Latest / AI for Founders with Ryan Estes / Healthcare's AI Operating System | AI Won't Replace Your Doctor. Here's What It Will Do Instead.
Transcript
- 0:00Your doctor's spending more time typing than healing, and that's
- 0:03killing people. Think about it.
- 0:05You get maybe 13 minutes with your physician.
- 0:07Half of that they're staring at the screen or filling out forms
- 0:10or entering codes, checking boxes.
- 0:12Can't AI give us those minutes back?
- 0:14What if the moment you walked into the exam room, your doctor
- 0:17already knew your full story and could actually look you in the
- 0:20eye? Healthcare is drowning in
- 0:22documentation. Clinicians became data clerks.
- 0:2581% of doctors don't even recommend the profession to
- 0:28their own kids. That burnout is a a billion
- 0:30dollar white space and the builders who treat presents as
- 0:33the product are going to win. What if the most valuable thing
- 0:36you could build is in the feature is giving someone their
- 0:39time back? What would that be worth in your
- 0:41industry? Welcome to AI for founders.
- 0:43I'm Ryan Estes. Today I sat down with Punit
- 0:46Singh, Sony, founder of Suki. The Ambient Clinical
- 0:49Intelligence platform quietly becoming the operating system of
- 0:53modern medicine in partnerships with Zoom.
- 0:55Optum, Athena, and more. This is the one for founders who
- 0:59want to see how AI infrastructure gets built in the
- 1:01hardest, most regulated industries on Earth.
- 1:04And if you want frameworks like this in your inbox every week,
- 1:07head to AI for founders.co. It's the podcast newsletter
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- 1:19Your next breakthrough might be 1 newsletter away.
- 1:22And if this episode hit different, leave us a review.
- 1:24It's the founders version of Standing Ovation and it cost you
- 1:27exactly nothing. And I would really appreciate
- 1:29it. Moody, welcome to the show.
- 1:34Thank you so much for joining me.
- 1:36Pleasure to be here, thanks for having me.
- 1:38For set, it's my pleasure. I'm very excited to have a
- 1:41conversation about healthcare and AI.
- 1:44You know, this is an ongoing theme within this show largely
- 1:48based on how many cool new innovations are coming, both for
- 1:52for patients, for clinicians, for administration.
- 1:55So I'm really excited about your company, Sookie.
- 1:58So if you would just give us an introduction and overview of
- 2:01what Sookie does and who it does it for?
- 2:03Yeah. I mean, you know, I think it
- 2:05probably starts a little bit from my background.
- 2:11You know, I've no experience in healthcare whatsoever.
- 2:14I only started working in this when I started building this
- 2:17company. And when I was looking in from
- 2:20outside, I was looking at what we were doing to our clinicians
- 2:25and it, it was interesting to see how much administrative
- 2:29burden we had put on them. It kind of felt like if I had
- 2:34AVP of engineering in, in Google and I told them that for every
- 2:39line of code they wrote, they need to write a comment and I
- 2:43would pay them based on how many comments they wrote.
- 2:45And if the by the way, the code broke, then we will sue them.
- 2:50Felt like a pretty big mess from my perspective on how we were
- 2:53treating these folks. And and so then the question was
- 2:59what could actually help change things And some of the work that
- 3:03was going on in Frontier AI, especially with now, now they
- 3:06call them large language models and stuff, it's clear that some
- 3:10of these workflows could be automated.
- 3:13And so the mission of Sookie is to bring presence back to
- 3:17healthcare. And we want to do that by, you
- 3:22know, if he can do that, we have a patient be able to connect
- 3:25with their doctor at a human level.
- 3:28Therefore, there to be mutual empathy and for them to actually
- 3:31do the things that they came in there, which is healthcare and
- 3:33not necessarily all the administrative work around it.
- 3:35And so bringing presence back to healthcare by building what we
- 3:40call ambient clinical intelligence is the mission of
- 3:44Sookie. We do that through an
- 3:47application called Sookie app, which we sell to health systems
- 3:51who deploy to their doctors and nurses and others.
- 3:54We also do that through the ambient clinical intelligence
- 3:57platform that we give to other healthcare companies who build
- 4:00their own versions of the Sookie app.
- 4:02And so that's basically what Sookie does.
- 4:04It brings presence back to healthcare by building ambient
- 4:06clinical intelligence. Ambient clinical intelligence.
- 4:10I'd love to dive deeper into that, you know, but just to kind
- 4:12of underline the problem, you know, speaking to another
- 4:15founder, it's on average a patient spends about 13 minutes
- 4:22with their doctor at any given session.
- 4:24You know, and largely to your point, it's like a lot of
- 4:28administrative, you know, the, the nurse always got the
- 4:30clipboard. They're asking the same
- 4:31questions every single time. It's, it's kind of, it's taxing,
- 4:37you know, so it, it and, and ultimately what, what doctors
- 4:41want and what patients want is they want more time.
- 4:43You know, as a, a patient myself kind of getting reintegrated
- 4:47into the medical system, largely because I'm more of like a
- 4:50hippie type. You know, I was like, give me a
- 4:52nutritionist, you know, give me a couple crystals to rub
- 4:55together and I'll do some meditation.
- 4:57I'll call it good. But you know, you start to get a
- 5:00little bit older and it's like, OK, well, I want to make sure
- 5:02that my numbers are right. So you start getting blood work,
- 5:04you start doing all these things and having more interactions and
- 5:07you realize that like that's where kind of the friction is.
- 5:09It's like, I want more time with my doctor so they have a
- 5:12personal relationship with me and they understand my nuance
- 5:15and my crazy attributes or whatever, and I get to know them
- 5:19and I can build trust that way. And that's exactly what the
- 5:21doctors want too. But there seems to be a lot of
- 5:24this administrative kind of a mess in the middle.
- 5:27So if we're talking about ambient clinical intelligence,
- 5:31what exactly is that? Yeah.
- 5:33I mean, we have taken one of the more sophisticated professions
- 5:39in this country and created data clerks out of them, you know,
- 5:43and that's not why they actually went to medical school.
- 5:48Now, ambient clinical intelligence is basically
- 5:52comprised of four different arcs.
