Latest / Becker’s Healthcare Podcast / Dr. John Whyte on AI, Wearables and the Future of Medical Education

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Dr. John Whyte on AI, Wearables and the Future of Medical Education · Becker’s Healthcare Podcast

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  - This is Scott Becker with the Beckers Health
• 1:00
  - Care Podcast.
• 1:02
  - We're thrilled today to be joined by an
• 1:04
  - absolutely brilliant leader, but we're joined today by
• 1:06
  - the chief executive officer of the American Medical
• 1:09
  - Association. We're joined by John White. We're gonna
• 1:12
  - talk to John a lot about AIs, about
• 1:15
  - wearables,
• 1:16
  - about the evolution of medicine, and what he
• 1:18
  - sees out there. Just thrilled to have you
• 1:20
  - with us. You've had this fantastic career, also
• 1:23
  - served as a board of trustees in the
• 1:25
  - Morehouse School of Medicine, done so many interesting
• 1:27
  - things.
• 1:28
  - Doctor White or John, can you take a
• 1:30
  - moment to to to first just introduce yourself,
• 1:33
  - and and tell us about the AMA
• 1:36
  - and and and and we'll go from there.
• 1:38
  - Yeah. And thank you so much for that
• 1:39
  - kind introduction
• 1:41
  - and for having me.
• 1:42
  - But by training, I'm an internal medicine physician.
• 1:45
  - And up until a year ago, I still
• 1:46
  - saw patients
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  - in every aspect of my career.
• 1:50
  - You know, I started coming here
• 1:52
  - in Washington
• 1:53
  - to work at CMS on Medicare policy, spent
• 1:56
  - some time at the Discovery Channel,
• 2:00
  - then have been in and out of government.
• 2:01
  - I went to the Food and Drug Administration
• 2:04
  - to work on issues of drug development
• 2:06
  - and then to WebMD,
• 2:07
  - where really helped lead
• 2:09
  - the strategy
• 2:11
  - of WebMD and Medscape and how to iterate
• 2:13
  - it. And I'm delighted
• 2:14
  - today to be the CEO of the American
• 2:17
  - Medical Association for which I've been a member
• 2:19
  - ever since I was a medical student, which
• 2:21
  - now, Scott, is a very long time.
• 2:23
  - You know, twenty five plus years.
• 2:26
  - And, you know, most people don't realize that
• 2:28
  - the AMA has been around since 1847.
• 2:31
  - So part of my job is not to
• 2:33
  - mess that up so that we can continue,
• 2:36
  - for another, you know, hundred and eighty plus
• 2:38
  - years. But, you know, I'm delighted because it's
• 2:41
  - an exciting time
• 2:43
  - to be involved in medicine,
• 2:44
  - partly because of what you talked about in
• 2:47
  - terms of the innovations in AI, but also
• 2:50
  - the innovations
• 2:51
  - in research
• 2:52
  - and still the very unique relationship
• 2:55
  - that physicians have with patients. So I'm excited
• 2:57
  - to talk to you today.
• 2:59
  - Doctor White, remarkable, remarkable career, remarkable leadership. I
• 3:02
  - did not realize that the AMA is almost
• 3:04
  - a 170 years old now, which is really
• 3:06
  - an amazing, amazing thing.
• 3:08
  - Talk to us a little bit. I know
• 3:09
  - that one of the things you focus a
• 3:10
  - lot on is
• 3:12
  - wearables and technology.
• 3:14
  - Talk to us about the issues, the trends
• 3:16
  - you're watching with wearables and technology
• 3:18
  - and and why that's caught so much of
• 3:20
  - your interest and why you think this is
• 3:22
  - such a game changer.
• 3:24
  - The reason why I think it's a game
• 3:25
  - changer is it's really moving
• 3:28
  - medical care
• 3:30
  - outside of the hospital,
• 3:32
  - outside of the doctor's office. And, you know,
• 3:34
  - what I really care about as a physician
• 3:36
  - is not your blood pressure or your blood
• 3:38
  - sugar when you're in the doctor's office,
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  - but what is it continuously?
• 3:42
  - What is it when you're at home? What
• 3:44
  - is it when you're at work? And now
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  - we have these tools. I mean, everyone's wearing
• 3:48
  - a smartwatch, a a smart ring. I call
• 3:50
  - it the smart jewelry craze. Right? We're collecting
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  - this data.
