WEBVTT 00:00:00.000 --> 00:00:03.859 Our childhood defines us in some ways. There 00:00:03.859 --> 00:00:06.139 are things we learned from our childhood that 00:00:06.139 --> 00:00:08.099 we keep with us, and there are things that we 00:00:08.099 --> 00:00:10.900 have to unlearn and let go of. Talk to me about 00:00:10.900 --> 00:00:12.679 your childhood. What are some things you have 00:00:12.679 --> 00:00:14.839 kept with you and what are some things you've 00:00:14.839 --> 00:00:19.120 had to let go of? Gosh, that's a great question. 00:00:20.780 --> 00:00:24.559 And maybe a little bit of background about my 00:00:24.559 --> 00:00:27.460 childhood or where I grew up. So I was born and 00:00:27.460 --> 00:00:30.679 raised in San Francisco. like truly in San Francisco 00:00:30.679 --> 00:00:36.520 proper. And I'm the son of an immigrant family. 00:00:36.979 --> 00:00:41.039 My parents actually immigrated from Burma, now 00:00:41.039 --> 00:00:45.840 known as Myanmar, but from a Chinese culture. 00:00:46.299 --> 00:00:48.159 And so I lived with my parents. I lived with 00:00:48.159 --> 00:00:51.859 my two brothers and sisters and my grandparents. 00:00:52.460 --> 00:00:56.640 So in some respects, we had a sort of a traditional 00:00:56.880 --> 00:01:07.239 Chinese family that was always sort of proper, 00:01:07.239 --> 00:01:11.459 I'll say. You have to wait your turn, you have 00:01:11.459 --> 00:01:15.459 to exercise your manners to the highest degree, 00:01:16.060 --> 00:01:23.640 always respect your elders, and be in place. 00:01:24.120 --> 00:01:26.200 And I would say that those aren't bad things, 00:01:26.200 --> 00:01:28.700 of course. You want to be respectful. You want 00:01:28.700 --> 00:01:35.819 to honor the wisdom of people who have more experience 00:01:35.819 --> 00:01:40.879 than you. And at the same time, I think that 00:01:40.879 --> 00:01:44.680 some of that feels a bit restrictive, right? 00:01:44.680 --> 00:01:48.519 Because you always have to do things in sequence, 00:01:48.760 --> 00:01:56.769 wait your turn. be confined to some of those 00:01:56.769 --> 00:02:03.629 roles. But thinking about where I am today, if 00:02:03.629 --> 00:02:07.450 I had not branched out or reached out or done 00:02:07.450 --> 00:02:11.710 things outside of the box, I would not have had 00:02:11.710 --> 00:02:13.669 the great experience that I've been able to experience 00:02:13.669 --> 00:02:18.870 throughout my career in enjoying the ability 00:02:18.870 --> 00:02:22.030 to express my creativity and my innovation and 00:02:22.030 --> 00:02:26.069 making the impact that I feel like I would have 00:02:26.069 --> 00:02:28.629 otherwise not been able to make if I sort of 00:02:28.629 --> 00:02:32.669 stayed confined within sort of I feel like a 00:02:32.669 --> 00:02:38.430 box that a traditional Chinese family might put 00:02:38.430 --> 00:02:44.330 myself in. So that's some of what I think about 00:02:44.330 --> 00:02:47.150 in response to your question there. And I'm happy 00:02:47.150 --> 00:02:50.990 to expand if that's something we want to take 00:02:50.990 --> 00:02:56.069 take down the road here. If you go back to, say, 00:02:56.469 --> 00:02:59.310 your 20, 25 year old self when you were starting 00:02:59.310 --> 00:03:03.509 med school, what did you think your career trajectory 00:03:03.509 --> 00:03:06.969 would look like? And how has it differed in reality? 00:03:08.229 --> 00:03:13.090 Oh, gosh. Back then, you know, when you're when 00:03:13.090 --> 00:03:14.629 you're early 20s, you think you know everything 00:03:14.629 --> 00:03:17.780 already. Because, gosh, two decades on this planet, 00:03:17.800 --> 00:03:22.139 gosh, you know everything. You know where your 00:03:22.139 --> 00:03:24.180 career is going to go. You know what your family 00:03:24.180 --> 00:03:26.759 is going to look like. And there are so many 00:03:26.759 --> 00:03:29.680 twists and turns that have come up along the 00:03:29.680 --> 00:03:37.039 way that the vision that I had when I was 20 00:03:37.039 --> 00:03:40.460 is actually quite different than what's actually 00:03:40.460 --> 00:03:43.719 happened in reality. And quite honestly, I wouldn't 00:03:43.719 --> 00:03:49.129 change a thing. But back then, I was thinking, 00:03:50.810 --> 00:03:55.550 I'm gonna go to med school. I'm going to specialize 00:03:55.550 --> 00:03:58.229 in internal medicine, which I did. I'm gonna 00:03:58.229 --> 00:04:01.770 be a primary care physician, which I have been. 00:04:02.469 --> 00:04:04.729 And that's what I was gonna do for my entire 00:04:04.729 --> 00:04:08.750 career. I was really interested in having that 00:04:08.750 --> 00:04:11.770 sort of longitudinal care that primary care physicians 00:04:11.770 --> 00:04:16.209 get to have with their patients. um, to be expert 00:04:16.209 --> 00:04:18.610 in a lot of different conditions, the broad breadth 00:04:18.610 --> 00:04:22.089 of what internal medicine has to offer. Um, and 00:04:22.089 --> 00:04:25.930 I've really enjoyed doing that part of medicine. 00:04:26.569 --> 00:04:29.209 Um, and I've done that for, for many years actually, 00:04:30.250 --> 00:04:36.189 but along the way, I was blessed with the opportunity 00:04:36.189 --> 00:04:41.290 to expand outside of that. Um, and you know, 00:04:41.310 --> 00:04:43.620 one thing that happened early in my career, after 00:04:43.620 --> 00:04:46.879 I finished residency was that my medical group 00:04:46.879 --> 00:04:50.279 deployed EPIC, the electronic health record, 00:04:51.740 --> 00:04:55.459 one year into my practice, which was, I would 00:04:55.459 --> 00:04:57.579 say, life -changing in many ways and life -changing 00:04:57.579 --> 00:04:59.920 for a lot of people because, of course, you're 00:04:59.920 --> 00:05:02.180 no longer docking on paper. You're putting everything 00:05:02.180 --> 00:05:05.279 in the electronic health record now. But it was 00:05:05.279 --> 00:05:10.540 not long after that happened where the inefficiencies 00:05:10.540 --> 00:05:14.949 of dealing with electronic health record became 00:05:14.949 --> 00:05:18.550 very apparent. Don't get me wrong, I would never 00:05:18.550 --> 00:05:20.910 go back to paper. There's so many advantages 00:05:20.910 --> 00:05:26.370 of having things in electronic format that we 00:05:26.370 --> 00:05:28.370 would never go back. I would never go back. And 00:05:28.370 --> 00:05:30.949 the quality of care that we deliver now is so 00:05:30.949 --> 00:05:35.449 much better because of that. But as we all know, 00:05:36.910 --> 00:05:40.029 working within an EHR, all the clicks, all the 00:05:40.029 --> 00:05:43.149 keystrokes, all the different screens and all 00:05:43.149 --> 00:05:46.149 the administrative tasks that we're dealing with 00:05:46.149 --> 00:05:53.529 now, they became into play when the EHR was introduced. 