Gastroenterologist | Medical Director, Oshi Health | LinkedIn Top Healthcare Management Voice | Forbes Health Contributor

I’m a board-certified gastroenterologist and the Founding Medical Director at Oshi Health, where I’ve had the privilege of helping shape and expand a virtual-first GI care model now serving patients in all 50 states. Working alongside an incredible team, I’ve contributed to building scalable clinical pathways for IBS, IBD, and other gut conditions—anchored in team-based care, empathy, and measurable outcomes.

With 28,000 + followers, I’m among the most followed gastroenterologists on LinkedIn, where I regularly share insights on topics including:

• IBS & the gut-brain connection — emotional triggers, stress, and personalized care
• Digital health innovation — virtual-first models, AI in GI, and wearable integration
• Colorectal cancer screening — rethinking pathways and improving early detection
• Reducing unnecessary testing — CTs, labs, and low-yield procedures in IBS
• Value-based gastroenterology — lower cost, better outcomes, patient experience
• Health plan integration — improving patient access to covered virtual GI care
• Microbiome & nutrition science — evidence-based takes on fiber, probiotics, and gut myths
• Healthcare system reform — tackling disparities, burnout, and reimbursement models
• Behavioral science in GI — the role of habit loops, psychology, and coaching in digestive health
• Virtual care leadership — insights from helping scale a 50-state GI operation

As a LinkedIn Top Voice, I collaborate across digital health, clinical care, and health plans to drive forward-thinking solutions in gastroenterology—without waste, and with humanity.

Let’s connect if you’re working at the intersection of GI, tech-enabled care, or value-based delivery models.

Michael Bass, M.D.

Most of us have taken antibiotics and moved on. This new Sweedish study says your gut hasn't.

A new Nature Medicine paper linked 8 years of prescription data to stool metagenomes from nearly 15,000 adults in Sweden.

The headline finding: a single course of clindamycin, fluoroquinolones, or flucloxacillin was still associated with changes in gut bacteria 4 to 8 years later. Not months. Years.

Clindamycin use within a year of sampling was tied to 47 fewer detected species on average. That's a massive hit to an ecosystem most patients assume bounces right back.

The species that increased after antibiotics included bacteria previously linked to higher BMI, elevated triglycerides, and type 2 diabetes risk. The ones that decreased were tied to lower inflammation and better metabolic health.

This matters because the gut microbiome isn't a bystander in human health. It regulates metabolism, immune function, and inflammation. When you wipe out key species with a broad-spectrum antibiotic, you're not just treating an infection. You're reshaping an organ system.

And the recovery isn't automatic. The fastest rebound happened in the first two years. After that, diversity plateaued well below baseline. Some species may never fully return.

We prescribe a 10-day course for a dental abscess and tell the patient they're done. But the disruption we triggered may still be measurable half a decade later.

If you've had a patient who "just hasn't been the same" since antibiotics a few years ago, this paper gives you a biological reason to take that seriously.
We can't undo the antibiotics we've already prescribed. But we can stop pretending the consequences end when the pill bottle runs out.

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The Gut doesn't Forget 

LinkedIn Top Voice | Gastroenterologist I Global Medical Director @ ViomeDx

Dr Erika Tajra

The most dangerous phrase in cancer screening right now might be “no cancer signal detected.”

Multi-cancer blood tests are having a moment. A single blood draw that claims to detect 50+ cancers sounds revolutionary. And maybe someday it will be. But the evidence is still catching up to the excitement.

There are now roughly 40 multi-cancer early detection tests in development or already on the market. Yet very few have been tested in randomized trials. And the first large trial results? They didn’t show a clear reduction in late-stage cancers. Which is the whole point. Finding cancer only matters if you’re finding it early enough to change outcomes.

Why is this so hard? Because early cancers are biologically quiet. Most current tests search for fragments of tumor DNA circulating in the bloodstream. The problem is that very small tumors often shed almost no DNA at all. The signal can be incredibly faint. You’re essentially trying to hear a whisper in a stadium.

