Post Author: Shiv K. Goel, MD

Shiv K. Goel is a board-certified internal medicine and functional medicine physician based in San Antonio, Texas, focused on integrative and root-cause approaches to health and longevity. He is the founder of Prime Vitality, a holistic wellness clinic, and TimeVitality.ai, an AI-driven platform for advanced health analysis. His clinical and educational work is also shared at drshivgoel.com.
Dr. Goel completed his internal medicine residency at Mount Sinai School of Medicine in New York and previously served as an assistant professor at Texas Tech University Health Science Center and as medical director at Methodist Specialty and Transplant Hospital and Metropolitan Methodist Hospital in San Antonio. He has served as a principal investigator at Mount Sinai Queens Hospital Medical Center and at V.M.M.C. and Safdarjung Hospital in New Delhi, with publications in the Canadian Journal of Cardiology and presentations at the American Thoracic Society International Conference.
He regularly publishes thought leadership on LinkedIn, Medium, and Substack, and hosts the Vitality Matrix with Dr. Goel channel on YouTube. He is currently writing Healing the Split Reconnecting Body Mind and Spirit in Modern Medicine.

Shiv K. Goel is a board-certified internal medicine and functional medicine physician based in San Antonio, Texas, focused on integrative and root-cause approaches to health and longevity. He is the founder of Prime Vitality, a holistic wellness clinic, and TimeVitality.ai, an AI-driven platform for advanced health analysis. His clinical and educational work is also shared at drshivgoel.com.
Dr. Goel completed his internal medicine residency at Mount Sinai School of Medicine in New York and previously served as an assistant professor at Texas Tech University Health Science Center and as medical director at Methodist Specialty and Transplant Hospital and Metropolitan Methodist Hospital in San Antonio. He has served as a principal investigator at Mount Sinai Queens Hospital Medical Center and at V.M.M.C. and Safdarjung Hospital in New Delhi, with publications in the Canadian Journal of Cardiology and presentations at the American Thoracic Society International Conference.
He regularly publishes thought leadership on LinkedIn, Medium, and Substack, and hosts the Vitality Matrix with Dr. Goel channel on YouTube. He is currently writing Healing the Split Reconnecting Body Mind and Spirit in Modern Medicine.
A patient stopped me in the hallway recently, not in an exam room, not seated, not “ready” for a clinical conversation. Just a human being catching me between visits and asking a question that felt heavier than any lab result:
“Doc, is this finally the thing that will work? Or is it just another trap?”
That question is the GLP-1 era in one sentence. And with the launch of oral Wegovy, it …
Read more…
“Can AI scale in medicine?” is the wrong question.
The real question is: Can AI protect the soul of medicine while people who have never sat with our patients decide their fate?
The ADVOCATE program: an overview
The Trump administration recently launched the ADVOCATE program: Agentic AI-Enabled Cardiovascular Care Transformation. Run by ARPA-H, this initiative aims to build and deploy autonomous “clinical AI agents” for cardiovascular disease, with an FDA authorization pathway of …
Read more…
Methamphetamine has become an unavoidable presence in South Texas medicine. It shows up in our EDs, clinics, and ICUs, usually framed as a cardiotoxic, neurotoxic, or psychiatric problem. But over the past few years, a different pattern has kept surfacing in my practice: “pneumonia” cases that don’t behave like pneumonia, young lungs that look like ARDS, and hypoxic patients whose imaging and labs do not match the story, until someone …
Read more…
“Doc, can you prescribe me some BPC-157 with sermorelin, and maybe semaglutide too?”
He didn’t come in asking about his sleep.
He didn’t mention that his last meal the night before was at 11:30 p.m., eaten in front of a laptop glowing with unanswered emails.
He didn’t bring up the statin he’d been taking for years, the creeping fatigue he’d started to normalize, or the way his waistline had slowly expanded as his …
Read more…
Last week, I spent over two hours on a prior authorization for a patient who needed a medication she’d been stable on for years. Two hours of hold music, transferred calls, and faxed forms, while patients waited.
That same week, Anthropic announced Claude for Healthcare: An AI system that can verify coverage requirements, build claims appeals, and streamline prior authorizations in minutes. OpenAI launched ChatGPT Health days earlier. Both promise to …
Read more…
By 11 p.m., my clinic was dark but my brain wasn’t. I found myself scrolling through my schedule for the next day: 22 patient visits, a pile of unsigned notes, two meetings squeezed into “lunch,” and a post-call morning that somehow still started at 7 a.m. None of these tasks were unusual, but what struck me was the growing tightness in my chest and the realization that I had quietly …
Read more…
Linda had seen seven physicians in three years. She was on five medications. And she was exhausted, not just physically, but existentially.
“Dr. Goel,” Linda said quietly, “I’ve done everything they told me. The diets. The pills. The exercise programs. Why isn’t anything working?”
At 54, Linda was a meticulous accountant living with hypertension, type 2 diabetes, obesity, chronic fatigue, and generalized anxiety disorder. Her lab results painted a picture of metabolic …
Read more…