Episode Transcript:
Dr. Geeta Nayyar
Misinformation is really the issue of our generation, and how we're going to use our technology strategies, our business strategies, our revenue strategies to address it will be really important as the consumer is in the driver's seat more and more in health care.
Robert Traynham
Hey, Dr. G.
Nayyar
Hey, Robert. How are you?
Traynham
I'm well, thanks. How are you, more importantly?
Nayyar
I'm doing well. It was a long flight from Miami to Portland. I will tell you, I'm a little bit tired.
Traynham
A little tired. You gotta hydrate, right, and do some stretching on the plane and all that good stuff.
Nayyar
That's what they say. That's what they say.
Traynham
Come on. You’re a doctor! You’re supposed to tell me this stuff.
Nayyar
But we are the worst patients, I think you should know this by now.
Traynham
You know, my sister is married to an OBGYN. And her wife is arguably the most horrible, horrible patient. I mean, it's bad.
Nayyar
It's bad. So my husband's a urogynecologist. He was actually, literally, having an asthma attack before I left. And I had to just remind him that he was a bladder doctor and everything above the waist was my territory. You need a nebulizer and you need it now, and he's like, “Don't be the boss of me.” And I'm like, “I am the boss of you.”
Traynham
Before we talk about an icebreaker, why do you think health care professionals, particularly doctors, are sometimes some of the worst patients.
Nayyar
You know, I think like everything when you're so in the weeds, it's hard to pick your head up and see the forest and realize what's going on. And, and there is kind of a distancing that happens, at least with physicians in particular, because the only way you can get through patient care sometimes is to have like, a beat, a beat between you and whatever's going on. Otherwise, you can get very emotional and overwhelmed.
Traynham
There is an old saying that the painter’s house needs to be painted, the plumber’s house needs new plumbing, I mean, there's something there, there's no question about it.
Nayyar
It's true. And I think when it comes to our own health, or our loved one’s health, you're just too close to it, you can't see it. And sometimes it takes that fresh pair of eyes that is a beat away to actually, you know, speak reality and truth.
Traynham
So, I'll be a little personal for a second. What gets you up in the morning? What motivates you? What's, what's your sunrise?
Nayyar
You know, I would have to say my daughter, my 11-year-old daughter literally wakes me up, especially because it's summer, so, she's home. And it's a bit hard to manage being home with an 11-year-old and working. But it's really, you know, what I think has always motivated me my whole career, which is science and medicine and people and making an impact.
You know, my dad is an 80-year ICU physician who goes to the hospital every day, and rounds in the unit, worked through COVID. And he has always inspired me to just make every minute count. And whatever happens, happens, but you only get 100 years if we're lucky. And you want to make it count. So, I approach every day as, “Let's make this one count.”
Traynham
Thanks for sharing. Appreciate it. So, you are an MD, you've alluded to, obviously, being a physician. But there's another thing about you that I find fascinating and that is technology and misinformation specifically. And look, listen, my bias with this is that we are living through unbelievable transformational change. And if you think about where we are, we're literally having a conversation around a cure for AIDS that's realistic, where we are literally having a conversation around how telemedicine and technology can predict, accurately, where we go next. And we had this thing called the pandemic where technology really was at the forefront and everything that we did. But there was a lot of misinformation there, right? There was a lot of stuff that was good and bad. Let's talk about that. Let's talk about the good first with the misinformation.
Nayyar
So, look, we're living in an era, like you said, that is unprecedented. Now we're post pandemic. And we have a lot of things we didn't have before. Number one, we have telemedicine that has exploded and is now considered kind of mainstay treatment. We have social media that we have realized has good parts and bad parts and maybe some ugly parts. We're probably going to learn the same thing about artificial intelligence.
But we also have a consumer that I think has been reminded how important their health is, and is really interested in being health literate, and is really interested in saying, “How do not lose everything I learned during COVID, but actually just pay it forward?” And so, I think that's what's really inspiring about the moment we're in is that we have a chance to get smart. And we have a chance to make that our call to action, whether we're the CEO of a hospital, a payer, a consumer company – who we keep seeing enter the market – retailers.
