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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gastroenterology-specialists-of-delaware-llc

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

graphical user interface, text, application

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.

Ronnie H. Kinsey, MBA

Success partner to C-Suite & High Achievers: Leadership + EQ ‣ MBA ‣ F100 Proven ‣ Helping Executives & Thought Leaders Thrive with Alignment. 🧠 View resources: LeadingGreats.com

I work with executives, founders, and high-output teams operating in complex, demanding environments where clear thinking, emotional control, and precise communication directly affect results.
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Ronnie Kinsey

Most people are not difficult.
They are carrying something
nobody can see.

• The colleague who snapped in the meeting.
• A friend who went distant without explanation.
• A high performer who stopped raising their hand.

Nobody woke up deciding to be hard to deal with.

And yet most workplaces reward speed over perception.
Reaction over curiosity.
Output over awareness of the person behind it.

That gap is where relationships quietly break down.

Closing it does not require a certification or a workshop.
It requires a different habit of attention.

➛ Pause before reacting.
➛ Assume weight before assuming attitude.
➛ Extend something before asking for anything back.

Kindness is not a transaction.
Not weakness dressed up in good manners.

It is deciding to treat people as full human beings
before having the full story.


𝟱 𝘄𝗮𝘆𝘀 𝘁𝗼 𝗺𝗮𝗸𝗲 𝘀𝗼𝗺𝗲𝗼𝗻𝗲'𝘀 𝗵𝗮𝗿𝗱 𝗱𝗮𝘆 𝗮 𝗹𝗶𝘁𝘁𝗹𝗲 𝗹𝗶𝗴𝗵𝘁𝗲𝗿:

1️⃣ Give someone your full attention for two uninterrupted minutes.

2️⃣ Ask how they are doing and actually wait for the answer.

3️⃣ Let a small thing go that normally would not get a pass.

4️⃣ Acknowledge effort out loud, not just results.

5️⃣ Send a message with no ask attached to it.


Understanding someone's burden is not required
to respect it.
Just remember it exists.

That is the whole practice.

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Some people read to pass time.
Others read to build something that lasts.

Charlie Munger spent most of his waking hours reading.
Not because he had to.
Because he understood what sustained success
actually requires:

Knowledge builds on itself.

The books you absorb at 30
shape the calls you make at 50, and beyond.

The disciplines you build across years create a depth
that shortcuts cannot produce.

That truth shows up constantly in my work 
with senior leaders.

The ones who keep growing are rarely the ones
who think they've already figured it out.
They read. They reflect.

They stay genuinely curious
long after they have earned the right to stop.

I try to live by the same standard.

Writing publicly is part of how I do that.
Not to perform expertise.

Because putting an idea into precise language
exposes exactly where the thinking is still soft.

A few months ago I added Stanley to that process.
An AI partner built for creators.

I was skeptical.
It helped me see patterns I was too close to notice
and gave me a sharper second read before publishing.

Not a replacement for the thinking.
A useful addition to it.

Munger surrounded himself 
with what sharpened his thinking.
Books. Partners. People who told him the truth.

That is the standard worth holding at every level.

Those who keep learning will keep rising.
The format changes.
The habit does not.

Try Stanley Free here: https://lnkd.in/efrzWr_2

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Early on, I thought doing it alone meant I was strong.
If I could carry it, I should.
If I asked for help, I was weak.

That belief wore me out.
I worked harder than I had to.
I got things done, but I wasn’t getting far.

Everything shifted when I saw this clearly.
The right people make the load lighter.
And the outcomes improve.

Leadership stopped being about proving
I could handle it.
It became about building something bigger with others.

Five things I’ve learned the hard way:

1. = 𝗦𝗵𝗮𝗿𝗲𝗱 𝗱𝗶𝗿𝗲𝗰𝘁𝗶𝗼𝗻 𝗺𝘂𝗹𝘁𝗶𝗽𝗹𝗶𝗲𝘀 𝗲𝗳𝗳𝗼𝗿𝘁.
When everyone knows where you’re going,
progress feels smoother.
You waste less time pulling in different directions.

