
AI in Modern Medicine: The Future of Patient Interaction with Dr. Jay H. Sanders
Hello. Welcome to another episode of the healthy enterprise. I have a very special guest today. His name is doctor Jay Sanders. I've been looking forward to this chat.
Heath Fletcher:Doctor Sanders has been a long standing, medical professional implementing organizational advancements and strategies over his length career. He is also the CEO of the Global Telemedicine Group. So, let's get started. So welcome, Jay. Thank you for, honoring me with, being on our podcast, and and this episode is all about you.
Heath Fletcher:So tell us tell us about who Jay who Jay Sanders is.
Dr. Jay H. Sanders:It's a good thing you didn't ask my wife. Well, I'm, I guess professionally, I'm a professor of medicine at John at Johns Hopkins University School of Medicine. And I had spent the last decade and a half, trying to get telemedicine started as well as, believe it or not, AI.
Heath Fletcher:Incredible. And I think when I talked to you last, you said you get, mislabeled as the father of telemedicine. Is that right?
Dr. Jay H. Sanders:Yeah. Unfortunately, I do. I guess in a way, should be happy about that, but it really doesn't give credit to the person who got me started, on this, who was my professor of medicine, doctor Kenneth Byrd at the Massachusetts General Hospital, who came up to me in 1967 when I was running the emergency department. There was no emergency medical specialty in those days. So the medical resident, the surgical resident, each to each to twelve hour shifts running the ER.
Dr. Jay H. Sanders:And I was running the ER this particular day and the ER doors swung open wildly. And, of course, I thought it was another Boston classic traffic accident victim.
Heath Fletcher:Right.
Dr. Jay H. Sanders:But no. It was my professor standing there. It was a summer day and he was he was sweating, red face, and looked upset. And he immediately saw me and he came walking up to me somewhat rapidly. He grabbed my arm and he said, Jay, I've solved the problem of the traffic in Boston.
Dr. Jay H. Sanders:Now he had an outside office. He was actually medical director at Logan Airport Medical Station at the time. And the airport was only about three, three and a half miles away from the hospital, but it used to take him an hour each way because of the terrible traffic. So I immediately said, well, what's that doctor Bert? He said, I'm gonna buy two black and white TV cameras.
Dr. Jay H. Sanders:And why he said black and white was there were no color
Heath Fletcher:Right.
Dr. Jay H. Sanders:In those days. And I'm gonna start to examine patients from here in the MGH ER out at Logan Airport. What do you think of my idea? Now you have to understand, and let me repeat, I was a resident.
Heath Fletcher:Right.
Dr. Jay H. Sanders:He was my professor. I thought it was the stupidest idea I'd ever heard of in my life. But I had enough common sense to say, gee, doctor Bird, that's a very interesting idea. And he then went to doctor John Knowles who subsequently became president of Rockefeller Foundation in New York. John was the medical director of the mass general at the time who was an equal maverick type as was Ken Byrd.
Dr. Jay H. Sanders:And John gave him the money to buy two black and white TV cameras. And by the way, the communication network in those days went microwave antenna
Heath Fletcher:Right.
Dr. Jay H. Sanders:Every 30 miles. You couldn't go more than 30 miles, the signal wouldn't help.
Heath Fletcher:Right.
Dr. Jay H. Sanders:So he set the system up and by 1969 when the system was already working functionally, I had become chief resident in Madison. And I what he was doing was fascinating. And he he did come up to me and he said, you know, what should we call this? We can't call it television medicine. Why don't we just call it telemedicine?
Dr. Jay H. Sanders:I saw the name thing about.
Heath Fletcher:That was it.
Dr. Jay H. Sanders:As simple and as strange as that
Heath Fletcher:Amazing.
Dr. Jay H. Sanders:That's how it that's how it occurred. And then, I subsequently went to the University of Miami School of Medicine, to be quite candid. The reason I did was I couldn't stand the gray skies in Boston and I loved the idea of sunshine in Miami. And the chairman that at the time allowed me to set something up, which I did in 01/01/1970 when I got down there, the first division of general medicine in the country. Now there's a division of general medicine in every department of medicine in the country.
Heath Fletcher:Right.
Dr. Jay H. Sanders:So what if you Google me, what it really should say is I'm the father of the division of general medicine. Right. Not the father of telemedicine. Okay. Moving on.