Misinformation is really the issue of our generation, and how we're going to use our technology strategies, our business strategies, our revenue strategies to address it will be really important as the consumer is in the driver's seat more and more in health care.
Traynham
You know, in many ways, it's empowering. It's very much empowering to give that consumer – literally in the palm of their hands – a choice around how they navigate health care.
Alright, Dr. G., bear with me here with this analogy, but there are some folks out there that believe what they believe. And they will say, “Look, I have a constitutional right to say what I think. I think Elvis is alive. I think the world is flat. And I’m going to create a group around that.” And that kind of creates this echo system of an alternative reality. What do you say to those people who say, “Listen, your misinformation can be my fact and vice versa?”
Nayyar
So, health literacy is certainly not a question of the Constitution and free speech, I believe in the Constitution, believe in free speech. The difference is, when we talk about misinformation, there's also disinformation, right, which is when you are purposely trying to manipulate others by algorithms, for example, by pretending or presenting yourself as a physician or a health care professional when you are, in fact, John Doe, or Jane Doe. So, I think it's important that it's not a question of free speech, but it's more how do we educate the consumer, to know where to go for health information? What is fact, versus what is rumor? And that I think, is the fundamental key and so much of what we saw during COVID-19.
And here's the thing, consumers are thirsty for that information they want it. Nobody wakes up and says, “Well, I'm gonna go on Google, because I want to be the fool today.” Right? They're going on different websites, different social media sites to get information because we've made access to health care so difficult.
Traynham
And I think that's important, Dr. G, just interject, their intent is “I want to get better. I'm trying to seek an answer to my problem.” I think your point is, but the answer needs to be sound and factually accurate.
Nayyar
That's right. And when we think about what we're doing here at AHIP, when we think about value-based care, when we think about decreasing the cost in the system, and elevating the value and the quality, it is so critical that we have educated and empowered consumers. That's where we fall off of everything.
Because when a consumer, when a patient, comes in and has read something, has a question about something, wants to know the answer to a side effect, or a dosing, a dosing question, those patients do better. They do better, because they're engaged, they come in, they want to have an intelligent, informed conversation with their physician. And I want that as a physician.
So, we as an industry, as health care leaders have to make that easier, whether it's part of your digital transformation strategy, whether it's harnessing the good in social media, giving your physicians in your organization, a voice. I know we have one Surgeon General; I say we have a Surgeon General in every zip code. Why are we not deploying all of our physicians, because health care remains local. And making it easy and accessible and scaling communication in a way that draws patients into the hospital when they're needed, or into the clinic, when that's the place, or in the comfort of their own home with telemedicine.
But how do you educate the consumer, make access easier, and build that trust because ultimately, this is about trust. People go to the wrong social media site or follow sort of the wrong leader because they're so thirsty for the access. And why don't we make that access more achievable and relatable with our health care leadership?
Traynham
Speaking of education, leadership, and access, you have a book coming out in a couple of, very soon, it's called "Dead Wrong." Tell us more about it.
Nayyar
Sure. So, you know, "Dead Wrong" really is what inspired me during COVID. It's not a COVID book. But I was really struck by the fact that so much of the mortality and morbidity we were seeing during COVID was because people were misinformed or disinformed.
And you mentioned AIDS earlier. You know, I trained in D.C. I trained at George Washington during some of the highlights of the HIV epidemic. And I saw so many parallels to HIV/AIDS that I saw with COVID-19. In other words, this is a universal chronic issue in health care. And so how do we take that call to action? And I really lay it out in "Dead Wrong" and lay out the issue, the landscape, the strategies you need to implore as a health care leader wherever you are in that ecosystem payer, provider, retailer, CEO, CFO – it doesn't matter.
It all goes back to building trust with your consumer and your patient and how do you become the source of truth so that they do know who to go to, and they can have better health outcomes and prevention. So much of being educated and informed leads to prevention, and all the things we talk about with value-based care.
