What life experience influenced your interest in the healthcare field?
I had to have surgery when I was a young kid. In the hospital, I interacted with dedicated and caring healthcare professionals who created an environment focused on my well-being.
This made a big impression on me. I started thinking then that maybe I wanted to be a doctor when I grew up.
You took a non-traditional path to medical school. Tell us more about that.
I did not go to medical school immediately after my undergraduate experience. I was involved in some work that I felt I had made a commitment to, so I tried to defer my acceptance, but that wasn’t possible.
Before eventually starting medical school, I took some odd jobs. I was an apprentice carpenter, a physician recruiter and a political campaign hack. I also got my Master’s of Public Health in Health Policy and Planning.
I arrived at medical school after several years with perspectives that were clearly shaped by these experiences. My public health experience trained me to focus on the big picture. Working with individual patients, I was also always thinking about the larger implications from a policy and other standpoints.
How would you describe your career path?
I think it’s fair to say that it’s been influenced by what I found intriguing at the moment. Everyone’s path is unique. In many respects, mine has been less deliberate, and more serendipitous. I’ve followed my passions. That’s true of how I first got involved in healthcare IT.
So tell us the story of how you got involved in healthcare IT.
I was in a fellowship thinking about pursuing academic medicine in clinical research, and was interviewing for this kind of role. Yet I recall being in those interviews where I wasn’t certain myself why I was there.
One day, I just happened to run into someone who had been the head of my residency. It was a sunny day, and we sat down together on a hill across from the hospital.
We had this classic conversation, catching up on what we each were doing. He told me he was getting involved in rethinking how healthcare delivery will evolve.
This was the very, very early stage of thinking about how healthcare IT would change healthcare. I quickly realized that I was much more interested in what he was doing, and this led to my involvement in my first healthcare IT start up.
Considering that you have been involved in healthcare IT since these early times, what has surprised you the most about its evolution?
I would have to say the slow pace of change.
When I first got involved in healthcare IT, we were naïve enough to think that electronic health records would be ubiquitous in five years. Yet here we are thirty years later, and we are still dealing with an immature set of products.
How do you think healthcare IT will evolve in the coming years?
The impact of connected health—from digital to mobile to telehealth—will be huge. We are in the early stages of this phenomenon today.
Connected health will dramatically change the doctor-patient relationship, resulting in better quality, lower cost and better satisfaction for both.
How will this connected health future shape doctors’ everyday practice of medicine?
Most doctors would say that they hope for the ability to deliver the best quality care they can. That’s why most of us went into medicine.
I think the emergence of connected health will free doctors to do that. I think that the office visit will become a time and place to focus on significant interactions that require “high touch”, but most interactions will become asynchronous.
Doctors and patients will rely on digital tools—from apps to sensors and other devices—to connect outside of the office visits. The key will be to take the quantity of data generated in the digital health world, digest it, and make it actionable for patients and doctors.
How do you see doctor-patient relationships changing?
I think that people are starting to see how important it is for the medical community to connect with the communities in which their patients live and work.
We know that people’s social support network and the resources where they live contribute to their health and well-being. That’s why the American Medical Association is working in partnership with the YMCA to get into communities to make inroads around diabetes prevention.
The notion that the office visit is the only way to connect with the healthcare community is antiquated. One day, people will look back and say, why did we think this way?
That’s just one example of the kind of community outreach that I think we need more of in healthcare. The notion that the office visit is the only way to connect with the healthcare community is antiquated. One day, people will look back and say, why did we think this way?
Why is the “Internet of Me” concept so relevant in today’s healthcare environment?
Healthcare is inherently personal. When it comes to our well-being, each one of us is a community of one. All the population health data in the world is still not necessarily about “me.”
The emphasis on Big Data is fascinating, and undoubtedly is valuable to how doctors and patients will make decisions in the future. But ultimately, there is a personal component in healthcare that no amount of Big Data can take the place of.
Healthcare is a major factor in your life—professionally, but also personally as a patient and a consumer. What are the intersections between the personal and the professional?
I actually try not to confuse the two. When I’m a patient, I try to preserve that role.
This was especially true with my kids growing up. I would tell their doctors that I didn’t want them to communicate differently because of what they assumed I knew as a doctor.
Having said that, I might ask a different set of questions than a non-physician would. But I never wanted my medical training to foreshorten conversations that needed to take place in my role as a caretaker.
What is the best advice you have ever received?
I would say experience has taught me never to take no for an answer. That’s just what I did when it came to getting myself into medical school. I knew it was the place for me.
On the first day of medical school, they tell you that half of what you learn will be proven untrue—but we don’t know which half. That stuck with me.
Throughout my life, when I’ve found myself challenging dogma and being told that I was wrong, I would simply redouble my efforts.
We live in an environment in healthcare and healthcare IT where our understanding is constantly changing. Resting on your laurels and accepting dogma is a mistake.
Who are your personal heroes and how did they inspire you?
There have definitely been people who have inspired me. What they have in common is a passion and dedication to what they are doing. And they were also very demanding of me.
I remember a high school teacher who excited my interest in life science, another who challenged my arrogance, and a college professor who could command the attention of an audience in a large lecture hall. I also recall an attending physician who had great passion that I admired.
Did the demanding and passionate nature of these people shape your own leadership style?
I like to think so.
While I continue to put a lot of demands on myself, I think you need to be more measured as a leader. You want to set high expectations without discouraging the people you have an influence on.
I think my style is still a work in progress—even at this stage in my career. Remember, this is the “practice” of medicine—I don’t think any of us ever stop evolving.