Dr. Jay H. Sanders:In 1973, the National Science Foundation and what was then HEW was it what was then, health education and welfare. I apologize. What was then h a what was now HHS, which was then HEW, Health Education and Welfare. And became very interested in, utilizing telecommunications to transport healthcare. And I applied for one of their grants and got that grant, did a three year study demonstrating how well telemedicine worked.
Dr. Jay H. Sanders:And then from 1976, after our grant was completed, demonstrating the incredible effectiveness of telepsychiatry, I could not get anyone interested in the country until 1991.
Heath Fletcher:What? Wow. Twenty years.
Dr. Jay H. Sanders:Twenty years.
Heath Fletcher:That's Had astounding.
Dr. Jay H. Sanders:But it was almost worth the twenty years. One, the telecommunication infrastructure dramatically in the country. Yeah. We didn't have to use microwave antennas any longer. It was the it was the, era of t one, lines in the ground.
Dr. Jay H. Sanders:And I got a call from the then governor of Georgia, governor Zell Miller, who said, Jay, I heard about your telemedicine interest. I'd like you to come up and meet with me because I'm thinking of developing a statewide television network in the state of Georgia. Now today, that wouldn't sound so exciting. No. But that was that was the first.
Dr. Jay H. Sanders:And between 1991 and 1993, I set up a 59 site hospital system throughout the state of Georgia connecting rural hospitals to secondary care comprehensive hospitals and those in turn to academic medical centers. And probably most one of the most important things I learned was not only the improvement of healthcare but what governor Zell Miller taught me about economics and I would call it economics one zero one which they never taught me in medical school and that was that, what was happening in Georgia was happening in every state in The United States. Rural hospitals were closing. The reason they were closing was they didn't have the expertise there to deal with the types of patients that they would see so they would have to transfer the patient.
Heath Fletcher:Right. Everything would happen in the major centers.
Dr. Jay H. Sanders:Absolutely. What we were able to do was fundamentally change that, diagram to put the arrows going from the academic medical centers out to the rural hospitals. We were able to now bring education to the primary care physicians who are out there, increase their level of care, sustained the hospital bed sexes.
Heath Fletcher:Right.
Dr. Jay H. Sanders:And next is the most important part, which was what governor Zell Miller taught me. He said, when we first met, he said, Jay, when a rural hospital closes, what most people forget is the fact that that rural hospital was the biggest employer.
Heath Fletcher:Exactly.
Dr. Jay H. Sanders:And when that rural hospital closes, the entire socioeconomic fabric of that community closes within a three to five year period of time. He was absolutely right. We were also able to demonstrate not only to be able to keep open those hospitals but fundamentally to improve the educational level of the primary care physicians. So you saw a primary care doc doing gastroscopies. He was never thought to do gastroscopies.
Dr. Jay H. Sanders:We taught him how to do it. Right. Over telecommunication.
Heath Fletcher:Incredible. On the job training.
Dr. Jay H. Sanders:Yeah. It was do you think about Star Trek and the transporter?
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:This was the original transporter.
Heath Fletcher:Yeah. I mean, it's very sign it was very futuristic. It was very forward thinking, wasn't it?
Dr. Jay H. Sanders:Yeah. And it was all because of w s l Miller and I also must mention the person who asked him to call me, that was the president of the Medical College of Georgia, doctor Francis Tedesco who I had recruited to the University of Miami initially And about three to four years after he was with us in Miami, he asked me to write a letter of recommendation for him to become chief of gastroenterology at the Medical College of Georgia. And over a number of years, he advanced to become the president of the Medical College of Georgia. So it was I'm really glad I recruited him initially to the University of Miami because none of this ever would have happened. And right after we filled up our system on 1993, I started the American Telemedicine Association, ATA.
Dr. Jay H. Sanders:And also put in for some funding from the US government. In those days, we called it an earmark And I got funding because of another observation I made when we set up our system in Georgia. And that was that there were some patients in these rural hospitals who are being readmitted about every two to three weeks. I was wondering why in the world particularly our asthmatic patients who would come into the ER needing to be intubated and sent off to the intensive care unit, then we'd stabilize them, before discharge. They almost had normal pulmonary function test.
Dr. Jay H. Sanders:And then two to three weeks later, they're back in the ER. He said, wait a minute, what is happening? I said, I need to be able to see these patients at home. So I put in for a government grant to set up a system whereby I could begin to see patients in their home. This was 1995.
Dr. Jay H. Sanders:Okay? And to make a long story short, all it took was the first patient that we saw open the system to realize what was happening. There was this patient who had severe asthma. I won't obviously give you her name.