- 5:54Arc 1 is clinical documentation what happened in the encounter.
- 5:59Arc 2 is assisted revenue cycle. How can I extract financial
- 6:04information from it so that the doctor can get paid and the
- 6:07system can get paid? R3 is clinical reasoning.
- 6:11How do I, based on the context of the patient and the doctor,
- 6:14provide information back to them that's contextual, that helps
- 6:17them practice medicine better? And then Arc 4 is clinical
- 6:21operations. How do you then take this
- 6:24artefact, the output of their encounter and automatically run
- 6:27agents on top of it so that they can do the things that had to
- 6:30happen as a result of that encounter, hence streamlining
- 6:34everything. So clinical documentation,
- 6:37assisted revenue cycle, clinical reasoning, clinical operations,
- 6:40all four together create this amorphous concept called ambient
- 6:46clinical intelligence, which I think by the way, every
- 6:51hospital, health system, group clinic doctor in the world will
- 6:55adopt. And every single healthcare tech
- 6:59product, every smart bed, every EHR, every telehealth company,
- 7:03every virtual nursing company, every single one of these will
- 7:06integrate. So in effect, it's going to
- 7:09become pretty much a part of the stack of healthcare.
- 7:11Yeah, makes a lot of sense for a lot of reason.
- 7:14I mean, largely because this country is so litigious.
- 7:17You know, just for like kind of a CYA, the doctors, like a man,
- 7:21we got ambient intelligence that records everything.
- 7:23So we, we can say what's what because we can run it back, you
- 7:28know. So are we talking about this as
- 7:29a device? Is it hardware plus software?
- 7:32Is it an application that's like listening kind of what?
- 7:35How does it gather data? Yeah.
- 7:37I mean, I mean clinical intelligence.
- 7:39I mean, the best way to understand Zuki is think of it
- 7:43like Google built Android and the Pixel phone was the best
- 7:49version of Android, the reference set of what Android is
- 7:52and then the Samsung's, the Motorola's, the one pluses.
- 7:55And all these people actually use Android to build their own
- 7:58phones that they actually sell. That creates A footprint.
- 8:01Sookie builds ACI, Ambient clinical intelligence.
- 8:05The Sookie app is the best version of ACI.
- 8:08We deploy that directly into health systems so that doctors
- 8:11can use it and learn how they actually we can make them
- 8:14happier. Other companies like Athenas and
- 8:18Medens and G Gastros and you know, and the Optums and all of
- 8:23these other people in the country Zoom, they all use ACI
- 8:27to build their own versions of these metrical intelligence apps
- 8:31that they deploy. So that's the structure in which
- 8:34we we, we do stuff. We build Suki app and learn how
- 8:39to build ACI. We give it to the rest of the
- 8:41world so they can they can provide it to everybody else.
- 8:44So how does it actually work? At the end of the day, just an
- 8:47application. You know, the key thing with AI
- 8:51is you have to make it super simple for people to use and
- 8:54very accessible. So there's no hardware.
- 8:57You don't need a custom device. You just download the
- 9:00application. Sookie, you log in and you
- 9:03basically just say pay attention.
- 9:05And then you know, Ryan is talking to doctor, Sony and
- 9:10Sookie will pay attention. It will create a clinically
- 9:13accurate note that represents the conversation, extracts the
- 9:16orders and sets them up for prescription.
- 9:19Put the problems in the right places, diagnose it, put the
- 9:23right words under it so that everybody knows what the doctor
- 9:26diagnosed. Attaches the ICD 10 codes next
- 9:29to it so that it goes to the claim processing.
- 9:32Provides a summary of Ryan to Puneet before he walks in so he
- 9:36knows who is actually going to treat, and then provides
- 9:38information to Doctor Sony in the room so that he can treat
- 9:43Ryan better. All of this just a simple
- 9:45application that is basically almost like an assistant working
- 9:49for you while you actually do what you're trained to do, which
- 9:51is clinical care. Amazing.
- 9:53So it's kind of like connective tissue between all the the
- 9:57stakeholders, you know? Yeah.
- 9:59I mean, look, the interesting thing is if you look at the, if
- 10:03you look at the software development in healthcare, it is
- 10:06basically a mishmash of rules and regulations driving it.
- 10:14Think about what the EHR looks like.
- 10:16Think about all the things people do and all these codes
- 10:18that are extracted, etcetera. They are just basically a
- 10:21collection of all the rules and regulations that we created to
- 10:24create structure to a clinical encounter.
- 10:27But in real life, humans just talk to people that you know,
- 10:32you, you walk in, you want to know who you're seeing, so you
- 10:35want to get some refresher on the patient's history.
- 10:39You walk in, you talk to the patient, you basically figure
- 10:43out what the diagnosis is. You end up actually attaching
- 10:45the, the, you know, setting up some orders and then you
- 10:50basically walk out. And sometimes once in a while
- 10:53you ask questions like, hey, it's 44 year old, he's got
- 10:56hyperkalemia. What's the key protocol for
- 10:58that? All of this are not rules and
- 11:01regulations. They're human interactions.
- 11:03And So what if you actually had an AI that you could keep with
- 11:06you that would just give you the right information and extract
- 11:09the right information as you were doing those things?
- 11:13That's what the product is. It's not an EHR.
- 11:16It's not a collection of rules and regulations.
- 11:19It's basically just an assistant that actually helps the doctor
- 11:24ambiently so that they can practice clinical care.
- 11:27Quick side note for founders who are using AI to write content,
- 11:31you've probably noticed this. It's incredibly fast, but it
- 11:34doesn't really Dr. meaningful traffic.
- 11:36And honestly, that's because most AI generated content is
- 11:39just average. There's no real insight, no
- 11:42depth, no structure, missing things like internal linking,
- 11:45and Google's getting very good at filtering that out.
- 11:48So instead of trying to just prompt better, I actually came
- 11:51across something interesting called Neena.
- 11:54It's a system that combines human strategy and review with
- 11:57AI writing to create high quality SEO optimized blog
- 12:00content that's actually designed to rank and keep ranking.
- 12:04What I like about it is that it's done for me.
