How Health Leaders can Empower Physicians and Increase Work Satisfaction without Experiencing Burnout with Stephanie Hartselle, Founder and Owner of Hartselle and Associates

: [00:00:01] Welcome to the outcomes rocket podcast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez

Saul Marquez: [00:00:19] Rocket listeners welcome back once again to the outcomes Rocket really appreciate you tuning in.

Saul Marquez: [00:00:24] This is where we chat with today's most inspiring and successful healthcare leaders. And you're tuning into yet another awesome show. If you like what you're hearing in the previous episodes or what you're about to hear now with my awesome guest go to outcomes rocket.com/reviews where you could go and then I'll send you straight to our Apple podcasts reviews where you could subscribe. Leave a rating leave a review. This is how we grow the show. This is how we get feedback to make it better so that it serves you the listener. So without further ado. I want to welcome our guests. Her name is Dr. Stephanie Hartselle.

Saul Marquez: [00:00:59] She is the owner and founder of Hartselle and associates as well as a clinical assistant professor of psychiatry at Brown University. Dr. Hartselle welcome to the show.

Stephanie Hartselle: [00:01:11] Thank you for having me.

Saul Marquez: [00:01:13] Absolutely. And so one of the things that I really wanted to do Dr. Hartzel is dive into this topic of health as well as sort of mental health as being part of it because a lot of times it gets left out of the equation or separated. Exactly yeah. And it's just like this different thing but yet it's part of the whole and so you I want to dive into that in today's show but I wanted to ask you first and foremost what got you into medicine.

Stephanie Hartselle: [00:01:40] That's a great question. I wanted to be a doctor ever since I was little and throughout school I actually just kind of messed around wasn't very serious and was always sort of those that are writing and speaking. And I was at math science and I never knew a doctors and so I figured being a doctor was completely out and so wonder my way through high school, wonder my way through college really graduated poorly and was working as an orderly and emergency departments and I love that even though it was you know just really scrappy work but I still love that and all of a sudden realize oh no I want to I want to be a doctor and then have to go back and so I was working nights and then it actually and for a while taking medical classes that took me about four years and that actually got to do it in university.

Stephanie Hartselle: [00:02:29] So I was thrilled. I actually thought I wanted to be an emergency doctor. That's why I knew then I figured out that what I loved about emergency was both psych and the trauma and I didn't want to be a trauma surgeon. And everyone said I'll talk to psychiatry and so I went ahead and become a psychiatrist.

Saul Marquez: [00:02:46] That's amazing. And it's so cool that you had this thought that you wanted to do it kind of hold the away and then all of a sudden here you are in the E.R. and it's just calling you and calling you and you just had to answer.

Stephanie Hartselle: [00:02:57] It did. It was it was funny because I gotten home from night shift and called my parents at 7:00 in the morning and said I'm going to go to medical school.

Stephanie Hartselle: [00:03:04] And you know my parents agreed that they had them right there. I said OK sure. Four years later you know that change is funny.

Saul Marquez: [00:03:15] And Dr. Odzala it's one of those things where it's like sometimes we don't choose medicine it chooses us right.

Stephanie Hartselle: [00:03:22] I think it's also a great way for me to connect with some of my patients. I'm anxious.

Stephanie Hartselle: [00:03:27] It is and our goal is to make this as any kind of piano or anything else. I've made our way through and I.

Stephanie Hartselle: [00:03:35] Well actually yeah you know I had a really difficult to do anything backtrack and work hard for it you get there.

Saul Marquez: [00:03:47] That's pretty awesome. Yeah. What would you say Doctor Hartselle is a hot topic that should be every medical leaders agenda today. And what are you guys at your practice focused on in approaching.

Stephanie Hartselle: [00:03:59] So I definitely think it's positioned right now. That is something that's all over. I think the general news is all over the medical news. We have an incredibly high suicide rate and physicians mostly because we don't miss almost everything she knows. Yes. Yes quotes But I think the most effective way to die.

Stephanie Hartselle: [00:04:19] And I think they're a combination of factors that are going on but I think that the fact that these issues are dying and they're doing it by their own hand is something that needs attention. And I think it has so much to do with psychiatric health, mental health and physical wellness.

Saul Marquez: [00:04:34] So what do you think is a good way to deal with it. Yeah.

Stephanie Hartselle: [00:04:39] Good question. So there's a combination of factors going on medical screening.

Stephanie Hartselle: [00:04:45] So you know it's four years of college if you do it once or twice then you do it once it's four years of college four years of medical school at least three years of residency although most of us I did five most people do between five and after I have people from 11 years.

Stephanie Hartselle: [00:05:02] And they get out and suddenly they're in these situations where they aren't in charge of patient care. And I think that can be really devastating. And so the person in charge of patient care is a system that will charge of patient care has changed into this kind of big box medicine. Now hospitals are having a private practice those are becoming big conglomerations becoming corporations. And if I want a giant box of cereal that will last me three months. I want to go to a big box store if I want my child to be treated really well for something that's happened to him. I want to go to physicians not burn them out and who's not being ruled and dictated by. I think that this is and it's medicine and I think that

Stephanie Hartselle: [00:05:39] As I think that's the real bait and switch for a lot of medical graduates and people who are mid career those the people who are killing and some of the highest rates.

Saul Marquez: [00:05:47] Now that's really interesting. And so you get through medical school you get through residency which could be very long and then you start practice and you realize oh my gosh I am not in control right.

Stephanie Hartselle: [00:06:00] I'm not in control and I'm not able to actually do what I want to do which was treat patients well and actual care for them in a way that I think is useful to us.

Stephanie Hartselle: [00:06:09] Instead you're often in clinic you're mandated to see 46 patients or more an hour. So you're running from the room.

Stephanie Hartselle: [00:06:16] I don't know. This is more and more complex I wonder you are able to make any kind of sessions like during the 2000 - 4000 patients there or more. And there's just no way to treat human beings and their medical complexities. Well that way I think doctors become just hired and burned out. And it was worth it.

Saul Marquez: [00:06:36] Yeah it's definitely an issue. You know I mean you see it in their physician bloggers out there there's people just expressing their frustrations. And I do feel like there is this undertone of just I've had enough.

Stephanie Hartselle: [00:06:49] Yes very much very exasperated a lot of people retiring early. And so to answer your question about how to how do we fix it.

Stephanie Hartselle: [00:06:56] I think one really important ways to make room for potential leadership so is hospitals and the corporations to not just have a board of MBA.

Stephanie Hartselle: [00:07:06] We're running a hospital series. The solution at any time is up to the leader. Yes gonna be carved out. One of the reasons I have now practice your own practice is you know how to treat patients.

Stephanie Hartselle: [00:07:21] We're learning how to run the business end of things. You know that's a learning experience every single day. But I'd rather learn that than I have people who understand how to run business help me how to treat patients. And so I think that's one of the ways that we improve.

Stephanie Hartselle: [00:07:34] I think they always start early and that's for training physicians to have them care cells how to stand up for themselves and how to make sure they're not psycho and feel like they have an ounce lot are trapped.

Saul Marquez: [00:07:46] Now that's a really good point and I do agree and just having spoken to many physicians physician leaders to you know just like this is a hot topic. Yes.

Saul Marquez: [00:07:55] This is a really hot topic and.

Stephanie Hartselle: [00:07:57] Then it doesn't just affect doctors it affects it you know if you think about it's a tragedy to lose a human being suicide but one physician dying and he's lost.

Stephanie Hartselle: [00:08:06] Now that doctor for thousands of physicians and even a family of her or him that's the connection that's so important and they've lost it. So this impacts not just the physicians and that impacts all of our patients.

Saul Marquez: [00:08:23] It sure does. Yeah the domino effect is without a doubt very serious. Can you give an example to the listeners. Dr. Hartselle of of how you and your practice or any other things that you may be involved with have created some results by doing things differently.

Stephanie Hartselle: [00:08:40] Sure.

Stephanie Hartselle: [00:08:41] And I can even tell you about how I was stuck in a box and after graduation I took a job as a medical director of one of the pediatric sites are here. It's one of the highest volumes surprisingly there are children in psychiatric crisis. And it was just it was a set up and it's like a hall and many many psych yards where the system has suddenly began yearly a patient or has increased and so

Stephanie Hartselle: [00:09:07] Hospitals do try their best. They try to cobble together teams to handle this but it's therapists and couples together. And I think you know I was stuck in a position where I wanted to be a physician leader I wanted to change decision but they're outside the resources at the time.