Heath Fletcher:No. And
Dr. Jay H. Sanders:we see her in her home. And as I'm watching, she's sitting in this great big puffy chair with a cat in her lap. And her husband is watching this interchange with a cigarette in his mouth. And never wondered again why she was being reinvented every couple of weeks. And it was then that it dawned on me that the best exam room is where the patient lives, not where the doctor works.
Heath Fletcher:Right.
Dr. Jay H. Sanders:That's that started, the state of Arizona paid to see our system. They put it into their yearly, budget, state budget. Then the state of California came. And then everything rolled over, every state followed, the same pattern. There was one problem though that basically put a stop sign, on all of this.
Dr. Jay H. Sanders:And that was that for some reason, HEW HEW would not pay the physicians for the care that they were providing over telemedicine.
Heath Fletcher:Really?
Dr. Jay H. Sanders:Yeah. And I When I questioned them about it, they said, well, you know what, we'll pay the radiologist but we won't pay anybody else. And I said, well, why? They said, well, the radiologist never really sees the patient, they just see the x-ray. So I said, why don't you pay the pathologist?
Dr. Jay H. Sanders:Pathologist doesn't see the patient.
Heath Fletcher:Good point.
Dr. Jay H. Sanders:And their and their answer was very simply, no.
Heath Fletcher:Is that the case today still? No. Oh, that's changed.
Dr. Jay H. Sanders:What changed it? Hey. I had to change it.
Heath Fletcher:They had to change it.
Dr. Jay H. Sanders:Why? COVID.
Heath Fletcher:Oh, it didn't change until COVID?
Dr. Jay H. Sanders:It did not change until Wow.
Heath Fletcher:It took COVID.
Dr. Jay H. Sanders:Unbelievable. So I started doing this in 1969, '19 '70, '19 twin 2020, '15 years of a proven product
Heath Fletcher:Right.
Dr. Jay H. Sanders:Would not be paid for. So if anyone wants to look at why it takes so long, sometimes we better look at them in the mirror and question what we're doing.
Heath Fletcher:It's such a good point. You know? It's and it's probably not an unusual story. I mean and and sometimes it it takes major incidences to to make that shift. But, I mean, had you not laid the groundwork and began that process and implemented those systems already, you know, I I guess, to a certain extent, you you you prepared the ground.
Heath Fletcher:It just took Right. Took a lot longer to to get the get the tree to grow.
Dr. Jay H. Sanders:Now a similar similar thing happened. Also in 1969, when I was chief president of the MGH, we had a we had a weekly routine where the third year resident would find a complex case in the hospital and then presented to me, the chief resident, as an unknown and had me explain what was going on or at least try to explain what was going on. And, I had just finished one of these sessions. And I was saying to myself, you know, you did a pretty good job with that. And the third year residents were leaving the room and all of a sudden, I got a tap on my back.
Dr. Jay H. Sanders:And I turned around and it was like another professor, doctor Octo Barnett. And everybody should look him up because he's considered the true father of bioinformatics.
Heath Fletcher:Oh, Octo Barnett?
Dr. Jay H. Sanders:Octo Barnett. Okay? And he said, Jay, you could be replaced by a computer. And I turned around and I did exactly that. I started laughing at him and I said, come on doctor Barnett.
Dr. Jay H. Sanders:He said, yes. Come on. Let's try it. So he tweaked my interest and we started doing AI. In 1969, our only problem was we didn't have the computer power to really go much Today, we not only have the computer power when we get fully functional quantum computing, we'll have all the computer power we need.
Heath Fletcher:Yep.
Dr. Jay H. Sanders:And quite candidly, eventually, AI will be much better than me. Mhmm. It'll be much better than any individual position because it brings collective
Heath Fletcher:Collective knowledge. Yeah.
Dr. Jay H. Sanders:And it will bring the most up to date information that none of us as individual physicians can do. We cannot keep up to date.
Heath Fletcher:Right.
Dr. Jay H. Sanders:The reason for the huge growth in specialty care is the fact that a doctor says to himself or herself, look, the only field I have to go into a narrower and narrower intellectual space for me to try and keep up. AI will keep up.
Heath Fletcher:Yeah. That's a great point. It brings us to today that, and I want you to explain to me where where you are at today and what you're actually doing currently because, you know, the issues with a that people complain about AI and some of the technologies, it's not it makes mistakes. You know? It is still you still need a human operator.
