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Would you like to exchange best
practices and ideas to improve care,

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enhance operational efficiency,

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and address financial
challenges with your peers?

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Becker's Healthcare is facilitating these
conversations at their eighth annual

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health IT digital health and RCM meeting.

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You can check your eligibility for
complimentary attendance at the Lincoln,

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the description. We are excited
to welcome you in October.

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Welcome everyone to the
Becker's Healthcare podcast
series. I'm Ryan Mohamed,

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she her pronouns with Becker's Healthcare.

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I'm thrilled to have with
me today Dr. Mark Schuster,

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founding Dean and Chief Executive
Officer of Kaiser Permanente School of

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Medicine. Dr. So nice to talk
with you today. How are you?

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I'm great. It's nice to talk with you.

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Yeah, of course. Well, to begin, doctor,

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would you mind introducing yourself and
telling us a bit about your background?

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Yeah, sure. So, um, as you
said, my name is Mark Schuster.

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I'm founding Dean and c e o of the Kaiser
Permanente Bernardy Tyson School of

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Medicine. I am a pediatrician.

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I also have a PhD in
public policy analysis.

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And I moved out here
to the Pasadena area in

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2017 to help get this school started.

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And it's a wonderful school
and we opened in July

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of 2020 and we have 50 students per class.

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They are amazing, terrific students. And,

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uh, uh, maybe I'll just say a
little bit more. We, we have, um,

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an emphasis on patient centered care,
community and population health,

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equity and inclusivity,

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student health and wellbeing
and, um, lifelong learning.

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And we have, um,

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a number of ways in which we're trying
to innovate and really create a very

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special educational environment.

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And one of the things we do is we
start our students in the clinic in a

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primary care clinic in the third
week of school, a half day a week.

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And that's been going really well.

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Absolutely. Well,
congratulations on that opening.

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That is a really big
achievement. And you know,

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since you're such in a prominent position,

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you must be following healthcare and
its changes every single day, <laugh>.

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So for you,

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what are the biggest issues
you're following in healthcare
headed into this new

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year?

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Yeah, well, it's hard to, um,

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it's hard to go five minutes
without having a newsletter or media

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story pop up on my
screen on generative ai,

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generative artificial
intelligence, um, chat G p T.

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So I'm definitely <laugh>
seeing a lot on that,

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and it's really exciting. Um, and, um,

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interesting. And, you know, it's really,

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really fascinating what may come from
it, both the good and the bad. And,

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you know,

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we may find that generative
AI is transforming how

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we provide healthcare.
Uh, let's see, you know,

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treatment plans may be
put together by, um,

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a computer. Um, it may make a huge
difference in the way we diagnose,

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in the way we really advance
in what's often called

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personalized medicine. And, um, you know,

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communication between clinicians
and patients may change.

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We may have some future version
of chat G P t putting together the

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emails that we might send that are
very individualized to a specific

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patient may change the way
we put information in EHRs.

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Maybe we'll record our
conversations with patients and

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genive AI may pull out information and
then package it and write it up for us.

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They're, they're just endless things
that may happen. Um, of course,

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being in the role that I'm in,

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i I focus a bit more on how it may
affect education. And of course,

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we need to teach our students about this
and have them prepared for what changes

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may come and have them think about it
and think about the ethical questions

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and, um, all of what's great
and all of what may, um,

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all the unintended consequences. But we
haven't done this yet, but I could see,

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um, chat G p t developing questions
for quizzes. Now, of course,

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we need, if we do that,

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we need our faculty to
really review those questions

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carefully and make sure
that they don't have errors.

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And it's very easy to have something
in front of you and just not think it's

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clearly about accuracy. So I, I
don't know if that would work,

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but that's certainly a possibility. Uh,

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generative AI could also develop
teaching plans. It could develop,

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um, support materials, it
could develop, um, lectures.

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We're not a lecture-based curriculum.
We're a small group case-based curriculum.

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Um, it could develop cases. There's
so much that we don't know yet,

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but there's lots of buzz about what
might be coming. And since I'm,

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I hope I'm not going on too long since
I'm spending so much time talking about

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this, um,

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I will say that we are very
aware of the potential for bias

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come through in what
general of AI is finding

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as it, you know, searches
information. If studies are biased,

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then what it finds will
most likely be biased.

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And also paired with that is the
concern about all the misinformation,

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the false information that
is out there on the internet.

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And to what extent will chat
G P T just draw that in and

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treat it as accurate, and
how do we deal with that? Um,

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how do we deal with the fact
that at least at this stage,

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completely false information at
times is created by chat G P t.

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And, and I realize there are folks
working on fixing all of that,

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but we need to make sure it's
fixed before we depend on it, um,

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in a way that is
unmonitored. And of course,

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there's always the concerns about
privacy and security with, um,

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systems being hacked or inadvertently
revealing patient's names

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even when creating a
communication for another patient.

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I'm gonna stop there because I
think I've gone on long enough. Um,

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but thank you for the question.

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Oh, yeah, no, absolutely.

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You gave great insight and
actually being a recent grad,

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I graduated last spring,

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some things you really mentioned
is a wild thought for me,

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like creating quiz questions
and such. Um, and you know,

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you talked about AI and how that, you
know, can make you nervous and excited.