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  - But right now, I don't really have a
• 3:57
  - way to utilize that data in a meaningful
• 4:00
  - way
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  - to address your care. You know, everyone's using
• 4:04
  - a chatbot, and there's a role for chatbots,
• 4:07
  - but we have to have confidence
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  - in the fidelity
• 4:10
  - of that data, of that wearable tool, and
• 4:13
  - we have to have confidence
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  - that the information that we're getting
• 4:17
  - from chatbots and and digital tools is accurate.
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  - So lots of opportunity here, but there's also
• 4:23
  - some risk because, fundamentally,
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  - this is changing the practice of medicine, and
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  - I think it can be in a good
• 4:29
  - way.
• 4:30
  - And and talk to us about that because
• 4:32
  - all of us are using different types of
• 4:33
  - wearables, different types of apps. You know, one
• 4:35
  - app tells me my stress was higher or
• 4:37
  - lower. One app shows me I'm more beat
• 4:40
  - this day or more tired this day, need
• 4:42
  - more recovery this day. But but you're right.
• 4:45
  - Day to day, you sort of look at
• 4:46
  - it. Some days it stresses me out. Some
• 4:48
  - days it's helpful.
• 4:50
  - But but how to actually integrate that with
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  - your actual
• 4:53
  - a clinician or a guide or a coach?
• 4:56
  - How do you combine those things? That seems
• 4:58
  - to be like everything. Because right now, like,
• 4:59
  - if I'm looking at I could be obsessed
• 5:01
  - about looking at things like my steps and
• 5:03
  - that's
• 5:03
  - easy. When I look at stress level recovery,
• 5:07
  - is my battery drained down? Not the iPhone
• 5:09
  - battery, but my battery. You know, you're you're
• 5:12
  - hoping it's directionally correct. And it feels like
• 5:14
  - it is because it seems to line up
• 5:16
  - with where I feel that day, but I
• 5:17
  - don't know if that's similar to placebo. But
• 5:19
  - how do you integrate that with with with
• 5:21
  - a physician, with medical care,
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  - and and how do you make those things
• 5:24
  - really work to your advantage?
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  - There there's a couple things to unpack there.
• 5:29
  - But one of the keywords
• 5:31
  - that, I would say
• 5:33
  - is interoperability.
• 5:35
  - And as you know, we've been talking about
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  - interoperability
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  - for more than a quarter of a century.
• 5:40
  - And what I mean by that, for the
• 5:42
  - most part, there are some exceptions that the
• 5:44
  - data that's on your smartwatch, that's on your
• 5:46
  - smart ring, it doesn't integrate
• 5:48
  - into the medical record, into the section where
• 5:51
  - I need it to be. It doesn't really
• 5:53
  - put the data in a way that I
• 5:55
  - can utilize, so I'm missing a lot of
• 5:57
  - opportunity
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  - in that data. And something that I recently
• 6:00
  - talked about in JAMA on wearables is it's
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  - kinda to your point about can you trust
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  - the information.
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  - The wearables kind of are this regulatory gray
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  - zone
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  - in the sense that if they're a wellness
• 6:12
  - app, they're not regulated as a medical device.
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  - And that's fine when it was a pedometer.
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  - Like you said, it talked about your number
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  - of steps. But now it's providing me this
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  - physiologic
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  - benchmarks. Right? Like my stress index. I'm not
• 6:25
  - even sure what that really is, you know,
• 6:27
  - medically. Right? It's telling me about my mental
• 6:30
  - readiness and these other aspects.
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  - I think it's good that they're doing those,
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  - but I also have to understand how they're
• 6:37
  - basing that recommendation. Because you gave a great
• 6:39
  - example
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  - about sleep.
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  - I actually, at one point, had three different
• 6:45
  - tools that I was using at the same
• 6:47
  - time in terms of smart jewelry. And and
• 6:49
  - they gave me different sleep scores. And I
• 6:52
  - was like, well, you know, you know, do
• 6:53
  - I get a good night's sleep? Did I
• 6:55
  - not get a good night's sleep? But we
• 6:56
  - also forgot I could just ask to see
• 6:59
  - myself. You know? Do I feel tired? That's
• 7:01
  - the best test for that in some ways.
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  - So There's really yeah. Yeah. It's about getting
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  - the right data and using it in the
• 7:08
  - right way and looking at trends. That's what
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  - I've been telling people and patients. Look at
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  - the trends, not what you are at any
• 7:14
  - particular day, but what are you doing over
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  - time.
