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Welcome everyone to the Becker's Healthcare podcast series. I'm Ryan Mohamed,
she her pronouns with Becker's Healthcare.
I'm thrilled to have with me today Dr. Mark Schuster,
founding Dean and Chief Executive Officer of Kaiser Permanente School of
Medicine. Dr. So nice to talk with you today. How are you?
I'm great. It's nice to talk with you.
Yeah, of course. Well, to begin, doctor,
would you mind introducing yourself and telling us a bit about your background?
Yeah, sure. So, um, as you said, my name is Mark Schuster.
I'm founding Dean and c e o of the Kaiser Permanente Bernardy Tyson School of
Medicine. I am a pediatrician.
I also have a PhD in public policy analysis.
And I moved out here to the Pasadena area in
2017 to help get this school started.
And it's a wonderful school and we opened in July
of 2020 and we have 50 students per class.
They are amazing, terrific students. And,
uh, uh, maybe I'll just say a little bit more. We, we have, um,
an emphasis on patient centered care, community and population health,
equity and inclusivity,
student health and wellbeing and, um, lifelong learning.
And we have, um,
a number of ways in which we're trying to innovate and really create a very
special educational environment.
And one of the things we do is we start our students in the clinic in a
primary care clinic in the third week of school, a half day a week.
And that's been going really well.
Absolutely. Well, congratulations on that opening.
That is a really big achievement. And you know,
since you're such in a prominent position,
you must be following healthcare and its changes every single day, .
So for you,
what are the biggest issues you're following in healthcare headed into this new
year?
Yeah, well, it's hard to, um,
it's hard to go five minutes without having a newsletter or media
story pop up on my screen on generative ai,
generative artificial intelligence, um, chat G p T.
So I'm definitely seeing a lot on that,
and it's really exciting. Um, and, um,
interesting. And, you know, it's really,
really fascinating what may come from it, both the good and the bad. And,
you know,
we may find that generative AI is transforming how
we provide healthcare. Uh, let's see, you know,
treatment plans may be put together by, um,
a computer. Um, it may make a huge difference in the way we diagnose,
in the way we really advance in what's often called
personalized medicine. And, um, you know,
communication between clinicians and patients may change.
We may have some future version of chat G P t putting together the
emails that we might send that are very individualized to a specific
patient may change the way we put information in EHRs.
Maybe we'll record our conversations with patients and
genive AI may pull out information and then package it and write it up for us.
They're, they're just endless things that may happen. Um, of course,
being in the role that I'm in,
i I focus a bit more on how it may affect education. And of course,
we need to teach our students about this and have them prepared for what changes
may come and have them think about it and think about the ethical questions
and, um, all of what's great and all of what may, um,
all the unintended consequences. But we haven't done this yet, but I could see,
um, chat G p t developing questions for quizzes. Now, of course,
we need, if we do that,
we need our faculty to really review those questions
carefully and make sure that they don't have errors.
And it's very easy to have something in front of you and just not think it's
clearly about accuracy. So I, I don't know if that would work,
but that's certainly a possibility. Uh,
generative AI could also develop teaching plans. It could develop,
um, support materials, it could develop, um, lectures.
We're not a lecture-based curriculum. We're a small group case-based curriculum.
Um, it could develop cases. There's so much that we don't know yet,
but there's lots of buzz about what might be coming. And since I'm,
I hope I'm not going on too long since I'm spending so much time talking about
this, um,
I will say that we are very aware of the potential for bias
come through in what general of AI is finding
as it, you know, searches information. If studies are biased,
then what it finds will most likely be biased.
And also paired with that is the concern about all the misinformation,
the false information that is out there on the internet.
And to what extent will chat G P T just draw that in and
treat it as accurate, and how do we deal with that? Um,
how do we deal with the fact that at least at this stage,
completely false information at times is created by chat G P t.
And, and I realize there are folks working on fixing all of that,
but we need to make sure it's fixed before we depend on it, um,
in a way that is unmonitored. And of course,
there's always the concerns about privacy and security with, um,
systems being hacked or inadvertently revealing patient's names
even when creating a communication for another patient.
I'm gonna stop there because I think I've gone on long enough. Um,
but thank you for the question.
Oh, yeah, no, absolutely.
You gave great insight and actually being a recent grad,
I graduated last spring,
some things you really mentioned is a wild thought for me,
like creating quiz questions and such. Um, and you know,
you talked about AI and how that, you know, can make you nervous and excited.