Stephanie Hartselle: [00:09:23] And in some cases because it's mental health not the interest because mental health hurt certain areas of medicine so scary. And so I had to leave that area and open my own practice.

Stephanie Hartselle: [00:09:33] And there were two things that had stuck with me and are in residency you know one was or thought that I would be able to care for patients in the way that I thought it could. And I learned later that that was not only possible in the system which it was working. The second was physicians come in and told us about how it was really important that after all these years of training as a psychic and just because there are so few of us in the country that we had a real charge to not only treat our individual nations but to also figure out a way to reach people across the country that after seven years of training and this much investment that we had to figure out a way to provide care to more people. So I think what you're doing with the show is really critical. So you are doing so well. Is it mandated that we do which is reach people everywhere and it's another thing that I've also tried to work on and so in addition to the private practice where I can or kind of rich people one to one I'm hoping to be able to bring videos about how to do some software for physicians and patients and be able to reach more people that way because there just aren't enough of us and be able to figure out a way to reach more people.

Saul Marquez: [00:10:35] That's outstanding and kudos to you Dr. Hartselle for saying you know what I want to make a bigger impact and I'm going to find a way to multiply myself and give these people that are looking for solutions for answers those answers and solutions.

Stephanie Hartselle: [00:10:51] I'm hoping so.

Stephanie Hartselle: [00:10:52] I really am because it's hard anyway to get in with a doctor regardless of where you are in the country to get in with a psychiatrist or child psychiatrist. It's almost impossible.

Stephanie Hartselle: [00:11:02] And I want to make that mark.

Saul Marquez: [00:11:05] That's amazing. And so I really admire you for making that effort outside of all the things that you already have going on to say you know what I want to do something because this is my calling. Without a doubt it is your calling and I'm excited to see what you put out there.

Stephanie Hartselle: [00:11:20] Thank you.

Stephanie Hartselle: [00:11:20] I'm hoping it will be great. Really I'm working on both. First of all how to get physicians can and maybe step away from the larger big box medicine and produce their own practice that's driven by themselves and think those practices like Pamela Weible as someone who is a real leader in this area I don't know her personally. I have exchanged e-mails with her but she talks about general medicine and how to scape a general physician and open up your own practice for very little money and be able to treat patients the way you want to. I think she's another wonderful physician into but I think that it's really important and then secondly some of the videos and I'd like to share on sleep insomnia I think that affects so many people and so for patients to be able to work on their own sleep and work on our own anxieties.

Stephanie Hartselle: [00:12:02] And that's where I'm aiming.

Saul Marquez: [00:12:04] We'll see how plastic. This is a truly exciting and it's so interesting because we went from an environment where physicians did you know they got out of medicine they hung their shingle and they practiced medicine and made to care of their patients.

Stephanie Hartselle: [00:12:18] Stayed at home visits which I get to do. But yeah we're traditional old old world authors.

Saul Marquez: [00:12:24] And there's no reason why if that's what you want to do you can't.

Stephanie Hartselle: [00:12:27] It's true. I think we're very indoctrinated funny word.

Stephanie Hartselle: [00:12:31] But yeah we have these huge hospital systems and I think you know in certain industries first orthopedic cases that you have to have an OR you have large systems.

Stephanie Hartselle: [00:12:43] But I think the general medicine is I think the NBN is fordable for patients and that helps you live a life worthwhile and helps your patients live better that that's absolutely rewarding thing that have seen the last few years was watching people get better and actually be able to not have to do therapy.

Stephanie Hartselle: [00:13:08] Right.

Saul Marquez: [00:13:09] Now that's really interesting and I agree. And if you're a physician listening to this interview and you're just thinking to yourself wow she's so right. Why don't you think a little bit more about what you want to do and collaborate. Definitely the people that come on the show like Dr. Hartselle are looking to collaborate with other like minded individuals. You were dealing with big issues here and the more common minded people that we can get together to deal with them the better wouldn't you agree. Dr Hartselle

Stephanie Hartselle: [00:13:37] I absolutely agree and I'm happy to talk to anybody who has great ideas about this because I think it's so important.

Saul Marquez: [00:13:43] Absolutely so. You shared with us some some really cool things. Now let's take a look at the other side of the coin here. Can you share a time with the listeners when you've had a setback and something that you learned from that setback.

Stephanie Hartselle: [00:13:55] Sure. So when I came straight out and was I just graduated from residency and was hired as the medical director I think I came into that system kind of guns blazing and had been trained for adult reasons yet all the hospital for those who are not in New York and I grew up in California didn't know what the hospital was and a lot of people who are older do. But it's one of the biggest psychiatric hospitals in the country is the oldest psychiatric hospital in the country and has hundreds of psychiatric beds and basically treats I think the most ill patients in the country if not the world. So it's why I chose to train. It's self-selecting.

Stephanie Hartselle: [00:14:28] I love that place still and it is a place where you kind of have to fight to get what you need. And I came I think into the bound system. So with that attitude. And I think that coming into a medical director position it is still middle management and I think I came into meetings and systems and blazing.

Stephanie Hartselle: [00:14:48] Why can't we change this. What's going on. I think now I would have tried to work with us live a little more even though it would have really been frustrating for me. So slowly but I think I could have made better change had them or patients in the system. And so if I continued in that position or if I may some day consults in that position again I think I'll be watching carefully and see how I approach the system and being more empathetic and listening more.

Stephanie Hartselle: [00:15:13] I think talking less I think I really came out knowing what I wanted to do and not were to anybody else I think that's a that's a real problem.

Saul Marquez: [00:15:21] They learn that that is really interesting you know because across the country I mean it's not one size fits all right. Every system is going to be different. So what advice would you give to somebody leaving one system and going to another on how to make big impact and get what they need.

Stephanie Hartselle: [00:15:40] I think for the first year that you leave the system then you go into another system.

Stephanie Hartselle: [00:15:44] I think the first year and head down and listen.

Stephanie Hartselle: [00:15:48] And also picture put your oxygen mask on yourself first. That's always a message to everyone is can't help anybody else.

Stephanie Hartselle: [00:15:55] You are burned out tired to let yourself down listen and just go with the flow for the first year and then start.

Stephanie Hartselle: [00:16:03] And certainly make a connection you see are moving in middle and then start to have the conversations and listen more than your like you. Now this is the. First. Time yourself when you figure out how to survive. This is something unsearchable.

Saul Marquez: [00:16:20] I love it that listeners put your oxygen mask on first because if your tank is empty there's no way you're going to be able to give. There's just no way you can't.

Stephanie Hartselle: [00:16:29] It's the last thing that goes with most people is work. And for physicians especially if less so everything else their lives will fall apart.

Stephanie Hartselle: [00:16:35] Families, their health the work will go last. So notice that because they will stop caring about what's going on a little more Brosnan's more every day.

Saul Marquez: [00:16:44] Yeah that's such a great message. Really great message. And so what would you say. Dr. Herd sell is one of your proudest medical leadership experiences to date.

Stephanie Hartselle: [00:16:54] So in June I was awarded the Dean's excellency award for teaching and that of us.

Saul Marquez: [00:17:00] And congratulations.

Stephanie Hartselle: [00:17:02] That was amazing just because it's an amazing award to get.

Stephanie Hartselle: [00:17:04] But also my mother was a teacher and I remember watching her in the classroom and thinking Oh my goodness she works hard.

Stephanie Hartselle: [00:17:12] I'm not doing our job. It's hard. I'm becoming a Doctor. I'm not kidding about that I really.

Stephanie Hartselle: [00:17:17] To this day I watched teachers and I have two patients and I work so hard and in residency I had a wonderful resident mentor her name is Grace Henessy from an MBA degree in Tennessee she made me lead a group from the SBA with a group of men.

Stephanie Hartselle: [00:17:36] It was incredibly squirrelly group and it was difficult. I remember trying to do it and coming to Dr. Henessy.

Stephanie Hartselle: [00:17:42] I felt like that went horribly ignorant. So the fact is the Brownstein had a word.