- 12:06Their team handles the topic strategy and the content review
- 12:10and data markups for Google, and turns blog posts into actual
- 12:14long. Term traffic assets.
- 12:16So if you're a founder thinking seriously about organic growth,
- 12:19this is one of those things worth paying attention to.
- 12:21You can check it out at Try neena.co.
- 12:24That's TRYNIN a.co. Try neena.co.
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- 13:30I love it. Is there actual kind of direct
- 13:33client access or this is strictly working with the
- 13:36clinicians? Well, we end up actually mostly
- 13:39working with large health systems who then will deploy it
- 13:43to their doctors. Yeah.
- 13:44So at the end of the day, then it becomes a 2 pronged sales
- 13:49cycle on this end on Sookie for clinicians.
- 13:52And we have a sales team that sells to health systems and a
- 13:55customer success team that actually works with the IT of
- 13:58the health system and also deploys to the doctors because
- 14:02you want the doctors to adopt AI and use them and learn how to
- 14:05actually engage with them on the Sookie for partners.
- 14:08And we have a ACI platform. We have a sales team that sells
- 14:12to large healthcare companies who will, like Zoom, incorporate
- 14:16that into their products so that when you do a telehealth visit
- 14:19on Zoom, the note that automatically being written is
- 14:22actually powered by Sookie. Amazing.
- 14:26I love it, you know, and it let's kind of outline some of
- 14:29the problems for clinicians because I'm very sensitive to
- 14:31them. Like I was telling you before, I
- 14:33got a bunch of buddies that are doctors and sometimes I'm a
- 14:37little harsh on them. So I'm coming to their defense
- 14:39today. You know, it's it's challenging
- 14:42for clinicians right now for several reasons.
- 14:45One, I think the trust between a patient and doctor is never been
- 14:48lower. You know, there's so much
- 14:50information and misinformation and Google MD's out there for
- 14:56and people with, you know, addictions and different things
- 15:00like like clinicians, doctors really have to deal with a lot
- 15:03of just kind of like building trust with their clients.
- 15:06You know, now you have AI added on to that where people are
- 15:10coming into their appointments and they've already made their
- 15:13own diagnosis. They've they're coming in asking
- 15:16very pointed questions. I saw a doctor on TikTok that
- 15:19was talking about this and they're, you know, he basically
- 15:22done a whole research on, you know, on Claude and came to the
- 15:26doctor and it's like, Hey, how many people have been diagnosed
- 15:28with this in the last 12 months? And like all these very pointed
- 15:31question. He's like, frankly, I don't
- 15:32know, I'd have to do some research, but like, they're kind
- 15:35of putting you on the spot. So it's really the faster that
- 15:38doctors can kind of keep up with, with their patients.
- 15:41Some of us who are like pretty advanced with at least using
- 15:44some kind of LLMS to our advantage, they they kind of
- 15:47have to be able to speak that language in order to kind of
- 15:50meet us into the future. Yeah, I mean the, you know, I'll
- 15:56say this with caution because I'm not a clinician, but I am a
- 16:01technologist. And I will say that the future
- 16:05medical student needs to be a student of medicine and AI both.
- 16:12You cannot just be student of 1. You have to actually be able to
- 16:15learn how to use AI as a tool and combine that with your human
- 16:21knowledge of of clinical to actually figure out what that
- 16:25what that combined skill set would look like.
- 16:30That is the future doctor that the doctor they're, I mean, they
- 16:33will have to teach AI classes to medical students in medical
- 16:38school and how they use them, what do they do, what's the way
- 16:41to actually get the best out of it, etcetera.
- 16:43So that's one comment, which is that's inevitable.
- 16:46The second comment I'll have is that I think we have to
- 16:49understand and put ourselves in the position of the patients
- 16:51too. What's happening with the AI
- 16:55revolution is that there's a lot of data that is in our hands
- 16:59that a lot a majority of the data looks suspiciously correct.
- 17:05And when it doesn't, it obviously has huge
- 17:09ramifications. But the answer to that isn't
- 17:12that people will not use these tools to actually work on their
- 17:16diagnosis. You may be a doctor, but if I
- 17:19have a problem, I literally have, I am the one who has the
- 17:23problem. I should be the one who should
- 17:25actually spend a lot of time understanding what to do with
- 17:28all the things that are disposable this at my disposal.
- 17:31So the then what is the role of a clinician?
- 17:34The role of a clinician in that world becomes a role of a guide,
- 17:40somebody who actually will take responsibility for you in spite
- 17:44of the fact that sometimes you might actually go off in
- 17:46different directions based on what you actually research and
- 17:49are able to use the tools at their disposal to actually
- 17:51provide coherence and a plan that actually makes sense for
- 17:56you to get treated. That is an interesting role and
- 18:00a slightly different role from the prior world of clinicians
- 18:03where they were like gods. Nobody else knew anything about
- 18:07what they were doing. We would walk into the room and
- 18:08just have to listen to them, regardless of whether we could
- 18:13understand it or not. That's not the world we are
- 18:15walking into with the new AI generation, savvy generation
- 18:18that's coming in. So I think clinicians have a lot
- 18:23of different complications. The administrative burden is
- 18:26real, the burnout is real. It's a tough profession.
- 18:30I actually also think you can have that and solve it with AI,
- 18:35not by giving them tools that make them more productive, but
- 18:38also by enabling and educating them to use it in such a way
- 18:42that they can practice medicine better.
- 18:44And that combination is actually where companies like Suki will
- 18:48show up. We are actually at the cusp of
- 18:51technology and clinical science and it is our job to actually
- 18:56help in some ways deny, derive the the next generation of what
- 19:02medicine would look like. It would help from these
- 19:04clinicians who are obviously at the front end of it and AI which
- 19:08is at the back end of it. Yeah, and I love it because it's
- 19:11kind of what can help them right now.
- 19:14You know, a, a lot of kind of folks I talked to are working on
- 19:18really cool companies. You know, whether it's like the
- 19:21robot that lives in your broom closet and can clean your teeth
- 19:24or the, you know, Amazon or Siri can like listen to you and
- 19:30detect if you're depressed. Like there's a lot of things
- 19:32that are coming, you know, whether it's prescriptive or
- 19:35finding new medications through like deep data analysts and all
- 19:39this stuff is in the future to near future.
