Insights Out_Dr. Harvey Castro: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Natanya Wachtel:
Brands that can connect with their audiences more viscerally and more authentically will always be successful. With the Insights Out podcast, you will get access to deep and detailed conversations with the heads of leading organizations to understand how they are making their customer relationships work best and how we can all become more aligned to deliver strong value exchanges and better realize the benefits. I’m your host, Dr. Natanya Wachtel. Welcome.
Natanya Wachtel:
Welcome to another episode of Insights Out, a spotlight on modern solutions to put customer data to work. We’re unearthing game-changing intelligence, predicting customer needs, and seamlessly connecting insights into measurable action everywhere your brand touches your customers. Today, I have a special guest, Dr. Harvey Castro, who is here to talk about some of the pioneer areas in customer insights around Chat GPT, AI, and healthcare. Welcome, Dr. Castro.
Dr. Harvey Castro:
Thank you for having me, I appreciate it.
Natanya Wachtel:
I was wondering if you might take just a few moments and give us a little bit of background on you and some of your latest developments.
Dr. Harvey Castro:
My name is Doctor Harvey Castro. I’m an ER board-certified physician, taking the liking of digital health, so the last part of my career has been focused on digital health. My background has been, I’m a serial entrepreneur, I’ve had over 20 healthcare companies, several successful exits ranging from iPhone app medical company that I had to emergency rooms and hospitals that I actually ran and started. And now I’m really into digital health, so the latest obviously is Chat GPT.
Natanya Wachtel:
It’s awesome, obviously, pretty impressive stuff there, and why you’re here today to help illuminate some of the maybe misconceptions that are being talked about and some of the trends. You can’t open any app that has any news in it today and not see something about AI and Chat GPT, fewer about healthcare and most people are either deathly terrified of the takeover and/or unsure in what to leverage and how or where to trust. So I was wondering if today we could pick maybe two or three topics that you found were maybe trending and had a unique position on that you could help share with listeners some tips to navigate them or ways to think about them.
Dr. Harvey Castro:
Yeah, good question, when I went on the web, just looking for other healthcare providers that were explaining Chat GPT in healthcare, I was shocked that I only found like two references all month. And so one of the references was really interesting and actually went viral, a rheumatologist doctor basically sent a letter to the insurance company and used Chat GPT in references to basically argue for that patient, saying, hey, this got denied this procedure, and these are the reasons why.
Natanya Wachtel:
… Nightmare, right? Nightmare for them. They’re like, oh, no, you’re going to use logic and reason in references to get care? Imagine.
Dr. Harvey Castro:
And so I’ve done these myself, and normally you have to do a research on the literature and see what literature is out there and explain. Sometimes you can get away with saying, my practice has done this and this, these are the indications typically done. What was interesting about this technology is, right now I call it in its rare form for all of us, because in that post that he did basically two things came out of it. The idea, the concept, everything seemed to be right on, and the problem, which was really interesting, is the Chat GPT referenced two references, and of the reference, the name did not match the article that it was referencing, and then another part of it was the actual article didn’t match with what the content.
Natanya Wachtel:
…
Dr. Harvey Castro:
Statement was.
Natanya Wachtel:
It wasn’t basically a real source.
Dr. Harvey Castro:
No, but I hate to say this, but some insurance companies may be going through hundreds of these, and if they see the general gist and say, yeah, this I can’t, I’m going to have to deny it or approve. It may have worked, I don’t know, but he should follow up with that particular story. But that was quite interesting because here’s a technology giving you information, and luckily, I’m a physician and I’m looking at healthcare data, but if someone is not understanding medicine to that level and reads Chat GPT, they’re going to say, wow, this is great, I’m going to do this, but unfortunately, there’s this phenomenon called hallucination. And in Chat GPT, it’ll put an output out, and for you and I, if we’re not educated in that field, we may think it’s perfect, but in reality, it doesn’t make sense or it’s not medically valid.
Natanya Wachtel:
It’s like anything where you don’t have subject matter expertise and someone asking your opinion or to choose A versus B, and you don’t necessarily have B, you don’t know what you don’t know, and to know how to be discerning. Although I think there’s another layer too, right, that even clinicians or laypeople or however might see this as treatment paradigm reversal or adjustment. And there’s things in place, whether you be in diabetes and cardiac care and oncology, where those treatment paradigms are there because they’ve been tested in large populations and that kind of stuff. So I see, like you said, there’s implications that you could really change the steering of a ship. Again, I think it’s also a benefit because so many people are denied claims or coverage procedures for testing and have to be their own health advocate, and not everyone is able to do that. Not everyone has a clinician that is willing to take the time to do what you were saying, unless it’s a mortality, life, and death situation. But I think having tools like that, getting to that claim review more quickly is a cool thing because that means more people can get the care that they need and it is appropriate care if you can demonstrate it, I guess.
