Charting New Frontiers in Medical Innovation and Entrepreneurship

[00:00:00] Jared: Hello everyone, and welcome to the med+Design podcast where we explore the journeys of medical innovators. It's my pleasure to welcome our next guest, Dr. Harvey Castro. Dr. Castro is a distinguished physician, entrepreneur, and healthcare innovator with a passion for improving patient care through cutting edge technology.

Throughout his career, Harvey has founded multiple healthcare startups, including Deep Think Health and iMobile Health Mission, focusing on areas such as AI driven clinical decision support, digital health and emergency medicine. As an author of several books and a leader in the healthcare innovation space, he's dedicated his time and expertise to transforming the future of healthcare for all of us.

Dr. Castro's wealth of knowledge and experiences in both medicine and entrepreneurship, make him an ideal guest for our podcast, as he often finds himself at the forefront of healthcare innovation. So, Without further ado, let's dive into our conversation with Dr. Harvey Castro.

Welcome.

[00:00:51] Harvey: Welcome everyone, and thanks everyone for coming.

And hey, both of you guys, thank you so much for having me. Honestly, this is an honor to be here, so I appreciate it.

And we're so happy to have you. So I think, we'll just get started with, what really inspired you to pursue a career in medicine in the first place, and how'd you ultimately choose emergency medicine as your specialty?

Ah, I take a little pause there and sigh. It all goes back to my upbringing. I grew up with basically nothing and that's not an excuse for what I'm about to say, but I think just not having access to healthcare, not having anything opened my eyes to the need for healthcare.

And it really created this spark and passion to help others. And I know that sounds very cliche-ish, but sincerely, that was the opening moment that I thought, huh, I have a really horrible scar here on my left hand, and it's a reminder. Typical idiot teenager that I was I was running around hitting parking signs and one of 'em was trying to be someone was trying to steal 'em and then left they couldn't get it up, but left a sharpie edge.

So when I went to hit it, I came down and slashed my hand open, pretty bad bleeding. I was about 12. Went to the emergency room, and I'll never forget they didn't use anesthetic. I felt every stitch. The doctor said that they couldn't use anesthetic for, I don't know why. I wish I could go back and look at my medical records and see who this guy is to have a conversation with him.

And I just remember waiting in the ER forever and thinking this is a horrible experience. And thinking I don't want this for my patients. I wanna be that person that's different. And so I know that's a little long-winded, but that's what got me into ER ultimately cuz I thought I want to be that person.

The other part of it is I have an octopus brain. I'm everywhere. I'm the mad scientist and . I think ER was perfect for me because I get to learn every discipline. Obviously not to the point of a cardiologist, but just enough to save lives and be effective and then learn everything. Very interesting.

[00:02:46] Jared: You've really had an incredible career so far. Steming from your time in emergency medicine, I've actually heard some wild stories about working in the ER. My dad was an ER nurse for like 20 years , and so I know you can't really speak on everything too much, all the stories, if you could just maybe paint a picture.

What is the day-to-day like for an emergency medicine doc? I know it's just all over the place every day.

[00:03:08] Harvey: Yeah. The nice part of it is it's never the same day. and it's never the same hour. We joke in the ER often, that's, oh, there'll be three cases today of whatever we see, or what will be the flavor today.

But in reality, we see everything and that's the part that excited me. You never know what's gonna come through those doors. So the typical day, honestly, was just crazy. Now with that said, the scientist in me. Found patterns. Nights and weekends was a different type of population than, five in the morning on a Monday was a heart attack.

This is, you guys are gonna laugh, but I actually did a research study that I should publish, but it was basically looking at ER flow and comparing it to football. And I actually was able to prove that during the football games of a certain city. So I was in Philadelphia at the time that the ER volume would go down during the time that the Eagles were playing.

And then I actually looked at the Cowboys, the same thing. And then if they were winning, it was longer. Like patients wouldn't come in. But then, and the ones that did were women and children. And then from if the game was a blowout or they were getting killed, then we were starting to see patients sooner.

And I remember literally during the Super Bowl talking to an individual and saying, Hey dude, why don't you come in? When the chest pain started, it's dude, this is a Super Bowl. I was waiting for it to be done and then I was gonna come in. I was like, oh my God, this is crazy. That's the part of the ER.