Stephanie Hartselle: [00:17:49] They were the ones who voted for has been in award with. Actually the proudest moment I've had in medical career

Stephanie Hartselle: [00:17:55] Besides getting getting into medical school, that was amazing. I was just I was just so proud of and so so happy about.

Saul Marquez: [00:18:02] Yeah you know and congratulations on that.

Saul Marquez: [00:18:04] And you know many of us in leadership positions in medicine oftentimes forget that hey we didn't get here alone we had teachers and we're standing on the shoulders of those that got us here. And so I think you bring up such a great point and thank a teacher today if you haven't thank your professor from 10 years ago or 20 years ago. If you're listening to this episode just send an e-mail to one of your previous teachers that made a difference today.

Stephanie Hartselle: [00:18:31] I so agree I think about the fact that I took some of my classes at the community college and then orders for my finance classes and two of the best teachers I had and professor and I are getting there and they were amazing and I had so many mentor for me. I read it.

Saul Marquez: [00:18:49] Yeah. And what happens is it takes you back and it puts your roots back down and it makes you understand what your DNA is. It does. yYu're here because of that. So thank them and Dr. Hartselle, thank you for that because I'm going to do it as well as soon as our interviews over.

Stephanie Hartselle: [00:19:05] I am, too. I am going to go right.

Stephanie Hartselle: [00:19:08] Dr. Ruth Emerson and tell him thank you again.

Saul Marquez: [00:19:14] I love it. I think that's great. So listeners. Be sure to do that as well. You know great things and really great outcomes can often start with gratitude. And so it's an awesome thing. Let's all do it. So Dr. Hartselle, tell us a little bit more about an exciting project or focus that you're working on today.

Stephanie Hartselle: [00:19:32] Sure.

Stephanie Hartselle: [00:19:33] I have a great friend now and Yuri Tomikawa who know me a few years ago and had said that she was putting together some Web sites out there. And of course I was there as well as some recommended.

Stephanie Hartselle: [00:19:47] And I said Hey I have a conversation. I realized what she was doing was. So needed because it was decided that it was all recommendations that it's. For

Stephanie Hartselle: [00:20:02] Psychiatrist. And she created the Zencare. So lucky to be a part of it. Now about her visor on it do it because I believe on it..

Stephanie Hartselle: [00:20:14] You see she interviews therapists she has this great job a head shots and videos of therapists

Stephanie Hartselle: [00:20:23] We interview couples the therapists and physicians and we make sure that we're creating a space for people to reliably find someone and make it so hard to reach out for help. And so I think it's a video of someone who has been vetted by several people and at least makes a certain level of excellence. And if anybody thinks that's most helpful thing therapy and then she has some amazing things. Every time I forget people I talk about it in different cities and good at it.

Stephanie Hartselle: [00:21:03] And everyone says well when is this coming to D.C. when they are Vermont or when's it coming in Chicago. Yeah.

Saul Marquez: [00:21:10] Doctor it's so I had the chance to meet with Yuri here on the show as well and it was just a wonderful person to speak with and has a strong vision that we said you know what you have the not that Uber put the lift of mental health does you really really does I think anything.

Stephanie Hartselle: [00:21:27] She has a concept like really the Stenzel areas in medicine and generally but you really this is such an important thing and her own personal during her honesty and that is why she likes this project they really think and are so proud of her. I'm so proud to be a part of that.

Saul Marquez: [00:21:45] That's pretty awesome. Yeah it's super exciting and for the listeners who haven't taken a listen to that podcast go to outcomesrocket.com/yuri that's y-u-r-i. I know you'll be able to hear our conversation with her and the cool things that Dr. heart cell and Yuri are working on through zencare. So, Dr. Hartselle, let's pretend that you and I are building a medical leadership course on what it takes to be successful in medicine today. It's the 101 course or the ABC of Dr. Stephanie Hartselle. We're going to build a syllabus here for questions lightning round. We're going to finish with a book that you recommend to the listeners you ready. I'm ready. All right. So what would you say the best way to improve healthcare outcomes is.

Stephanie Hartselle: [00:22:26] I think take care of your providers first for making sure that they know how to figure out what is the biggest mistake or pitfall to avoid.

Stephanie Hartselle: [00:22:35] I think branding medicine as glamorous medicine is not a cause in any kind of machine. We're not a treadmill. Make sure that you are not since you need any other kind of operation that has priority number one all the time for employees and also they also have

Saul Marquez: [00:22:58] A strong message. How do you stay relevant as an organization.

Saul Marquez: [00:23:01] Despite constant change.

Stephanie Hartselle: [00:23:03] I think you really do need to keep up with what's going on.

Stephanie Hartselle: [00:23:05] I think there's a certain amount of social media and news that well over in terms of putting your own oxygen mask on.

Stephanie Hartselle: [00:23:12] I think there's with that small steps you need to make sure you have your finger on the pulse.

Stephanie Hartselle: [00:23:16] But for things to take way that I think you in half an hour understand what the trends are right now.

Saul Marquez: [00:23:25] What is one area of focus that should drive all else in your organization.

Stephanie Hartselle: [00:23:30] Always always always patients first always.

Stephanie Hartselle: [00:23:33] That is of course the caveat that you are in yourself are healthy and it is making sure that whatever you are doing, have the patient in mind and that's the bottom line and things will fall into place.

Saul Marquez: [00:23:44] Love it. What book would you recommend to our listeners.

Saul Marquez: [00:23:47] Dr. Hartselle.

Stephanie Hartselle: [00:23:48] This year I read getting things done by David Allen and I really enjoyed it and really talked about prioritizing and I think it's a stand for everything else static.

Saul Marquez: [00:23:56] That's wonderful.

Saul Marquez: [00:23:56] And so to the listeners everything that we've talked about here all of the pearls of wisdom that Dr. Hartselle has shared the book her website the things that she's up to the show notes you could find those at outcomesrocket.com/hartselle.

Saul Marquez: [00:24:12] That's H A R T S E L L E.

Saul Marquez: [00:24:16] So don't worry about writing them down. You could just go ahead and check it out on line. So before we conclude Dr. Hartselle I like to just ask you to share one closing thought and then the best place for the listeners to get ahold of you.

Stephanie Hartselle: [00:24:28] Sure.

Stephanie Hartselle: [00:24:28] So I think my closing thought would be for medical providers so that anybody in medicine physicians or nurses anybody providing healthcare to others.

Stephanie Hartselle: [00:24:38] If you are burned out if you are struggling and feel like you have no work is.

Stephanie Hartselle: [00:24:44] More than anything else.

Stephanie Hartselle: [00:24:46] What we do as all the rules and there are places where if you are not going right and you have nowhere to go. My cell phone is on my Web site. I'm not kidding.

Stephanie Hartselle: [00:24:58] It's all on there all the time and it's with me all the time and we will try to figure something out. We've got nowhere else.

Saul Marquez: [00:25:08] Such a wonderful message Dr. Hartselle and the listeners just know you know you're definitely not alone and if you do find yourself in that place and you can't reach your oxygen mask. You just can't do it on your own. Go to outcomesrocket.com/hartselle and you'll find the best way to get ahold of Dr. Hartselle there if you need her answer. Doctor thank you so much for spending time today. It's been so much fun. And really looking forward to seeing the awesome things that you do with the videos.

Stephanie Hartselle: [00:25:39] I was really excited to be here.

Stephanie Hartselle: [00:25:40] I really appreciate you for having me.

Outro: [00:25:46] Thanks for listening to the outcomes rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com dot for the show notes, resources, inspiration, and so much more.

How to Transform Monitoring and Diagnostics with Voice-Based Technologies without Violating Privacy with Jim Harper, Co-founder and COO of Sonde Health

: [00:00:01] Welcome to the Outcomes Rocket cast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez

Saul Marquez: [00:00:19] Outcomes Rocket listeners, welcome back once again to the outcomes rocket podcast where we chat with today's most inspiring and successful healthcare leaders. If you like what you listen to today or you like what you listen to in general with the podcast, go to iTunes podcasts and give us a rating and a review and subscribe. We'd love to hear your feedback and always are looking for ways to do things better or keep doing things that you're enjoying on the show. So without further ado, I have an outstanding guest for you. His name is Jim Harper is the co-founder and chief operating officer at Sonde health. And so Jim has just a wealth of experience in this industry as an entrepreneur he's had an experience here at San health for the last almost three years but he's also been an entrepreneur in residence and also has a deep understanding of bioengineering systems. With his experience at MIT. So before I go into it any further I just want to give you a warm welcome Jim and open up the microphone to you.

