Dr. Kirsten Bibbins-Domingo has spent her career in the space between what science knows and what healthcare systems actually do about it. As Editor in Chief of JAMA and the JAMA Network, she oversees 13 journals and is trying to close that gap. At the Civic Health Forum – co-hosted by Fedcap, Digital Health Hub Foundation, and StartUp Health – she joined Unity Stoakes for the closing fireside chat of the day, and the word that kept coming up was "convergence."
The US spends more on healthcare than almost any other country and gets less to show for it in population health terms. That gap, she argued, is not a technology problem. It is a silo problem. Clinicians, public health experts, tech builders, payers, and regulators are all working on the same challenge and rarely in the same room.
Her response at JAMA has been to launch JAMA Summits: closed-door convenings designed to bring thought leaders from across sectors together and ask a simple question: what would it take to make real progress in the next one to three years? The most recent summit tackled obesity. She expected arguments about food versus drugs. What she found instead was rapid consensus that both matter, and that the harder reckoning was what direct-to-consumer access to GLP-1s means for a prevention paradigm built around clinical gatekeepers. Optimism was real, grounded in the biology underlying GLP-1 development and what's still in the pipeline. But the room recognized that optimism without structural change risks producing weight loss that doesn't translate into lasting health.
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On AI, Dr. Bibbins-Domingo is enthusiastic and clear-eyed in equal measure. A major global survey found that trust in AI applied to science and medicine was highest in China and India and lowest, by a significant margin, in the US. That finding matters because the hunger for trust is a design constraint, not a sentiment to work around. Even as AI-powered health tools proliferate, people still read JAMA reviews in higher numbers than before. They still trust the person they can sit in front of. "We have to understand what is the trust that really underlies what people want and how people make decisions," she said, "and how can we leverage the good of all of these modes and deliver that for better health?"
Her ask for the next five years is simple: evidence that the innovations being built actually improve health across the full breadth of the population that needs them most. Not in pilots. Not only for people with means. At scale, across the board.
This conversation happened live, in the room, with questions from the audience, because that's what StartUp Health membership makes possible. Members join fireside chats, interactive office hours, and AMAs like this one in real time, with their own questions and direct access to the leaders shaping health's future. If you want a seat at the table for what comes next, visit startuphealth.com to learn more about our new open membership model.