You just never know. What you're gonna see. Yeah, totally.

[00:04:27] Jared: Something I heard from my parents as well from their medical background was for some reason there's a correlation with full moons and craziness happening as well. And I don't know what that is but I remember hearing that you just never know what's gonna happen those days.

[00:04:40] Harvey: That's interesting. Just gonna comment real quick on that. There's supposedly some literature that disproves that, but anecdotally, when I'm working in the ER on full moons, I feel like we see more psych on full moon days. So I think there is a correlation personally.

[00:04:55] Jared: There's gotta be something to it,

[00:04:56] Ty: and Harvey, you described yourself with Octopus brain and like how the ER, the emergency room environment, you thrived there. And yet also you're a very successful entrepreneur and it seems like some of that mindset has translated really well for you.

Reminded me of a Harvard Business Review article that came out years ago that was looking at the different branches of the military. And how if you were in the Marines that you tend to do really well in entrepreneurship because you're having to respond to very fluid situations versus if you were in the Navy, you did really well in corporate innovation groups where you need to have that rigid structure and discipline and following a process because, you're dealing with much larger scope but more narrowly constrained environments.

And so it was interesting from that standpoint. And do you feel like maybe the different disciplines in healthcare for clinicians and physicians might tend towards, different avenues if you're like translating that outside of healthcare?

[00:05:53] Harvey: It's interesting you say that I'm biased, obviously I'm an ER doctor, so obviously my brain is wired in the ER. And I'm also biased by sample group. I spend more time with ER doctors than other populations. And not to promote it tomorrow, but tomorrow I am talking about entrepreneurship, genetic versus environment.

And my point is this, I personally, again, biased information here. I feel like ER doctors tend to be more entrepreneurs because they're wired a certain way. They're risk takers. They love the adrenaline. They're okay with taking big loans, they're okay with taking risks that other specialties don't.

With that said, you don't have to be an ER doctor to be an entrepreneur, but I've just noticed that correlation. You can make the argument that surgeons are the same in the sense that they're, cutting and they're doing things. And then just that whole thing that you just said about the military, I do believe it.

Each specialty attracts a certain specialty in that person and that indirectly can correlate to business. But I know this is oversimplifying it. At the same time, it's important to note that each of us are different. So just because I'm a ER doc doesn't necessarily mean I may be an entrepreneur cuz it just might be my personality.

I just may have landed in that spot and that's not really my spot.

[00:07:04] Ty: So just, yeah, that was a good nuanced answer there to maybe there's some trends here potentially. But you don't wanna overgeneralize.

[00:07:10] Jared: Yeah. Yeah. So I wanted to dive back into a little bit of your, experience, working in the ER and as a physician, you're really impacting the lives of people on their worst days a lot of times.

And, working in the ER. And what was it like the first time that you saved somebody's life and you actually got to go talk to that patient after the fact? Like I know that I've had that experience. When I almost died from sepsis after I had appendicitis when I was 15, and it was, the surgeon told me I was like a couple hours away from possibly, being critical.

And just be, must be a very humanizing experience to go through that process of saving someone's life and then get to talk to them after and they get to go and live their lives and get married and, just, I don't know, just must be incredible to feel that feeling.

[00:07:58] Harvey: Yeah. I'll never forget the first time I was able to make a difference. Again, it sounds cliche-ish, I became a doctor for that moment. I became a doctor to make that difference, and so the first time that I actually got to save someone's life, I just remember inside just being in tears thinking, wow, thank you God for giving me the tools to be that medium for you to help someone else.

And it's a really humbling experience. And try to make sure that I don't have a God complex ever, that it wasn't me that did it, that it just was, I had the tools and I studied and I was able to do it. And I was just a medium because I see some doctors unfortunately getting that God complex and I get it.

But back to the question, it is an amazing feeling, the ability to talk to someone to know that you were there for them to be that hand that made that change. It's amazing because, on both sides of the coin, that person's changed forever in a good way. And you as that person is also changed because you're touched by it.

