Join Dr Ankur Kalra on Parallax as he explores the evolving landscape of precision medicine in cardiology with Dr Calum MacCrae, Vice Chair for Scientific Innovation at Brigham and Women’s Heart and Vascular Center. Dr MacCrae reflects on how the promise of matching treatments to individual risk and disease mechanisms has evolved, from its roots in molecular medicine to today’s data-driven aspirations, revealing why progress has lagged behind expectations. The discussion dissects the complexities of modern cardiology, challenging assumptions about therapeutic precision by examining barriers like incomplete disease understanding, flawed electronic health records, and the high cost of integrating biomarkers into practice. Listeners will value Dr MacCrae’s incisive breakdown of precision medicine’s ecosystem, and how innovations at each level could redefine treatment strategies. The episode delivers practical insights for clinicians, while posing critical questions about how systemic inertia and fragmented healthcare delivery can impede meaningful change.