Traynham
I believe firmly that building trust, you also have to have a relationship. And in that relationship, you have to over communicate. It's a job, you have to work at this. Assuming that I'm right, Dr. G., how do you do that, from your perspective? How do you develop that level of trust and that level of authenticity, that relationship where I can say, “I'm struggling with this, Dr. G, what do you think?” Or, “Dr. G, I actually think you might not be informed on this, here are my points of view.” In other words, there is this level of trust back and forth. How do you establish that from your perspective?
Nayyar
You know, I think we do it every day in health care, but we're doing it in pockets. Right. Mary J. Blige actually came out when she had her breast cancer diagnosis and, and said, “I didn't know about mammograms. I had no idea what a mammogram was.” Why is that? Why is it that we couldn't reach Mary J. Blige, who has resources and intelligent people all around her.
We have to start not having these conversation in pockets and instead scaling them. Figuring out, number one: how do you scale the message, whether it's your texting strategy, your EHR strategy, your AI strategy, your telemedicine strategies, there are ways to reach the consumer where they're at and scale the conversations that are happening in pockets.
And then there are ways to partner in our communities to reach the underserved, the black and brown communities that we know are most affected by mis- and disinformation.
And there is a way to partner. You know, one of the things I saw during COVID was Matthew McConaughey did a LinkedIn live – sorry – an Instagram Live with Dr. Fauci. And I loved seeing a celebrity who did not try to be the expert, but instead partnered with an expert to say, “Hey, I don't know about this virus, and I don't understand how to prevent it. And do I really need a mask? That feels wrong to me,” and having that conversation in a non-health-care environment, but in a way that was reachable, accessible, and palatable in simple language. And so, it's really a question of how do we scale and make it part of every part of our strategy? Again, wherever we sit as health care leaders, it has to be on your digital transformation strategy. It has to be on your patient acquisition and retention strategy. And it has to be how you build brand loyalty.
Traynham
Health insurance providers, they clearly play a unique role here in many ways, in terms of the connective tissue, in terms of perhaps maybe being the foundation of a relationship. How else can they/we step up?
Nayyar
That's a great question. So, look, ultimately the consumer, the patient, still trusts their physician, right? It's not unconditional. It's not a universal trust. But the one person survey after survey has shown us is that patients and consumers trust their physician. So, insurance companies need to partner with their physicians, they've got to find a way to make prior authorizations easier, they've got to find a way to practice that makes it easier. They've got to find a way to help providers and patients communicate and get good information out there.
Combat misinformation, and disinformation, whether it's social media, whether it's AI, whether it's part of the EHR strategy, or patient engagement strategies. Insurance players can play that really, really amazing role in that connective tissue to come out as the partner to the physician that is part of their network, and really empower and make that relationship, one that makes the patient want to come back and stick with their insurance provider and say they were there for me when I most needed them.
Traynham
I love this conversation. And for the folks that are on their smart device or watching this at home, they're probably thinking, “This is great. I love this conversation. But I'm not sure what the next step is for me as a consumer,” and/or the next step for maybe the physician out there. So that's a two-part question for the consumer. They're probably thinking, “Okay, what do I do next? Do I have this conversation with my doctor?”
What would you say?
Nayyar
I would say absolutely have a conversation with your doctor in person or virtually, you know, one of the things I tell my patients all the time is when they do have a set of questions, or Google has informed them before I've had a chance, I tell them the sites that I think they should go to: the Lupus Foundation, the Arthritis Foundation. So, your doctor will be more than happy to say, “Hey, here are some great places to read. And, by all means, come back with your questions.”
And when you leave the examining room, also pressing the folks in your organization to say, “How do patients get in touch with me easily?” So, when they have the question, we can extend that conversation beyond just the four walls of the clinic.
And, where and when possible, to have that amplification of your message. Whether it's a blog, a social media post – that’s critical.