But just like mentioning the positive, unfortunately seeing the negative is hard. It's hard emotionally as a human being to see someone suffer. Then especially in the ER, going into one room knowing someone just died and then going into another room that maybe someone's there just for med refill and you're just having to act like nothing happened and have that emotional intelligence to give that person your all still yet knowing that someone just died and you're seeing their family grieving it, it's a tough pill.

This is a really interesting question. We just got. So it's from Joseph Arrington and says, I'm an entrepreneur who is career changing to become a physician on route to emergency medicine too. Any advice for how to juggle his entrepreneurial desires during the rigors of medical school and residency or maybe some advice on how to avoid the stigma of avoiding the culture of, some of the field and seeing, them as only a trainee and wanting to be more than that.

So on the entrepreneur side, juggling I think you're born with it in some extent. You have it in you, it's just a matter of like medicine. You're just growing and flourishing it. So I think our educational system sometimes will squash certain things out of us and my encouragement to you is, just like you became a leader in medicine in the sense that you said, you know what?

I'm gonna study my butt off to become a doctor and I'm gonna be the best I can. I would encourage others to do the same. Make entrepreneurship just like medicine, just another passion, that it's not just a one time, it's life learning. And so on the entrepreneur side, it's all about thinking outside the box.

Obviously being here today says a lot about you because you're wanting to learn. You're taking time out of other things that have attention, and you're spending it here. So I encourage you to do that. Read, listen to podcasts. Follow some really good entrepreneurs and just see what they have to say.

And then obviously there's two ways of learning. There's the hard way and the easy way. Learn as much as you can the easy way, meaning just learn up on books and everything else because later in life you're gonna have to do things and you may make some mistakes, and that'll be the hard lessons in life.

[00:11:02] Jared: And just to circle back to the stigma of being an entrepreneur in healthcare. Did you experience that where like you're, I'm sure you're constantly coming up with ideas. I can just see it in your personality. How did the culture respond to your personality, particularly as you're going through med school and residency?

[00:11:18] Harvey: I love that question and I'm glad for bringing it up. Cause I didn't finish that part of your Thank you. I laughed because at one point when the first iPhone came out, I went crazy and I made 30 apps and I grew it and I was in the top 10 apps in the world for medicine and the first one was called IV Meds, but I was labeled as the app guy.

And I wasn't labeled Dr. Castro, I was labeled, oh, there's the app guy. And then later I started helping out with TV and helping out with the news. And nobody wanted to be present when it came to doing stuff for the hospital. And I was like, I'll do it. I don't care. And pretty quickly I became not Dr.

Castro again. I was like, oh, there's the news guy. And I'm like, no I'm Dr. Castro here. But no, I got labeled as the app guy, the TV guy, the media guy everything but medicine. And at times it was hard pill cuz I thought, man I'm a doctor at heart. That's what I do every day, but, you know that stigma as I get older, the more I'm like, and it's true.

The older you get, the more you start not caring what others think about you. And I know that sounds horrible but it's true. You talk to the elderly, someone in their eighties and the stuff they say, you're like, holy cow. I would never say that. But who knows? Maybe when you're 80 90, you get the right to say that

[00:12:27] Jared: I've heard a few of those from my grandparents as well.

Sticking onto the entrepreneur side you're a very experienced entrepreneur and I know you've been a businessman since you were a teenager selling vitamins and, you had the entrepreneur hustle from a very early age.

Do you feel like the transition to emergency medicine and then still being in business was it difficult for you cuz you were always hustling basically your whole life?

[00:12:50] Harvey: Honestly. , and again, I'm going back to that first question. I try not to take it at heart, but I know sometimes when I would talk to different leaders, they're like, man, you're everything but a doctor. And I'd get insulted by it, but I think it's because I've done so many other things that side hustle or doing, yes, that was my first big business, but my very first business I had a paper route for this company called the New York Times.

And I literally got a few extra newspapers every day. And before school I would go to the subway system and if I remember it was be 35 cents a newspaper, I would sell 'em for a quarter. And I would just, New York Times would probably cringe I did this, but I was like I need extra cash.

And I was an easy couple bucks every day that I could make. And transitioning into the ER and having an entrepreneur spirit at times has been hard, but the more I've grown, the more I understand, the more I think I'm able to help. And if anything, I've converted it to, here's my brain for emergency medicine and medicine.