2. = 𝗛𝗼𝗻𝗲𝘀𝘁 𝗶𝗻𝗽𝘂𝘁 𝗽𝗿𝗲𝘃𝗲𝗻𝘁𝘀 𝗮𝘃𝗼𝗶𝗱𝗮𝗯𝗹𝗲 𝗺𝗶𝘀𝘁𝗮𝗸𝗲𝘀.
People who care will tell you what you’re missing.
That feedback saves you from bigger problems later.

3. = 𝗦𝘁𝗿𝗼𝗻𝗴 𝘁𝗲𝗮𝗺𝘀 𝗿𝗮𝗶𝘀𝗲 𝘁𝗵𝗲 𝗯𝗮𝗿.
Being around capable people raises your level.
You grow faster when the standard is high.

4. = 𝗛𝗲𝗹𝗽𝗶𝗻𝗴 𝗼𝘁𝗵𝗲𝗿𝘀 𝘀𝘁𝗿𝗲𝗻𝗴𝘁𝗵𝗲𝗻𝘀 𝘆𝗼𝘂 𝘁𝗼𝗼.
When you support someone else’s growth,
you sharpen your own.
Confidence spreads in healthy teams.

5. = 𝗖𝗵𝗼𝗼𝘀𝗲 𝗽𝗲𝗼𝗽𝗹𝗲 𝘄𝗵𝗼 𝘄𝗮𝗻𝘁 𝘆𝗼𝘂 𝘁𝗼 𝘄𝗶𝗻.
Work with those who actively advance your goals.
And be the kind of teammate others rely on.

The most effective people don't chase attention.
They build trust with solid partners.

No one sustains meaningful work alone for long.
The clearest sign of strength is aligned execution.

Find people who stand with you when it’s heavy.
Then become that person for someone else.

📹 credit: open source

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Many search for the next big move.
Markets are volatile. Entire industries shift.
The leverage is closer than you think.

I have sat with executives who routinely explore
what to pursue next.
New role. Bigger title. Different industry.

The breakthrough rarely came from chasing harder.
It came from strengthening the operator.

Here is what I have observed over time.

1️⃣ The people who get ahead build capacity before
 visibility.
• They deepen skills while others polish profiles.
• When complexity increases, their preparation shows.
• They do not scramble. They execute.
  
2️⃣  The most confident leaders rehearse privately.
• They think through scenarios before stakes rise.
• They practice hard conversations before they happen.
• Confidence follows preparation, not ego.
  
3️⃣  The most trusted individuals refine themselves
 continuously.
• After setbacks, they review decisions instead
of assigning blame.
• They ask for feedback without defensiveness.
• Over time, this habit builds credibility.
  
If you are unsure what to pursue next,
invest in the person making the choice.

When you organize the skills you have already earned,
someone further back benefits from what you now
execute naturally. 

That's leverage.

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Success does not require distance.
Early on, I thought wanting more meant
measuring myself against everyone else.

Experience corrected that.

I have sat in executive meetings where new roles
were assigned and responsibility expanded.
You could feel the shift.

Some withdrew.
Others leaned in.

The difference was not capability.
It was composure.

One reaction asks, “Why not me?”
A stronger one asks, “What can I learn?”

Supporting someone else’s progress
does not slow yours.
It strengthens your position.

• It sharpens awareness.
• It protects relationships.
• It builds credibility under comparison.

In competitive environments, advancement rarely favors
the most impatient voice.

It favors the person who can stand near someone else’s
success without losing focus.

𝗙𝗶𝘃𝗲 𝗖𝗼𝗺𝗽𝗲𝘁𝗶𝘁𝗶𝘃𝗲 𝗥𝗼𝗼𝗺 𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲𝘀:

1️⃣
When someone else advances, you find out
how secure you really are.
That reaction reveals what still needs work.