Dr. Harvey Castro:
Yeah, what I find fascinating is if, I’ve been quoted this, I’ve seen this in several articles, they’re saying between 71 and 73 days, our medical knowledge doubles. So if you think about, that is just massive amount of data that as a physician I’m responsible to keep up with. And so as a human being, it’s really hard to know every single thing, and that’s why all of us specialize. I’m an ER board-certified doctor, you know, a cardiologist, or your primary care doc, we all have different specialties. With that kind of data, I’m excited to see Chat GPT because in the future I see that being a key role in medical education and obviously other fields out there, just the ability to have all that data and go through it with you, that’s just unreal to have a basically a tutor that’s online for me.
Natanya Wachtel:
Yeah, I know that they’re continuously informed by the new studies.
Dr. Harvey Castro:
It’s just amazing. And so on the medical school side, I wish I had this when I was in med school. Just, there’s just cases and pattern recognition. There’s a lot of new blogs out there talking about Chat GPT was entered, what we call the USMLE, is basically one of my tests that I have to do to in order to get my doctor, calling it a certificate, but my credentials, and believe it or not, the Chat GPT was able to score about a 75, I think it was, percent, somewhere in there, which is amazing because that tells me that the Chat GPT was able to dissect the part of the question. It was a biased study in the sense that they took out complexer questions that were, had too many numbers in it, but just the crux of it, I think what an amazing feature, if it can get to the next level.
Natanya Wachtel:
Especially if we think about the application in analysis, right? And also as we are becoming more integrated globally, at the global health, as humans of the world, whereas I remember working on the pharma side when anything OUS was really siloed and we had to make quite a bit of effort and investment to have affiliate connection, to be able to share information, be able to share best practices, to help maybe even affect policy changes or access for different groups in different countries. And now with AI, they’re able to make pharmaco-economic models from different environments such that, to affect change across different with different inputs within a matter of minutes or weeks or days that used to take us months. And that all that time means people are waiting for their treatments.
Dr. Harvey Castro:
I’m just excited. I know this it’s still in its infancy, but I really think this technology is going to take off. I’m going to date myself and say that I’m almost 50 and I really think when I hit about 60, 70, I would not be surprised if this is a bigger tool than it is today.
Natanya Wachtel:
Absolutely, I heard someone refer to, loosely, to this as a calculator was to mathematics initially, and I think we chatted about this a little bit before and how there was a lot of concern among educators in the mathematical realm, in primary grades and in upper grades, right, across the globe, that if you give the kids or young adults or adults calculators, they won’t know how to do math because it’s cheating, it’s doing the work for them. And in some ways that could be true, especially if we’re talking about basic numeracy, basic arithmetic, understanding of your times, tables, and things like that. But overall we’ve seen that calculators ultimately are a tool that can be used to do higher-order thinking and higher-order math that become computers and evolved to a way, as an opportunity to see math in a whole new way. And I see that for Chat GPT in healthcare as well, I don’t know how you feel about that.
Dr. Harvey Castro:
I cannot agree with you more. It’s just fascinating. We’re, the human beings, we don’t like change. I always talk about if you’re failing out of a business, is it because you’re resisting change? And with that said, I remember when I created my first iPhone app, it was the very first iPhone that came out and I tried to push things out and the FDA or Apple wouldn’t allow me because the FDA wouldn’t allow it. Now, I look at the App Store and I’m shocked at the stuff that’s out there that I was told I couldn’t do. And so I give that analogy and story because I feel like that’s what’s going to happen with Chat GPT. I personally think, and this is all my personal opinion, that in the future the government’s going to have the pressure because patients out there are going to demand to use it, they’re going to start using it, and so it’s going to get to the point where the government is going to want to regulate, and that’s another soapbox that is going to happen, but I think, big picture, we will get there. I do think the FDA finally will figure out a way to allow it, just like apps are allowed today. I think it sounds foreign today to say, oh, Chat GPT will be out there, but I do think it will be a medical device for us, or not defined as a medical device for, lawyersay, but it will be used as such.