Heath Fletcher:You still need a human to verify or to validate. But how do you feel about that? Like, I mean I mean, it's still early days for AI. We're just kinda figuring out how to use it and and apply it in life. But, bring me up to speed.
Heath Fletcher:Where are you at today? Because you're working with, the Global Healthcare Group. Right? And, tell me what that is and and what you guys are doing around that.
Dr. Jay H. Sanders:Sure. Well, the Global Telemedicine Group, consists of me.
Heath Fletcher:Oh.
Dr. Jay H. Sanders:I'm a sole consultant. I don't know why I put group there. It's probably because I was I was spending so much time talking to myself. That caused me to to call it a group. Your multiple multiple personalities.
Dr. Jay H. Sanders:That's right. I think after meals, somebody someone's gonna refer me to a psychiatrist.
Heath Fletcher:Well, you can do it over tell us telemedicine at least.
Dr. Jay H. Sanders:Right. Exactly. No one will know. But fundamentally, let me let me go back to what you just said. You just said that AI makes so many mistakes.
Dr. Jay H. Sanders:You know how many mistakes we physicians make? It's been documented. In 1999, the Institute of Medicine, they changed its name within the past number of years. It's now called the National Academy of Medicine. And came out with a paper called, very benignly called to air this human.
Heath Fletcher:Mhmm. Makes sense.
Dr. Jay H. Sanders:Unfortunately, if you read the paper, it says that we wonderful physicians kill up to ninety eight thousand people a year from inadvertent medical error.
Heath Fletcher:Misdiagnosis?
Dr. Jay H. Sanders:One thousand percent.
Heath Fletcher:All kinds of things
Dr. Jay H. Sanders:go away. To back it up, in 02/2015 in the British Medical Journal, my institution, Johns Hopkins, said, no. Jorah's human is wrong. We actually kill closer to two hundred and fifteen thousand people a year Wow. From inadvertent medical errors.
Dr. Jay H. Sanders:So no one should point a finger at AI.
Heath Fletcher:Right.
Dr. Jay H. Sanders:They should point a finger at us.
Heath Fletcher:And I suppose, you know, when you when a doctor's, know, presented with a a patient problem, I mean, really, they're they it's not like they know the answer up right off the bat unless they're a specialist like you said. So they gotta go and and look at peer reviewed studies. They gotta look at what other people have done in the past, compare their current patient situation with other patient situations because, yeah, it might be a very similar condition, but everybody's genetically predisposed to something different, and it could react slightly different. And that's why we're seeing all these sorta, like, custom pharmaceuticals because it matches each person's genetic information plus the disease that they're where they have might have slightly different genetic combinations as well. So I I guess in that sense, you it it's right.
Heath Fletcher:It's collecting all this data, all this information, and then you're use you're using that to actually streamline processing all that information to get some sort of, prognosis or diagnosis.
Dr. Jay H. Sanders:Well, I should be interviewing you. Not you interviewing me because you hit the nail on the head. The fundamental First of all, let's look at a broad scope. What a lot of people don't realize is that healthcare today, medicine today is statistically based. It's not individually based because we don't use an individual's genetics.
Heath Fletcher:Right.
Dr. Jay H. Sanders:An aspirin may be 95% effective in reducing coagulation and reducing a a thrombus.
Heath Fletcher:Right.
Dr. Jay H. Sanders:A thromboembolism to the lung. Okay? But what about the five percent who are put on aspirin who it doesn't help? Genetics need to be incorporated into our evaluative system and we now know what the genome is and the cost of getting a genetic analysis has gone down dramatically. Every child that births, when they stick your heel for your blood type and the other inborn errors of metabolism that they're checking for.
Dr. Jay H. Sanders:They should also get a little extra blood to do a genetic analysis.
Heath Fletcher:Yeah. Right out of the gate.
Dr. Jay H. Sanders:And now the third thing, telemedicine, AI and medical sensors Right. That are programmed to your genetic makeup. And now, we go from healthcare that is reactionary, I e, we take care of you after you get sick
Heath Fletcher:Right.
Dr. Jay H. Sanders:To healthcare that is anticipatory Right. In which you and I as the patient become the primary care physician. Right. Because we are now have the appropriate AI and medical sensors that we're wearing in our shirt, in our belt, on a ring, on a watch that tells us, you know what, something's wrong, We better go do something about it. We go from reactionary health care where you go into your ER because you just got sick to anticipatory health care where you prevent the illness in the first place.
Dr. Jay H. Sanders:Right. That's where our health care delivery system needs to go.