2️⃣
Being close to excellence is an advantage.
Study what earned it instead of competing with it
in your head.

3️⃣
People register your composure.
Especially when recognition lands on someone else.

4️⃣
Waiting well requires disciplined preparation.
Progress continues even when it is not public.

5️⃣
The way you support others shapes future opportunity.
Professional circles are smaller than they appear.

Your turn is earned long before it is announced.

Keep applauding others.


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Burnout gets addressed at the symptom,
never the source.
That single mistake costs organizations
⤵️
their best people every year.

I have sat across from leaders who had no idea
their team was running on fumes.

Not because they were indifferent.
Because the culture they built made
honesty too expensive to offer.

𝗧𝗵𝗲 𝗿𝗼𝗼𝘁𝘀 
𝗮𝗿𝗲 𝗮𝗹𝘄𝗮𝘆𝘀 𝘀𝘁𝗿𝘂𝗰𝘁𝘂𝗿𝗮𝗹.

🟥
Someone never defined the boundaries
so everyone absorbed everything.
🟥
Expectations outlived the resources
attached to them and nobody said so.
🟥
Effort went unrecognized long enough
that people stopped bringing their best.
🟥
Workload piled onto the willing
because distribution was never revisited.
🟥
A leader's unpredictability became
the team's full time second job.

𝗚𝗿𝗲𝗮𝘁 𝗹𝗲𝗮𝗱𝗲𝗿𝘀 
𝘁𝗿𝗲𝗮𝘁 𝘁𝗵𝗲𝘀𝗲 𝗰𝗼𝗻𝗱𝗶𝘁𝗶𝗼𝗻𝘀
𝗯𝗲𝗳𝗼𝗿𝗲 𝘁𝗵𝗲𝘆 𝗯𝗲𝗰𝗼𝗺𝗲 𝗽𝗲𝗿𝘀𝗼𝗻𝗻𝗲𝗹 𝗱𝗲𝗰𝗶𝘀𝗶𝗼𝗻𝘀.

🟩
They create space to speak
before people go quiet permanently.
🟩
They plan ahead so the team
leads the work instead of chasing it.
🟩
They recognize effort specifically, early,
and often enough to make it mean something.
🟩
Every one of these is addressable.
🟩
Every one responds to deliberate leadership.

The best time to act is before
the team stops believing you will.

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Success rarely shows up first attempt.
High achievers expect that.
Unstoppable begins with a single shift.

The difference between
stalled and unstoppable is 𝗬𝗘𝗧.

➢ Not skilled enough yet.
➢ Not where you want to be yet.
➢ Not confident yet.

That word keeps ambition intact
without lowering the bar.

It prevents early self-rejection.
It replaces “I’m not built for this”
with “I’m still building this.”

Most people stop at the first hard result.
High achievers review, adjust, and re-enter.

YET protects momentum.
It keeps you practicing when improvement feels slow.
It keeps you accountable without turning
on yourself.

Use it deliberately:
🟡
Raise the quality of what you consume.
Better rooms create better standards.
🟡
Track proof of improvement.
Progress you can see fuels discipline.
🟡
Upgrade your self-talk.
Language shapes behavior under stress.
🟡
Strengthen more than one capability.
Success expands when skills intersect.
🟡
Make your contribution visible.
Results that are understood travel further.
🟡
Protect your attention.
Energy spent carelessly delays progress.
🟡
Stay coachable.
Learning speed compounds over time.

Success is not a straight line.
It is sustained effort plus adjustment.

The people who reach it
rarely quit early.

They just hadn't arrived there yet.

𝗡𝗼𝘁 𝘄𝗵𝗲𝗿𝗲 𝘆𝗼𝘂 𝘄𝗮𝗻𝘁 𝘁𝗼 𝗯𝗲 𝗬𝗘𝗧?
If you’re serious about closing the gap,
let’s work on it.

🎯 𝗗𝗠 𝗺𝗲.
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