Here's my brain for business. Why not combine the two and create a new product and a new way of thinking or thinking outside the box or new angle to the point where when I'm in front of the C-suite, they look at me, they're like, you're not Dr. Castro, you are Dr. Castro plus slash mba. You have both, and I see it.

And so I feel like that is what I offer and that's how I see the world and I'm doing things differently. I'm honored and happy to be with the company that I'm the Chief Clinical Operating Officer called ViTel Health, and the skinny is I'm able to use my business slash MD degree to do things a little different, to push the envelope to do things that maybe the traditional doctor wouldn't see that way.

That's really interesting. And some people, I would say they see the results of folks like yourself, and they're drawn to the entrepreneur path, they're not really always aware of what it takes to really actually make it. And, so I'm curious of, what would you say some of the hidden costs to being a successful entrepreneur that people probably overlook?

[00:14:49] Jared: Because they just see the success. They see you on podcasts, they see you on tv.

[00:14:52] Harvey: Yeah. It's a hard pill. I know personally, I have gained weight the last few months and my health to some degree is suffering because it's hard to balance. And so I'm constantly reminding myself, okay, I need to make sure that today I spend time with my sons, my girls, my wife. That I'm carving out time that I make sure that it's not just a one hour a week, that it's a daily event, because as an entrepreneur it's really hard to put your heart, mind, and soul into something and your passion.

And then sometimes inadvertently you're neglecting what really matters, and it's your family and the ones around you, the ones that are supporting you. Your cheerleading team behind you. And so I'm humbled every day saying, okay, yes, I wrote this book. Yes, I made this but did I fail as a father?

Did I fail as a husband. You know those to me, at the older I get, the more I realize that's really what matters. When I pass away one day, my tombstone will be my family around it, not my LinkedIn followers. It'll be the ones that were there with me and the voyage.

That's the truth.

[00:16:00] Jared: Still sticking on entrepreneurship and, you talked about risk appetite a little bit earlier. Aspiring entrepreneurs, they're sometimes afraid of risk, which kind of ends up holding them back. They decide, I don't know if I should do this.

And what, at what point in your life did you really accept risk as just part of the journey? Become friends with it and just start to overcome it and excel through it.

[00:16:20] Harvey: Unfortunately, I think it may be good or bad. I think I overdid it with the risk. I think I just went all in and risked and failed left and right, and made mistakes left and right and lost tons of money and fell on my face.

But the smartest thing I did was every time I fell, I learned from my mistakes and I saw how I could avoid that mistake. and instead of it taking me, a year to turn our company around, I was able to do it pretty quickly cuz I already learned from all my mistakes. And so my advice to others is on the risk side, it's twofold.

One, it's okay to fail, it's just not okay not to learn from your failures. Number two. As you're going through business, it's important to find your work wife or work husband, depending on your gender, because you need to have that person to compliment you. The last thing you want is someone that's just like you.

You need to find someone that is opposite in the sense that they compliment the skills that you lack. So if you're a risk taker, then I would encourage you to find someone that's not a risk taker so that you guys could sit at the table and discuss why one or the other, because I think personally the magic number is two personally.

So no disrespect to companies that have five or 20 leaders. I think the key number is two, because then between the two of you, you will see both sides if you pick your partner right. The worst partner, in my opinion, would be the one that is just like you, because then it gets to the point where you're both looking at everything and everything's a yes and let's go, and you're both making the same mistake.

And in reality, you need someone to compliment you.

[00:17:57] Ty: A hundred percent. I've often as we work with different startup clients, is like my shorthand is, okay, you're no. And that person's yes, as long as we've got yes and no on the same team, then there can be a constructive dialogue or in traction, they talk about visionaries and integrators. right? That the visionary's, the one who has, yeah, 10 ideas in a week. One of 'em might actually be the breakthrough that saves the company, but it's the integrator who helps buffer the rest of the team from getting whiplash because the visionary is shifting back and forth, and the integrator is the one who's providing stability and structure and no, we shouldn't go off that cliff again.

You already learned that lesson.

