Hard Medicine

What does medicine lose when it tries to measure everything it values? In this opening talk from Stanford’s Big Ideas in Medicine Conference 2026, Dr. Ilana Yurkiewicz examines how a hyper-focus on metrics can create the illusion of care while patients still fall through the cracks. Through three examples — continuity, coordination, and connection — she argues that when medicine’s most important v...

Certain chronic diseases are rising, and no one knows why. These include autoimmune diseases such as Crohn’s, metabolic conditions like diabetes, early-onset cancer, and even disorders of mental health. One unifying theory is the microbiome. This diverse community that lives among us has been blamed for everything and nothing. In this conversation, Dr. Yurkiewicz sits down with microbiology profes...

Despite a majority of Americans reporting dissatisfaction with the U.S. healthcare system and agreeing it needs reform, very few presidents have been able to do it. In fact, according to longtime Washington insider and co-author of Whiplash Dr. David Blumenthal, advisors explicitly tell the president: Don’t go there. In this episode, Drs. Yurkiewicz and Blumenthal explore what power the most power...

What is longevity medicine, and how is it different from good primary care? That’s the first question Dr. Yurkiewicz asks her guest Dr. Hillary Lin, a longevity physician and entrepreneur. They get into how to separate hype from substance, what aspects of longevity medicine are evidence-based, and what hasn’t made it into medical guidelines but has emerging evidence behind its use. The purpose of...

Cancer care still mostly revolves around one goal: chasing cure. But what if that approach is costing us thousands of lives and untold suffering? In this episode of Hard Medicine, Dr. Yurkiewicz speaks with Dr. Azra Raza, oncologist and author of The First Cell , about why cancer medicine still prioritizes treatment over prevention — and the paradigm shift needed to change that. They discuss what...

The U.S. has doctors, but they’re not distributed where the needs are greatest. We are in short supply of primary care physicians, especially in rural communities. In this episode, Dr. Yurkiewicz speaks with policy analyst Lawson Mansell about the incentives — largely from the government — that influence what doctors choose to practice and where. These incentives systematically steer doctors away...

What is dependence, and is medicine built to handle it? That’s the question at the center of this conversation between Dr. Yurkiewicz and Leah Libresco Sargeant, a writer and thinker. Sargeant’s latest book, The Dignity of Dependence , argues that society treats autonomy as the default, when in reality our lives are shaped by need. Does healthcare, of all places, fully accept this? They discuss th...

All of life, in a way, is decision-making with a deadline — paired with deep uncertainty about that deadline. For people living with stage IV cancer, both the deadline and its uncertainty are radically heightened. Cancer is one word, but it’s not one disease. Thanks to targeted therapies and evolving treatments, some people live for years with metastatic illness. They must make ongoing choices abo...

Despite being one of the only parts of American medicine that consistently improves outcomes, primary care is in crisis. In this episode, Dr. Yurkiewicz talks with Dr. Lisa Rotenstein, a primary care physician and health systems researcher, about why modern primary care leaves doctors both chronically overworked and functionally unavailable. They unpack the structural mismatches driving this crisi...

Healthcare is one of our most important institutions. But it’s no secret it’s deeply broken. Hard Medicine is a monthly podcast tackling the hardest questions facing medicine today: Can primary care be saved? What does a good life look like with stage IV cancer? Why does it take months to see a doctor? Hosted by Ilana Yurkiewicz, MD, Stanford physician, professor, and journalist, and the author of...