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  - And and and doctor White, talk to us
• 7:18
  - about
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  - how are physicians
• 7:21
  - like, when you're doing a physical, you're doing
• 7:22
  - an exam, you're talking to a patient, not
• 7:25
  - not you, the 350, 400,000 primary care doctors
• 7:28
  - in the country, internal medicine doctors in the
• 7:29
  - country, whatever the exact number is. When you're
• 7:32
  - talking to patients,
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  - I I know it's a bell curve in
• 7:35
  - everything in life or a spectrum is better
• 7:37
  - word than a bell curve, but you have
• 7:39
  - people talking to their patients about their wearables.
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  - How are those conversations starting to happen? Are
• 7:44
  - patients more and more I mean, obviously, patients
• 7:46
  - over the last several years have have more
• 7:48
  - and more come in and said, well, I
• 7:49
  - saw this on the Internet. And, you know,
• 7:51
  - back in the day, it was often wildly
• 7:54
  - inaccurate, but getting better, I assume. But I
• 7:56
  - assume that patients that used to come in
• 7:58
  - and ask about, I saw this on the
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  - Internet. This is what I think I have.
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  - Now we're coming to with the wearables and
• 8:03
  - saying it says this, this, and this. What
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  - do you think? Are you are people starting
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  - to have those conversations with the doctors, and
• 8:08
  - and what does that look like? Patients still
• 8:11
  - come in and tell us what they have,
• 8:12
  - and and and that's okay. That that is
• 8:15
  - a a good thing. And and what I
• 8:17
  - would say
• 8:18
  - is, really,
• 8:19
  - where the patient visit starts
• 8:22
  - is before
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  - the actual patient visit. So what they've done
• 8:26
  - is, in the past, you're right, they would
• 8:28
  - go to places like WebMD, and and they
• 8:29
  - still do, and and and other websites that
• 8:32
  - you know, and information they put in Google.
• 8:34
  - But now they're interacting with LLMs as to
• 8:38
  - what their symptoms
• 8:39
  - might mean. And that's okay as long as
• 8:42
  - you still come to the doctor
• 8:44
  - to talk about it. Because in some ways,
• 8:46
  - it's democratizing
• 8:48
  - information if done in a right way, and
• 8:50
  - I think that's a very good thing to
• 8:52
  - do. But the visit starts before they actually
• 8:55
  - come in, partly because of what their wearable
• 8:58
  - data has told them, partly because of these
• 9:00
  - other, you know, physiologic sensors they might have
• 9:03
  - on, such as a continuous glucose monitor.
• 9:05
  - More information, if it's the right information, is
• 9:08
  - a good thing. Now more information isn't always
• 9:10
  - better information,
• 9:12
  - and that's what we have to tease through
• 9:15
  - right now and how it helps me as
• 9:17
  - a physician
• 9:18
  - make better decisions. And and what I'm happy
• 9:21
  - to say is that the AMA recently did
• 9:23
  - an international study about wearables
• 9:25
  - and
• 9:26
  - in from the perspective of physicians. And what's
• 9:28
  - nice to hear is that physicians are very
• 9:30
  - interested in this data and embracing,
• 9:33
  - if they can, the data. And what I
• 9:35
  - will say is, you know, patients have come
• 9:37
  - in to talk to me. My my smartwatch
• 9:39
  - told me I had a fast heart rate.
• 9:42
  - Right? That's good to know. Now watches are
• 9:44
  - perhaps giving some indication about blood pressure, which
• 9:47
  - still needs work to do, but that can
• 9:50
  - cause meaningful reduction
• 9:52
  - in cardiovascular
• 9:53
  - disease, and I'm excited by it. But this
• 9:55
  - is the great opportunity
• 9:57
  - to talk about how these tools are utilized,
• 9:59
  - what data they're based on, how the patient
• 10:02
  - interacts with them, and what's the role of
• 10:04
  - the physician. And what I would argue is
• 10:07
  - that these tools can be an important part
• 10:09
  - of the care team, Not by themselves. I
• 10:12
  - don't want you diagnosing yourself and treating yourself
• 10:15
  - because there's been bad outcomes.
• 10:16
  - But rather, let's make it part of the
• 10:19
  - care team and get you better care.