Jim Harper: [00:01:22] Well thanks, Saul. And I think it's great to be a part of the conversation you've started on outcomes rocket and you know just a little bit of context for my background and why. As somebody has formally trained as a biochemist and with a long background in technology development that I'm so interested in health outcomes it's really started back with when I was studying neuroscience and looking at Alzheimer's disease and mechanisms. I realized that for me basic science and the big questions there had some limits and there were other big questions that I wanted to be able to answer. But we just couldn't we didn't have the information tools. So I've been really excited about both the drive to improve healthcare as well as the convergence of technologies that may help us do it. And so that's why I'm here.

Saul Marquez: [00:02:07] That's pretty awesome. And the meandering road of research and just biochemistry brought you here just to create a bridge to really fulfill that missing gap that you experienced.

Saul Marquez: [00:02:18] And Jim tell us a little bit about sonde health and what you guys do there.

Jim Harper: [00:02:22] Yeah so sonde health is a digital medicine company where we're developing voice based technology that has the potential to transform the way that mental and physical health is diagnosed and monitored. And I think our goal is really to be innovating at the intersection of voice interactive devices machine intelligence and AI systems and the overall healthcare system to enable what we call persistent health awareness. The technologies that are always sensitive and always secure. So we've been demonstrating that proprietary analytics that are running on devices that are already in almost every pocket and entering more homes every day have the potential to transform what are often imperceptible changes in the sound of our voice. So how we say something not what we are saying and transform those into objective and quantitative information about a range of important health states that affect the nervous muscular and respiratory systems and maybe even more.

Saul Marquez: [00:03:17] And so are you thinking like tonality things like that.

Jim Harper: [00:03:20] Yeah. So their speeches are a really interesting thing for a variety of reasons. One it's unique to humans and it's really the most complex thing we do it involves more active muscle groups operating at the same time than any other physical action that we do it involves large numbers of brain circuits kind of proportionally for actual areas of the brain to produce effective speech. And then it requires a healthy respiratory system to activate the source. And so what we're looking at are how changes in the physiology of those three major systems are reflected in acoustic changes. So back to your earlier point it can be changed in pitch slow changes in intensity changes in pacing of the speech and even more so. You know we can describe mathematically thousands of different low-level features that represent different aspects of those acoustics and only a subset of those are we seeing in our investigations very when the physiology of those systems change. And so finding those and appropriately weighting and combining those with the best analytical methods are we able to then get outputs from this voice analysis that correlate very well with existing best measures in health.

Saul Marquez: [00:04:37] That is super interesting and just to think that the technology necessary to do this is already in many of our pockets.

Jim Harper: [00:04:47] That's right. So you know I think the convergence that's happening we're all very aware and we've seen more of it every year. The computing power in our pockets exceeds what took us to the moon. And I think that just within the past year the explosion of voice services from Apple Amazon Samsung.

Jim Harper: [00:05:06] You know a range of people has shown that the underlying capability to analyze voice in real time exists at least with respect to analyzing the content of we say now we can argue about how you and what we're able to do with that so far. But I think the trajectory is universally seen as very positive and I think what we're trying to do is offer a new dimension of information beyond just the linguistic content that can help move these technologies from just menial assistance that automate things that we could already do to ourselves to provide more transformational capabilities that disrupt things like healthcare.

Saul Marquez: [00:05:43] This is interesting and Tommy. Jim what do you think around this topic should be you know just something that healthcare leaders should be focused on.

Jim Harper: [00:05:52] So being newer to healthcare right longtime and technology I've been talking to a lot of leaders in the space and going to a lot of places where they gather and I hear conversations about transitions from volume value-based care and moving from reactive to preventative patient management philosophies.

Jim Harper: [00:06:12] Yes but within that you know as I look at it with my system perspective what I see is a glaring lack of data on what is happening in our health day to day with a frequency that is sufficient to help us understand what does the transition from health to the disease look like and how can we measure it in a paradigm that isn't what we think of today as diagnostics. And so I think translating that into a different question is if we're going to seek better outcomes and in ways that are measurable what is it that's going to allow that measurement to be affordable and to understand how to quantify whether prevention is working.

Saul Marquez: [00:06:54] Yeah. And so the thing that comes to mind Jim is we've got these awesome technologies. How do we scale them? How do we make them available? What are your thoughts on that?

Jim Harper: [00:07:03] Yeah. And so for me right it started a number of years ago I was excited as everybody else thinking about the potential of wearables right to really address the gap in information and after wearing between 5 and 10 wearables at a time for a couple of years in a couple of conclusions and one is even for somebody as motivated as I am to understand the burden of operating what are otherwise simple devices is actually quite high and two the cost even if they are 100 dollars a person if you scale that to population scale health management it increases the cost of that at a time where it's really kind of addressing the unsustainable increase in the cost.

Jim Harper: [00:07:45] That is the driving motivation. So I just found those to be very inconsistent. And what I saw as the white space and I think pure tech you know when I joined them or was seeing the same opportunity. Is how do we eliminate the cost and the device burden and the user burden with collecting this information by enabling new analytical technologies on devices. People already know and so you look at the space and people have tried and I think successfully in some domains to utilize accelerometers or activity on the phone to get insights into behavior which is appropriate to behavioral health in some ways but to be really relevant we need what I think is the equivalent of the CBC or the blood panel you know how can we take single samples or small numbers of samples from people that don't require them to change their daily activities but derive a number of meaningful tests that give us the equivalent of a thermometer. Right. We don't have to have a true diagnostic but we need to understand better how to allocate scarce resources and costly resources to the patients that will actually benefit from that. And I think that's a sign the driving force behind why we make choices on the way to implement the technology. And I think the value propositions that we see most exciting emerging from it.

Saul Marquez: [00:09:01] Now the really interesting Jim and you bring up a good point right because I forget what the statistic is but the majority of healthcare is light comes from 5 percent of those in the system.

Saul Marquez: [00:09:11] And if you know if we could focus the devices on that small niche population that's causing most of the expense.

Saul Marquez: [00:09:20] Maybe that's where we start.

Jim Harper: [00:09:21] Now and I think you're right. So for things like wearables that I was talking about earlier where there is some cost into implementing the systems. That's absolutely right. There are best addressed to the sickest people in the system.

Jim Harper: [00:09:31] If what you're trying to do is not prevent healthcare transactions and not prevent costly care episodes which I think is implied by targeting those sickest individuals get us what we want to do is improve outcomes by helping people not to need that care in the first place or not to transition to disease. And I think the question is different and I think that's where the economy really changes and where passive technologies that essentially are free to implement derive their value from the utilization of the information and the services that they cue is Where I think I'm excited about the potential. It's a longer term potential to be sure. Yes, it's one where the time is now from a technology perspective. And I think that progressive leaders in healthcare who are really looking to create new models of care that are based on preventing disease are the kinds of partners that I think are ideal for this technology.

Saul Marquez: [00:10:26] It's really fascinating to hear a perspective on that Jim because yes, on the one hand, my approach with my suggestion was yes you know let's go to that population. Let's cross.

Saul Marquez: [00:10:36] But you're saying let's keep people out of the health care system let's keep them healthy through the use of technology.

Jim Harper: [00:10:42] Absolutely as a long term goal I think that's where we all want to be in terms of like the ultimate outcome is to prevent us from having to encounter the system and those costly ways.

Jim Harper: [00:10:51] Now in the road from here to there I think that there are several addressable places where we can begin that process and looking at kind of conditions that are traditionally difficult to diagnose that is heterogeneous in the kind of way that the disease manifests in individuals and have long lags between onset of disease and diagnosis.