[00:18:35] Harvey: And I chuckle because I tend to be the visionary that loves literally my brain doesn't stop. Literally, I have to watch movies sometimes to take my brain on hold for a minute because I'm just constantly going. And even depending on the movie that I pick, I'm like, Ooh, that's a good idea.

Maybe I should do this, I chuckle because as the older I get, I'm trying to convert myself to some degree to be more of a hybrid. That person that can have the vision, but that person that can execute so that way I offer more and that way I'm self putting the brakes on myself. So that I know that, okay, I can't do it all.

I need to focus here. And so that's why I'm enjoying right now being a consultant for different companies, cuz it gives me a platform to sit down and look at their problem. And I don't run it, I don't own it. I'm just there to advice and it's almost more fun because I don't have the stress.

I just give my 2 cents and help them out.

[00:19:24] Jared: Something that you touched on as well is just failure in general. Failure in business happens to everybody. If you've been in the game long enough, it's gonna be there. And I think people deal with it differently. And so how did you learn to make it so constructive to where it ends up being a PO net positive in the long run for you. Cuz I know a lot of people, they fall flat on their face and especially if they haven't experienced it before, they don't even know how to deal with it. They just think I'm a failure. They take it personally.

[00:19:51] Harvey: Yeah. I think it's a combination of having a strong why in my life, having that ammunition behind me to just continue to push me to go forward. The other part of it is, I get this a lot. People are like, gosh, Harvey, you're always smiling, you're always happy. And I'm like, I'm not on any happy pill.

I'm not taking any drugs. I'm not on anything. That's just my personality, and I think that carries into the workforce and entrepreneurship. They're I can't quote studies like Ty over here, but I know, I do remember reading that positive leaders. Tend to have better outcomes in their CEO companies because the CEO is positive.

They're thinking they're optimistic, and that rolls into the company and I feel that's happening with me. I think I'm so optimistic that even when I know I'm going against Goliath here, or something crazy. I feel like I can do it. I don't know if my mom did a good job brainwashing me, cuz at a young age she's Hey, if you wanna be a doctor, if you wanna be the president of the United States, you can do it.

And I believed it and I still do. And so I don't know if that fantasy world is translating into the entrepreneurship spirit that I feel like I can't fail. It's just a matter of execution and doing it right based on my failures in the past. That's really interesting.

[00:21:03] Jared: That's a really cool way to look at it.

I try to find myself trying to make myself positive. When you are facing adversity as well, it's very difficult. That's a really hard muscle to train.

[00:21:12] Harvey: But I think when you come from very little and you get pushed, and you come from nothing and then also being in the ER and seeing people die and going through this horrible experience. I think, not to make it light but then when I see a financial sheet and it's not going well, it's No one died on this financial sheet. No one got hurt. Yes. We're not making money. So then it makes it harder for me to look at it negative.

It makes me compare it to something else and say, you know what? We're gonna change this around. We're gonna work on this. And, anyway, sorry to interrupt, but keep going. I just wanted to say that

[00:21:46] Jared: Yeah, absolutely. Context is everything. And so still, we're wrapping up the entrepreneur side of things here, but, I'm really curious of what would you say are some of the traits that make physicians, particularly well suited for entrepreneurship? Because, what we have seen with entrepreneur founders like yourself and I see Raji is here as well, is you're stretched for time. You're busy as heck.

A lot of practicing physicians are working 60, 70 plus hour weeks and they're still innovating something. They're trying to run a business and, so what do you think some of those traits that just help you guys push over the top?

[00:22:20] Harvey: I think, and I know I sound like a broken record. I think it goes back to a lot of why did you become a doctor? What was the ammunition that got you there. And I think that mindset, because think about it, to get to that point you had to do well in school. You had to be consistent. You had to take tests, you had to go through an interview, you had to go through all these steps, and then you had to go through medical school, which is a bunch of other tests, and then residency.

And then by the time you're out you've pretty much killed it in your field. And, but my point is this. It's not that you're a doctor that made you successful, it's that you learned the process of learning that made you successful. And going back to my broken record is having that strong "why" to channel into and say, I became a doctor because of X, to take that energy and that X into that entrepreneur spirit.