• 10:22
  - And and you could see a lot of
• 10:23
  - bad outcomes where people just listen to their
• 10:25
  - watch. It says they're fine, and then they
• 10:26
  - have a heart attack. You know, they they
• 10:28
  - haven't they'll get it's not really
• 10:30
  - you know, it's not it's an imperfect guide
• 10:33
  - to be coupled with a physician and so
• 10:35
  - forth. I'll ask you a question. You don't
• 10:36
  - have to answer it. Is is you know,
• 10:39
  - and and this is not generally,
• 10:41
  - but what wearables
• 10:44
  - is there a wearable that you love to
• 10:45
  - use, that love to to to look at,
• 10:48
  - and and what do you want out of
• 10:50
  - it? Because to your point, if somebody gives
• 10:52
  - you a 100 different stats, it's like it's
• 10:55
  - like overwhelming an internal an an internist with
• 10:57
  - a 100 different thoughts, and oncologists seem to
• 10:59
  - face this every day to day, this information
• 11:01
  - overload.
• 11:02
  - Do you have a favorite wearable personally? Not
• 11:05
  - an endorsement, nothing like that. But is there
• 11:07
  - something that you use? And what are the
• 11:08
  - few things that you look at? Because you
• 11:10
  - seem to be as good a guide as
• 11:11
  - anybody. You've got this amazing medical career to
• 11:14
  - go with leadership career. Mhmm. And people can
• 11:16
  - be overloaded by data. There's actually, you know,
• 11:18
  - terminology
• 11:19
  - around that that they get so consumed by
• 11:21
  - the data, and they're trying to manage according
• 11:23
  - to the data. Because some people wanna always
• 11:25
  - get an a. Right? So they wanna make
• 11:27
  - sure they have 8,000,
• 11:29
  - 9,000 steps. So here's again what I would
• 11:32
  - tell you is the exciting part of this
• 11:34
  - is it's continuous data over time. As a
• 11:38
  - physician, as a patient,
• 11:39
  - I wanna be able to contextualize
• 11:42
  - that data. So with the caveat that we
• 11:45
  - still have more to do, I've used a
• 11:47
  - lot of different tools, all of which I
• 11:49
  - like without giving any endorsement. I've used a
• 11:51
  - Fitbit. I've used an Oura Ring. I have
• 11:54
  - an Apple Watch on right now. And what
• 11:57
  - I use those for, I look at trends.
• 12:00
  - I'm very interested in looking at steps and
• 12:02
  - having a goal of about 8,000 steps a
• 12:05
  - day. And what I love about it is
• 12:07
  - there are some days, like, when I was
• 12:09
  - in clinic, I think I'm really busy because
• 12:10
  - I'm walking, you know, from one patient room
• 12:12
  - to the next, but I'm really just going
• 12:14
  - next door. And at the end of the
• 12:15
  - day, I have 3,000 steps. I'm like, how
• 12:17
  - can that be? I feel like I was
• 12:18
  - walking around all day, and this is why
• 12:20
  - I'm gaining weight. You know, I'm interested to
• 12:22
  - see in terms of exercise, you know, trying
• 12:25
  - to do three days a week and and
• 12:27
  - getting that calculation because I feel like I
• 12:29
  - am, you know, exerting myself. But then when
• 12:31
  - I actually look at the data, I'm not.
• 12:34
  - So many of these tools do that, and
• 12:36
  - that's the type of tool that I want
• 12:38
  - because it's giving me feedback
• 12:41
  - to change behavior,
• 12:42
  - and I'm looking at trends over time. I
• 12:45
  - still use a scale. I do it once
• 12:47
  - a week.
• 12:48
  - It also gives certain measures of body fat,
• 12:51
  - you know, muscle mass, things like that. I
• 12:53
  - don't get bogged down in the exact number
• 12:56
  - if it's 1% or 2% off, but I
• 12:58
  - look at trends.
• 12:59
  - And that's the exciting
• 13:01
  - aspects of these because I actually think they
• 13:04
  - can be an early warning sign. Right? And
• 13:07
  - there's been some data that talks about based
• 13:10
  - on your your oxygenation,
• 13:12
  - based on your heart rate, based on how
• 13:14
  - many times you're waking up during the night.
• 13:16
  - That could be an early sign of flu.
• 13:18
  - That could be an early sign of other
• 13:20
  - conditions. That's a good way for you then
• 13:22
  - to go get checked with your doctor. These
• 13:24
  - are exciting
• 13:25
  - opportunities,
• 13:26
  - but we haven't harnessed
• 13:28
  - this information the way that we need to.
• 13:30
  - That's kind of the frustrating part.
• 13:33
  - So let me ask you a couple questions.
