Most healthcare still waits for a reason to act. A symptom shows up, a test gets ordered, a diagnosis follows, and treatment begins after a problem has already taken hold. For people who want a real picture of their health risk before that point, the standard system offers little beyond a once-a-year physical built around population averages rather than individual data.

Dr. Michael Doney (MD, MPH, MS) is the Executive Medical Director at Biograph, a precision diagnostics and preventive medicine platform that combines advanced testing, medical expertise, and AI. Before Biograph, Doney spent years as a board-certified emergency physician, treating the acute consequences of chronic disease long after prevention was possible.

In this episode of Lead with AI, Dr. Tamara Nall speaks with Dr. Michael Doney about how Biograph puts AI to work across diagnostic imaging, clinical efficiency, and clinical reasoning, the patient stories that show what earlier detection can change, and why he still believes a human physician has to make the final call.

A Friend's Diagnosis Became a Company  

Biograph's origin traces back to Doney's years in the emergency department. Setting aside accidents and injuries, most of what he treated was the acute flare-up of a chronic disease that had been building for years. He began to think there had to be a better way to reach people before a 2 a.m. emergency room conversation became necessary.

The idea took a concrete shape when one of Biograph's co-founders, a close friend of Doney's, discovered thyroid cancer through a preventive whole-body MRI. The technology was not new. What was missing was a platform built specifically to marshal it, pairing diagnostics like that with medical expertise aimed at early identification and intervention before a chronic condition becomes an emergency.

Who Actually Walks Through Biograph's Doors?  

Biograph serves people at different points in that arc. Some are in their 30s and 40s and want a baseline: where their health actually stands today. Others are in their 40s and 50s and are starting to think about how to shape their own aging process. People in their 50s and 60s often come in ready to act on specific risks rather than just understand them, and older members are managing issues that have already become visible.

Doney also sees people who arrive after a friend or family member receives a diagnosis, prompting questions about their own hereditary or familial risk, as well as busy executives who want more than the conventional executive physical can offer. Each path leads into what Biograph calls the Biograph Journey: a plan built with registered dietitians, an exercise team, nurses, and physicians, aimed at specific, prioritized risks rather than a general checklist.

Three Places AI Shows Up in the Process  

Doney breaks Biograph's use of AI into three categories. The first is diagnostic imaging. Biograph uses tools like Siemens' Deep Resolve, which applies machine learning to raw imaging data to shorten MRI acquisition time, and a separate tool called Subtle MR, which sharpens and denoises images to improve signal quality without additional scanning.

The second is clinical efficiency. Biograph built what Doney calls a clinical copilot: a tool that can parse years of a member's data across many formats and generate a summary, with links back to where each piece of information sits in the medical record, in seconds rather than hours. That shifts a physician's time away from chart review and toward actual clinical reasoning.

The third is clinical reasoning itself, where Biograph uses frontier large language models carefully. Doney is direct about the boundary: the models are not used to tell the clinical team what is happening. They are used to pressure-test an interpretation, surfacing the strongest argument for one reading of the data against another. The human stays the decision-maker in that loop.

A Stent Within a Week, No Symptoms at All  

Doney points to specific outcomes rather than abstractions. One member came in with a low estimated cardiovascular risk by conventional measures. A CT coronary angiogram, part of Biograph's standard diagnostic approach, found critical stenosis. He had a stent placed within a week of his assessment, without ever having felt a symptom.

Doney also described testing the Biograph method on his own data: several years of 3D movement analysis, DEXA body composition scans, and whole-body MRI, combined with notes on his own intermittent knee, back, and shoulder pain. Run through Biograph's tools, the data surfaced a gradual asymmetry in his upper leg muscles and reduced range of motion in his right shoulder and hip. Targeted corrective exercises resolved his knee and lower back pain; the shoulder issue improved further with the help of a physical therapist he was referred to.

Can Soft Plaque Really Be Reversed?  

A conversation about heart disease risk raised a specific question: what happens to soft arterial plaque, the kind considered more dangerous than hard plaque because it can rupture. Doney described three mechanisms Biograph works with. Plaque conversion turns unstable soft plaque into more stable hard plaque, often with statin therapy. Plaque reduction can shrink plaque through a combination of lifestyle change and aggressive lipid-lowering treatment. And reducing inflammation in the coronary artery wall, through the same combination of statins and lifestyle change, addresses a third contributing factor. Full reversal is not guaranteed and depends on the specific plaque features and clinical picture, but Doney said Biograph's preventive CT coronary angiography, informed by research including the Miami Heart Study, results in new or intensified therapy in roughly 40 percent of the cases where members bring their results to an outside physician.

The Privacy Rules Biograph Won't Bend On  

Doney was direct about where Biograph draws its lines. The platform only works with vendors under business associate agreements that meet HIPAA requirements, including Google Cloud and Vertex AI, and no model call leaves that architecture. Member data is not used to train public models, and Doney noted that de-identified data is not the same thing as truly anonymized data. Biograph does not sell member information, and it shares only what a specific case of care requires, such as sending an image out for post-processing or a sample to a lab.

Doney framed Biograph's approach to ethics the same way: the platform only tests for things the team can act on, built around a member's own clinical and lifestyle context rather than a one-size list. He was also clear that Biograph is not trying to replace a member's existing doctor. Every plan is built as a joint effort with that physician, not around them.

Looking three to five years out, Doney envisions healthcare built less around scheduled visits and more around continuous health navigation, powered by wearables and environmental data that update in close to real time. His boldest prediction: walking out of a doctor's visit without a full picture of one's own health risk will eventually look as outdated as walking in with a cigarette.

For anyone curious about what preventive, AI-supported diagnostics actually looks like in practice, Biograph is live at biograph.com, with clinics in Manhattan and San Mateo.

For more conversations with the founders and physicians building the next generation of healthcare, subscribe to Lead with AI on your favorite podcast platform.

Quick Answers  

What is Biograph?

Biograph is a precision diagnostics and preventive medicine platform that combines advanced testing, medical expertise, and AI to identify chronic disease risk earlier, with clinic locations in Manhattan and San Mateo.

How does Biograph use AI?

Biograph uses AI in three ways: in diagnostic imaging, to speed up and sharpen scans; in clinical efficiency, through a clinical copilot that summarizes years of a member's data in seconds; and in clinical reasoning, where frontier language models help pressure-test an interpretation while a physician makes the final decision.

Does Biograph replace a member's regular doctor?

No. Dr. Michael Doney describes Biograph's work as a joint effort with a member's existing medical team, not a replacement for it.

How does Biograph handle member data?

Biograph works only with HIPAA-compliant vendors under business associate agreements, does not use member data to train public models, and does not sell member information. Data is shared only when a specific aspect of care requires it.

Who is Dr. Michael Doney?

Dr. Michael Doney is the Executive Medical Director at Biograph. He previously practiced as a board-certified emergency physician before moving into precision preventive care.

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