Junaid Kalia, MD: Good morning, everyone. Grateful that you guys are joining us for Signals and Symptoms podcast. We have two amazing guests today. Arlen Myers, which I truly respect. He is one of the most premier entrepreneurs. He created the Society of Physician Entrepreneurship. We'll talk to him more about it consistently. And of course, my good friend, Muhammad Siddiqui, who definitely lives up to the title of visionary chief information and development officer driving the true spirit of CIOs in healthcare at Reid Health.

Harvey Castro, MD. MBA: For me, one of the top questions for him personally, I want to know, what do you think is kind of holding us back in the AI healthcare world? Is it the education system? Is it the culture? What are some of the things you think can really help that move forward?

Alen Myers, MD. MBA: So what do I think is holding us back? Personal, organizational, systemic, and societal barriers. So that's a big stack. And I'll just headline it. The personal is why we keep creating sick care providers that don't have an entrepreneurial mindset. So it really has to do with the mindset and the culture of medical education. And that's all another conversation. Organizationally, there's a whole list of resistance to change and why that happens. Not the least of which has to do with trust and cost. So what we're seeing is where's the beef? And we're seeing this in the market. These companies have created such high valuations, The real issue is where's the ROI and who's gonna pay for this over the long run. From a systemic standpoint, there's a whole host of federal and state and regulatory agency barriers to launching this thing. And it's really all wrapped up in politics and everything that we're seeing. And from a societal standpoint, there's this whole doom and gloom and is this… the savior of civilization or is it the destroyer? It's the next Oppenheimer moment. This is a pretty complicated, wicked problem. It's a multi-systems engineering problem. There probably is not one clear solution. People are fooling around with different models and states and agencies and teams and all that other business but that's the bottom line. what do you do? You can't just throw up your hands and say, well, gee, this is just too big of a problem for me to deal with. So I think you just have to pick your spot and try to make a difference at some level. And as you know, I've been pretty involved in medical education and sort of personal development and physician entrepreneurship and mindset change and all that other stuff. So there's plenty of room for improvement. It's a pretty big sandbox where people can play. And it's just a question of where you want to play.

Harvey Castro, MD. MBA: Yeah, thank you. Any of you guys, what do you guys think? Ed and Dr. Muhammad?

Muhammad Siddiqui: Yeah, I think first of all, thanks Junaid to having me on this podcast. It's very, very hard for me to come with Dr. Arlen and Dr. Harvey Castro and my mentor and my coach, Marks, and say a few words about my opinion on this. But I agree with Dr. Myers as well. think justifying the cost to implement AI and resistance to change, I think those are the foundation thinks that really holding us back. But I think this time, one thing I can see a change now. I finally seen in last 12 to 18 months, we are AI just not become a shining object anymore. It really bring out value to any organization, right? Let me just paint a picture. I work in a healthcare systems. Just imagine 645, primary care doctor wanted to go home, he cannot go home because he has to close the chart. He still has to go and look at the flood of email that comes through the inbox that he has to respond back. How about if the AI can comes in in a picture, be able to help them solve the problem, where they be able to go home on time. And I have an amazing testimonial that I have seen coming from our providers family. As a matter of fact, one of the providers wife call me and say, you, Muhammad, whatever you implemented is coming home on time. Be able to spend some time with the cares and able to go to the bath while being with my son. I think Allah, so until we see that kind of lucrative benefit for end users, we would never be able to successful for adoption.

Junaid Kalia, MD:I'm going to pose a question and then we're going to do rapid rounds today because there's so much to get into. So make your answers short and then we'll go from there. So here's my problem as a founder. Number one, I do not find educated, which is by the way, Arlen's article we put in the show notes, transitions, clinicians with data science background or AI background or coding background. mean, essentially, when you look at, when I talk to people, either you need to be a hipster, a hacker or a hustler. Right. Otherwise, you're not coming into my team. End of discussion. So the question is why are LLM physicians are not doing this and everyone else can go around?

Arlen Myers: MD. MBA: Well, there's a couple of reasons. One is because they're not trained to do it. Two is because that's not why they got accepted to medical school or grad school or whatever. Three, because there's frankly just not enough incentive to do it. And it's going to take a long time for, you know, I've written this concept of the new triple threat and the new triple threat, you know, old triple threat like me in academics was, you know, a clinician researcher, patient educator. That is no longer a viable business model as far as I'm concerned for the academic medical center faculty. The new triple threat will be clinician, technologist, entrepreneur. And we just simply don't have the infrastructure to produce those kinds of folks. The problem is that the people, it's blind leading the blind when it comes to the faculty because it's an adoption curve. There are the laggards and they have to wait to die or retire before they can be replaced by people who sort of get it. I'm not that worried about it actually, because I'm seeing a whole bunch of medical education reform.

Junaid Kalia, MD: Harvey, our own hipster, hustler and hacker, whatever your thought. How can we replicate you at mass level?