• 13:34
  - What do you say to a patient like
• 13:36
  - myself that says Yeah. I don't wanna go
• 13:38
  - on the scale when I know it's going
• 13:40
  - up. I don't wanna look at my portfolio
• 13:42
  - when I know it's going down. How do
• 13:44
  - you get past that to actually
• 13:46
  - take care of yourself and look at the
• 13:48
  - scale or the portfolio? Take the portfolio aside,
• 13:51
  - but, you know, I know when it's going
• 13:52
  - well. I'm dying to go on the scale
• 13:53
  - because my weight's gonna look great and would
• 13:55
  - be reinforced.
• 13:56
  - And then avoiding the psychological downfall of, oh
• 13:59
  - my god. I'm up another percent or two.
• 14:00
  - I'm moving in the wrong direction again. What
• 14:02
  - do I do about it? How do you
• 14:03
  - motivate to stay after these things even, like,
• 14:05
  - when you're looking at your steps and you
• 14:06
  - don't get a bad day of steps? Yeah.
• 14:08
  - You don't wanna look at it because, like,
• 14:09
  - oh my goodness. I I like to get
• 14:10
  - 8,000. I'd like to go to a number,
• 14:12
  - but I only got 3,000. Yeah. How do
• 14:13
  - you get yourself past that? That's one question.
• 14:15
  - And then I'm gonna ask you a question
• 14:16
  - about lifespan versus health care in a second.
• 14:18
  - Yeah. Let me ask you the first question.
• 14:19
  - Mentally getting through to keep on looking at
• 14:21
  - this stuff Yeah. Even when you don't like
• 14:22
  - the numbers because it's easy to
• 14:24
  - disassociate.
• 14:25
  - I I've had a lot of patients like
• 14:27
  - you in in a good way. In some
• 14:29
  - ways, I'm like that. You know, I don't
• 14:31
  - I feel like I've gained weight. I don't
• 14:32
  - feel like getting on the scale. And and
• 14:34
  - there's a concept that sometimes we call a
• 14:36
  - FOMO. Right? We know FOMO, fear of missing
• 14:38
  - out. There's also FOMO, fear of finding I
• 14:41
  - don't wanna know Exactly. What my cholesterol is.
• 14:45
  - But here's what I've always tell patients and
• 14:48
  - I and I tell friends,
• 14:49
  - there's not a value judgment on that number.
• 14:52
  - People are putting a value judgment that maybe
• 14:55
  - they failed or they did a bad job.
• 14:58
  - It's just a number,
• 14:59
  - and it provides a perspective.
• 15:01
  - And that trend over time is good. So
• 15:03
  - a lot of people don't wanna know their
• 15:05
  - cholesterol level. Maybe they don't wanna start up
• 15:07
  - medication.
• 15:08
  - Maybe they don't want to, you know, be
• 15:10
  - told that they're not eating healthy. And I'll
• 15:13
  - tell you there's a genetic component certainly,
• 15:15
  - to high lipids. But what I tell them
• 15:18
  - is, again, there's no value judgment. You need
• 15:20
  - to know where you're at. It's as simple
• 15:23
  - as that. And it's feedback data that then
• 15:26
  - you can do something with. And that's why
• 15:28
  - I tell people don't,
• 15:30
  - you know, step on the scale every day.
• 15:32
  - You know, maybe not look at your steps
• 15:33
  - every day, but look at it on a
• 15:35
  - weekly basis. Look at it on a monthly
• 15:37
  - basis. No more, you know, no less frequent
• 15:39
  - than that, but to check it over time
• 15:41
  - because you wanna be in a better place.
• 15:42
  - And, you know, I often tell patients,
• 15:45
  - I say, do you wanna do your cardiac
• 15:46
  - rehab now, or do you wanna do it
• 15:49
  - in ten year? Right? And that really hits
• 15:50
  - people the right way. I you know, I
• 15:52
  - I've toyed with that idea. It's not a
• 15:53
  - great, you know, sounding message, but it is.
• 15:55
  - You know, you can make the changes now
• 15:57
  - in your thirties, your forties, your fifties, and
• 16:00
  - even in your sixties. And you wanna make
• 16:02
  - them now, or do you wanna have to
• 16:03
  - be forced to do it later? And that's
• 16:05
  - the perspective I give. You can take ownership
• 16:07
  - of many aspects of your health. But but
• 16:09
  - it's very much the concept of it's better
• 16:11
  - to avoid getting inflamed and have a problem
• 16:14
  - than to get inflamed and have to treat
• 16:15
  - the problem. I mean, that's I think that's
• 16:17
  - right on. Am I allowed to stay at
• 16:19
  - home to Liz,
• 16:20
  - Liz,
• 16:21
  - you're not cooking enough. We're going out for
• 16:23
  - dinner too often, and this is why my
• 16:25
  - weight is going up. Would you recommend that,
• 16:28
  - or would you not recommend that?