Heath Fletcher:Right.
Dr. Jay H. Sanders:Now, whether it's gonna take the fifty years it took me to get telemedicine going, Well, I won't see it, I'll be long gone but we need to come realistic about what is wrong with our healthcare delivery system and get rid of our egos and begin to use some of the technologies that we developed and let that be our egos.
Heath Fletcher:That's right. Right. That's that's the trophy at the end of that. You know, like, that's what, you know, lead all this, like, fifty years of of, or more longer, hundreds of years of of collecting information and data could bring us to this point where we're leveraging technology to make not only doctors' jobs easier, but actually the patients' lives easier so we can like you are you saying more or less self diagnose or have the information to understand what your condition is in advance. Right?
Dr. Jay H. Sanders:Absolutely.
Heath Fletcher:Right. Or what your Absolutely. What your potential what your genetic potential is, I suppose, for for being predisposed to certain illnesses.
Dr. Jay H. Sanders:There there's actually a very simple way, to do it that protects everyone's ego. Everybody has electronic medical records these days.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Certainly in Canada, certainly here in The US.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Okay. Don't we put an AI genetic system into interrogating every patient's physicians EHR, looking at their history Mhmm. Their physical exam, their differential diagnosis, their laboratory data, their radiological data and comparing it with the most up to date database constantly changing as new information comes aboard and then notifies the physician, hey by the way based upon this patient's genetic, this medication is not going to work for this condition but this other medication will work and it notifies the physician, doesn't embarrass the physician, okay? And the physician notifies the patient. And by the way, it won't cost the physician anything and it won't cost the patient anything
Heath Fletcher:Right.
Dr. Jay H. Sanders:For the system to be developed Right. Because guess who's gonna pay for it? The physician's malpractice insurer will pay for it.
Heath Fletcher:You're right. They sure will.
Dr. Jay H. Sanders:And the hospital's insurer will pay for That's the solution.
Heath Fletcher:Well, I mean, they're they're the ones that are paying the bills at the end of the day when, somebody gets sued and and and yeah. They're getting paid they're getting paid by the patients already too to cover those costs.
Dr. Jay H. Sanders:Yeah. Absolute absolutely.
Heath Fletcher:You know, you were talking about connecting all the data. So you connect all your your lab results and and your doctor's notes and the visits to the specialist, etcetera. So I can't even you can't even right now, you can't even get drugstores to connect their information so that if you happen to go to a different drugstore for a for a refill on your medication, they're not talking to each other. Everything is a closed circuit. So, you know, one series of drugstores has it.
Heath Fletcher:So if you can go to as long as you go to their drugstore, they got your data on records. Sometimes, I've even run into that where it's, you know, you know, it's a a drug store chain, and they don't actually they can't even talk to each other, and they are in the same company. So, you know, what are the risks of that? Of bringing all that information into one place, all that very sensitive information about each individual and their information. Do you see risks there?
Heath Fletcher:Do you see that some people will just be opposed to one giant health medicine data center that holds all that information and connects all the people. You know, there are there risks that people think I mean, someone's bound to wanna take advantage of that in a dark and evil way.
Dr. Jay H. Sanders:But No. Absolutely. I think that's a very pertinent question. I haven't thought a lot about it. Yeah.
Dr. Jay H. Sanders:But the they're gonna be cyber attacks.
Heath Fletcher:Yeah. Yeah.
Dr. Jay H. Sanders:I think the more the more we put data out electronically, the greater attempts are gonna be to break in
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:With that database. And on the opposite side, there'll be greater cybersecurity. Yeah. I
Heath Fletcher:Someone on the
Dr. Jay H. Sanders:totally agree. There can be there will be problems.
Heath Fletcher:But if you can imagine the advantages of all that coming together where all that information is stored, collected, and then analyzed by AI and and it and and results are presented.
Dr. Jay H. Sanders:Absolutely.
Heath Fletcher:It would be a it would be a a whole new world. Yep. I mean, the pandemic, it shifted a lot of perspectives in a lot of ways. So, you know, and and in some cases to the good, but it also exposed a lot of, weaknesses. And I think the medical, the health care profession and the medical industry realize that.
Heath Fletcher:I mean, the capacity overload, the shortage of doctors, the burnout of of frontline workers. I mean, it was it was rampant, and it we are aren't prepared for those kinds of situations, are we?