Natanya Wachtel:
As a tool in the toolbox, the way EHR, electronic medical records, it’s still bumpy, we won’t talk about all the flaws there, too, but in terms of what it could do for the system, for the people who rely on it, on both sides, for clinicians and for patients, and even for insurance in the loop to share information, to avoid medication error, all those kinds of things. There’s still a long way to go, but the potential that it becomes available. We were talking also a little earlier about the talk I had done actually a couple of months ago about AI and ethics in healthcare. And one of the things that we spoke about was, again, ripped from the headlines type of news where we, like the claim example, where there were people following advice, self-help advice that was written by AI as a joke by a young student. And in fact, when someone tried to say, I think this was written by AI, all the other people in the chat like jumped on the person and said, you’re not being, you’re not in the spirit of this group, and don’t knock it if it doesn’t affect you, you don’t have to say anything, not nice. And people were like saying, this is so valuable and the person who authored it did come back and say, actually, I didn’t write this, this was an experiment. And so it makes me think about what is the line in terms of credibility, trust, and authenticity, and decision-making when you, for you, and how do you feel about, because that’s an area that I think makes people nervous, right? So taking advice, if you know it’s from AI versus if you don’t, and human in the loop, and how those stack up in your mind, in your experience?
Dr. Harvey Castro:
Good question, I think life is a progression. I think today it sounds foreign to hear an AI tell you something and not have human input into it. I think we’re at the infancy with Chat GPT, and I think when Chat GPT three, four, comes out, it’ll be more trusted. With that said, if I had to make up a number, I think it’s going to be like Chat GPT like nine before we fully get there.
Natanya Wachtel:
This is recorded for posterity, so we’ll come back. Let’s see, we’ll see, maybe we should have put some money on the table about it.
Dr. Harvey Castro:
But to answer the ethical question, I think everything is education. If you don’t educate someone else on any subject, they’re going to be upset. But I think if you explain your logic and part of that logic is saying, hey, I did use this as a tool and this is the things that it gave me, and then not only filter the bad and the good, but explain, hey, I excluded this from Chat GPT because it didn’t comply with X, Y, Z, or my thinking, or where the medicine’s at. And I think if a patient heard both sides, I think they would respect that. I always give the analogy, and I’m going to date myself some more, when I was a med student and Google came out and then consult, and I remember my colleagues being upset because the patient came in with diagnosis from the MD consult and it was way off. I feel like that’s where we’re headed with Chat GPT, and I think that’s going to come sooner than later. I know it’s not medically indicated and Chat GPT says or not, but I do see that coming. I do see patients putting in their symptoms and doing that anyway. Even if I said it on this podcast or not, I see that coming and I’m warning my doctors out there, hey, be ready.
Natanya Wachtel:
Yeah, basically WebMD 3.0.
Dr. Harvey Castro:
Exactly.
Natanya Wachtel:
Phenomenon, not as a problem.
Dr. Harvey Castro:
I know what you mean, yeah, exactly.
Natanya Wachtel:
Simply shout out to WebMD, I love those guys. … we’re in early stages, but that was the thing we would hear from clinicians that people would come with four pages of printouts and be convinced of a diagnosis that may or may not be accurate. And it’s an awkward thing because you’re trying to forge that relationship, you have less time, all those layers. So, absolutely.
Dr. Harvey Castro:
Go ahead, sorry, I was just going to jump in because this was interesting. A colleague this week pulled me aside and said, hey, I’m really intrigued by the ethics involved because this is, makes, everybody out there just think about it. The theory is that OpenAI was just open source and no company owned it. And so the theory when they opened it, no pun intended, was to really just keep this away from the private sector so that from an ethical point of view, there would never be this business pressure behind the product. Say, Microsoft, I forget if it’s a billion dollars they put in at first, but all I know is that they have about 49%. And so now the business model has changed and they’ve said that come March, April, Microsoft should be adding Bing to Chat GPT and it’ll be on a search engine. And Microsoft is looking at different products that they have and they’re saying they might be in their in-your-office products. And so now from an ethics point of view, and this is where my colleague asked me the question, do you think that because business is behind it, are they going to take advantage of this technology, maybe take advantage of people that have certain medical conditions? And I’m just putting it from an ethical point of view.
Natanya Wachtel:
Yeah, and also the flip of that, I think about when we talk about ethics, one of the things we think about is also access. So does it create a barrier because only people who have computer literacy, or literacies, speak languages that have access to use Microsoft products, are they going to be at a disadvantage if it becomes the groundswell that I also think it’s going to be?
Dr. Harvey Castro:
Now, that’s actually a really good point, too, so much ethics. And then, I hate to say, it’s a US company, but what happens to people outside the US? Does that mean they are second-tier to the US? And, because I know a lot of software comes out and they allow it and for example in the United States and then they spread it out to other parts of the country, so it’s just interesting to see the ethics. I know Chat GPT is currently looking at a professional edition where people will pay a monthly fee. Like you said, what if that’s the feature that becomes the standard of care in our lives, let’s say, and then all of a sudden that just becomes a barrier in the price point of view?