00:05:54.310 --> 00:05:57.970 And so I saw opportunities early on after the 00:05:57.970 --> 00:06:01.430 deployment of the EHR around being able to improve 00:06:01.430 --> 00:06:04.170 the efficiency of which I was operating within 00:06:04.170 --> 00:06:08.290 the EHR and to help my colleagues who were equally 00:06:08.290 --> 00:06:11.399 struggling with getting through their day. Not 00:06:11.399 --> 00:06:14.680 only were they now faced with having to provide 00:06:14.680 --> 00:06:17.379 excellent care to their patients, they had to 00:06:17.379 --> 00:06:20.899 figure out, well, how do I get this ordered in 00:06:20.899 --> 00:06:23.040 the system? How do I place this referral? How 00:06:23.040 --> 00:06:29.000 do I do any of these electronic tasks now that 00:06:29.000 --> 00:06:34.180 are in there in a quick way so that I'm not spending 00:06:34.180 --> 00:06:37.680 twice as much time in front of the computer as 00:06:37.680 --> 00:06:44.860 I am, you know. in front of a patient. So along 00:06:44.860 --> 00:06:52.579 the path, I got to program tools into the system 00:06:52.579 --> 00:06:55.439 that improved our efficiency, that made us get 00:06:55.439 --> 00:06:59.100 through our day more quickly. I developed a program 00:06:59.100 --> 00:07:01.620 that went viral across my medical group very 00:07:01.620 --> 00:07:03.879 quickly, actually. And it's still actually used 00:07:03.879 --> 00:07:08.209 today. within the Kaiser Permanente where I was 00:07:08.209 --> 00:07:12.430 practicing in the past. And that was sort of 00:07:12.430 --> 00:07:17.949 my foray into creating technologies or leveraging 00:07:17.949 --> 00:07:20.509 existing technologies to integrate into the practice 00:07:20.509 --> 00:07:25.250 that allows us to get through our day more quickly 00:07:25.250 --> 00:07:31.769 with as little friction as possible. So, you 00:07:31.769 --> 00:07:35.000 know, it's been very fulfilling but at the same 00:07:35.000 --> 00:07:37.660 time, gosh, there's just so much more that can 00:07:37.660 --> 00:07:40.100 be done that I can see. And that's some of the 00:07:40.100 --> 00:07:42.839 work that I'm still doing now, even though I'm 00:07:42.839 --> 00:07:45.439 no longer with the current microgroups I'm at. 00:07:46.100 --> 00:07:48.240 I'm still doing work in technology, technology 00:07:48.240 --> 00:07:52.959 integration within healthcare. This transition 00:07:52.959 --> 00:07:57.579 from clinical medicine to physician, innovator, 00:07:57.879 --> 00:08:01.819 entrepreneur, and leader, was it? You following 00:08:01.819 --> 00:08:05.800 your natural curiosity at that point or was it 00:08:05.800 --> 00:08:08.540 something more planned? And something you had 00:08:08.540 --> 00:08:13.819 to train yourself to excel in I Would say it 00:08:13.819 --> 00:08:17.279 was not planned You know, there are some people 00:08:17.279 --> 00:08:21.100 out there. I think that have a grand master plan 00:08:21.100 --> 00:08:26.040 You know the the moment they were born or the 00:08:26.040 --> 00:08:27.660 moment they went to high school or college or 00:08:27.660 --> 00:08:30.310 med school wherever and they have a grand vision 00:08:30.310 --> 00:08:32.610 of this is where I need to be, this is where 00:08:32.610 --> 00:08:36.490 I want to be. Things for me kind of happened 00:08:36.490 --> 00:08:39.309 organically and naturally over a period of many 00:08:39.309 --> 00:08:48.970 years. And I have to give thanks to the many 00:08:48.970 --> 00:08:53.190 mentors that I had along the way who saw potential 00:08:53.190 --> 00:08:55.950 in me, who pushed me, who gave me opportunities 00:08:55.950 --> 00:08:59.470 to do things that they felt I could do that I 00:08:59.470 --> 00:09:03.149 even know I could do myself and helped me develop 00:09:03.149 --> 00:09:06.690 and help me grow into having those abilities 00:09:06.690 --> 00:09:11.450 to be able to do more than just clinical care. 00:09:11.509 --> 00:09:14.990 Now, I kind of hate to say that because just 00:09:14.990 --> 00:09:18.570 clinical care, oh my gosh, it's such a noble, 00:09:19.809 --> 00:09:23.429 important thing to do. And at the same time, 00:09:25.379 --> 00:09:29.500 There are other things that can be done to help 00:09:29.500 --> 00:09:33.559 at a larger level, at a larger scale, which I've 00:09:33.559 --> 00:09:36.820 been fortunate enough to have those opportunities 00:09:36.820 --> 00:09:42.379 to do along the way. I would say it wasn't necessarily 00:09:42.379 --> 00:09:46.440 kind of, I wasn't born with that. It wasn't innate 00:09:46.440 --> 00:09:51.860 in me, but I learned that through the practice 00:09:51.860 --> 00:09:55.129 of what I was doing. educational courses that 00:09:55.129 --> 00:10:01.389 I attended, and of course the mentors that I 00:10:01.389 --> 00:10:06.730 had along the way who helped educate me, teach 00:10:06.730 --> 00:10:13.330 me, and build on what I had I think as the foundational 00:10:13.330 --> 00:10:17.529 aspects of what I could accomplish to where I 00:10:17.529 --> 00:10:21.750 have come today. For the physicians listening, 00:10:22.720 --> 00:10:26.840 A lot of them would like to cut back on clinical 00:10:26.840 --> 00:10:32.139 medicine and expand their scope in non -clinical 00:10:32.139 --> 00:10:35.980 sidekicks. What's stopping them is the immediate 00:10:35.980 --> 00:10:40.100 loss in income that you often see. What advice 00:10:40.100 --> 00:10:43.279 do you have to those physicians, and what made 00:10:43.279 --> 00:10:47.279 you take this leap into non -clinical medicine 00:10:47.279 --> 00:10:51.539 and be okay with the short -term loss in income? 