Dr. Jay H. Sanders:No. We're not. I mean, we have organizations in each country, that is constantly looking at, potential cyber attacks. I think our capabilities will become more and more sophisticated the more of these types of systems get developed. So it's going to be a chain or a wheel type of type of effect.
Heath Fletcher:Mhmm.
Dr. Jay H. Sanders:Whether that should stop us in this position there?
Heath Fletcher:No. We gotta keep pushing ahead. Yeah.
Dr. Jay H. Sanders:No. I'd I'd rather know that I'm getting the right medication
Heath Fletcher:Yep.
Dr. Jay H. Sanders:For my illness. And the fact that somebody else knows and I'm taking this medication, I really don't care if it's helping me.
Heath Fletcher:Yeah. Yeah. It's a good point. Yeah. You're a visionary.
Heath Fletcher:You know, like, you've been you've been doing things, since you started your career. I mean, I yeah. We didn't talk a lot about it, but when you, you know, developed the division of general general Medicine. Medicine. Yeah.
Heath Fletcher:I mean, you were already trying to create new ways of doing things better. And what what inspired that anyways? What what made what brought you to that decision to to start that?
Dr. Jay H. Sanders:Well, that also happened during my chief presidency year. One of the things that the president was allowed to do every day was to choose, a different team, to work with. And when I say work with, really to attend their attending rounds. And basically, an internist specialist at the hospital would be assigned on a monthly basis to a particular resident intern team. And he or she would come around at 10:00 in the morning and make rounds on all the new patients that came in and to go over any problems that existed on the previous that may have come up over the previous twenty four hours.
Dr. Jay H. Sanders:And one of the things I noted, I I was really just a guest. I could fit in though on on any of these rounds
Heath Fletcher:Right.
Dr. Jay H. Sanders:On just as an observer. And one of the things I observed was quite startling to me that I never really realized when I was your resident and that was, I'll give you an example. Let's assume a patient came in who had diabetes and had a diabetic foot ulcer. That diabetic foot ulcer is caused by a neuropathy that the patient has, a nerve problem that they have. But if the attending was a cardiologist, he or she would spend the entire hour talking about diabetic cardiomyopathy and nothing about the neuropathy.
Dr. Jay H. Sanders:So the residents left at pending rounds knowing everything about diabetic cardiomyopathy and nothing about the patient. And I said I said to the chief of medicine at the time who is doctor Alex Lee, just a wonderful human being and great doc who said, Jay, I'd like you to stay here at the MGH and I'd like you to run a division. I'm not gonna mention the division for personal reasons because the head of that division who was head at the time, who I was going to replace by took Alex Leap's suggestion, was a good friend. I so he said, I'd like you to stay here to run this division. And I said, thank you very much, doctor Leith.
Dr. Jay H. Sanders:And I had taken some, specialty training in that particular specialty area. And I said, you know what? One of the major problems here at the MGH which is a well known institution Mhmm. Is what I just described to you. The fact that they, the residents are learning what this particular doctor knows but not nothing about the patient had just came in.
Heath Fletcher:Right.
Dr. Jay H. Sanders:I said, what I'd like to do is develop a division that is made up of faculty that have a very, very broad base that can handle eighty five percent. Those are my exact words. Eighty five percent of the patients who come in and help daucephat. They care about that patient. And he looked at me and he said, no, I want you to run this present division.
Dr. Jay H. Sanders:And I said, well, give me a couple of weeks to think about it. About two weeks later, I got a call from doctor William Harrington from Barnes Hospital in Saint Louis who had just been named the new chairman of the department of medicine at the University of Miami. He said he wants me to come down to run the house now which was great for me. I said, doctor Harrington, would you also let me start a new division called the division of general medicine? They said, what's that?
Dr. Jay H. Sanders:I explained to him what I'm explaining to you. And he said, well, I really don't know what that is. But if you wanna do that also, you can. So on 01/01/1970, when I first got to the University of Miami, I started the first division of general medicine in the country. And that's what I'm the father of.
Dr. Jay H. Sanders:And I'm the father of my four other sons. But not the father of telemedicine despite what Google said. It's Ken Byrd.
Heath Fletcher:Maybe you're the son of Pennell telemedicine or the nephew of telemedicine or something like that.
Dr. Jay H. Sanders:The net I'm the nephew.
Heath Fletcher:Oh, that's great. That I mean, so you I mean, you've been yeah. In a way, you kind of been working organizationally to simplify and streamline and innovate health care for so many years. You know, I mean
Dr. Jay H. Sanders:Much much to my dismay.