- 19:41But this really works for the the system we have right now.
- 19:45It just makes, you know, order of magnitude improvement on it.
- 19:49So I love that fact. And and I also love the fact
- 19:52that like you were so early, I would love to kind of pick your
- 19:56brain on why you chose this probe problem when you did,
- 20:00because, you know, Suki was founded in 2017.
- 20:03And I mean, people were not thinking about AI.
- 20:05People were thinking about like little chat bots in the corner
- 20:08or they're, you know, thinking about machine learning.
- 20:10It was kind of had a different flavor.
- 20:13But you saw that very early in the game, so I'd love to hear
- 20:16how kind of like the the origin story.
- 20:20Yeah. I mean, you know we started in
- 20:2620/17/18 time frame and around that time it was actually for
- 20:33those who were paying attention, clear that the attention span of
- 20:37these speech models was going to keep increasing.
- 20:40And the question that was the last is today if I said navigate
- 20:47me to Starbucks, this device actually has a low power chip in
- 20:50it and it can pick up and actually navigate me there today
- 20:53as in in 2017. But tomorrow from that vantage
- 20:57point, why would I just say one sentence?
- 20:59I could probably have a whole conversation and it would
- 21:01actually make sense of that conversation.
- 21:03So the, the tech was actually moving in the direction for the
- 21:07people who are paying attention. And it was pretty clear that
- 21:10what we called speech models for intent extraction, for
- 21:15understanding single phrases and single shot commands, we're
- 21:18going to expand to things that would actually listen to the
- 21:22whole thing and be able to summarize them or extract
- 21:25information out of it. Then the question becomes, if
- 21:28that is indeed going to happen, then where would you use that
- 21:30technology? And and you know, I'll Ryan,
- 21:33I'll be the first one to tell you that I didn't come up with
- 21:37some emotional reason to start Suki in healthcare because I had
- 21:42like some healthcare story that I wanted to actually deal with.
- 21:46I literally looked at the technology and asked myself,
- 21:50where is this going to have the biggest impact?
- 21:52And it turns out that places where it has impacts are is
- 21:56places where you have a sophisticated user.
- 21:59There is a lot of data at your disposal, unstructured usually.
- 22:03And there are these repeatable workflows that are again and
- 22:08again have to be done that these sophisticated users don't want
- 22:11to do. They find it boring, they find
- 22:14it burdensome. And if you start looking very
- 22:18carefully, there is two or three different places that actually
- 22:20start showing up. Actually legal is a good example
- 22:23of a place where this can actually be used.
- 22:27Another place that actually it looked like it could be used was
- 22:30doctors, sophisticated user, lots of unstructured data.
- 22:35They have to repeatedly see people sometimes for similar
- 22:38ailments and issues and keep doing the same task again.
- 22:42Again, same documentation, same coding again and again and
- 22:46again. And the March of AI was such
- 22:48that we could actually extract and automate a lot of those
- 22:51things. So then I started thinking, OK,
- 22:53well, healthcare looks like it's a it's a place to go.
- 22:56Added bonus points that it actually matters.
- 22:59You know, in my prior life, you know, I used to run games, you
- 23:05know, Google games in Google. I used to build mobile apps at
- 23:08Google. I was in the social team.
- 23:10And some of those things actually mattered, but some I'm
- 23:12not so sure. But this who's going to argue
- 23:16against this, right? It actually adds value to the
- 23:20world. It is a technical company that I
- 23:22actually have an ability to actually do something about and
- 23:26and we can practically build it such that to your point, it
- 23:29would actually make a difference today.
- 23:31And so that's how we started the company in 20/17/18 time frame
- 23:36and a lot of things have happened since then.
- 23:38But one thing is pretty clear, that our thesis was right.
- 23:42You know, we are in the right place. 100% and I believe that
- 23:45thesis was AI as the new UI. Yeah, which is true, I mean.
- 23:51What we true? It is, right?
- 23:53Yeah, you do right now. I mean, like we're all, you
- 23:56know, the more this has happened at regular intervals.
- 24:03Remember when Internet showed up that before that, the user
- 24:06interface was humans talking to each other, doing things.
- 24:11Then the Internet showed up and then you had like this big
- 24:13screen and then you had a mouse and then you had a keyboard.
- 24:17And then at some point, mobile became the new UI.
- 24:20And people like, well, mobile, what's mobile?
- 24:23It's nothing. It's just a laptop shrunk into a
- 24:25small form factor. It turned out it was not.
- 24:28It is a fundamentally different way of looking at it because it
- 24:30actually brought with it touch, tap, swipe.
- 24:35It brought all these interactions in it.
- 24:38And then comes what the latest improvements in Frontier AIR and
- 24:43now you have whole new user interfaces that are even more
- 24:46human like talk right and listen.
- 24:50And by the way, not too far from now, think, and when these
- 24:55things come, the information density that actually can be
- 24:58shared between computing devices and human beings dramatically
- 25:02improves, which actually means that a lot of different tasks
- 25:05can be automated. So AI is the new UI and it's
- 25:10going to continue to be the new UI to the point where one day
- 25:14there's a chance that we'll be able to speak and talk to it as
- 25:18fluently with the same amount of information density that we do
- 25:22with each other. And at that point you would have
- 25:25a different world all together. Yeah, you really kind of nailed
- 25:29it and really looked into the crystal ball and pulled out the
- 25:32bright idea. I mean, AI is the new UI.
- 25:35If you look at what happened last Friday, give context, when
- 25:37we recorded this, you know, Claude dropped Claude Design and
- 25:41immediately Figma dropped 7%, you know, so people are holding
- 25:45their breath. It's like, OK, Claude Design
- 25:48could come through and knock out Adobe, it can knock out Canva.
- 25:53So everyone's like, OK, well, what's next?