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Is there anything else you're more excited
about or anything that is making you

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nervous? Whether it's anything you're
working on, um, in your, you, you know,

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your line of work or anything you're
seeing in the news, et cetera?

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Well, let's see. I mean,

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I'm really glad that we as a

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profession are spending more
time thinking about health

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equity and disparities.

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That's an area I've been working in
throughout my career and many, many,

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many people have. But I
think it's more in the news,

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it's more in the general
public consciousness.

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And I think the idea that
what goes on in the home,

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in the schools, in the workplace,

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in the neighborhood can have more effect
on people's health than what we can do

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in the clinic. Um,

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oftentimes is really an
important concept for us all

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to understand those of us who work in
healthcare and those who, who don't.

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And I think there's growing, uh,

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recognition that we as
clinicians need to look at,

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um, get to know the whole
person who is sitting next to us

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or sometimes, um, sitting
virtually over, um, the internet,

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um, on screen. And I, I think
that that's a good thing.

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I think we need to recognize
how much impact, um,

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what goes on in people's lives, um,

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how much impact that has on their health
and how if we don't pay attention to

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it, we can't really do our jobs as well.

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When we are writing a
prescription for a patient,

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we need to make sure they have the copay
or are they gonna take the daily pill

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every other day to stretch
it out? And, you know,

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if that's an anti-hypertension,

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anti high blood pressure medication
every other day is not not

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good. We want you to take
it every day. And, um,

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that when we say, well, you need
to exercise more, first of all,

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the doctor saying that and just moving
on is not usually gonna have much of an

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impact. But talking with the
patient about do they have a plan?

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Is there a place they can
exercise? Is there a gym at work?

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Is there a place in the
neighborhood? And if they say,

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you know, doc, I used to run in
high school, I, I would go running,

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it just doesn't really feel safe.
There are no lights in the park nearby.

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It doesn't feel safe on the
streets. You know, explore,

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could lights be put into the
park and can you as a physician

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call parks and recreation in
your town and see if, you know,

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you can get a dialogue going,

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maybe you can get on the
budget for the next cycle. Um,

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you're gonna have a lot more influence
calling and advocating for the whole

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community than a single individual might.

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And maybe there are ways you can
be helpful. But the point is, we,

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um, you know, we at Kaiser Permanente
have folks who can help with that,

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who are trained in how
to work with communities,

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how to work with government
agencies, and that's great. Uh, uh,

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but we need to at least be
thinking about these issues,

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ways in which we give advice all the
time, you know, you need to eat better,

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but our patients may live in communities
where they can't even find fresh fruits

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and vegetables in the stores.

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So we need to know what's going on in
our patients' lives so that we can help

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them the best way possible.

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Absolutely. Yeah, I
completely agree with you.

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You gave some great solutions
for daily problems for sure. Uh,

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before I let you go, the last
thing I wanted to ask you is,

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what will the most effective healthcare
leaders need in order to be successful

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in the next two to three years or so?

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I would say to listen,
I think we need to, uh,

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when we're in patient care
environments, listen to our patients,

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find out what they want, find out what's
working, find out what's not working.

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And you know, if,

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if we find that our clinicians
are so busy that they just tell

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the patient, here's your diagnosis
and here's what we're gonna do,

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rather than saying, you know,

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here's several possible
approaches to your diagnosis and

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exploring with the patient, their
values and the pros and cons of each,

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rather than just defaulting to
what we would do if we were the

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patient. Uh,

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we need to find out how we're doing and
how things are going from the patient

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perspective. And I think
that's very important.

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And then the same for our
teams, our clinicians,

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our, you know, our physicians, our
nurses, our respiratory therapists,

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our social workers. There's a large
team of people working to provide care.

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And, you know, in a
medical school environment,

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there are faculty and
staff as well as students,

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and we need to hear what's
going on. Uh, talk to folks in,

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in large groups, but also
one-on-one in small groups.

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Give those around us a chance
to, um, share what's going on,

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an environment to share in which
they feel comfortable sharing,

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whether it's directly with the leader,

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whether it's a designated
Ombuds person or others who are,

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um, there with a certain sort of, um,

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set of trainings and skills to
be able to hear things and pass

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information on in a way that's
packaged and confidential. Uh,

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but I think it's very important that
we create avenues for communication

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so that we really know what's going on.

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It's easy to think that the way
we provide care is fantastic

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and not have a perspective of,
it's aiming to be fantastic,

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but it's kind of missing
the boat in certain areas.

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And the one of the hardest things for a
leader is to get accurate information.

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And I think that's something that
we all need to work really hard on.

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Absolutely. Thank you so much
for those final thoughts. Doctor,

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this has been an amazing discussion.

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So I wanna thank you so much for coming
on Baker's Healthcare and I look forward

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to connecting with you again soon.

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Well, I, I've really
enjoyed talking with you.

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Thank you for these great questions.

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Thank you for the opportunity and
I would love to talk again. So, um,

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I look forward to it.

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Yes, absolutely.

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It's so important for leaders at the
top of organizations to keep learning,

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00:13:41,260 --> 00:13:42,910
stay sharp, grow their networks,

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00:13:43,260 --> 00:13:46,510
help our audience better do this
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00:13:46,570 --> 00:13:50,510
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00:13:51,020 --> 00:13:54,030
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