Heath Fletcher:You've come a long way. So tell me, what's on your desk today? Like, what's what's paramount for you, when you get up every day? What are you working on that's the most important thing right now for you?
Dr. Jay H. Sanders:Well, as I mentioned, I'm a consultant, in the areas of telemedicine, AI, and medical sense.
Heath Fletcher:Mhmm.
Dr. Jay H. Sanders:Sometimes I feel more like a cheerleader than a consultant.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:But, yes, that's what I'm doing because then we'll have that kind of health care system that we really need
Heath Fletcher:Right.
Dr. Jay H. Sanders:From birth. And it'll be an anticipatory health system. You and I will be the primary care practitioners
Heath Fletcher:Mhmm.
Dr. Jay H. Sanders:For our own health.
Heath Fletcher:Right. And so when you're consulting who are you called consulting with during this process and to know what kind of challenges are they facing through this?
Dr. Jay H. Sanders:Well, first of all, we should underline challenges
Heath Fletcher:k.
Dr. Jay H. Sanders:Because I really have to explain the rationale and the logic and then identify, some of the better technologies that are out there. For instance, you may find this crazy but just as as one example, I view Alexa as a technology that I can incorporate your personal, medical background into as well as your genetics. And Alexa, for the Alexis of this world
Heath Fletcher:Right.
Dr. Jay H. Sanders:The AIs of this world will be in your home. I see I know you're gonna laugh. I see homebuilders. I see home security companies knocking on your door and saying, look, we provide like ADT. We provide home health home security but we also provide you home health security technology.
Heath Fletcher:Yep. I believe that.
Dr. Jay H. Sanders:It will tell you whether or not you've forgotten to turn off, your gas burner in your kitchen. It will let you know, by the way, it's time for you to take your medication.
Heath Fletcher:Right. Right.
Dr. Jay H. Sanders:Okay? Even if you have Alzheimer's, it's gonna tell you you need to take your medicine at this point in time. By the way, don't take this other medicine that you just bought at the store. It's not gonna work.
Heath Fletcher:It'll
Dr. Jay H. Sanders:As a matter of fact, it's gonna create problems for you.
Heath Fletcher:It's gonna conflict with your other medicine or your vitamins or whatever.
Dr. Jay H. Sanders:Exactly. I see I think as I mentioned or tried to mention before, we need to become more responsible for our own health.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:The same way we're responsible for crashing into another car by our driving.
Heath Fletcher:Right.
Dr. Jay H. Sanders:We need to take care of our own health and we go to the doctor when we don't have a choice. Okay? When what we're doing is not working. But we need to be our own primary care physician.
Heath Fletcher:Yeah. Before it gets to that point.
Dr. Jay H. Sanders:Absolutely.
Heath Fletcher:Right. Yeah. When you're at 911, it's not really much help when you haven't paid attention along the way. I mean, just going back to the lady with the cat and the smoking husband. I mean, what we're doing in our living rooms and our kitchens and our you know, in at home is is more important than, you know, really the the the byproduct of that, which is some sort of condition or illness or something.
Heath Fletcher:It's Now we're at.
Dr. Jay H. Sanders:Yeah. Abs absolutely. And in a way, we're moving in that direction. Yeah. Perhaps the wrong perhaps the wrong way, but maybe we'll get there.
Dr. Jay H. Sanders:And that is the new hospital at home program.
Heath Fletcher:Right.
Dr. Jay H. Sanders:Where we're taking care of a lot more patients in their home
Heath Fletcher:Yep.
Dr. Jay H. Sanders:Rather than keeping them in the hospital. Right.
Heath Fletcher:Well, I mean, they are they have they do have the telemedicine model is really well, and since pandemic, it's really quite it's been activated. It's probably quite popular now.
Dr. Jay H. Sanders:Absolutely.
Heath Fletcher:Most initial visits, I'm understanding, from doctors, family physicians are over the phone, video calls just to kinda get an idea of what's going on rather than, there you go. We take them with us everywhere we go.
Dr. Jay H. Sanders:Yep. Yep. Yep.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Exactly. We're connected.
Heath Fletcher:We are. We all are. And I'm glad we're connected. I've really enjoyed this conversation. I I knew it was gonna be great, and I knew we would probably need more time.
Heath Fletcher:So you might have to come back for another chat some one of these days here soon.
Dr. Jay H. Sanders:Sounds sounds good.
Heath Fletcher:Yeah. And yeah. So for to wrap up, what what what's ahead? What do you see what do you see in the near future for you? Where's you know, what are you excited about?