Jim Harper: [00:11:14] Those are really interesting places to start using the technology that bridge kind of near term value propositions but also demonstrating the long-term potential of constant persistent health awareness to address needs. So a few examples. But I tend to think about. There are in neuroscience where a lot of the assessment and diagnosis today is heavily reliant on interactions in the clinical setting not just on diagnostic tests. So for Alzheimer's disease, Parkinson's disease, depression, those fall into this category. But it's stunning when you look at depression the diagnostic lag the time between the first episode of depression and when somebody actually engages the system in care is on average around four years. So when we talk about taking bergan out of the system and improving outcomes if we can do something to reduce that lag and reduce the number of episodes I think we're doing something very meaningful that's addressable a really good example right in Alzheimer's. Those kinds of numbers and diagnostic lag from first onset of cognitive impairment may be on the order of 1 to 1 and a half years in Parkinson's it's more like a year. It's a process of ruling out a lot of other things that take a lot of time and burden. If we have objective measures that can help winnow down and narrow those they don't have to be the diagnostics themselves to have significant value and improving outcomes.

Saul Marquez: [00:12:40] Really really interesting yeah it's a good distinction that you made there. Jim So would you give us an example of what you've done there at Sonde health to apply some of these ideas to do things differently and better outcomes.

Jim Harper: [00:12:54] Yeah so let's talk a little bit about the work we've done in depression so far. So if we look at screening for depression the United States Preventative Services Task Force last year put out two recommendations that suggest that all adults and adolescents in the United States be screened at least once a year for depression in recognition of the burden associated with untreated disease.

Jim Harper: [00:13:16] But if you look at the latest Ambulatory Care Survey the number of individuals who are actually being screened is around four point two percent. So we have you know a 96 percent addressable market there in terms of people who aren't being captured by the existing screen. There are a lot of reasons for that but we feel like and I love your conversations with other people about access to care because access to something like that screen is a big part of that. And one question we have is why does not screen in satisfying that necessarily have to be in the care event or the visit to the primary care physician. Why can't it be done in close coordination with it. So the 9 is the most common instrument that is used it's a 10 question questionnaire and you answer multiple choice depending on the severity of how you've experienced symptoms over the last couple of weeks. You some the score and then over a number of studies they validated threshold score of 10 or more. That indicates moderate to severe risk for depression. So in practice that's the most commonly used screen. What we've been doing is doing studies where we offer our research tool which is an app that's on iOS and Android phones asked people to provide basic voice samples so these can be as simple as repeating ah for five seconds or something like Potapov like a product which is called a diode kinetic pasque. We're just getting voice samples. We may ask them to read a sentence or just give us a prompt in speech.

Jim Harper: [00:14:47] Then we ask them to complete the pH Q9 which gives us the training reference and what we have seen is in thousands of subjects. Now to date who have completed this study with us that we can take as little as 10 seconds of speech and derive the vocal biomarkers create models that predict the pH Q9 score that agrees a high percentage of the time. So now instead of requiring people to recall their symptoms sometimes, that's imperfect or complete the questionnaire. Now we have something that's consistent with a quick voice sample. Yes. They even pass it right. So being able to listen and derive those features. Now I want to be really careful when I introduce that that's not what we're doing today. We're being very careful because we understand. Right. And I have the same concerns. There's a lot of privacy and security concerns around this kind of monitoring. And so it's really important to us that before we try to present that kind of technology that we ensure that it is capable of being always sensing always secure. And there's a number of things that have to happen there in terms of using the right kind of linkage and biometrics to say the individual speaking as somebody who's consented to that measure. So those are misused and also making sure that the accuracy has been validated rigorously scientifically so that any answers we provide are no.

Saul Marquez: [00:16:09] Jim that's really interesting. And then the other idea here is OK so we've got the power of this sensing technology the voice biomarkers maybe we even use the power of the pen and prescribe spot checking for this maybe a couple of times a week.

Jim Harper: [00:16:24] It's possible you know and I think what we envision great and I think really what's possible with the technology has provided that we address the privacy and security concerns adequately is a world where your Siri your Alecks your you know all of these voice interact and substance instead of waking up to a keyword they could actually wake up to a health condition like the onset of depression or the onset of Alzheimer's disease. And cue you encourage you to interact with the healthcare system in appropriate ways so we don't see that as in any way replacing the doctor. But the goal for us and I think a really interesting question as we try to drive better outcomes is how do we change the equation from requiring that patients know when and how to seek care and make it possible for care to effectively seek those patients.

Saul Marquez: [00:17:18] So let me ask you, Jim. Who are you looking to interact with? I mean you've got a big project on your hands. Who are you looking to interact with to make this happen? Because it sounds like a really great idea.

Jim Harper: [00:17:30] So I think around depression screening for example if we are working and having conversations with integrated delivery systems that are trying to integrate behavioral health into primary care in meaningful ways. And I think implementing this kind of system at the beginning first through the pH Q9 but ultimately with an eye toward augmenting and then replacing when validated with the voice system we learn together about how to provide access to patients in meaningful ways to screening. And for us too there's an added kind of motivation that the information and the screening by itself is not necessarily the whole story but it creates the opportunity for new timely feedback loops in care. I think all of us have experienced you know you go you get a prescription you go home. But the follow up and the feedback is often difficult and challenging the system and here there's an opportunity if somebody screens with mild risk of depression cognitive behavioral therapies other things that can increase access to appropriate care and be delivered on the same platform now become really interesting and meaningful opportunities to explore with partners who are trying to improve persistence.

Saul Marquez: [00:18:43] Interesting yes. So to the listeners if you're looking for a new way or are just another partner to help in your efforts in this area. By all means, consider Jim and his team at sonde health to create that part of the reason we created outcomes rocket is to help break down those silos and give you access to people thinking about ways to improve healthcare and improve the collaboration that that happens within this space. Jim thanks for sharing that. Sure. So tell us about an exciting project or focus that you're working on today now.

Jim Harper: [00:19:17] So I think one of the exciting things we are doing is what I was describing it is really moving beyond the cued kind of samples that we're talking about and building in the features necessary to listen.

Jim Harper: [00:19:32] On health we like to say your health speaks and who want to listen. And so the other projects that are exciting are partnerships with healthcare organizations that have a large number of people with a range of diverse conditions and to be able to discover together new vocal biomarkers so who we are working both with pharma companies as well as academic researchers looked at local biomarkers and a range of other conditions.

Jim Harper: [00:20:02] So I mentioned Alzheimer's and Parkinson's disease not by accident or efforts that are beginning there.

Jim Harper: [00:20:09] And I think we the exciting thing to me about this vocal source is that we want people to bring us their problem I think there's a lot of ways for creative data analysis to happen and the burden of implementing the system is so low that there are great opportunities.

Saul Marquez: [00:20:25] I'm just curious and thank you for sharing that Jim about vocal biomarkers. I mean how do you determine that in a nutshell. Like for somebody, it doesn't know the power of that. Maybe you can give us like the 101 here.

Jim Harper: [00:20:37] Yeah. So I do that or use biomarkers intentionally by analogy to what we traditionally look at as follicular biomarkers that we will analyze in blood or saliva or genetic biomarkers of disease risk.

Jim Harper: [00:20:51] I think in very similar ways we are seeing these subtle changes in the voice that we can measure quantitatively objectively have a similar predictive value in terms of the presence of a condition and or potential progression of the disease. So we perform and we look at the science in doing studies in the same way we look at large numbers of population individuals with and without a condition to correlate these specific acoustic features to the presence of that condition. So each one of these low-level features then become independent biomarkers that we can combine to achieve different predictive outputs.

Saul Marquez: [00:21:31] That's fascinating and kudos to you guys for just being able to decipher those specific markers that are indicators of disease or depression. I'm really intrigued by it. I think I'll definitely be taking a deeper dive into the understanding of this area and I encourage anybody else listening to this podcast to start thinking about the feasibility of taking the voice recognition as part of the healthcare put in your health care tool just because it's definitely something that is starting to become more commonplace. Jim, we're at the part of the show where we do the lightning round so it's a medical leadership course we're going to build the syllabus it's the 101 course or the ABC. On health care with Jim Harper and so I like to write out the syllabus with you four questions and then we'll follow up with a book that you recommend to the listeners. Sure. All right. What is the best way to improve healthcare outcomes?

Jim Harper: [00:22:27] I think one of the best ways to improve healthcare outcomes is to understand how health is changing with better information from the patient side not just from the by-products of care.

Saul Marquez: [00:22:38] What is the biggest mistake or pitfall to avoid.