00:10:52.190 --> 00:10:56.409 Yeah. Well, my leap into non -clinical medicines, 00:10:56.529 --> 00:10:59.309 like I mentioned, could happen over a long period 00:10:59.309 --> 00:11:04.710 of time. I started as a ten -tenths primary care 00:11:04.710 --> 00:11:07.789 physician, did that for a number of years, and 00:11:07.789 --> 00:11:10.230 over time, say, went from nine -tenths to eight 00:11:10.230 --> 00:11:15.330 -tenths to five -tenths, and so on. And I'll 00:11:15.330 --> 00:11:19.490 say that it was always important to me to continue 00:11:19.490 --> 00:11:22.669 to practice medicine because it was always, that 00:11:22.669 --> 00:11:25.649 was my goal coming out of medical school, to 00:11:25.649 --> 00:11:30.309 be a doctor. And even now, I still see patients 00:11:30.309 --> 00:11:34.950 because it's such a fulfilling part of what I 00:11:34.950 --> 00:11:37.830 do during my week, during my month, during the 00:11:37.830 --> 00:11:44.549 years. And it's such an important part of what 00:11:44.549 --> 00:11:49.950 I do in my non -clinical. because being able 00:11:49.950 --> 00:11:52.870 to see patients and understand the challenges 00:11:52.870 --> 00:11:59.190 and the joys of clinical care allows me to have 00:11:59.190 --> 00:12:04.509 a better understanding of how to shape the technology 00:12:04.509 --> 00:12:11.190 that I'm working on that is helping hundreds, 00:12:11.950 --> 00:12:13.350 tens of thousands, and hopefully hundreds of 00:12:13.350 --> 00:12:15.169 thousands, even millions of other clinicians 00:12:15.169 --> 00:12:19.399 out there eventually to be able to sustain their 00:12:19.399 --> 00:12:23.639 practice, to continue to build on their clinical 00:12:23.639 --> 00:12:27.960 careers. You didn't ask this question, but I'm 00:12:27.960 --> 00:12:31.019 going to opine a little bit here around why are 00:12:31.019 --> 00:12:34.440 people looking for side gigs and trying to get 00:12:34.440 --> 00:12:38.019 out of clinical medicine? And I think it's because 00:12:38.019 --> 00:12:44.259 clinical medicine is so hard. And it's hard for 00:12:44.259 --> 00:12:49.259 a number of reasons. It's hard because the demands 00:12:49.259 --> 00:12:53.919 of knowing all this information and trying to 00:12:53.919 --> 00:12:56.519 apply it to the best care delivery they can to 00:12:56.519 --> 00:13:00.460 the patients they're taking care of, it takes 00:13:00.460 --> 00:13:04.080 a toll. And that's why I actually am so enthusiastic 00:13:04.080 --> 00:13:08.139 about technology and artificial intelligence, 00:13:08.480 --> 00:13:11.559 because those are things that can help offload 00:13:11.559 --> 00:13:14.980 the cognitive burden of clinical medicine aspects. 00:13:15.669 --> 00:13:19.529 But on top of that, of having to deal with the 00:13:19.529 --> 00:13:21.529 clinical aspects, there's these whole administrative 00:13:21.529 --> 00:13:24.950 aspects that clinicians have to deal with, which 00:13:24.950 --> 00:13:28.129 when I was in med school, I didn't think about 00:13:28.129 --> 00:13:30.950 that. I didn't think about prior authorizations 00:13:30.950 --> 00:13:36.049 and clinical documentation and all the notes 00:13:36.049 --> 00:13:38.190 that we have to, things like that. I didn't think 00:13:38.190 --> 00:13:41.090 about that, but they're very readily apparent 00:13:41.090 --> 00:13:44.549 in today's clinical world that there are so many 00:13:44.549 --> 00:13:47.490 administrative burdens placed on clinicians that 00:13:47.490 --> 00:13:51.009 I think that's one of the reasons why they're 00:13:51.009 --> 00:13:53.450 very willing to try to give up some of their 00:13:53.450 --> 00:13:57.389 clinical time, even though it is as rewarding 00:13:57.389 --> 00:14:02.169 as it is to find things outside of clinical medicine. 00:14:04.809 --> 00:14:13.129 So advice that I would give, well, be true to 00:14:13.289 --> 00:14:19.269 why you're wanting to venture outside of clinical 00:14:19.269 --> 00:14:24.169 care. Because if it's to make money, as you just 00:14:24.169 --> 00:14:27.809 mentioned, there are probably better ways to 00:14:27.809 --> 00:14:34.809 do that. Or at least short -term because being 00:14:34.809 --> 00:14:38.330 a doctor, being a clinician has its financial 00:14:38.330 --> 00:14:41.549 rewards as well. But if you're not true to yourself 00:14:41.549 --> 00:14:49.490 and you aren't following your passions, what 00:14:49.490 --> 00:14:54.590 you stand for, what you believe in, it's going 00:14:54.590 --> 00:14:57.269 to make it that much more challenging. And for 00:14:57.269 --> 00:15:05.629 me, as I sort of decrease the amount of time 00:15:05.629 --> 00:15:10.190 I spent at the clinic, I felt like there was 00:15:10.190 --> 00:15:14.970 a a higher calling, a higher level of responsibility 00:15:14.970 --> 00:15:17.929 that I could have to have an even bigger impact 00:15:17.929 --> 00:15:20.110 aside from the individual patient that I was 00:15:20.110 --> 00:15:24.250 seeing within the office. And so putting that 00:15:24.250 --> 00:15:29.049 all together has continued to drive me to do 00:15:29.049 --> 00:15:32.429 the work that I do to have a larger impact across 00:15:32.429 --> 00:15:37.429 healthcare, across society. Another thing that 00:15:37.429 --> 00:15:41.190 physicians struggle with I think it's balancing 00:15:41.190 --> 00:15:44.769 finances, retirement planning, and lifestyle 00:15:44.769 --> 00:15:50.409 creep, especially as we get into our late 30s, 00:15:50.409 --> 00:15:54.509 40s. How do you think about these things when 00:15:54.509 --> 00:15:58.830 you make career decisions? And what is your general 00:15:58.830 --> 00:16:02.230 outlook on financial planning as a physician? 00:16:04.330 --> 00:16:11.090 Yeah, you know, I think it's hard to generalize 00:16:11.090 --> 00:16:16.149 because everyone's different in terms of their 00:16:16.149 --> 00:16:20.049 income earning potential, as well as what their 00:16:20.049 --> 00:16:25.690 lifestyle is. And if I, you know, it's funny, 00:16:25.750 --> 00:16:28.669 I talked to my wife this time, for good or bad, 00:16:29.429 --> 00:16:34.210 our lifestyle is fairly similar to when we first 00:16:34.210 --> 00:16:37.350 met in residency and we were working on a residency 00:16:37.350 --> 00:16:40.769 salary. compared to when we both became practicing 00:16:40.769 --> 00:16:47.210 physicians and had a much higher salary to live 00:16:47.210 --> 00:16:50.970 off of. And even at that, having had two kids 00:16:50.970 --> 00:16:59.899 now, we still live a fairly modest life. I mean, 00:16:59.919 --> 00:17:02.840 you know, we take our vacations, you know, and 00:17:02.840 --> 00:17:06.900 we like to enjoy the time we have with each other, 00:17:06.980 --> 00:17:09.980 you know, things like that, of course. And so 00:17:09.980 --> 00:17:15.660 for me, the financial aspects of it are obviously 00:17:15.660 --> 00:17:17.539 important. You know, we had to pay off school 00:17:17.539 --> 00:17:23.579 loans and, you know, we still need to take care 00:17:23.579 --> 00:17:27.700 of two kids and plan for their futures as well. 00:17:29.079 --> 00:17:33.559 But thankfully, because our lifestyles aren't 00:17:33.559 --> 00:17:37.240 necessarily extravagant, we're able to get by 00:17:37.240 --> 00:17:40.920 with what we've been doing. Now, I think it's 00:17:40.920 --> 00:17:44.099 absolutely critical, though, to do financial 00:17:44.099 --> 00:17:46.460 planning, because again, everyone's different. 