• 16:30
  - Should I take responsibility?
• 16:31
  - You should take responsibility,
• 16:33
  - and you should have a role in, you
• 16:35
  - know, the preparation of food. That's tricky. And
• 16:38
  - I hear this where people will be like,
• 16:39
  - they want their spouse to go to the
• 16:41
  - gym or not to go to the gym.
• 16:42
  - Some people want it separate. But the point
• 16:45
  - is
• 16:46
  - you wanna talk about what your goals are
• 16:48
  - collectively. Right? No. She does well. I don't
• 16:51
  - do well. I need to work at it.
• 16:52
  - She does great. So okay. Next question is
• 16:54
  - there's so much discussion, and I'll bring you
• 16:56
  - back to the conversation in a second, of
• 16:58
  - lifespan versus health span. I'm you're one of
• 17:00
  - these people. I don't know what age you
• 17:02
  - are. Whatever age you are, you look fifteen
• 17:03
  - years younger than whatever you are. You look
• 17:05
  - like you're you're very tracked on health span
• 17:07
  - versus lifespan.
• 17:09
  - How important is that dialogue over time with
• 17:11
  - our communities, with our patients of, you know,
• 17:13
  - this concept of trying to keep yourself physically
• 17:15
  - and mentally healthy for as long as you
• 17:17
  - possibly can. And and, you know, it's not
• 17:20
  - that you can't recover once you go in
• 17:21
  - the wrong direction, but it is a little
• 17:23
  - harder too It's harder. If you let yourself
• 17:25
  - off, you know, off the wagon and get
• 17:26
  - off the wagon on staying in shape, staying
• 17:28
  - physically fit, and mentally healthy.
• 17:30
  - It's an incredibly important perspective.
• 17:32
  - And I think implicitly,
• 17:34
  - most people feel that. Do you wanna live
• 17:37
  - longer, or do you just wanna feel like
• 17:39
  - it's longer? Right? You wanna enjoy life.
• 17:42
  - You wanna be able to still be active
• 17:44
  - in your seventies, your eighties, your nineties.
• 17:48
  - The way you
• 17:49
  - preserve that and protect against frailty
• 17:53
  - is what you're doing in your thirties, your
• 17:55
  - forties, your fifties, and your sixties. And people
• 17:57
  - don't always understand that concept.
• 18:00
  - People do have this goal to be centenarians,
• 18:03
  - you know, 100 year old, where most of
• 18:05
  - them are outside of The United States and
• 18:07
  - other areas of the world and are living
• 18:10
  - a fulfilled life. That's what most people want,
• 18:14
  - and you control most of that. People think
• 18:16
  - it's all relating to genetics. Genetics does play
• 18:19
  - an important component,
• 18:20
  - but lifestyle
• 18:21
  - plays the bigger component. And I love how
• 18:24
  - you think about it. It's about lifespan.
• 18:27
  - You know, what what are you enjoying out
• 18:29
  - of life? You know, how are you contributing?
• 18:32
  - Those are the important aspects that I think
• 18:34
  - most people care about. They don't wanna be
• 18:36
  - 80 years old and be very frail and
• 18:38
  - not to be able to enjoy life. So
• 18:40
  - there's steps that we need to take to
• 18:42
  - get there.
• 18:43
  - I I've got two more questions for you.
• 18:45
  - I promise this will be a low stress
• 18:47
  - part of your day. One is more of
• 18:48
  - a of a of, hopefully, a humorous question.
• 18:50
  - One is more of a serious question. The
• 18:52
  - the first question is, which is the better
• 18:54
  - academic institution,
• 18:56
  - Harvard or University of Pennsylvania? Where do you
• 18:58
  - rank the two?
• 19:00
  - They're both great institutions,
• 19:03
  - as many
• 19:04
  - colleges and universities are. So you couldn't go
• 19:07
  - wrong with either of them. It depends
• 19:10
  - whether you like, the Eagles or the Patriots.
• 19:13
  - So, you know, you you could toss it
• 19:15
  - up like that.