Jim Harper: [00:22:40] I think the biggest pitfall to avoid and this is on my side as well as the healthcare side is believing that technology in itself is the solution to the problem. We need to be improving the relationships between individuals and the providers and the way to navigate the system.

Jim Harper: [00:22:57] And I think that voices is a great way to do it.

Saul Marquez: [00:23:02] How do you stay relevant as an organisation.

Saul Marquez: [00:23:04] Despite constant change.

Jim Harper: [00:23:06] I think that you stay relevant by trying to as Wayne Gretzky said skate to where the puck is going to be not where it has been so far but you try to anticipate the change in what consumers are learning to use and demand from other industries and how that may impact the healthcare industry.

Saul Marquez: [00:23:26] What is the one area of focus that should drive all else in the organization.

Jim Harper: [00:23:31] I think that the area of focus needs to drive us is improving the experience for the patients ultimately.

Saul Marquez: [00:23:39] And finally what book would you recommend to our listeners to read.

Jim Harper: [00:23:42] Yeah so in a funny way I am I'm a huge science fiction fan and although it doesn't seem like an obvious choice I think Ender's Game is a very interesting read and partly for me.

Saul Marquez: [00:23:56] I've seen the movie.

Jim Harper: [00:23:57] Yeah so I think the movie is good but one of the things that the movie doesn't emphasize is the role of ai Ender's Game has kind of a great character and relationship between ai and the main protagonist that's mediated by a device in New York called the jewel which is very much like a future version and that's why it's all of our intelligent voice assistance wannabe. And I think that in that dynamic we'll learn a lot about how seamlessly technology can integrate into the device and the more you reduce the friction to access information the more meaningful it is. So for me a lot of the takeaways and what I want my technology.

Jim Harper: [00:24:40] And what I think all to look like is that ever-present good in a true sense kind of advocate in your ear. So hopefully that's inspiring to some.

Saul Marquez: [00:24:49] Now I love that Ender's Game and so outcomes rocket listeners take note of these things. And the beauty of it is you don't have to take note.

Saul Marquez: [00:24:57] Go to outcomesrocket.com/jimharper.That's jimharper and you'll be able to see all of the show notes with the just links to the book that Jim recommended as well as links to his company and all the things that they've done. Check it out. Don't worry about taking note if you're driving running. That's the beauty of the podcast and the notes so be sure to check that out at outcomesrocket.com/jimharper. Jim, before we conclude I just want to ask you to share a closing thought and then the best way that the listeners can get a hold of you.

Jim Harper: [00:25:32] Yeah. So who a closing thought. I think that the hardest things to do are often the most worthwhile so as difficult as it is to change and improve outcomes I think it's something we all want to do.

Jim Harper: [00:25:43] And if you want to talk to me about ways to do that you can always email me at jim@sondehealth.com

Saul Marquez: [00:25:51] Outstanding. Jim thank you so much. Looking forward to staying in touch with you.

Jim Harper: [00:25:54] I appreciate it.

Jim Harper: [00:25:55] Thank you very much.

: [00:26:00] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

How Second Opinions can Improve Care without Increasing Costs with Michael Yuz, CEO & Founder @ SecondOpinions.com / USARAD Holdings Inc

: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez

Saul Marquez: [00:00:18] Welcome rocket listeners welcome back once again to the Outcomes Rocket podcast where we chat with today's most successful and inspiring healthcare leaders. Do you love what you heard today or in general. I always ask. Go to iTunes subscribe and leave us a rating and review. We'd love to hear our listeners feedback. That's how we create content that's relevant to you and that's how we make sure that we're always putting the things that resonate with you to help you improve outcomes and decrease efficiency. So without further ado, I want to welcome our outstanding guest today. His name is Dr. Michael Yuz. He is the founder and CEO of USA RAD Holdings Incorporated as well as second opinions.com. Dr. Yuz has been in the business for quite some time. Traditionally trained as a radiologist he got into the entrepreneurial space and hasn't looked back and has been providing services to help healthcare providers deliver the best care possible. So really we want to welcome you Mike to the show.

Michael Yuz: [00:01:23] Thank you. Saul, I'm very honored to be on your show.

Saul Marquez: [00:01:26] Absolutely. So what is it that got you into the medical sector, to begin with, Mike.

Michael Yuz: [00:01:30] Well actually first I was an entrepreneur. I was on my first business venture.

Michael Yuz: [00:01:36] At age 14 and I never said I never wanted to get first to be a physician. My parents are not physicians. I don't have any ancestors or relatives or physicians. And I was very much into internet and computers. As a teenager, I started my venture in teenage years and I thought I wasn't going to be and you know we made in the technology business space but I actually match radiologist when I was 17 18 years old. I was accepted into my bachelor's and master's degree master's program for computer engineering. And I met a radiologist and she changed my mind. And the reason just remind me is I saw the student analogy was that we utilized back in the late 80s I was sleeping the hard copies and make something out of my head, I said look, this is going to be it will be a real illusion. Everything dies. And I told you know when I actually it's time when I met my current wife and we've been together for about 25 years. And she still reminds me every chance she gets. I told her look, I'm going to be sitting on the beach one day reading radiologist studies. I told them I was 18 and that was probably one of them a turning point why I wanted to go into a healthcare. And it was back then I knew I'm going to be a radiologist and also I'm you will be I'm going to be running some kind of a telehealthcare or telemedicine business so that's what had happened.

Saul Marquez: [00:03:11] Man that's super interesting Mike and what I love about your story highlights the power of a conversation. The power of that conversation. Your conversation with this gentleman that sort of tipped the scales and got you to focus on radiology for several years of your life. You know the power of a conversation when we talk to our customers or we talk to our patients. The power of a conversation is oftentimes underrated and that's where big movements for big things start including improving outcomes and so loved your story. Mike and I'm really glad that you shared it because it really highlights that important fact.

Michael Yuz: [00:03:46] Thank you, Saul. Yeah sometimes power for you. Few words that could be incredibly strong and can change the opinion of not just one person. Like in my case you could change the opinions of millions or even billions of people.

Saul Marquez: [00:04:01] Totally totally. So, Mike, you've been in the business and you've been on the provider side as well as the business side of health care for quite some time. What do you think a hot topic that should be on every medical leader's agenda today and how are you guys addressing it at USA rad and your other business.

Michael Yuz: [00:04:18] I think it's all about improving quality affordable healthcare and lowering costs and took power away.

Michael Yuz: [00:04:26] You can do this. You can do is more power to you. I mean there are many ways to skin a cat but that's really the big topic nowadays.

Saul Marquez: [00:04:34] Yes. So give us an example Mike how have you guys done that let's just say for instance at secondopinions.com

Michael Yuz: [00:04:47] Right so we can we sort of Holdings consists of two divisions.I started the division in 2008 and I am of the second opinion as telemedicine division. Just about four years ago and the way we do is until geology is right technology. So it's all about automation. So, for example, our business model is actually a lot of moving parts of a company. It's pretty simple. Now we get images and we just get into the right radiologist we always provide reports and then the records and the reports transmitted to the customers and then of course patients go and access those records as well. So we haven't. Oh, wait might get like a clock formation. There are multiples so special to geologists. We have a lot of Tooryalai is when you're on the clock. And each case is rounded with the proper radiologist. And it's sort of like to compare it to an older model in a way. Yes. The way we work internally the first three hours is available who's available will do the report will do the case. And that way we also improve turnaround time. So by introducing automation by improving turnaround time and making radiologists more efficient you know we are lower cost efficiency significantly but we also are adding another element to technology which is artificial intelligence and that's a very hot topic right now and radiology is really in the center which is just artificial intelligence and an amazing element of automation because it makes reality is even more efficient and more accurate.

Michael Yuz: [00:06:19] So this is really exciting what's happening know in healthcare and I'm so glad I made a decision in the 80s you know when I chose to be in this profession and I don't regret for sure because radiologist is always an image. Now the second part of it is second opinions and it's really the way we build our second opinion services is really modeled after the entire service. So, of course, we have 4000 physicians in every specialty especially some in America who are available on demand. Again the same idea you know by making them more efficient. They can do more cases. It lowers costs. We can actually lower the cost to our customers. And we've always been it's always been about high quality. We turn around time and lower cost competition and that's how we stay ahead of the game because if you do two or three it's not good enough for me. You have quality turnaround time. And of course the price.