- 25:55If you can have Claude Design, you could have Claude
- 25:57Accounting, you could have Claude Legal, you could have
- 26:00Claude everything, but you can't have Claude Medicine, you know
- 26:04what I mean? There are certain places that
- 26:06like you're the, the role of the human becomes increasingly
- 26:10important as the AI tools get better.
- 26:13So in this place, it's like AI augmentation for these
- 26:16physicians because that's what you need.
- 26:18You always need a person. I know for one, I will never go
- 26:21to a robot doctor, you know what I mean?
- 26:24Be very uncomfortable. Felt very appealing and and and
- 26:28was engaging to you. But I'll, I'll add, I'll add to
- 26:32that. I think there is this myth and
- 26:35concern that AI is going to replace doctors.
- 26:40I actually think that is very misplaced.
- 26:44Why you are 7 to 8 billion people at this point of time.
- 26:49The amount of healthcare needs of these 7 to 8 billion people
- 26:53is such that you cannot possibly create enough doctors to
- 26:57actually serve these people. And in the world we are walking
- 27:01into, technology is going to be such that the medicine is going
- 27:05to become increasingly very personalized.
- 27:07You already saw what's happening yesterday with the mRNA vaccine
- 27:12for pancreatic cancer. That's like one of the most
- 27:15difficult death serving cancers in the world.
- 27:18And they now have a very specific personalized vaccine
- 27:22that they can create for the individual to do stuff.
- 27:26So, so your personalized medicine, a place where every
- 27:29human being is treated like a single human, You're not going
- 27:32to have a doctor for each one of them.
- 27:34So then what do you need? You actually need medical AI and
- 27:38you need these guides, these humans who actually know more
- 27:43than us and better than us and can actually help guide us to
- 27:46use the AI and use their information to actually, we get
- 27:49better. That's the world we're all going
- 27:51to go into. So I, I think you're exactly
- 27:55right. It's going to be augmented, but
- 27:58there is such swaths of the world in which there is just no
- 28:01access to medical care that those people will probably
- 28:04benefit from AI showing up, even if it is a little less augmented
- 28:08than what we used. Yeah.
- 28:10Well, and then it points to a future that I'm really
- 28:12interested in, which is like, we don't have enough doctors to
- 28:16handle the folks that are sick, so they spend all their time
- 28:19with pathology. But I'm really interested in
- 28:21human flourishing just to say I feel good, but boy, I want to
- 28:24feel better, you know? And so we have all these new
- 28:27therapies coming on board now, whether it's nutrition or
- 28:30supplements or hormones or or peptides, you know, you want to
- 28:35be able to have the time and the doctors have the resources to
- 28:38say like, hey, we can create personalized medicine for you,
- 28:41not to treat any kind of pathology, but rather to make
- 28:43you the best version of yourself possible, you know?
- 28:47Totally agree with you. And that's the world we're
- 28:49walking into. So if you, if you look at that
- 28:52world, tools like Suki invariably just create more
- 28:57presence, more time for clinicians to actually operate
- 29:01better. And the more they operate
- 29:03better, the more perhaps they can see a couple more patients
- 29:07that they wouldn't have seen earlier.
- 29:08The more they don't retire early because they don't feel like
- 29:12they're getting burnt out, the more they encourage their kids
- 29:14that they should do medicine. I mean, there was a Stanford
- 29:17study that said 81% of all doctors don't recommend the
- 29:19profession to their own kids. Well, so our job is to actually
- 29:25make, you know, you know, make it, make it.
- 29:30There's no such thing as fun, but I would say make it
- 29:33enjoyable to practice medicine so that you can bring some
- 29:38happiness back to people. And then invariably that
- 29:41actually leads to better consequences for patients.
- 29:44Beautiful. I'd like to talk about you a
- 29:45little bit. I was, I was doing some research
- 29:48on you and I was like, Dang, this guy has a gigantic audience
- 29:52on LinkedIn. I'm sorry, that is that is not
- 29:56easy to do. And then I started reading some
- 29:58of your posts. I was like, oh, I get it because
- 30:00you're very quotable. And I pulled some of my favorite
- 30:03quotes. I wanted to talk about this
- 30:06Japanese concept of Kotawari, which is the pursuit of
- 30:10excellence in a particular craft with absolute dedication.
- 30:14Dedication not for any recognition, but for the sake of
- 30:17it. Yeah.
- 30:19It's very interesting How How is that important to you?
- 30:23You know, you have to hold on to things that actually matter to
- 30:28you if you're going to do something hard.
- 30:32And as you probably correctly pointed out at the start,
- 30:35building companies, actually building companies.
- 30:39I mean, there is a lot of romance associated with
- 30:42entrepreneurship these days, rightfully so.
- 30:46But like starting anything new, doing something hard, creating
- 30:50things, writing a book, building a company, all of these things
- 30:54actually require you to go above and beyond what your innate
- 30:58capabilities are. And in some cases, many cases,
- 31:01you actually end up seeing, you know, versions of yourself that
- 31:05you have to improve. And so how do you survive that?
- 31:10You know, I actually don't think money can be motivating enough.
- 31:14You can try, but money cannot be motivating enough.
- 31:18If you really wanted to only make money you won't start a
- 31:20company. Would just join a company.
- 31:22Especially with the background and skills some of us have.
- 31:26Fame can be interesting for some time but in today's world it's a
- 31:32double edged sword. You know, you almost have to be
- 31:36shameless to actually survive, and most people are not.
- 31:41So therefore fame has its own consequences that people don't.
- 31:45You may not enjoy that much. And then you start thinking,
- 31:48digging deeper and deeper and deeper.
- 31:50And then you realize, why do you actually do something?
- 31:53Why do you climb a mountain? Because it's there.
- 31:55Why do you do something? Because you want to figure out
- 31:57what's the best version of yourself.
- 31:59And that then comes back to the pursuit of excellence, you know,
- 32:03not because Ryan will think it was a cool conversation, which I
- 32:08hope you do by the way, but not because, you know, my friends
- 32:13will think that I'm very successful or my company will
- 32:16think that, Oh my God, such a good CEO, but just because I
- 32:21want to be better. And when you actually work for
- 32:24that, then you sometimes have the strength to actually do hard
- 32:27things much more than for other motivations.