00:17:46.759 --> 00:17:50.160 And if you have certain things that you want 00:17:50.160 --> 00:17:53.140 to accomplish in life, you want to do goals that 00:17:53.140 --> 00:17:58.529 you have, and they're expensive. you have to 00:17:58.529 --> 00:18:03.670 think about what you're going to do with your 00:18:03.670 --> 00:18:07.750 work and your earning potential. And I think 00:18:07.750 --> 00:18:12.490 of where I went in terms of my career, or if 00:18:12.490 --> 00:18:16.089 I had just stuck with being a primary care physician 00:18:16.089 --> 00:18:22.470 and my decision to go into primary care, if I 00:18:22.470 --> 00:18:29.690 had larger loans that I had to pay off, in deciding 00:18:29.690 --> 00:18:31.829 which residency to go into, which specialty to 00:18:31.829 --> 00:18:34.049 go into, I may have picked a completely different 00:18:34.049 --> 00:18:39.450 path. I may have tried to go into orthopedic 00:18:39.450 --> 00:18:43.809 surgery or become a cardiologist, some procedurally 00:18:43.809 --> 00:18:50.569 based specialty that pays more than a primary 00:18:50.569 --> 00:18:55.069 care physician. But thankfully, I was able to 00:18:55.069 --> 00:18:58.970 balance the finances of it. and my interests 00:18:58.970 --> 00:19:02.849 and my passions to pursue a career where I thought 00:19:02.849 --> 00:19:09.630 would be professionally satisfying. And that's, 00:19:09.690 --> 00:19:15.150 again, how I ended up in primary care. So it's 00:19:15.150 --> 00:19:17.230 a tough question because everyone's different, 00:19:17.309 --> 00:19:19.569 everyone has different goals, and the situation 00:19:19.569 --> 00:19:24.460 varies from person to person. How do you think 00:19:24.460 --> 00:19:27.259 about balancing your personal life and your career 00:19:27.259 --> 00:19:31.519 life? Specifically with kids as well and there's 00:19:31.519 --> 00:19:34.339 something I've learned with kids is you can't 00:19:34.339 --> 00:19:37.960 be more Efficient at parenting because what kids 00:19:37.960 --> 00:19:42.900 want is your time And you know, you can't spend 00:19:42.900 --> 00:19:48.480 time You know, you can't spend ten minutes with 00:19:48.480 --> 00:19:53.759 them in a better manner they need more of your 00:19:53.759 --> 00:19:56.319 time every day, ideally. So how do you think 00:19:56.319 --> 00:20:00.420 about balancing your personal and career life 00:20:00.420 --> 00:20:03.259 and where does happiness lie for you on that 00:20:03.259 --> 00:20:08.900 spectrum? Wow. So you're right. I mean, kids, 00:20:09.319 --> 00:20:15.880 family, those are first and foremost the top 00:20:15.880 --> 00:20:21.279 of my priority. You know, talking about sort 00:20:21.279 --> 00:20:26.920 of traditional Chinese family. It was always 00:20:26.920 --> 00:20:31.779 family and health. Those are the two sort of 00:20:31.779 --> 00:20:35.099 untouchables. We always talked about that. And 00:20:35.099 --> 00:20:36.440 then it was like, well, how are you going to 00:20:36.440 --> 00:20:43.640 make a living? So that was secondary. And I think 00:20:43.640 --> 00:20:47.200 as you asked earlier, what have you carried into 00:20:47.200 --> 00:20:52.099 sort of adulthood and into your career? Those 00:20:52.099 --> 00:20:55.200 are things that I think about. And the things 00:20:55.200 --> 00:21:01.160 that allow me to find balance in my career and 00:21:01.160 --> 00:21:05.480 in my family life is having variety, I think, 00:21:05.720 --> 00:21:09.240 is one of the biggest things. Having variety 00:21:09.240 --> 00:21:13.259 and having challenges. Because let's talk about 00:21:13.259 --> 00:21:17.660 variety here. I mean, doing the same thing over 00:21:17.660 --> 00:21:22.369 and over, I think it'll be easy to get bored. 00:21:23.950 --> 00:21:27.170 And if you want to do something for the long 00:21:27.170 --> 00:21:32.289 haul, for an entire career, for your entire life, 00:21:33.450 --> 00:21:36.930 having that variety is, I think, one of the most 00:21:36.930 --> 00:21:44.210 important things to keep in mind. And I think 00:21:44.210 --> 00:21:46.369 that's one of the things and one of the reasons 00:21:46.369 --> 00:21:49.130 that I kind of took the leap of faith of leaving 00:21:49.400 --> 00:21:52.720 my practice of what I had for 20 years to do 00:21:52.720 --> 00:21:57.039 something different, to join an AI startup company, 00:21:57.259 --> 00:22:01.559 to work at a medical school, and to still maintain 00:22:01.559 --> 00:22:06.960 some clinical practice is that within my work 00:22:06.960 --> 00:22:09.740 life, I've got a variety of things that I get 00:22:09.740 --> 00:22:12.660 to work on that I feel like I'm having a positive 00:22:12.660 --> 00:22:17.079 impact on, either at an individual level, at 00:22:17.079 --> 00:22:20.000 a larger organizational level or the future lives 00:22:20.000 --> 00:22:24.099 of physicians or students who are training to 00:22:24.099 --> 00:22:30.880 be physicians. I always believe that if you're 00:22:30.880 --> 00:22:35.059 doing something fun and exciting at work, it 00:22:35.059 --> 00:22:37.819 often doesn't feel like work. It's just that's 00:22:37.819 --> 00:22:40.160 what you're doing during your day. And I feel 00:22:40.160 --> 00:22:43.660 like a lot of that is what I get to do during 00:22:43.660 --> 00:22:49.589 my professional time. But in terms of my family 00:22:49.589 --> 00:22:54.369 time, my time away from work, I've got two kids. 00:22:54.450 --> 00:22:58.789 They're both teenagers now. And you talked about 00:22:58.789 --> 00:23:02.430 time and spending time with them. And as I think 00:23:02.430 --> 00:23:05.470 about my daughter, who's 16, a junior in high 00:23:05.470 --> 00:23:08.990 school, my gosh, it's going to be like a year 00:23:08.990 --> 00:23:12.690 and a half before she's off to college. And the 00:23:12.690 --> 00:23:18.730 time that I get to see her every day and get 00:23:18.730 --> 00:23:20.690 to spend time with her and talk to her every 00:23:20.690 --> 00:23:24.769 day and to see her continue to grow into adulthood, 00:23:25.829 --> 00:23:30.329 that time is shrinking. It's sad to see, but 00:23:30.329 --> 00:23:36.630 also so exciting to have her be able to develop 00:23:36.630 --> 00:23:41.750 into her own and explore her own future. So just 00:23:41.750 --> 00:23:45.579 trying to cherish every moment that I have. with 00:23:45.579 --> 00:23:49.559 my 16 -year -old daughter, 13 -year -old son, 00:23:50.000 --> 00:23:57.579 with my wife, at home, traveling, experiencing 00:23:57.579 --> 00:24:02.759 different cultures, forming