That’s why researchers are exploring another layer of biology: RNA. 

RNA reflects what cells are actively doing, not just what mutations exist. Signals can appear earlier, even when tumor DNA is scarce. It can capture the body’s response to cancer, not just the tumor itself. And it provides insight into active biological pathways rather than static genetic changes.

None of this means DNA-based tests are wrong. But it highlights something important: detecting cancer early may require listening to more than one biological signal. DNA is probably part of the answer. It’s not the whole story.

Patients deserve innovation. But they also deserve evidence that it actually improves outcomes. Because “no cancer signal detected” only means something if the test was capable of detecting the signal in the first place.

The AI prescribing debate feels very different after you’ve cleared 40 refill requests in your inbox at the end of a clinic day.

Most people think prescribing is the clinical decision. Clinicians know the reality is everything wrapped around it. Prior auths, quantity limits, step therapy rules, plans that only cover 90 pills, missing labs, drug interaction checks, and the quiet liability of deciding what can safely go through and what needs a visit.

That’s why a recent The Washington Post  opinion criticizing Utah’s AI refill pilot with Doctronic caught my attention. Joseph Sakran , Johns Hopkins trauma surgeon and a medical researcher, argues that autonomous AI prescribing is moving forward on dangerously thin evidence.

His case is straightforward. The safety data rests largely on a single preprint on medRxiv that hasn’t been peer reviewed. The study authors hold equity in the company. The underlying data hasn’t been publicly shared.
They also point out that the widely cited 99.2% accuracy figure comes from urgent care encounters, not chronic medication renewals, which is what the Utah pilot is actually doing. Different context, different risk profile.

And they raise a fair concern about scale. Even a small error rate applied across thousands of prescriptions could affect vulnerable groups. Elderly patients, people on complex medication regimens, patients whose conditions have quietly changed since their last visit.

Those are legitimate concerns. But the authors also acknowledge something that gets lost in the headline debate. Medication renewals for stable chronic conditions are among the lowest-risk prescribing tasks in medicine.

If AI could safely handle routine renewals, it could free physicians to focus on the stuff that actually requires a doctor.

That tension is where the real conversation should be. Because the system clinicians are currently working in is already broken. 

Practices average nearly 40 prior authorizations per physician per week. Physicians and staff spend more than 13 hours weekly on them. Nearly 90% say prior auth contributes to burnout.

So I find myself in the middle on this one. I don’t want AI replacing clinical judgment. But I’m very open to AI reducing the administrative friction wrapped around routine prescribing. Stable medication renewals with guardrails and escalation paths? That’s not AI practicing medicine. That’s AI doing paperwork.

Those are two very different things. And until we can talk about them separately, this debate is going to keep going in circles.

Byron Crowe

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Everyone says AI will replace doctors. But the first thing physicians are actually using AI for? Reading the medical literature.

A new AMA survey shows more than 80% of physicians now use AI professionally. And the most common use isn’t diagnosis. It’s summarizing medical research and standards of care. That tells you something important about where medicine actually is right now.

The biggest bottleneck in healthcare isn’t intelligence. It’s bandwidth. Thousands of new papers publish every week. Guidelines constantly evolve. Biology keeps getting more complex. No physician can realistically read everything. 

So knowledge diffuses slowly through the system. Conferences, guidelines, word of mouth. Sometimes it takes years for a new insight to reach everyday clinical practice. I’ve seen it firsthand. A study changes how we should think about a condition, and five years later half the clinicians managing it haven’t read it yet.

AI changes that dynamic. Instead of reading 20 papers, a physician can read a two-minute synthesis. Instead of discovering a new mechanism years later at a conference, it can surface in clinical workflow the same week. That doesn’t replace physicians. It amplifies them.

Which is why most real-world physician AI use today looks nothing like the headlines,despite what the Silicon Valley tech- bros might be tweeting. 