- 32:30So that's where it comes from. Codavari is a very interesting
- 32:33concept because if you go to Japan, you see some of the
- 32:36practice, the way they actually do things.
- 32:39I saw this very interesting video the other day of somebody
- 32:44in acquaintance who had like, it's my age probably.
- 32:49And he decided he wanted to really, really learn how to play
- 32:53a very difficult piano piece. He's never played, he doesn't
- 32:57know how to play piano. So over the course of one year,
- 33:00every day he spent one hour practicing, practicing,
- 33:04learning. And at the end of the year, he
- 33:07actually could play a very beautiful piece from scratch.
- 33:10That's Cadaveri, your pursuit of excellence for just the sake of
- 33:14it, you know. There also seems to be a
- 33:18spiritual calling in that, I mean, I've never been to Japan,
- 33:21but I'm a big fan of that aesthetic, the the kind of fuel
- 33:23Japan aesthetic and the the rigor and tension that exists in
- 33:29in all of that, which is usually broken with some kind of like
- 33:32beautiful Zen humor. But I have seen it in my
- 33:34cathedrals where you go and you just go to the outside and you
- 33:37can touch the stone that is was so perfectly crafted by someone
- 33:42you know, probably the word they would use is devotion, where
- 33:45they're crafting the stone on the foundation, knowing that
- 33:49their great, great grandchildren will be dead before this
- 33:52cathedral is completed. So they're spending their whole
- 33:55life and their children's life and it's, it's, it's doing it
- 33:59for the sake of doing it the best.
- 34:01I think with a cathedral or if you're thinking about a church,
- 34:03it's easy to interpret that as kind of a spiritual higher
- 34:06calling. Does it feel spiritual to you?
- 34:08Yeah, you know, you're exactly right.
- 34:11And and that's, you know, I mean, there are so many
- 34:13different directions this can go.
- 34:15The truth is there is, you know, I was born in India, you know,
- 34:21and in India, perhaps because of the stage of where the country
- 34:26was and how it was actually evolving itself, you almost have
- 34:30to be spiritual to actually to actually do things.
- 34:35You know, you have to combine that with, I mean, you know,
- 34:38Eastern cultures have this. In India, there's a concept of
- 34:41Dharma and karma and the idea that you you do things because
- 34:46that's your responsibility to do.
- 34:48And the idea that you will actually be the fate is
- 34:51inevitable and you should just actually be the best person you
- 34:54can be. Then you go to the Western side
- 34:56of things and here it's individualistic.
- 35:00We can actually make things happen.
- 35:01Like, you know, there's you can actually build, you can move
- 35:04things, kind of want to put both of them together.
- 35:08You know, there is this beauty of being able to construct the
- 35:14world that you want to do by the sheer dearth of your ambition
- 35:18and your your motivation. And then if you marry that with
- 35:23the fact that the outcome perhaps is not that important at
- 35:27all. And it's actually just the
- 35:28journey and what we're actually doing is just what our
- 35:31responsibility for this world is.
- 35:33Kind of get a best of both worlds, in my opinion.
- 35:35And that's actually somehow I feel the best way to run a
- 35:38company is, you know, realize that it's a responsibility, but
- 35:43also have the ambition to actually make the best out of
- 35:45it. Love that.
- 35:48I love that I got a couple more quotes that I feel like maybe
- 35:52have tension with each other that I want to throw at your
- 35:54stuff you'd written. One you said building companies
- 35:59is like constantly eating glass and then the other said love and
- 36:03care is a strategy too. Yeah, well, the amount of I am,
- 36:16you know, when I started this company, I was so much worse as
- 36:21a human being. Like I and I generally tend to
- 36:25be self critical, but I was like, you know, just so full of
- 36:31myself. So used to actually being in
- 36:35somewhat semi powerful positions, kind of feeling like
- 36:39I was very good and I very smart and if deserved all of those
- 36:43things. And then you start a company and
- 36:45you're on the ground floor and nobody actually cares about your
- 36:49background because that what they actually were paying homage
- 36:53to was your role and your title and not you.
- 36:57And then when you actually realize that, and then you go
- 37:00through the act of building it and you get a lot of failure, a
- 37:03lot of failure, that actually teaches you that it kind of
- 37:07breaks your ego down properly. And then you can assemble the
- 37:10kind of place you want to. So I think we know building
- 37:15companies is like many hard things is like constantly eating
- 37:19glass because no matter when you are at what place, there is so
- 37:23much more to do. Today we might be a successful
- 37:26company, but the company that I'm trying to build requires
- 37:28skills that I don't have. And so now I'm suddenly back
- 37:33asking myself, who do I talk to? Who are my mentors?
- 37:35What should I learn? How should I actually organize
- 37:38myself for that world? So this, there is no limit,
- 37:41there is no end point to this learning that you need to
- 37:44actually build it. So that's the eating glass
- 37:46perspective. But when you're eating so much
- 37:48glass, you need to also basically have empathy and care
- 37:53for yourself. And if you're going to care and
- 37:57empathize with yourself, you should probably exude it for
- 37:59everybody else too. You know, people around me will
- 38:02probably say, Puneet, you're not sure if you are as empathetic
- 38:06and caring. You know, when you actually are
- 38:08operating, you are sharp, you're moving, you're shaking things
- 38:13up, you're aggressive. But the but the underlying
- 38:17feeling is I still care. I care for you.
- 38:21I want you to succeed. I care for my partners.
- 38:24I want them to succeed. I want us to build great things
- 38:26together. You know that matters.
- 38:30You have to do that and then the then then the outcomes will
- 38:33automatically show up. That's what those quotes mean.
- 38:37I don't really know if they're successful or not yet, right?
- 38:43Like I mean, I have Sookie for partners business.
- 38:47We have these massive companies, Zoom, Optum, Athena Med and like
- 38:53we have, you know, all these large health edge, all these
- 38:57companies were building on top of 30 large companies.
- 39:00And I can constantly feel like I want to work very closely with
- 39:04them so we can make healthcare better.
- 39:07But, you know, but there is also the bureaucracy and structure
- 39:11and how incentive structures are aligned.