those core memories 00:24:02.759 --> 00:24:04.779 that hopefully they're going to remember the 00:24:04.779 --> 00:24:07.380 rest of their lives, where they took that trip 00:24:07.380 --> 00:24:10.700 with mom and dad, and they can tell their grandkids 00:24:10.700 --> 00:24:14.359 or great grandkids about, and just sort of... 00:24:14.599 --> 00:24:18.099 building that legacy for the future. Those are 00:24:18.099 --> 00:24:22.099 the things that I think about. I'm jealous of 00:24:22.099 --> 00:24:24.519 you and correct me if I'm wrong, but it sounds 00:24:24.519 --> 00:24:28.319 like your natural inclination is family, health, 00:24:28.380 --> 00:24:32.019 and then career. My natural inclination is career, 00:24:32.700 --> 00:24:36.599 family, and then health. And that's caused quite 00:24:36.599 --> 00:24:40.200 a bit of grief and a few episodes of burnout 00:24:40.200 --> 00:24:44.210 in my life. And I'm working really hard to change 00:24:44.210 --> 00:24:49.890 the order of that, too, as you said, family, 00:24:50.670 --> 00:24:57.490 health, and then career. I guess my question 00:24:57.490 --> 00:24:59.529 is, what piece of advice do you have for me? 00:24:59.849 --> 00:25:03.029 And people like me, and the people in the startup 00:25:03.029 --> 00:25:07.410 ecosystem are often like this. And as an investor, 00:25:07.490 --> 00:25:11.549 I look for founders, and maybe I shouldn't, who 00:25:11.549 --> 00:25:15.430 put their startup above all. So what advice do 00:25:15.430 --> 00:25:17.529 you have for me? And is that your natural inclination? 00:25:17.750 --> 00:25:20.690 Or have you had periods in your time where, and 00:25:20.690 --> 00:25:23.710 I'm sure you have, where your career asked you 00:25:23.710 --> 00:25:26.690 to compromise your family or your health, or 00:25:26.690 --> 00:25:30.750 you had opportunities which may lead to financial 00:25:30.750 --> 00:25:34.609 freedom in three, four years? but they would 00:25:34.609 --> 00:25:37.589 come at a cost of family and health. And how 00:25:37.589 --> 00:25:42.549 do you think about these things? Yeah. So you're 00:25:42.549 --> 00:25:44.829 spot on and very observant about what I feel 00:25:44.829 --> 00:25:50.670 like my priorities are. And, you know, I don't 00:25:50.670 --> 00:25:54.250 think these are necessarily fixed in place at 00:25:54.250 --> 00:25:56.910 all times, just as you mentioned, because there 00:25:56.910 --> 00:26:01.789 have been times where I've had to prioritize 00:26:01.789 --> 00:26:06.589 my career so that I could take care of my family. 00:26:08.430 --> 00:26:12.430 There are times that my health unfortunately 00:26:12.430 --> 00:26:15.470 has suffered because either I didn't get enough 00:26:15.470 --> 00:26:18.390 exercise, my diet was terrible, I just didn't 00:26:18.390 --> 00:26:21.549 have enough time for sleep because I was focusing 00:26:21.549 --> 00:26:24.710 on the career aspects and making sure that that 00:26:24.710 --> 00:26:28.309 piece was successful. And I'm not gonna say that 00:26:28.309 --> 00:26:31.799 someone who prioritizes and has their career 00:26:31.799 --> 00:26:34.160 at the top, and then career, family, and health 00:26:34.160 --> 00:26:38.180 in that order is wrong. I don't think it's wrong. 00:26:38.359 --> 00:26:40.480 I think it depends on... I think it's wrong. 00:26:40.799 --> 00:26:43.200 You think it's wrong? Okay. Yeah, go ahead. I 00:26:43.200 --> 00:26:45.400 think it's where you are in your life and where 00:26:45.400 --> 00:26:47.779 you sit and what your perspectives are, and I 00:26:47.779 --> 00:26:49.160 think people can have different perspectives, 00:26:49.180 --> 00:26:52.579 and I think it can be right. But the way I see 00:26:52.579 --> 00:26:58.140 it is this. If you don't have your health, And 00:26:58.140 --> 00:27:00.039 maybe I'm making a case for health being on top, 00:27:00.059 --> 00:27:02.559 but if you don't have your health, you're gonna 00:27:02.559 --> 00:27:05.619 have a much harder time taking care of your family. 00:27:06.039 --> 00:27:08.420 And if you don't have your health, you're not 00:27:08.420 --> 00:27:13.519 gonna be optimally performing at your job. And 00:27:13.519 --> 00:27:17.380 over the past several years, I've been very interested 00:27:17.380 --> 00:27:22.980 in lifestyle medicine and thinking about how 00:27:22.980 --> 00:27:27.170 physical activity, diet and nutrition, stress 00:27:27.170 --> 00:27:30.390 reduction, sleep, avoiding unhealthy substances 00:27:30.390 --> 00:27:34.089 and social interconnectedness, those pillars 00:27:34.089 --> 00:27:39.609 of lifestyle medicine play into family and work. 00:27:40.329 --> 00:27:43.470 And so I recently became board certified in in 00:27:43.470 --> 00:27:45.130 lifestyle medicine because I have such a strong 00:27:45.130 --> 00:27:49.289 interest in it and want to apply that to my own 00:27:49.289 --> 00:27:53.170 health and my own family, but also impart those 00:27:53.170 --> 00:27:55.089 principles to the patients that I see and the 00:27:55.089 --> 00:28:01.519 people that I work with. And so if you don't 00:28:01.519 --> 00:28:04.539 have your health, it just makes it more difficult 00:28:04.539 --> 00:28:08.759 to do those other pieces that we talked about. 00:28:09.099 --> 00:28:17.599 And the family aspect, I've had disagreements, 00:28:17.740 --> 00:28:21.279 fights with my immediate family. I think all 00:28:21.279 --> 00:28:26.299 families do. And I remember a time where I was 00:28:26.299 --> 00:28:29.619 probably in my early 20s and I had a big argument 00:28:29.619 --> 00:28:32.880 with my brother. I've got two brothers, one sister. 00:28:33.319 --> 00:28:35.960 And I didn't talk to that brother for months. 00:28:38.859 --> 00:28:41.299 And my mom, she's like, well, you know what? 00:28:42.799 --> 00:28:47.200 He's your family. You're not going to build other 00:28:47.200 --> 00:28:50.640 brothers. She was done with having kids. She 00:28:50.640 --> 00:28:53.339 wasn't going to have any more brothers for me. 00:28:54.599 --> 00:28:58.579 And your family is your family. And when it comes 00:28:58.579 --> 00:29:00.759 down to it, at least within our culture and our 00:29:00.759 --> 00:29:03.980 family, there's no one that's going to have your 00:29:03.980 --> 00:29:06.000 back like your family. There's no one that's 00:29:06.000 --> 00:29:08.799 going to be there who's going to support you 00:29:08.799 --> 00:29:11.079 in your time of need. And there's no one going 00:29:11.079 --> 00:29:15.859 to be that is in tune with who you are, how you 00:29:15.859 --> 00:29:20.880 grew up, the culture that you are part of to 00:29:20.880 --> 00:29:25.750 be able to to have that level of support that 00:29:25.750 --> 00:29:29.490 others may try to give you. So I feel like that's 00:29:29.490 --> 00:29:33.970 why the family aspect is such an important piece 00:29:33.970 --> 00:29:36.450 of sort of that layering that we talked about 00:29:36.450 --> 00:29:40.549 here. Let's talk a bit more about lifestyle medicine. 