It’s summarizing research, generating chart summaries, creating discharge instructions, reducing documentation burden. Not autonomous diagnosis. Not robot doctors.

Caitlin Owens highlighted this in a recent Axios Healthcare newsletter. AI’s earliest clinical adoption is largely about helping physicians manage information and administrative load, not replacing clinical judgment. That distinction matters more than most people realize.

Medicine isn’t moving toward autonomous doctors. It’s moving toward augmented cognition. Doctors still make the decisions. But AI helps them see patterns faster in an ocean of information that no human brain can process alone. And as biology gets more complex, that ability won’t just be nice to have. It’ll be essential.

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Novo Nordisk  just agreed to let hims & hers  distribute Wegovy and Ozempic through its platform and dropped the lawsuit it filed last month over compounded semaglutide. This isn’t a GLP-1 headline. It’s a preview of where telehealth is going next.

The first era of telehealth was about convenience. Fast visits, easy prescribing, consumer-friendly access. The next era will be judged on something much harder: can telehealth become a trusted distribution and care layer for complex chronic disease?

For years, telehealth has been underestimated as a lightweight front-end. Good for access, good for demand capture, good for meeting patients where they are. But this deal signals something bigger. Large pharma now sees digital care platforms as legitimate channels for branded therapy distribution. Not lead generators. 

Because once telehealth becomes a true distribution channel, the business model gets serious fast. It’s no longer about customer acquisition and conversion. It’s about clinical credibility, regulatory discipline, patient safety, adherence, supply continuity, and what happens after the prescription is written. 

Especially in obesity care, where anyone can build demand but very few can build durable care models. The companies writing scripts the fastest aren’t necessarily the ones that will survive this next phase.

There’s a second signal buried in this story too. Just days after U.S. regulators warned telehealth firms over misleading compounded GLP-1 advertising, one of the most visible players struck a deal around approved branded drugs instead. 

Telehealth is no longer disrupting healthcare from the outside. It’s being absorbed into the system itself. That creates more legitimacy and more accountability in the same move.

Galileo

In my role, I have the privilege of providing virtual integrated primary care services to patients across multiple states, utilizing a cutting-edge platform. Through evidence-based interventions such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT), I have supported patients in their journey towards improved mental and physical well-being.

Additionally, I have actively contributed to the development of programs, pilot initiatives, and operational changes aimed at enhancing the integration of behavioral health services. My focus has been on promoting the adoption of the Primary Care Behavioral Health (PCBH) model, ensuring seamless integration of mental health support within primary care settings.

By leveraging technology and evidence-based interventions, I strive to provide high-quality care that is accessible and tailored to the unique needs of each patient. Through program development and innovation, I am committed to advancing the integration of behavioral health services in the primary care setting, ultimately improving outcomes and patient experiences.

Health Psychologist

The University of Texas at San Antonio

Adjunct Faculty
Department of Counseling
Courses: Internship I & II (Integrated Care Focus), Practicum, Integrated Behavioral Health Foundations.

Adjunct Professor

Defense Health Agency

Department of Surgery
Emphasis on Bariatric surgery 
Integrated weight management program
Interventional Pain Medicine
C/L for post-surgical patients on the medical floor

Oshi Health

I provide concise and effective Integrated Behavioral Health (IBH) services to individuals with gastrointestinal (GI) conditions as part of Oshi Health's comprehensive healthcare approach.

Lead GI Psychologist

Tend Health

I offer therapy services tailored specifically for physicians, medical residents, and allied health professionals, recognizing the unique challenges and demands they face in their roles. My goal is to provide support, guidance, and a safe space for these individuals to explore and address their emotional well-being and professional growth.