Dr. Jay H. Sanders:Well, let's deal with your first question. What do I see for me? I guess being able to proselytize, continue to proselytize where we need to go. But I'll be very candid. In July, I'll be 88.
Dr. Jay H. Sanders:So I'm not sure I have that much more time but I'm counting on you to do that.
Heath Fletcher:Well, man, I wouldn't I didn't guess you're 88. You're doing awesome.
Dr. Jay H. Sanders:Well, thank you.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Thank you.
Heath Fletcher:And you're still not retired?
Dr. Jay H. Sanders:No. I I right now, I'm only driving my wife crazy, but I would probably drive everybody else crazy if I retire.
Heath Fletcher:And then I had one other question. What was it? I said, what are you excite oh, what are you excited about? What are you are you going on any vacations or are you just gonna are you working on this project?
Dr. Jay H. Sanders:No. Working on this project.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Yeah. Starting a long time ago doing this.
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:I'd like to see it finally accepted
Heath Fletcher:Yeah.
Dr. Jay H. Sanders:Adapt it.
Heath Fletcher:What's that gonna what's that gonna take? What do you think what do you need? What if you could resolve this tomorrow, when woke up tomorrow and it and it was where you want it to be, what did what does it look like?
Dr. Jay H. Sanders:Well, if you had a magic wand Yeah. Yeah.
Heath Fletcher:Wave that around. Yeah.
Dr. Jay H. Sanders:Wave it as rapidly as you count. Now it's gonna take time. Yeah. I'm old enough to know that we don't change our minds very quickly. And the complexity of what it takes here in The US, the complexity was a simple one.
Dr. Jay H. Sanders:Two things happened. One, a pandemic and two, the government had to let down and pay for it. And then finally, people began to realize, the potential value of AI.
Heath Fletcher:Right.
Dr. Jay H. Sanders:And and I hope it continues to accelerate because it's desperately needed, but we need it can't be generic like our system is today. It's gotta be specific. The only way it's gonna be specific is to integrate genetics.
Heath Fletcher:Well, one thing I agree on is that AI is be much better applied and more useful to us than, using it for deepfake videos and blog posts. Yeah.
Dr. Jay H. Sanders:Let let me end yeah. Let let me end with this. I I view telemedicine as simply providing access. It doesn't provide accuracy. AI is going to provide accuracy sensors with generics.
Dr. Jay H. Sanders:They're gonna provide specificity.
Heath Fletcher:Right.
Dr. Jay H. Sanders:Those are the three critical components.
Heath Fletcher:I love it. Access, accuracy, and specific specificity? That's not easy to say. We gotta find
Dr. Jay H. Sanders:a better word. Specific. This
Heath Fletcher:is great. Thank you, Jay, so much. It's been a pleasure. And definitely would like to have you back if you're up for it, but it's been great having you on a podcast. So thank you for your time.
Dr. Jay H. Sanders:Oh, you're very welcome. And you better if you're gonna have me again, you better do it quickly given my age.
Heath Fletcher:Okay. You got it. Speaking to somebody who has been, working as long as he has in, in the medical profession and how innovation was happening for him, you know, fifty years ago. He was, like, on the front lines of, like, of telemedicine, which is pretty remarkable that, of course, that it took until during the pandemic to actually roll it out and and where it's become mainstream. But I think, you know, he's kinda had a whole career of always being ahead of the curve, you know, modifying, simplifying processes, incorporating new ways of of looking at how health care should work.
Heath Fletcher:So, you know, a pioneer in a sense, in technology also. And now even now, still at 88 years of age, Jay is still, pushing the envelope, you know, with taking telemedicine, which what he says is the access to medicine and medical professionals. AI, which he believes is going to improve accuracy and and and speed, obviously, for the process. And then censoring, which is going to advance our our perspective of medical support as being more preventative as opposed to reactive. So fantastic conversation.
Heath Fletcher:I thoroughly enjoyed that. I'm gonna have him back because after we were recording, we were talking about genetics. So but that's a subject for another day. We didn't have time for any more than that. I do want to point out that doctor Sanders has a book co out called digital medical home.
Heath Fletcher:It's co written with Michael s Gordon. And so I'm gonna get that I'm gonna order that book right now. How the telemedicine revolution ignited the creation of precision health. So there you go. There's a book you can go check out of doctor Sanders.
Heath Fletcher:Thanks for listening, and stay tuned.
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