- 39:13So yeah, love is a strategy. Not clear if it's a winning 1
- 39:18yet, but we'll find out. I love it and I love that that
- 39:22story because, you know, folks that have ego, folks that have
- 39:27confidence, folks that have swagger, they find themselves in
- 39:31powers of authority because that's, that's where you want
- 39:34your leaders. That's the attribute you want
- 39:35out of your leaders. But also you need, you know,
- 39:38unless you're a psychopath, there's a person in there.
- 39:40So you have this confidence that's kind of like a, a layer
- 39:44of armor. And through that breakdown
- 39:45process, you realize, OK, I'm made of butter.
- 39:48So I gotta I gotta balance this out.
- 39:52When do you feel like it's like a superpower to wear that armor
- 39:56of confidence and where is it the most appropriate times to
- 39:59kind of take it off? It's interesting you say that it
- 40:05all depends. I mean, the times then when it's
- 40:08the biggest superpower is when you're faced with great failure,
- 40:11right? It's, it's, it's a good thing to
- 40:15have around you so that when the world tells you you're not going
- 40:20to succeed, you can basically say, well, we will see, you
- 40:24know, we will see, we can pull it together.
- 40:28But it's not a good thing to have when you're faced with
- 40:31other people's insecurities, because squashing that and
- 40:36destroying that in, in creating or destroying them is not really
- 40:40going to help anybody. And so I think that in our
- 40:44society today, psychopathic behaviour to some extent is
- 40:49almost rewarded. And I'm not being political.
- 40:53I'm just, you know, look at like the greatest entrepreneurs of
- 40:57our time, like greatest, right? We look at them and they are
- 41:02basically, I mean the word that you use is probably the right
- 41:06one, which is the psychopaths, like you know, they are single
- 41:09minded in trying to get something done with almost no
- 41:14other like almost no other aspect to them.
- 41:19You know, did you ever see a Forbes magazine cover that said,
- 41:24oh, look at you know, XYZ. He's a 47 year old CEO with a
- 41:33great happy family of three kids and a brother who loves him and
- 41:37parents who think he's the best thing.
- 41:40That's not a thing. What we actually do is we
- 41:43actually we actually create heroes out of people who are
- 41:47psychopathic. And I actually think that's that
- 41:52may lead to unreasonable, may lead to the world actually
- 41:55getting new things, But I'm not sure if that actually leads to
- 41:58world being a better place. And in this mix that you talk
- 42:02about, where you actually have the strength to actually be a
- 42:05little edgy and push through the world, but also have the warmth
- 42:09to understand that our time is limited and what we actually do
- 42:12and how we live is probably more important than what how much
- 42:15money we made and what we built. Beautiful.
- 42:18And I love that image too, of like showing restraint when you
- 42:21can be caring for somebody who needs it, but using that as a
- 42:25bank so that when the world steps on your neck, then you put
- 42:30it on and you're like, no, you're not ready for me yet.
- 42:32I have this Bank of confidence that I've been waiting for this
- 42:36exact moment to deploy. Completely and nothing actually
- 42:40does a better job of extracting that out of you than healthcare,
- 42:43by the way. Really tough sector, long nail
- 42:48cycles, very difficult to build a company, so much bureaucracy.
- 42:53I mean you could take out three out of the four bureaucrats in
- 42:57this place and I don't think it would change the efficiency
- 43:00levels of this place. So you know, but I understand to
- 43:04them, so I can't really. Say to them, we've got a couple
- 43:07more minutes here, so I want to take this conversation into the
- 43:10quantum round. Are you ready?
- 43:11Sure. All right, let's talk about
- 43:13failures. But before we do, let's talk
- 43:16about success because my friend, you've had a lot of it, you
- 43:18know, since 2017. Just the numbers I found maybe
- 43:22170 million raised, call it 3-4 hundred employees of three, 400
- 43:27customers. You've crushed it.
- 43:31What are maybe some failures that you you mentioned that that
- 43:35folks might not be able to see from seeing your highlight reel?
- 43:37Oh my God, how much time do you have?
- 43:43Well, I think that I was, as I said when I started, you know, I
- 43:50was not equipped to be ACEO. You know, being a senior leader
- 43:55and a senior executive at large companies doesn't give you the
- 43:58training to be a CEOCEO is a completely different role.
- 44:02And so first of all, it took me some time to actually become
- 44:05one. Probably the first three years
- 44:07it was hard. Second, I think that I didn't
- 44:12hire as well. And since I didn't hire as well,
- 44:16I then compounded that with the second mistake that I didn't
- 44:19really fire as well for the first few years.
- 44:25So those were some of the things that I remember.
- 44:29I'm a product guy and I invariably feel that we still
- 44:31continue to do more than we should in terms of focus, which
- 44:34is hilarious because my entire like career is actually product
- 44:38management. And so I would say if you cut 20
- 44:42percent, 25% of the arc of what you're doing, you would probably
- 44:45still have a much faster company with the same kind of impact.
- 44:48And that's probably another area I would look at.
- 44:50So those are some of the things I can think of.
- 44:52What I will tell you is the number of things that I'm
- 44:56probably not good at is much larger than things I'm good at.
- 44:59But there's one thing that I am good at, which is I will learn.
- 45:03So if I make mistakes, which I do quite regularly, then I'm
- 45:08happy to reflect on it and try to get better at.
- 45:12And that's probably the one thing I'll leave with the folks
- 45:16who are listening, which is, yeah, you know, we all actually
- 45:19are flawed people and have hundreds of things we can we
- 45:22probably don't do well. But as long as we have that one
- 45:25capability that we can learn from our mistakes, we will
- 45:28invariably just keep becoming better versions of ourselves.
- 45:32Yeah, I love that. You know, in the beginning, like
- 45:36you said, a lot of barriers of entry in, in healthcare, HIPAA
- 45:39compliance, all kinds of compliance all over the place.
- 45:42Plus you're going after enterprise type clients, large
- 45:45organizations. When you were thinking go to
- 45:47market, how did you get your first clients?
- 45:50Did you use design partners and then kind of expand from there?
- 45:54Being a product guy, was that a challenge to to not be kind of
- 45:57product market focused? Yeah, it was.