00:29:41.599 --> 00:29:43.720 And, you know, lifestyle medicine and longevity 00:29:43.720 --> 00:29:45.839 medicine, they both still have somewhat of a 00:29:45.839 --> 00:29:49.160 bad rep in the academic and the clinical world, 00:29:49.180 --> 00:29:53.960 although I find it is changing slowly. What are 00:29:53.960 --> 00:29:59.839 some biomarkers that you thought were, you know, 00:30:00.039 --> 00:30:02.900 fufu, and when you did lifestyle medicine training, 00:30:03.140 --> 00:30:06.230 you've kind of changed your mind on? and you 00:30:06.230 --> 00:30:08.710 know maybe you'll surprise me and say cortisol 00:30:08.710 --> 00:30:12.509 levels but talk to me about because this is something 00:30:12.509 --> 00:30:15.150 I'm interested in as well and I think a lot of 00:30:15.150 --> 00:30:17.390 physicians are starting to get interested in 00:30:17.390 --> 00:30:22.029 there's a big push towards hormone balancing 00:30:23.409 --> 00:30:26.390 And you know, like if you're testosterone, and 00:30:26.390 --> 00:30:29.410 I'm used to the older scale is nine, which is 00:30:29.410 --> 00:30:31.230 within the normal range, like if you want it 00:30:31.230 --> 00:30:33.549 to be 1450, and you feel better, that's fine. 00:30:34.150 --> 00:30:36.990 But if you push it beyond the normal ranges, 00:30:37.430 --> 00:30:39.470 and then we can get into you know, well, how 00:30:39.470 --> 00:30:42.430 do the normal ranges exist? Is it based on a 00:30:42.430 --> 00:30:45.529 specific Western white male population? And does 00:30:45.529 --> 00:30:47.920 that apply? Like as a normal range of testosterone 00:30:47.920 --> 00:30:50.500 different for a different population at different 00:30:50.500 --> 00:30:52.900 age groups and um, you know, we just don't have 00:30:52.900 --> 00:30:55.859 the data for a lot of these things or maybe We 00:30:55.859 --> 00:31:00.099 do and i'm stuck in my med school Days or residency 00:31:00.099 --> 00:31:02.319 days. So talk to me about lifestyle medicine. 00:31:02.400 --> 00:31:05.420 What are some Some things you've um changed your 00:31:05.420 --> 00:31:08.220 mind on um by learning more and training in lifestyle 00:31:08.220 --> 00:31:11.240 medicine Yeah, um, so I mean I know you asked 00:31:11.240 --> 00:31:13.559 about sort of biomarkers and hormone levels and 00:31:13.559 --> 00:31:16.470 things like that and you know, when I think about 00:31:16.470 --> 00:31:18.710 lifestyle medicine, I don't, honestly, I don't 00:31:18.710 --> 00:31:22.130 think as much in terms of those terms as what 00:31:22.130 --> 00:31:26.269 I'm about to say that I think of in the terms 00:31:26.269 --> 00:31:29.930 that I consider lifestyle medicine. And some 00:31:29.930 --> 00:31:32.509 of the bad rap I think that you hear about or 00:31:32.509 --> 00:31:35.029 you think about that's out there is like, oh, 00:31:35.029 --> 00:31:38.029 it's just about, you know, eating plants and 00:31:38.029 --> 00:31:42.910 vegetables. You know, and it's about being Zen 00:31:42.910 --> 00:31:49.890 and just sort of disconnecting from all the evils 00:31:49.890 --> 00:31:54.630 of society. I'll just throw that out there. But 00:31:54.630 --> 00:32:03.630 there's real evidence around being able to use 00:32:03.630 --> 00:32:10.730 lifestyle medicine to treat diseases, to prevent 00:32:10.730 --> 00:32:16.759 diseases, and to reverse diseases. And so what 00:32:16.759 --> 00:32:21.099 we're talking about here are things like chronic 00:32:21.099 --> 00:32:25.059 diseases in general, obesity, diabetes, hypertension, 00:32:25.339 --> 00:32:30.480 heart disease, cancer, dementia, all those things, 00:32:31.180 --> 00:32:34.779 all those conditions, if we were able to fully 00:32:34.779 --> 00:32:37.480 realize the potential of lifestyle medicine, 00:32:37.880 --> 00:32:44.250 we could likely eliminate 80 % of those chronic 00:32:44.250 --> 00:32:49.269 conditions. We could save millions of lives, 00:32:49.349 --> 00:32:52.430 really, by practicing those pillars of lifestyle 00:32:52.430 --> 00:32:59.109 medicine. And there is real data. Like you think 00:32:59.109 --> 00:33:03.289 about studies in New England Journal of Medicine, 00:33:03.549 --> 00:33:05.829 animals internal medicine, JAMA, different things 00:33:05.829 --> 00:33:07.569 like that. There's real studies that have been 00:33:07.569 --> 00:33:12.829 done to show that I'm not I'm not just speaking 00:33:12.829 --> 00:33:14.950 fluff here. There are peer -reviewed journals 00:33:14.950 --> 00:33:18.150 that have shown the benefits of lifestyle medicine 00:33:18.150 --> 00:33:22.329 here. And so if we could impart even some of 00:33:22.329 --> 00:33:29.529 these principles to more of what we do in the 00:33:29.529 --> 00:33:31.170 care of our patients, I think we'd be so much 00:33:31.170 --> 00:33:36.640 better off. And I'm not also not saying we don't 00:33:36.640 --> 00:33:39.140 need medicine and we don't need procedures and 00:33:39.140 --> 00:33:42.700 you know that's definitely not the case. Putting 00:33:42.700 --> 00:33:48.039 those things in place and complementary with 00:33:48.039 --> 00:33:51.759 you know and then looking at the patient in a 00:33:51.759 --> 00:33:54.859 holistic manner we need all of that to take care 00:33:54.859 --> 00:33:56.579 of patients because despite our best efforts 00:33:58.070 --> 00:33:59.809 We're going to need medicine. We're going to 00:33:59.809 --> 00:34:04.690 need procedures to help treat and protect our 00:34:04.690 --> 00:34:07.789 patients. One thing I've noticed anecdotally, 00:34:07.890 --> 00:34:12.289 I've been prescribing with a lot of us, a decent 00:34:12.289 --> 00:34:17.980 amount of GOP1, Ozempic, Manjaro, Wigovy. is 00:34:17.980 --> 00:34:19.880 sarcopenia. And for those listening who are not 00:34:19.880 --> 00:34:24.059 medical, sarcopenia is this phenomena of muscle 00:34:24.059 --> 00:34:27.179 loss or loss of muscle mass as we get older. 