• 19:16
  - Doctor White, you've had this magnificent career,
• 19:19
  - both at WebMD,
• 19:20
  - doing so many other things over the course
• 19:22
  - of your career. I mean, amazing role there
• 19:24
  - as chief medical officer. Now the last couple
• 19:26
  - years, serving as the CEO of the AMA,
• 19:28
  - the most prestigious health care society in the
• 19:30
  - country.
• 19:31
  - Talk for a second about what are you
• 19:33
  - most excited about and focused on the next
• 19:35
  - year or two? Where are you most focused
• 19:37
  - and excited? What are the what are the
• 19:38
  - big things?
• 19:39
  - And I've been here at AMA, for about
• 19:41
  - fourteen months just so you know. Don't wanna
• 19:44
  - don't wanna, you know, artificially,
• 19:47
  - inflate the amount of time that I've been
• 19:48
  - there. But, you know, I I I really
• 19:50
  - have to say there are some days
• 19:53
  - that I pinch myself,
• 19:55
  - that I have this amazing opportunity
• 19:57
  - to lead this historic organization
• 20:00
  - at a critical time.
• 20:02
  - So what I look at is
• 20:04
  - the history of the AMA
• 20:05
  - and how it really started in reforming medical
• 20:09
  - education.
• 20:09
  - And that's what I'm really interested in, and
• 20:12
  - the AMA has had a strong role in
• 20:14
  - terms of how AI
• 20:16
  - plays an important role in health care delivery.
• 20:18
  - We have to change how we train doctors,
• 20:21
  - and the AMA has to lead there. You
• 20:23
  - know, we have this archive for the AMA
• 20:25
  - because we've been around for so long, and
• 20:27
  - there's a section on one of our floors
• 20:30
  - that talks about medical quackery.
• 20:32
  - So how the AMA has always stood up
• 20:34
  - against these potions and lotions and other things
• 20:37
  - that had no medical value.
• 20:39
  - And I think about it, and and I
• 20:41
  - say to myself, what's old is new again.
• 20:43
  - We're standing up against misinformation.
• 20:46
  - We have a campaign, multiple campaigns,
• 20:48
  - about how we educate the public on important
• 20:51
  - health issues. That that is so important to
• 20:54
  - aspects of public health and evidence of medicine.
• 20:58
  - I I I wanna take you back to
• 20:59
  - something you said because I think it's the
• 21:00
  - thing that I focus on more than anything
• 21:02
  - else, which is this medical education issue.
• 21:04
  - Right now, we're at a spot where four
• 21:06
  - years of college,
• 21:07
  - four years of medical school, three to five
• 21:10
  - years of residency, often a fellowship.
• 21:12
  - We get doctors out not till the '30,
• 21:14
  - '32 or so.
• 21:16
  - In other countries, they do it quicker. They've
• 21:18
  - got people going right to medical school after
• 21:19
  - college, and they're out by '28, '29 after
• 21:21
  - the residency here.
• 21:23
  - We've also got a situation where it seems
• 21:25
  - like medical education
• 21:27
  - I've got a fourth year medical student as
• 21:28
  - a one of the kids,
• 21:30
  - and they're doing rotations. It seems like you
• 21:32
  - could easily cut out that year, and the
• 21:33
  - kids wouldn't lose anything or not much because
• 21:35
  - they'd go to residency for four years. But
• 21:37
  - what how do we get medical in back
• 21:39
  - when I was younger, there were six year
• 21:41
  - med programs. Went to college medical school, we're
• 21:43
  - done by 2324.
• 21:45
  - It seems like we're making it less attractive
• 21:47
  - for the best and brightest to go into
• 21:49
  - medicine.
• 21:50
  - The debt is too high. The costs are
• 21:51
  - too high. The track is too long.