I also think there's a space here for pharma and med device. If we think about how doctors get informed, so much of the research is done by pharma companies and, and med device companies. Now, no one's ever going to trust their farmer or med device company. But how do you empower your KOLs if you are a pharma or med device company to take the actual, factual information but make it attainable and reachable to the consumers. There are many ways to start, but definitely starting with your own physician is one, and two, I would say, “Buy the book! Buy the book.” Read about it, pass it on, I'm open to feedback. And look, this will be the issue of our generation, particularly as we think about AI and where that's gonna play.
Traynham
Let's talk about that next. So there's some good, bad and the ugly with AI. Right, I think we kind of know that intuitively. What are some guardrails that you would like to see in place? For the folks out there that are thinking about the algorithm feed? When it comes to privacy, when it comes to data controls? There's a really, really big conversation going on, Dr. G, as you know, is that “Whose data is it? Is my personal data, my data? And do software companies have the right to sell it? Or, is it quite frankly, not my data? It's really these little pieces that perhaps the software companies really own?” And I don't know the answer to that. But I think that's part of the conversation.
Nayyar
For sure. So, look, first of all, I am incredibly excited by artificial intelligence. If we think of the opportunities available to us in this next generation of health care, it's outstanding to think about the things we can do. But we want to start with the low-hanging fruit and the problems of today.
And the problems of today lead back to the physician shortage, the nursing shortage, burnout, pajama time. Right now, we have doctors and nurses that are burned out, because half the time is spent on paperwork and documentation. So how can AI alleviate that, right? That's low-hanging fruit. If we can immediately hit that issue, we have made a huge dent in the number one issue every CEO is dealing with.
Number two, how do you think about augmenting and complementing clinical decision support, diagnostics, and therapeutics? Not to replace the physician, not to replace the nurse, but to augment and complement. The example I often give is a self-driving car, right?
Sounds really cool would be really nice to be drove around by a robot, or maybe not, it still feels better if there was someone in that front seat, particularly if my daughter's in the car, right? So, we have to think about medicine the same way. It is ultimately life and death. Great idea to complement and have those safety regulations and features, but ultimately, we still need the human factor in health care. And I think we always will.
No one is coming and booking an appointment to see the coolest or latest robot. They're still coming to see the doctor, and they want to know the doctor has the best tools available to them and that those tools are being used with their own data, privacy, and HIPAA in mind.
Traynham
We talked about what wakes you up in the morning, your daughter, I'm curious to know what keeps you up at night, when it comes to AI, when it comes to privacy? Is there anything that you're like, “You know what? This worries me. This is something that I really think we're not having a conversation about,” and all the reasons why we should read "Dead Wrong." But is there something that you would like to impart with our audience about what keeps you up?
Nayyar
I think it's important to realize that we're still learning, right? So, we have this really powerful tool that we didn't have before, and we need to take the time to understand it. We have to be careful when we think about words like hallucinations, just the idea of hallucination. It's like a dream, right? And you believe it to be real, when in fact, it's not. So imagine me seeing a physician and seeing something served up to me by an AI tool that I believe to be real and factual. And I make a clinical decision based on that. I can kill someone, right? So being really mindful of understanding the tools available to us no different than a stethoscope an MRI or a CT scan. We always take all these data points and tools. But ultimately, we are the builders and we make the final call with our patients when we're making a life and death choice.
Traynham
The next big thing in health is, according to Dr. G.?
Nayyar
It is absolutely going to all lead back to AI. Whether we're talking about misinformation, disinformation, diagnostics, therapeutics, I think there's ample opportunity to alleviate the physician workforce and burnout issue with AI but we just have to be mindful of the problems we're solving. And that we go about it in a crawl-walk-run approach.
Traynham
So, to that point, I'm going to run, not walk, to pick up the next copy of "Dead Wrong" and that's going to be available this fall. And it's going to be available in bookstores, on other devices as well.
Nayyar
You got it, everywhere you can find it. October 17 is the drop date.
Traynham
All right. And the title once again is called "Dead Wrong."
Nayyar
You got it.
Traynham
Dr. G, thank you very much for joining us really appreciate it.
Nayyar
Thanks for having me, Robert.