Is there anything else you're more excited about or anything that is making you
nervous? Whether it's anything you're working on, um, in your, you, you know,
your line of work or anything you're seeing in the news, et cetera?
Well, let's see. I mean,
I'm really glad that we as a
profession are spending more time thinking about health
equity and disparities.
That's an area I've been working in throughout my career and many, many,
many people have. But I think it's more in the news,
it's more in the general public consciousness.
And I think the idea that what goes on in the home,
in the schools, in the workplace,
in the neighborhood can have more effect on people's health than what we can do
in the clinic. Um,
oftentimes is really an important concept for us all
to understand those of us who work in healthcare and those who, who don't.
And I think there's growing, uh,
recognition that we as clinicians need to look at,
um, get to know the whole person who is sitting next to us
or sometimes, um, sitting virtually over, um, the internet,
um, on screen. And I, I think that that's a good thing.
I think we need to recognize how much impact, um,
what goes on in people's lives, um,
how much impact that has on their health and how if we don't pay attention to
it, we can't really do our jobs as well.
When we are writing a prescription for a patient,
we need to make sure they have the copay or are they gonna take the daily pill
every other day to stretch it out? And, you know,
if that's an anti-hypertension,
anti high blood pressure medication every other day is not not
good. We want you to take it every day. And, um,
that when we say, well, you need to exercise more, first of all,
the doctor saying that and just moving on is not usually gonna have much of an
impact. But talking with the patient about do they have a plan?
Is there a place they can exercise? Is there a gym at work?
Is there a place in the neighborhood? And if they say,
you know, doc, I used to run in high school, I, I would go running,
it just doesn't really feel safe. There are no lights in the park nearby.
It doesn't feel safe on the streets. You know, explore,
could lights be put into the park and can you as a physician
call parks and recreation in your town and see if, you know,
you can get a dialogue going,
maybe you can get on the budget for the next cycle. Um,
you're gonna have a lot more influence calling and advocating for the whole
community than a single individual might.
And maybe there are ways you can be helpful. But the point is, we,
um, you know, we at Kaiser Permanente have folks who can help with that,
who are trained in how to work with communities,
how to work with government agencies, and that's great. Uh, uh,
but we need to at least be thinking about these issues,
ways in which we give advice all the time, you know, you need to eat better,
but our patients may live in communities where they can't even find fresh fruits
and vegetables in the stores.
So we need to know what's going on in our patients' lives so that we can help
them the best way possible.
Absolutely. Yeah, I completely agree with you.
You gave some great solutions for daily problems for sure. Uh,
before I let you go, the last thing I wanted to ask you is,
what will the most effective healthcare leaders need in order to be successful
in the next two to three years or so?
I would say to listen, I think we need to, uh,
when we're in patient care environments, listen to our patients,
find out what they want, find out what's working, find out what's not working.
And you know, if,
if we find that our clinicians are so busy that they just tell
the patient, here's your diagnosis and here's what we're gonna do,
rather than saying, you know,
here's several possible approaches to your diagnosis and
exploring with the patient, their values and the pros and cons of each,
rather than just defaulting to what we would do if we were the
patient. Uh,
we need to find out how we're doing and how things are going from the patient
perspective. And I think that's very important.
And then the same for our teams, our clinicians,
our, you know, our physicians, our nurses, our respiratory therapists,
our social workers. There's a large team of people working to provide care.
And, you know, in a medical school environment,
there are faculty and staff as well as students,
and we need to hear what's going on. Uh, talk to folks in,
in large groups, but also one-on-one in small groups.
Give those around us a chance to, um, share what's going on,
an environment to share in which they feel comfortable sharing,
whether it's directly with the leader,
whether it's a designated Ombuds person or others who are,
um, there with a certain sort of, um,
set of trainings and skills to be able to hear things and pass
information on in a way that's packaged and confidential. Uh,
but I think it's very important that we create avenues for communication
so that we really know what's going on.
It's easy to think that the way we provide care is fantastic
and not have a perspective of, it's aiming to be fantastic,
but it's kind of missing the boat in certain areas.
And the one of the hardest things for a leader is to get accurate information.
And I think that's something that we all need to work really hard on.
Absolutely. Thank you so much for those final thoughts. Doctor,
this has been an amazing discussion.
So I wanna thank you so much for coming on Baker's Healthcare and I look forward
to connecting with you again soon.
Well, I, I've really enjoyed talking with you.
Thank you for these great questions.
Thank you for the opportunity and I would love to talk again. So, um,
I look forward to it.
Yes, absolutely.
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