- 46:00I was not very commercially astute.
- 46:04And like most people, I kind of like flip back between, oh, we
- 46:08should sell to like small and medium people first.
- 46:11Oh no, we should sell to enterprises or we should and
- 46:13kept going back and forth. The truth was that it is
- 46:18probably a good idea to sell to small and medium clinics so that
- 46:22you can learn how to build the product.
- 46:24But it is not a good idea to build a whole motion on that
- 46:26because the long tail of Ehrs that they sit on are so complex
- 46:30that the AI can't work with that very easily.
- 46:33So enterprises is actually probably the right go to market.
- 46:35The problem with enterprises, if you start there, you end up
- 46:38spending three to four, they will, they will put you, they
- 46:42will put you through the paces for years or until you run out
- 46:45of money and not pay you. So you can't really do that till
- 46:49you're actually really ready for them.
- 46:51And so I flipped back and forth, but ultimately we ended up in a
- 46:54place where we used small clinics to design the product
- 46:58and learn how to build the right thing.
- 47:00And then we found our first customers through some
- 47:02combination of just relationships.
- 47:04You know, I mean, to be honest, anybody who says they found
- 47:08their customer through some classic go to market, you know,
- 47:13cycle and they had like AVP of sales, they're bullshitting you.
- 47:17The only way you find your first customer is you're on the street
- 47:21and you convince somebody who actually runs something to take
- 47:25a bet on you. Because if you can't do that
- 47:28yourself, you can't sell yourself.
- 47:29Like if you can't sell as an entrepreneur yourself, nobody
- 47:34else is going to come into your team and sell better than you.
- 47:36And so that's what we did. Cool.
- 47:40Last question, aside from Sookie, what else are you kind
- 47:44of building in a plane around with with AI?
- 47:48Oh my God, I have so many. Interesting things that we were
- 47:51actually randomly doing. I'll give you one example.
- 47:54We went to Japan. Since you're talking with Japan,
- 47:57I took like everybody's feedback around me on what places I
- 48:00should go to and what I should do.
- 48:02And I put it into Gemini, and I asked it to lay it on a map and
- 48:07create a notification system so that when I'm actually walking
- 48:10in Japan, it would ping me on my phone saying Ryan recommended
- 48:14you go to that bar that's 100 feet that way.
- 48:16Oh, it's so cool. Right.
- 48:18Yeah, that's a cool product. Like, and there's so many
- 48:21interesting things you can build like these.
- 48:23And so anyway, I have, I can tell you like 10 other things
- 48:26like these, but you know, I love it.
- 48:29My, my 14 year old has just discovered that stuff.
- 48:32Also, he's building like this very interesting.
- 48:36He's building an AI tutor for science for himself.
- 48:40So he's literally uploading like, like curriculums and he's
- 48:46trying to figure out what is the fun way for him to learn from
- 48:48it. I'm looking at that and
- 48:49thinking, wow, like kids nowadays, like they have so much
- 48:52access to do these things. So any other thing that I
- 48:56recommend people doing if they're listening to this, if
- 48:59you have kids, especially at the age group I'm talking about,
- 49:04give them like, you know, Gemini Pro or Cloud Pro with tokens.
- 49:09Let them build stuff because it's just such a amazing time to
- 49:14be building things right now. So cool.
- 49:16I have a 17 and 18 year old and my my daughter, she's 18.
- 49:19We meet for an hour every Wednesday and we do Claude
- 49:22projects. You know, she's like a really
- 49:25cool kind of fitness app where she can find influencers and
- 49:28like pull their workouts. It's super cool.
- 49:31Exactly. I mean, anything can be done at
- 49:33this point of time. We need to just build like, and
- 49:36that's the last part I'll say. I know we had a time.
- 49:39You know that my son sometimes looks at me and says like, what
- 49:44am I going to do? What jobs will be there?
- 49:47Like how what You know, you kind of did your math and engineering
- 49:52and ended up actually becoming an electrical engineer.
- 49:54And then you found your way into business.
- 49:56What am I going to do? What should I learn?
- 49:59And I was like, well, you are going to do things that we can't
- 50:05even dream of doing. You will discover new disease
- 50:09cures. You will discover space travel.
- 50:13Heck, you might actually solve new physics, the rules that
- 50:17nobody's even thought of that could be signed, you would do.
- 50:21It's just the what they are going to do and the jobs that's
- 50:24going to create and the cool things they're going to do will
- 50:27make us look like so boring and so must aid.
- 50:31So I am so optimist, optimistic about the the world that's
- 50:36coming in front of us and what our kids are going to have.
- 50:39Not only agreed, Puneet, this has been absolutely amazing.
- 50:42People please check out Suki. It's Suki dot AISUKII want to
- 50:49give a shout out to Alex and Trinity with Solcoms.
- 50:52Thank you for organizing this, Puneet.
- 50:55Where's the best place for people to connect with you
- 50:57online? Is it LinkedIn?
- 51:00Yeah, LinkedIn is probably OK. The problem with LinkedIn is
- 51:02there's just so many followers there that it's really hard to.
- 51:06But probably LinkedIn, you know, just find me on put it Sony at
- 51:09LinkedIn. Cool.
- 51:10Thank you so much for joining me.
- 51:12I really appreciate it. Thank you.
- 51:14What if you had a partnership manager working for your podcast
- 51:17full time, reaching out to brands, securing deals, handling
- 51:21all the back and forth while you just focused on making great
- 51:23content? That's Casey.
- 51:25Casey is the AI partnership agent from Howdy who actually
- 51:28goes out and gets your sponsors. Casey reaches out to brands on
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- 51:34partnership. You make the show.
- 51:36Casey makes the money. And look, Casey doesn't sleep.
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- 51:42discouraged by a non reply. Casey's out there right now
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- 51:48The only question is whether your show has a Casey yet.
- 51:51So go meet casey@gethowdy.com. That's GETHOW. di.com takes a
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- 52:00immediately. That's gethowdy.com.
- 52:04Every week I sit down and ask myself one question.
- 52:07What do founders actually need to know about AI right now?
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