Contract Psychologist

South Texas Veterans Health Care System

In my role as a specialist in Primary Care Mental Health Integration (PCMHI), I have successfully developed and implemented integrated services for a physical clinic while operating remotely. This involved collaborating with various stakeholders to establish efficient workflows and procedures that facilitated seamless integration of mental health services within the clinic. Additionally, I played a key role in providing comprehensive education to the entire clinic staff, ensuring a shared understanding of the integrated care model. Beyond my primary clinic, I have also provided virtual support and guidance to other integrated clinics, further expanding the reach and impact of integrated healthcare services.

Primary Care Psychologist

Brown & Brown Insurance

In my role, I specialize in conducting disability claim reviews for companies that require third-party assessments for individuals diagnosed with behavioral health conditions. I provide comprehensive and unbiased evaluations to determine the validity and impact of these diagnoses on individuals' ability to perform their job duties. By offering this crucial service, I assist companies in making informed decisions regarding disability claims, ensuring fair and accurate assessments of behavioral health-related challenges.

Psychologist Consultant

Advantage Point Behavioral

In my role, I specialize in conducting pre-surgical psychological evaluations for patients considering various surgical procedures. Specifically, I provide evaluations for individuals seeking bariatric or weight-loss surgery, spinal surgeries such as Fusion, Laminectomy, and Disc Replacement, as well as stimulator implantation procedures like Spinal Cord Stimulation (SCS) and Peripheral Nerve Stimulation (PNS). These evaluations are designed to assess the psychological factors and suitability of patients for these surgical interventions, ensuring comprehensive care and optimal outcomes.

University of Rochester Medical Center

As an Internal Medicine Fellow, my primary focus is on providing exceptional clinical services while also dedicating myself to the education and coaching of medical residents. One significant accomplishment during my fellowship was the development of a clinical pathway for Behavioral Health (BH) integration, specifically tailored to support patients in their weight loss journey. This involved conducting extensive research, collaborating with interdisciplinary teams, and implementing evidence-based practices to optimize patient outcomes.

In addition to my clinical work, I took an active role in educating faculty and staff about the importance and benefits of integrated care development. By delivering educational sessions, I aimed to foster a shared understanding of the value and impact of integrated care approaches. Through these efforts, I aspire to empower healthcare professionals with the knowledge and skills necessary to provide holistic, patient-centered care.

Postdoctoral Fellow

University of Oklahoma Health Sciences Center

During my internship, I had the privilege of training in both the OKC VA and OUHSC, with a strong emphasis on primary care. Throughout my rotations, I gained valuable experience in a wide range of clinical settings. These included primary care for both adult and child populations, bariatric surgery, STAR (Substance Abuse Treatment and Recovery) program, cystic fibrosis care across the lifespan, as well as health psychology assessment.

My time in primary care allowed me to develop a comprehensive understanding of the challenges and opportunities in delivering primary care services to diverse patient populations. Through my rotation in bariatric surgery, I gained insights into the unique psychological aspects of weight management and the multidisciplinary approach required for successful outcomes. In the STAR program, I honed my skills in working with individuals struggling with substance abuse, helping them navigate the complexities of recovery. Additionally, my rotation in cystic fibrosis exposed me to the complex medical and psychological needs of patients across different life stages.

Throughout these diverse rotations, I had the opportunity to conduct comprehensive health psychology assessments, enabling me to evaluate and contribute to the holistic care of patients. This well-rounded training has equipped me with a breadth of knowledge and a versatile skill set to provide comprehensive and patient-centered care across various healthcare settings.

Pre Doctoral Intern

As a passionate health psychologist, my primary interests lie in the fields of behavioral medicine, health psychology, and primary care behavioral health (PCBH). I have developed expertise in working with individuals who face the challenges of chronic illnesses, HIV, and those in the LGBT community, as well as individuals seeking to modify their health behaviors. Embracing the advancements in technology, I strongly believe in the potential of the tech wave to revolutionize healthcare, particularly in the realm of behavioral medicine. I derive great satisfaction from collaborating with others to create and implement innovative programs and provide consultation for virtual care models that prioritize seamless integration.

https://healthpsychologycentral.com

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