Saul Marquez: [00:07:16] Now that's really interesting and so this second opinions Tom. Mike is this intended for the consumer of the services or is it something that that health systems use as well.

Michael Yuz: [00:07:27] Yeah great question. So when we started my goal was to bring this service to millions even billions of people around the world. So the way we build the model was actually consumer based but then, of course, we have many requests. We were raised by businesses by third-party resellers by institutions insurance companies, yeah attornies as well but we were very careful with that.

Saul Marquez: [00:07:57] You know I actually said employers and yes I know are not attorneys.

Michael Yuz: [00:08:06] They were asked to turn away a bunch of them because we have to be careful.

Michael Yuz: [00:08:10] But I think that this statistically number two reason why people browse the internet is to get really the second opinion online. When I get to the number one reason. And number two reason is really healthcare related resources. In addition, they want to get a second opinion.

Michael Yuz: [00:08:29] So it was billed as a consumer model and then we now technology to any third party resellers insurance companies, brokers whoever is institutes can use the service.

Saul Marquez: [00:08:44] Very interesting. And I think I don't remember the stats on this. Maybe you know them better than I do Mike but around the second opinions and you know the first one potentially hey you may not need a procedure.

: [00:08:55] So the several are probably two or three main reasons why people get a second opinion, of course, is only for surgery and those with a serious condition such as cancer.

Michael Yuz: [00:09:07] And of course if the doctor is in surgery. So from the cases that we were evaluated approximately at least 50 percent of the time, the surgery can be postponed or patient can be treated with conservative management or just medication or other less invasive options. So it's my modeling and this is really what to resolve in tremendous savings. You know imagine death you know if you do you know do surgeries I recommended and the surgery can be fifty to hundred thousand dollars. If we prevent even 10 percent of the surgeries from say and given a system my millions and millions of dollars.

Saul Marquez: [00:09:44] Oh yeah I would say even billions for the system. Right. Exactly. And my thought here Mike is if you're a large company that manages to 3-4000 employees and you notice that the cost of your health care seems to be going up year over year double digits is frankly what I'm what I'm hearing out there. Just a service like second opinions as a requirement for your people to actually evaluate before they just jump into the surgery can result in lower premiums and really just overall better outcomes.

Saul Marquez: [00:10:18] Surgery can be avoided that's not necessary.

Michael Yuz: [00:10:20] Absolutely, Saul. That extensive several extensive studies really. And one of the major institution I will not name those specific institutions.

Michael Yuz: [00:10:29] Several months ago they release a data and they found that 85 percent of kids that reviewed for a second opinion change the course significantly for their patient with memories. So this is not necessarily a day surgery but it could be no different treatment. Patient has been misdiagnosed and had a totally different condition and he was treated for. I mean it's mind-boggling. Eighty-five percent of patients may have a wrong diagnosis or wrong treatment or treatment as too aggressive or maybe treatment is not aggressive. You know some people may have cancer for example which are not diagnosed so it's just it's mind-boggling. So although power and indifference we can manage for so many people.

Saul Marquez: [00:11:12] Yeah for sure. I love this. You know and it's all about being thoughtful about the approach. And it sounds like your business. Second opinions really help people be that much more thoughtful in what could potentially be something that's not as clear and not an area of expertise for them.

Michael Yuz: [00:11:27] Yes absolutely so it will make a difference every day for so many people and we love hearing stories almost on a daily basis. We can help patients and we know science to continue this mission.

Saul Marquez: [00:11:41] Hey so Mike give us an example of one of your proudest medical leadership moments today.

Michael Yuz: [00:11:47] Sure sure.

Michael Yuz: [00:11:48] So from the standpoint of the business or the medical leadership experience I was very proud when two years ago Siemens ventured capital approached us and they evaluated many companies and he found us to be really special and different in the category that were looking for which is a medical diagnostics as well as Second Opinion Space and so they decided to partner with the investment company and then they also really opened the doors to us to expand globally and internationally I mean their presence obviously in every part of the globe. They are the largest diagnostic company and radiology laboratory in either of those areas and very proud that they decided to partner with us. So that was probably my proudest medical entrepreneurial moment.

Saul Marquez: [00:12:39] So now that's really you know it's great to have a large partner like Siemens really just kind of validate what you're doing and become interested because really it becomes an opportunity to scale and take it to the next level because ultimately we could improve outcomes locally but we're really looking for ways to scale and bring this to the globe.

Michael Yuz: [00:12:59] That's the whole point. I always say if you're going to invest your energy and do some things why not do something big and really on technology we are able to really help so many people. And with Siemens outreach now we just announced a few months ago the technology that they released called the ecosystem as a team play.

Michael Yuz: [00:13:21] So every Siemens customer will have access to their strategic partners like us. So imagine you are a patient in Ohio or are you a patient you know in Nigeria and you undergo MRI examination. You know you are able to have access to a team a team of some of the best physicians and that is where you are just because she wants to get a scan the next step you may need a neurologist orthopedic surgeon or oncologist so. So the whole full gamut of services professional services.

Saul Marquez: [00:13:55] Now that is super exciting and congratulations to you and your team Mike for getting that honor and looking forward to seeing how that develops. What would you say a setback you've had Mike. You say it's not all rainbows and sunshine. Share a setback that you've experienced and then potentially get out of it.

Michael Yuz: [00:14:11] Yeah absolutely. Everyone has setbacks.

Michael Yuz: [00:14:15] I think I would have to say so I ran the company I'm a CEO of the company but I cannot run on my own. So I rely on people. I'm very proud of the people and we were able to bring on board. But I will say that beside me was by bringing in more people and the mistake that I made was by looking at the CV and in turn people as a whole.

Michael Yuz: [00:14:39] I think that anybody can get lucky anybody can succeed. I think you have to lose that pattern of success. And also we also have to look how are you able to work with certain people. And then we judge the book by its cover so to speak. Yes, I made some mistakes by probably hiring a couple of people which probably caused some setback for the company but overall I think I'm proud of having an amazing team.

Michael Yuz: [00:15:08] It's really hard Saul to find the right people. And it's not just me I think if you speak with CEOs and that's really the biggest challenge. You know to find the right people.

Saul Marquez: [00:15:19] Yeah it's definitely one of the big ones that the guests on the show will bring up as one of the biggest challenges of being a leader and what would you say Mike, obviously you made some good great choices and you know some that haven't worked out. I've done the same thing I've hired people that haven't worked out.

Saul Marquez: [00:15:34] And boy can they create a mess and then hiring the right ones. But what would you say One or two pearls that you've gotten out of your hiring experience to get the right teams in place. What are one or two pearls that you do with the leaders. Yes.

Michael Yuz: [00:15:49] So you look at a pattern of success. So like I said anybody in the company you know a great one time a lot of it is time. You can have the best idea in the planet but you'll never get anywhere because the timing is off.

Michael Yuz: [00:16:06] Usually people who are really you know have succeeded or may made anything they touched.

Michael Yuz: [00:16:13] Yes. And it's very rare when those people when they really exist. If you also look outside of the industry don't get too attached. You know somebody who was you know made it an amazing thing. You know a few years back you were 10 years ago and wasn't your space.

Michael Yuz: [00:16:32] That's the biggest mistake people make.

Michael Yuz: [00:16:34] Look at all the industries look at the current reasons of success look at them reputed success also look at people that are 24/7.

Saul Marquez: [00:16:44] What do you mean by that. Mike 24/7 you know like me people don't sleep when you do it.

Michael Yuz: [00:16:51] I got to be able to call my manager or executive and say to them and say Do you have a problem. Can you help me. So especially now business which is 24/7 diversified. That's probably one of the pearls you know willing to work on the weekends. They commit it to you 100 percent. You all do they have an agenda because you want to really see what they want to do. So those are some of the pearls. that's really helpful Mike and appreciate your sharing by the way I want to share with you. I'm able to work actually 24/7, 365 65 and I don't demand any money. I think when I was I was in college I actually discovered that I actually didn't need sleep. And sleep is you know don't try to home sleep is extremely important. But I was able to you know be with someone who buys laptops that have a solid state memory. Yeah. So I was able to discover that I'm kind of like hard drive with a solid-state memory that my brain can be shut off and on within milliseconds so I can't get into deep sleep and have enough sleep but I can sleep on three of the four or five hours a night if needed. Of course. I normally sleep. You know everybody else for six hours but I'm able to function for days without real sleep. Long sleep but I can sleep a few minutes and fully and fully recover. So that's fine. And that's I want I'm here.