00:34:28.300 --> 00:34:32.579 And it's been shown to be linked with mortality, 00:34:32.860 --> 00:34:35.840 morbidity, dementia, and muscle mass is very 00:34:35.840 --> 00:34:38.260 important, especially as you get into your 80s 00:34:38.260 --> 00:34:43.099 and 90s and maybe even 70s. What are your thoughts 00:34:43.099 --> 00:34:48.320 on And, you know, I'm asking this more as a personal 00:34:48.320 --> 00:34:51.900 thought because I think the evidence is still 00:34:51.900 --> 00:34:55.719 kind of out there of GLP -1 inhibitors. Are they 00:34:55.719 --> 00:34:59.960 the lifesaver that we think they are? Or are 00:34:59.960 --> 00:35:02.880 we going to get more data? And do you think it 00:35:02.880 --> 00:35:07.210 will kind of fizzle out? Gosh at the trajectory 00:35:07.210 --> 00:35:09.889 that it's been going in it's hard to imagine 00:35:09.889 --> 00:35:12.829 it fizzling out At the rate that we're going 00:35:12.829 --> 00:35:15.949 at right now with all the benefits that we are 00:35:15.949 --> 00:35:24.590 seeing with the GOP ones So much chronic disease 00:35:24.590 --> 00:35:28.650 out there is related to obesity and being overweight 00:35:28.650 --> 00:35:31.690 And that's why I'm a believer of lifestyle medicine 00:35:31.690 --> 00:35:34.469 too. I know it's it's it's you know, perhaps 00:35:34.469 --> 00:35:36.750 not as easy as, you know, prescribing a pill 00:35:36.750 --> 00:35:39.090 or prescribing an injection to help lose weight, 00:35:39.090 --> 00:35:43.710 but as patients do lose weight, you know, the 00:35:43.710 --> 00:35:46.309 diabetes disappears, the hypertension disappears, 00:35:46.309 --> 00:35:50.949 and we know what those conditions can lead to 00:35:50.949 --> 00:35:53.130 down the road after years and years of having 00:35:53.130 --> 00:35:54.750 that, or even not even that long of having those 00:35:54.750 --> 00:35:58.989 type of conditions. So I'm very much encouraged 00:35:58.989 --> 00:36:05.139 by what the GOP1s have been able to do. And sometimes 00:36:05.139 --> 00:36:08.940 we just, you know, the shortages that are seemingly 00:36:08.940 --> 00:36:13.380 easing up, but the cost is still very high. And 00:36:13.380 --> 00:36:16.719 so I worry a little about sort of the equitable 00:36:16.719 --> 00:36:19.460 distribution of these type of medications that 00:36:19.460 --> 00:36:25.179 we can apply to our populations. With that said, 00:36:25.440 --> 00:36:29.139 too, sort of the beautiful thing of medicine 00:36:29.139 --> 00:36:32.099 and academic medicine is that we are constantly 00:36:32.099 --> 00:36:37.869 learning. And the longer we use these type of 00:36:37.869 --> 00:36:39.969 medications, the more patients who are out there 00:36:39.969 --> 00:36:41.909 who have been exposed to them for a longer period 00:36:41.909 --> 00:36:46.010 of time, we'll learn more. There are potential 00:36:46.010 --> 00:36:48.210 side effects, as you know, of course, to these 00:36:48.210 --> 00:36:51.250 medications. And we'll find out potentially more 00:36:51.250 --> 00:36:56.329 side effects as the years pass. I like to bring 00:36:56.329 --> 00:37:00.989 up the example of FenFen. We thought it was such 00:37:00.989 --> 00:37:04.940 a great treatment for weight loss but it was 00:37:04.940 --> 00:37:07.000 shown to you know cause valvular issues with 00:37:07.000 --> 00:37:09.260 the heart and then so we you know we obviously 00:37:09.260 --> 00:37:11.559 no longer use that combination of medication 00:37:11.559 --> 00:37:15.500 but hopefully the GOP1s are not going to have 00:37:15.500 --> 00:37:19.460 that fen -phen moment and continue to prove to 00:37:19.460 --> 00:37:25.320 be safe and effective and life -changing in many 00:37:25.320 --> 00:37:30.340 respects. And talking about equity and medical 00:37:30.340 --> 00:37:34.480 treatment and care being equitable, and excellent 00:37:34.480 --> 00:37:37.940 medical care being ubiquitous and equitable worldwide, 00:37:39.480 --> 00:37:43.840 it seems like one of the costs of medical care 00:37:43.840 --> 00:37:48.039 that's been targeted is us as physicians and 00:37:48.039 --> 00:37:51.539 our salaries, which is entwined with our length 00:37:51.539 --> 00:37:57.860 of training. With the rise of NPs, it seems like 00:37:57.860 --> 00:37:59.840 there's a growing sentiment that maybe we're 00:37:59.840 --> 00:38:03.900 overtrained, overpaid. And with AI now and AI 00:38:03.900 --> 00:38:07.579 agents, there is also a growing trend that physicians 00:38:07.579 --> 00:38:11.059 should be replaced. So I'll ask a two -part question. 00:38:12.000 --> 00:38:14.659 What do you think is the role of physicians the 00:38:14.659 --> 00:38:18.699 next five to 10 years? And the second part is, 00:38:18.900 --> 00:38:25.150 if AI can replace us with the same accuracy for 00:38:25.150 --> 00:38:33.769 treatment and diagnoses, should it? Wow. That's 00:38:33.769 --> 00:38:35.849 going to be probably a billion dollar question 00:38:35.849 --> 00:38:40.150 here with respect to that. And the role of physicians 00:38:40.150 --> 00:38:42.730 over the next five years, I don't see the role 00:38:42.730 --> 00:38:47.440 of physicians. We're all I will as a physician 00:38:47.440 --> 00:38:49.699 maybe I'm biased but I think that we're always 00:38:49.699 --> 00:38:53.559 going to need physicians someone that has additional 00:38:53.559 --> 00:38:58.460 expert training in being able to Understand the 00:38:58.460 --> 00:39:01.699 disease processes and to be able to treat patients 00:39:01.699 --> 00:39:09.519 Can a computer do that Yes to degree but can 00:39:09.519 --> 00:39:14.559 the computer develop the empathy and understanding 00:39:14.559 --> 00:39:22.099 and sort of put in and compute aspects of a patient's 00:39:22.099 --> 00:39:26.300 situation that a human could do. I don't think 00:39:26.300 --> 00:39:29.659 you can do that at this point here, right? What 00:39:29.659 --> 00:39:32.420 if it can fake empathy? Is there a difference 00:39:32.420 --> 00:39:34.860 from the patient perspective if they can't tell? 00:39:35.420 --> 00:39:38.679 if the empathy is fake or real. Because our perception 00:39:38.679 --> 00:39:41.659 of reality is reality. And objective reality 00:39:41.659 --> 00:39:45.000 is hard to discern. Yeah. It's a good question. 