Harvey Castro, MD. MBA: Yeah. Well, thank you. At the end of the day, it does require a skill set, right? You need to know medicine, and then you also need to know AI. But then you also need to know AI, be creative and put it all together. That's been one of my advantages in that I've had experience where I've owned hospitals, I've created healthcare system, grew it to over 400 employees. But then with AI, I have really thought outside the box and how can we take that? And so to Arlen's point, I really think it's two main things. Number one, we don't know what we don't know. So by listening to this type of podcast, following Arlen, Muhammad, hanging out with Ed here, we're gonna learn. And as we learn, our village expands. And as our village expands, then we'll start accepting things. You see, two years ago, everybody on this podcast listening to Chat GPT is doing things way different today than it did two years ago. What is the difference? education and understanding, knowing what you don't know. And so a big picture, I think, is with time, I call it the AI IQ of healthcare goes up and up. And with that time, we'll understand and we'll start accepting things. And then people out there will be like, well, heck, why am I paying this vendor? I could do this myself. And with time, we're to start seeing that improve healthcare.

Edward Marx: And that's what we need is leadership. think the, I don't want to oversimplify, but I think the solution to a lot of what we're speaking about is leadership. like Arlen was referring to the military, like even in the military to go from, to be a junior officer, you've got to go to your, like when I was an engineer, I went to engineer officer basic school. Then a couple of years later, before I made captain, I've got to go to advanced engineering school. So I'm always learning more engineering capability. Then I get to a certain level and I have to go to command and general staff college. In order to become a battalion commander, I've got to go to the next level. And before I become a field general, which I never did, but there's another school, there's a Army War College. So you're always learning and educating and you will not advance if you don't have it. In healthcare, typically we don't have anything like that.

Junaid Kalia, MD: And then, of course, Harvey is introducing me to tons of CIOs, CMOs. Edward is going to make me shake hands with board members. But I want to create that story as a founder, which are many listeners. And this is all about two problems. Number one, how, as a clinician, even a hipster hacker, something like me, still need to create that story properly for soft and hard ROI. That's number one. And number two. Even being a director of New Royce, you are VP of clinical strategy, talking to at our advocate senior executives, I see how do I close that gap from a clinician entrepreneur to talk better finances.

Muhammad Siddiqui: Yeah, yeah. think that's a great question. I think the best clinician founders that I work with understand the problem deeply. I think that's very, very critical. I think this is what Dr. mentioned earlier as well. They not only know the problem, they basically live in the problem. They know exactly what the person is dealing with. And I think we also see the bigger gap between the solve my pain points, right? Does this drive measurable… ROI at the scale, right? And I think this is where the job of a CIO today, of what I call a modern CIO, is building the bridge, the gap between those two worlds, right? The word one would be, hey, listen, am I'm gonna get some measurable ROI, not only the soft ROI? To be honest with you, what CFO really looking for, hey, listen, will that allow me to get more service level? Will that allow me to get more, shrink the appointment time so I can see more patient that day? So when we deploy any AI solution, and I'll give you an example of my own health system, whether it can be clinical documentation, decision support, coding automation, anything we name it, we just don't train everyone and hope for that option, right? We build a report to identify what are the stakeholders that we need to train on, right? The clinician who are integrated in the tools fully and be able to utilize that, right? Then we study and we get the data out and say, listen, what exactly this person is doing before we deploy the AI solution versus now, right? And what we found sometime is very fascinating, right? Our top performer, not necessarily the most tech savvy, to be honest with you, Devi are the one who figured out the optimal workflows and integration, So when to activate an AI, how to review the output efficiency, right? And where it's naturally fit into the existing platform.

Arlen Myers, MD. MBA: But Junaid, there's eight people in the buying group when you're trying to sell a product to a health care organization. And to your point, they all want to hear a different story. There is no one story. Nurses want to hear one thing. IT wants to hear another thing. Supply chain, central supply, et cetera. The problem is the Rubik's cube is putting all those together in a single decision maker. Yeah. So the challenge is finding out the game is rigged. They're all these gatekeepers. And if you just keep banging on the door, you're not going to get anywhere. So you have to understand that the game is rigged, that this is a people to people. Who do you know and who knows you? Who do you trust when you make the referral? Who are these guys anyway? And you have to tell the story to the decision maker and get to the decision maker.

to make the clothes. And this just has to do with sales and marketing and making the close. And that's about telling the story. And it's another gap, incidentally, in medical education. We don't teach doctors how to sell.

Edward Marx: Given all the things that we just talked about and the current state of healthcare in America, how it's financed, things like that, certain things we can't change. But you as a leader, what is your word of advice to other leaders, to other peers? What can we do in our span of control? So what are some action steps that people can do? Because I want to make sure this is practical, right? We talk a lot of theory, which is really important.

Muhammad Siddiqui: I think the top of my mind is embrace the technology, embrace the AI, right? Don't look at the AI as artificial intelligence as a workforce reduction, but enhancing and enhancing your access and accessibility, fix those issues, the revenue will come to the organization. We need to see how we're to enhance the CIO, the smarter CIO, the modern CIOs are looking beyond day-to-day infrastructure, be honest with you. They need to get more involved in day-to-day operations. They need to get more involved in a transformation there as well because they need to understand their pain point, just like a founder entrepreneurs are.