Saul Marquez: [00:18:20] You're a superhuman. Mike, you are a superhuman. Are you sure you're not a robot?

Michael Yuz: [00:18:25] You know what I do think of myself as a robot winterization. That's funny man. Understand I don't understand easily the mosque is my hero and I miss him and he doesn't because I think I think he probably has that same ability.

Saul Marquez: [00:18:44] You got to leverage your towns and whether it be not being able to function without much sleep or being on or stay able to understand people or are understanding chemistry whatever it may be leverage your strengths and focus them in this area that we're all very much caring about which is improving health outcomes. Now that's interesting to note. OK, Mike, this is the part of the show where you and I put together a little medical leadership course and what it takes to be successful in medicine. It's the 101 course of Dr. Mike for all the listeners. OK. So it's four questions. It's lightning round. I'm going to ask you the question you give me a brief answer and then we finished the syllabus with the book that you recommend for the listeners. You ready? Awesome. Yes. I'm like What is the best way to improve healthcare outcomes.

Michael Yuz: [00:19:36] I think the best way to improve outcomes is by offering choice and bringing transparency to consumers. Clearly, this is the engineering behind the secondopinions.com into play the ability to really question am I treated properly do I have the right diagnosis and clearly the studies or major institutions that show 85 percent change in course. You know the rationale diagnosis is that it's clearly you know my value and I believe that's transparency and choice and questioning is what it's all about.

Saul Marquez: [00:20:08] What is the biggest mistake or pitfall to avoid.

Michael Yuz: [00:20:11] Right well I think probably the answer that is avoid the wrong people when applying. Yes. So hiring the right and the right people it's all about people it's all about the team. One person cannot do. I wouldn't be anywhere without my wife for example who's always been there for me or the great team. I have right now.

Saul Marquez: [00:20:30] How do you stay relevant Mike as an organization. Despite constant change.

Michael Yuz: [00:20:34] Right. Well, you have to know. I'm probably Saul sounds crazy but I wake up I don't sleep many hours but I wake up every day with probably several ideas. So now I write them all down or do you just think about them sometimes write them down.

Michael Yuz: [00:20:49] But think of myself as a musician who some do really well in music. I wake up every day with an idea and you know some idea is crazy in my room and my people close to me with some crazy ideas on the radio today they may be amazing potential in the future. But some of them are relevant today some of them you know two years or 10 years. So innovation is the only way and improvements when you have I will not sell you know unless we do something different and we implement something you're pleased with something new and exciting company once a week.

Saul Marquez: [00:21:25] What is one area of focus that should drive all else in the company right.

Michael Yuz: [00:21:29] Well I think that we have a common goal is to make a difference so we can help really millions even billions of people. That's really what drives us.

Michael Yuz: [00:21:39] For me it's about making a dent in the universe. And I was. This is something that drove me when I was a teenager and I never stopped. I never stopped dreaming and never stopped taking that one at a step.

Michael Yuz: [00:21:52] Now when we have helped maybe thousands of people I know soon will be making news for millions and millions of people.

Saul Marquez: [00:22:00] And finally Mike what book would you recommend to the listeners at some time. All right. You got two of them for us.

Michael Yuz: [00:22:06] Yes. One is biography called Elon Musk. I think it's amazing. It's amazing, love that. Yeah.

Michael Yuz: [00:22:14] And a second one my favorites at all times is zero to one by Pether Thiel you know this one, Saul? You know what.

Saul Marquez: [00:22:21] It was actually recommended by one of our guest Scott Becker. I picked it up Mike and it was unbelievable. I loved it.

Michael Yuz: [00:22:28] Yeah OK. So it was recommended. So anyway it's all about thinking outside the box outside your comfort zone. Any time in my experience of my life any time I reach some kind of goal of success I get really bored. So I I break out of the zone and I do something else and I take risks. You know I could just in my example as a medical doctor I couldn't just practice medicine and you know the radiology and you know what specialties is living a comfortable life. I broke it through that comfort zone so many times. So and again some people think I'm crazy because I think I'm taking a huge risk. I want to Chow's one-two houses. Know she had to sell one house when I was 17 years doesn't require a lot of resources. It's going gangbusters. I can tell you I mean look at the Elon Musk man the guy made almost 20 million selling one of these companies, that's eBay right. And then you took everything he had every penny and he was he was basically living on the streets. I mean I love that. It's totally nuts of them someone to do that. I'm kind of like them as well. I take a lot of risks without risks. You're going to be staying the same place.

Saul Marquez: [00:23:44] Now that's a great message Mike and I could definitely hear the passion in your voice. I love it. And you know and if everybody can come at it with that passion that Mike is sharing with us it's just a matter of time because the health care system that we have it's it's already fixed. But it's how we approach it and how we cut and slice it and how we optimize it that's going to give us the health system that we all deserve and that includes new technologies new approaches and approaches with the passion that Mike has. And boy let me tell you it's only a matter of time before sustained thought gives us the answers that we're looking for. I agree. Thank you so much. Thank you, man I appreciate the passion that you bring. So we're close to the end here. The last thing that we're going to ask you to do Mike is share closing thought and then the best place where the listeners can get ahold of you.

Michael Yuz: [00:24:35] Absolutely, Saul. I would give very simple advice. Actually, a smart person once told me you know many years ago and he was very successful he sold his company to GM. It was probably one of the first PACS systems. And I'll never forget that Mike, The harder you work the luckier you get. So it cannot be more true.

Michael Yuz: [00:24:55] It's all about the size and passion and everyone has passion, has ideas right but ideas.

Michael Yuz: [00:25:04] You know without hard work. Basically, they'll call you crazy, dreamers. So it's easy to have ideas and I mean so many people with amazing ideas on them they just give so listen never give up work all your butt off and obviously, you gotta work pretty smart so you got to find the ways. Sometimes you have to find shortcuts from point A to Point B. And that's very important. Otherwise, it'll take you two months or years what can be done in one day. Right. So you got to be very efficient to achieve success to your goals. And last one is think outside of the box. Don't treat people, especially healthcare, have this mentality you know. And it's really something does nobody thought of and then test for it. Every great idea you got to you know a lot of fail a lot of will not hold out. But you got to think of some experiments with some amazing ideas and you'll be surprised you know one out of a thousand ideas that you wake up with will actually work.

Michael Yuz: [00:26:06] And it means a huge difference. You again the Elon Musk many times interview. He's really my hero. So that's one day, of course, I drive Tesla as well. One day you'll have a fully automated car and you know what it's really 90% there. So on a highway, it is fully autonomous while the technology goes. Somebody like suddenly would drop the price because space x company two hundred times the price of a spaceship the same thing, for example, Jonathan Roberts a hero of mine for example in Jenae. I know him personally I met him and he is a gentleman who lowered the price of a DNA sequencing by you know thousands of times. So he's the guy before him.

Michael Yuz: [00:26:56] It goes from a thousand dollars to sequence your genome.

Michael Yuz: [00:26:58] And he made it because the prize is a thousand dollars. So it's hard work innovation and working very efficiently anyway.

Michael Yuz: [00:27:07] I'm gonna shut out at this point.

Saul Marquez: [00:27:09] Now you this is great but this is this has been so much fun and I really appreciate the words of wisdom that you've shared here with us and I'm excited for the listeners to really dive in and get to better understand the healthcare system through your words and get that inspiration but also to understand that they have to take action in order to make things happen because a graveyard is filled with millions of ideas. And so they want to take a second time here to thank you for being on the show Mike and looking forward to staying in touch with you.

Michael Yuz: [00:27:42] Saul thank you so much.

Michael Yuz: [00:27:44] And I think you know you do an amazing job and a lot of people are really really educational.

Michael Yuz: [00:27:49] I'm sure they learn a lot and it's very helpful.

Michael Yuz: [00:27:52] So looking forward to staying in touch and we'll talk soon.

Outro: [00:27:59] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources inspiration and so much more.