00:39:45.679 --> 00:39:48.099 Because you're probably aware of the studies 00:39:48.099 --> 00:39:51.980 that have been done, too, around where some patients 00:39:51.980 --> 00:39:56.840 felt like the chatbot was more empathetic than 00:39:56.840 --> 00:40:03.219 the human physician. And so I think there's more 00:40:03.219 --> 00:40:08.679 to learn. um around there and um part part of 00:40:08.679 --> 00:40:14.019 I think that um the mission is some of the empathy 00:40:14.019 --> 00:40:17.639 that I think human physicians uh want to provide 00:40:17.639 --> 00:40:21.380 and can provide is based on some of the time 00:40:21.380 --> 00:40:24.960 constraints that um we're faced with some of 00:40:24.960 --> 00:40:31.019 the burnout issues that we all have and if we 00:40:31.019 --> 00:40:34.489 were able to use technology to offload some of 00:40:34.489 --> 00:40:36.769 those things that we, again, we don't have to 00:40:36.769 --> 00:40:38.150 do. I think the burnout will be better, the time 00:40:38.150 --> 00:40:43.530 screens will be improved. And I don't know, maybe 00:40:43.530 --> 00:40:48.909 I'm being a little old school here in thinking 00:40:48.909 --> 00:40:53.409 that we're still gonna need physicians. I really 00:40:53.409 --> 00:40:57.769 believe we are. Even as technology advances, 00:40:58.110 --> 00:41:00.969 as AI agents are out there looking at all this 00:41:00.969 --> 00:41:04.840 data, processing all of it, going out and doing 00:41:04.840 --> 00:41:07.940 tasks for us, and then bringing things back. 00:41:08.500 --> 00:41:13.239 I think when it's brought back, I really do believe 00:41:13.239 --> 00:41:15.480 there needs to be that human in the loop that 00:41:15.480 --> 00:41:19.920 we talk about, that needs to have that trained 00:41:19.920 --> 00:41:22.800 clinician with years of experience who went through 00:41:22.800 --> 00:41:25.780 medical school, who have seen you know a patient 00:41:25.780 --> 00:41:28.059 in the past that reminded them this is what we 00:41:28.059 --> 00:41:30.380 need to look out for or this we need to take 00:41:30.380 --> 00:41:32.300 into consideration as we're treating this patient 00:41:32.300 --> 00:41:37.739 in front of me here and and taking that say AI 00:41:37.739 --> 00:41:44.340 agent recommendation and applying it as it has 00:41:44.340 --> 00:41:47.960 come back or tweaking it because you know this 00:41:47.960 --> 00:41:49.840 patient and you've treated this patient for 20 00:41:49.840 --> 00:41:54.570 years and and understand what their goals are, 00:41:54.670 --> 00:41:59.130 their beliefs are, and how they would want to 00:41:59.130 --> 00:42:02.929 be treated as a patient, which I think is hard 00:42:02.929 --> 00:42:06.190 to plug into a computer algorithm and to be able 00:42:06.190 --> 00:42:10.269 to put that all together. If your 16 -year -old 00:42:10.269 --> 00:42:14.230 daughter came to you today and said, Dad, I want 00:42:14.230 --> 00:42:17.010 to be a primary care physician, what would you 00:42:17.010 --> 00:42:21.179 tell her? I would say follow your dreams. And 00:42:21.179 --> 00:42:26.000 in fact, she has told my wife and I that she 00:42:26.000 --> 00:42:30.880 wants to be a doctor. She's 16. She's got time 00:42:30.880 --> 00:42:33.820 to think through whether that's the right choice 00:42:33.820 --> 00:42:38.519 for her. But I would love to support her in that 00:42:38.519 --> 00:42:42.460 decision, because I have had an amazing, fulfilling 00:42:42.460 --> 00:42:46.860 career being a primary care physician. I know 00:42:46.860 --> 00:42:48.340 that's not always the case. And I know there 00:42:48.340 --> 00:42:50.340 are a lot of doctors out there who said who would 00:42:50.340 --> 00:42:53.480 say don't go into primary care and don't become 00:42:53.480 --> 00:43:00.599 a physician. But I think it's such a. You know, 00:43:00.599 --> 00:43:03.619 you can give so much and you can get so much 00:43:03.619 --> 00:43:10.699 back. And you're you've got so much opportunity 00:43:10.699 --> 00:43:15.329 that you can. being a primary care physician, 00:43:15.789 --> 00:43:18.570 like where I went with my career, being able 00:43:18.570 --> 00:43:24.050 to see patients, being able to integrate other 00:43:24.050 --> 00:43:25.809 interests around things like lifestyle medicine 00:43:25.809 --> 00:43:28.710 and technology into my practice and into the 00:43:28.710 --> 00:43:32.590 work that I do, and being able to affect patients 00:43:32.590 --> 00:43:36.050 on an individual level or at a population level. 00:43:36.449 --> 00:43:40.389 And having that impact, and as I reflect on the 00:43:40.389 --> 00:43:45.650 career that I've had, um it's it's been so gratifying 00:43:45.650 --> 00:43:50.349 and if she wants to do that um whether it's a 00:43:50.349 --> 00:43:53.449 small part of that or a large part of that uh 00:43:53.449 --> 00:43:58.630 i would fully support her i'm mindful of the 00:43:58.630 --> 00:44:01.210 time do you have time for one more question yeah 00:44:01.210 --> 00:44:05.820 yeah sure If your 30 year old self saw where 00:44:05.820 --> 00:44:09.380 you were at from a career perspective today What 00:44:09.380 --> 00:44:11.880 would they think and where do you see yourself 00:44:11.880 --> 00:44:20.960 in 10 years from now? My 30 year old self um 00:44:20.960 --> 00:44:24.900 You know I I I mentioned earlier that I you know 00:44:24.900 --> 00:44:28.159 someone in my 20s or 30s a they wouldn't know 00:44:28.159 --> 00:44:30.239 what was coming or what would have happened here 00:44:30.239 --> 00:44:33.260 today. I think they would have been impressed. 00:44:34.559 --> 00:44:37.099 Like, gosh, you thought you were going to be 00:44:37.099 --> 00:44:41.880 on this particular career path, but you got to 00:44:41.880 --> 00:44:46.340 do so much more, experience so much more effect 00:44:46.340 --> 00:44:51.199 and have that impact that I would have never 00:44:51.199 --> 00:44:55.199 imagined. And so I feel like I am so fortunate, 00:44:55.659 --> 00:44:59.579 so privileged to have been able to go through 00:44:59.579 --> 00:45:04.340 what I've been able to, and to affect the lives 00:45:04.340 --> 00:45:08.840 that I've been able to make the people healthier, 00:45:09.000 --> 00:45:13.880 people happier, people be able to get through 00:45:13.880 --> 00:45:19.599 their day better. And where do you see yourself 00:45:19.599 --> 00:45:27.360 in 10 years? Gosh, I've been really enjoying 00:45:27.360 --> 00:45:32.420 what I'm doing now. It's hard to imagine doing 00:45:32.420 --> 00:45:36.539 something different than I'm doing now. But, 00:45:36.539 --> 00:45:45.679 you know, I'm basically mid to getting to the 00:45:45.679 --> 00:45:48.900 latter part of my career. And as long as I'm 00:45:48.900 --> 00:45:52.860 having fun and feel like I'm making an impact, 00:45:54.079 --> 00:45:57.739 I'm going to keep on doing what I'm doing. Thank 00:45:57.739 --> 00:46:00.199 you so much for joining me today. This has been 00:46:00.199 --> 00:46:02.739 a little bit of a therapy session for me as well, 00:46:02.760 --> 00:46:06.760 so thanks for doing that. Me too. Yeah, this 00:46:06.760 --> 00:46:09.320 has been amazing. Thanks, Ed. Thanks so much 00:46:09.320 --> 00:46:10.500 for having me. I appreciate it.