Natanya Wachtel:
Also, I go even more granular back to the open source thing in terms of what was put into it, who did that coding, and what are the rules that were set up in that core machine learning such that, are we looking at things with what kind of bias, with what kind of lens? So there’s a lot of layers to it. …, from different populations that don’t typically get studied because again, usually, maybe they don’t have insurance or they’re in the US and globally as well. In the US, I would say maybe they don’t have insurance or they don’t they’re not a citizen, so they’re not included in a lot of these studies or people in different parts of the globe where there are certain rare and orphan diseases and they just don’t have this kind of tie into the mainstream. But I’m hoping that because the lift, the heavy lifting, if you will, was already done, it’s just, there are ways, like there are initiatives to get Internet access into everyone’s home, for example, in the US. And there are millions and maybe probably more than millions of dollars of grants from many providers, government organizations to do that. So the thing is, the more we rely on tech, the more people only who have access to the tech can use it. So that’s just another area that I didn’t know if you heard any discussion about, but it’s something that I think about.
Dr. Harvey Castro:
I love the ethics, that’s actually one of my favorite classes when I was a med student. Just the ethics of everything, it’s very deep, really interesting. I can’t wait to see what the future holds. On the positive side, I think it’s going to be a tool, and I think my goal is to just increase awareness of this tool because interestingly enough, I’ve asked my doctor friends and a lot of them look at me like I’m crazy, what are you talking about? And so just introducing the product to them, it’s interesting. And then there’s the flip side also, patients out there that I just randomly asked people that I meet, hey, have you heard of this product? And they haven’t. Feel like once this really gets going, it’s going to be like having a cell phone, in my opinion, like everybody will just be using it. Maybe not that brand. Let’s just pretend that Google has their own brand and somebody else, that’s the same similar technology. I really do think all of us will be using it.
Natanya Wachtel:
Yeah, I do as well, hence my glomming on to you and being so excited. And speaking of the glomming on to you, we have full disclosure to our listeners, another couple of areas of overlap. And as we wind down time, I thought it might be nice to talk about one of those areas of overlap and what you’re going to be doing there, and what your hopes are. And also to maybe talk just a little bit about your book that’s behind you in the background there and tell people where they can get it.
Dr. Harvey Castro:
Yeah, I am blessed to be working with ViTel Health, they’re a telemedicine company, and I’ll be their chief clinical operating officer, and my main goal will be working with the company as far as the clinical different applications. Obviously, with Chat GPT, we are already in talks with, how can we integrate this into the company. Obviously no promises there, but we are in discussions to see how we can do this the right way. You’ve already mentioned the ethics behind it, the technology, the barriers, there’s just a lot of issues that need to be addressed before we get to that point. As far as my book, the book is called Chat GPT and Healthcare, it’s currently on the Amazon store, both the Kindle edition and paperback, and I’ve had a lot of fun just working on it and to take it to the next level, my main goal in all this is not really the book, it’s more the idea behind the book, which is I want to increase people out there talking about this subject, doctors about the subject, and I made a little LinkedIn group so that scientists, computer programmers, patients, lawyers can go in there and just put X, Y, Z, or I saw this article and people can have discussions. Because in my mind, if these discussions start happening, I know there’s some CEO out there that’s watching and saying, oh wait, we could create that product. And then my bigger thinking is eventually that’s going to be in the market and eventually it’s going to help patients, and that’s the main goal for the book.
Natanya Wachtel:
Thank you, that is incredible, and thank you for all of your commitment to better us all, empower us, expand our thinking. And I don’t know if we could have a competition who is up later at night between you and I, but I know you bring the midnight oil to try and make sure that all of that is realized, and I thank you for that. I thank you for being on the show today. And in terms of the best way to get in touch with you, what would you recommend? Would it be LinkedIn?
Dr. Harvey Castro:
Yeah, LinkedIn I’m on, but if you don’t have LinkedIn, my handle is HarveyCastroMD, as in medical doctor, and I’m on Facebook, Twitter, Instagram, and LinkedIn.
Natanya Wachtel:
Awesome, thank you so much, and when we do air this episode, you’ll, all of your content will be there as well. Thank you.
Natanya Wachtel:
Thank you for listening to Insights Out. We hope you enjoyed today’s episode. If you have a specific topic in mind and you want us to discuss, please reach out to us by visiting NewSolutionsNetwork.com. See you next time!
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