• 21:54
  - How do we and it seems like a
• 21:56
  - lot of the problem
• 21:57
  - is not just the lack of residencies, but
• 21:59
  - also the physician societies
• 22:01
  - that seem to be not trying to get
• 22:03
  - our I mean, some of the best doctors
• 22:05
  - we have are doctors from other countries
• 22:07
  - that are finished earlier. How do we how
• 22:09
  - do we move how do we make a
• 22:10
  - move on that? Because it seems like we're
• 22:12
  - running into a spot where doctors are gonna
• 22:14
  - make themselves almost irrelevant if there's just enough
• 22:16
  - doctors out there, and and none of us
• 22:18
  - feel that way. I mean, you know, you
• 22:19
  - know, there's this concept that minor surgery, minor
• 22:21
  - cancer, there's only minor surgery, minor cancer when
• 22:24
  - somebody else has it. That's right. There's no
• 22:26
  - such thing as a minor surgery or minor
• 22:27
  - cancer when you have it, but there's not
• 22:29
  - nearly enough specialists, doctors, etcetera. How do we
• 22:31
  - expedite medical education? How do we solve this
• 22:33
  - so we don't get to the spot where
• 22:34
  - there's 900,000 doctors and 350,000,000
• 22:36
  - people with? Let me let me turn it
• 22:37
  - to you. Yeah. There's two there's a couple
• 22:39
  - challenges there that in some ways,
• 22:42
  - we have to keep in mind that more
• 22:44
  - than forty percent of physicians
• 22:46
  - feel burnout. And that's an improvement than it
• 22:48
  - was before, but forty percent is huge. We're
• 22:49
  - doing all these administrative tasks. We have to
• 22:51
  - see too many patients in a compressed period
• 22:53
  - of time. So if we could address some
• 22:55
  - of those administrative burdens, physicians would have more
• 22:57
  - time to see patients and to see more
• 22:59
  - patients, and and that would be an important
• 23:01
  - element and and have greater quality of life.
• 23:04
  - I agree with you about the timing of
• 23:05
  - medical education. And as I as you rattled
• 23:07
  - off all that time in school, I feel
• 23:09
  - like, oh, I am old. But what's interesting
• 23:11
  - is you talked about at one point in
• 23:13
  - time, we did think about six year medical
• 23:15
  - school program, seven year medical school program. What's
• 23:18
  - interesting,
• 23:19
  - Scott, is we're actually starting to have those
• 23:21
  - conversations again, that maybe you don't need all
• 23:24
  - of those years in training before
• 23:26
  - residency
• 23:27
  - and fellowship. And that's the kind of discussions
• 23:30
  - that we need to be having. I don't
• 23:31
  - know what the right answer is about the,
• 23:34
  - complete amount of training, but that's something that
• 23:36
  - we should look at because you're right. We've
• 23:38
  - done that before with compressed undergraduate and and
• 23:41
  - graduate school, and then we also have to
• 23:43
  - address the physician shortage. And maybe this is
• 23:45
  - a way to do that. So for me
• 23:47
  - and at the AMA, all things are on
• 23:49
  - the table, and and we wanna have those
• 23:51
  - discussions
• 23:53
  - that you bring up. And and, fundamentally, the
• 23:53
  - training is different. When I went to medical
• 23:56
  - school and became a doctor, you're rewarded based
• 23:58
  - on your ability to memorize.
• 24:00
  - You couldn't do that today even if you
• 24:02
  - wanted to. Now it's how do you access
• 24:04
  - information and the right information
• 24:06
  - and utilize it in the right way.
• 24:08
  - Oh, no. I think that's so right, and
• 24:10
  - I love hearing that because I do think
• 24:11
  - so much medical education was developed prior to
• 24:13
  - the Internet, and training students still this twelve
• 24:16
  - year program is insane.
• 24:18
  - And you want you and I might not
• 24:19
  - know the exact number of years,
• 24:21
  - that we have clear clear indications because we're
• 24:24
  - doing it in other countries quicker that it's
• 24:25
  - shorter than we're doing now. We don't know
• 24:27
  - what that number is, but it but it
• 24:28
  - has to be changed if we're gonna fix
• 24:30
  - this proportion of doctors to our population.
• 24:32
  - Currently, we're turning out nurses at 200,000 a
• 24:35
  - year. Doctors are only 25, 30,000 a year.
• 24:37
  - So with 33,000 starting med school, MD and
• 24:40
  - DO school, and retiring fifteen, twenty. The numbers
• 24:42
  - just don't work unless we fix this, and
• 24:44
  - I and I and I love the fact
• 24:45
  - that you're focused on that. Doctor White, we've
• 24:47
  - gotta wrap up. I wanna thank you so
• 24:49
  - much for joining us. What a great pleasure
• 24:51
  - to speak to you,
• 24:52
  - yourself, doctor John White, CEO of the AMA.
• 24:55
  - What a pleasure. You're welcome on anytime to
• 24:57
  - the Becker Salinger podcast. We love hearing your
• 24:59
  - perspective.
• 25:01
  - It's been a fun conversation. So you're right.
• 25:03
  - Not a lot of stress. So thank you.
• 25:05
  - We hope not. Doctor White, thank you so
• 25:07
  - much.