word choice matters to me. Our platform exists solely for the sake of the pipeline, and our resources are allocated accordingly. We invest in our platform in a targeted manner, always with a clear vision of what the therapeutic application will be.
This also means that there are certain platform investments we won’t make. If the science is too early, too distant from a program, we choose to spend our money on other efforts that can make a more immediate impact on our pipeline. For an early-stage startup like ours, we want an investment into our platform to yield a development candidate within a year or so.
A company is defined by how it chooses to allocate the capital it is given. Targeted capital allocation to a platform makes sense, so long as the focus remains fixed on generating new programs. But the moment the platform comes first, you have lost the tune.
So please, don’t call mine a platform company. We’re a pipeline company.
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