Because guess what? You've had a whole lifespan of learning, but you really haven't learned business. And so it's taking that tool, that ammunition, that right behind ears and not knowing business to focus and use those tools that made you successful. That got you those initials of becoming a doctor to use that as energy in your why and the tools to success.

So it's not necessarily the doctor, but it's the process of becoming a doctor.

Yeah. It's that sort of overcoming a hill in a mountain that not many do, right? Or not many of us have in us. Switching now, to the technology side of things, a huge portion of your work focuses on, the impact and implementation of technology for the betterment of healthcare or for patient care.

[00:23:55] Jared: And, when did you really start to grow an affinity to the technology side And what really pushed you to lean into it?

[00:24:01] Harvey: I feel blessed. I'm gonna date myself. During my training Dr. Google was a thing and was a new thing. And back then it was a big deal to have a pom pilot to have, this technology that has a peripheral brain to help you.

And I'm a dude, I love gadgets. My wife wants to kill me cuz I always wanna have the latest toy and everything. And that's just probably my personal addiction. But with that said I think the moment that it really just came to heart was when I realized how much technology is helping people, how much technology can really, if it's used correctly, can educate our patients, can help our workday can reduce physician burnout.

And I thought, huh, this is a good tool because now I can do more and I can get better care for my patients. And then to drive the example, I was in the emergency room, literally the first iPhone had just come out. I'm coding a patient. I tell the nurse, Hey, start a drip. And she says, one minute she gets a textbook, she goes to the table of contents, she's flipping through, finds the drugs, finds the exact dose, goes, gets the medicine starts.

And I'm freaking out thinking, I just said I graduated from residency. I'm thinking there's gotta be a faster way this is taking too long. I know some nurses memorize a lot of the drips, but this particular nurse didn't and wanted to verify and a lot of 'em wanna verify as well. And so I literally thought, huh, what if I create an IV med app that you click and three clicks, you have to dose and ready to go and you're done.

And that's what I did. So fast forward, I'm playing with Open AI's Chat GPT, December 1st. And I'm looking at it thinking, oh my gosh, this is the next iPhone, but I think this is gonna be more powerful. There's gonna be more uses. And I literally told my wife, Hey, I'm writing a book on Chat GPT. And she's what is that?

What are you talking about? And so I wrote it and I wasn't really happy with it, and I was like, you know what? It's okay. It's not my best work. I know it's not the best, but I still want to get this out there cuz I want to do a public service announcement. I want to help patients. I want to tell doctors I knew I was gonna get slack for it cuz people were like, this is a horrible book.

But I thought, you know what it's 10,000 feet high. My goal is to educate and since then I'm trying my best to make it each book better and better. , but I can honestly say I was the first doctor out there to take it to that level. And then every book that I've done since is actually taking it to another level that doesn't exist.

Still I can still claim Hey, I'm using Chat GPT faster in a way that no one else is using. Now, fast forward a couple months from now, I'm sure there'll be companies with apps doing what I'm doing, but I can honestly say I was the

first.

[00:26:39] Ty: That was so cool. It blew my hair back to see you be able to publish that quickly.

And don't have a copy of the book with me here, but I was a early fan and enjoyed going through it. And I found some tips and tricks in there, new tools that all of a sudden I'm text messaging with an AI because of you just text this phone number and find out what happened.

Did that prompt and holy shit. Oh yeah. Okay. I guess we can swear on this podcast, but it was an amazing experience and a lot of it was just you being at the tip of the spear really starting to uncover a lot of these technologies and tools that haven't hit the mainstream yet.

And it's just neat to see that you're just taking that octopus brain and putting it into these books and getting them out there. Me personally, having, started and worked on different books and then just never quite had the courage to just publish and get it out there. I admire what you were able to do just to get this, pushed out in very topical conversations.

[00:27:32] Harvey: Yeah, I appreciate that. I know sometimes no not, sometimes I take things to heart and so when I see a bad review or I see someone saying negative, it's hard cuz I take it personal cause I'm trying my best to do my best, I know that isn't my best. So then I take it with the grain salt.

Cause I'm like, yeah, I guess if I stopped everything and I just a hundred percent. Poured into this for a year, I could have an amazing product, but by then, the technology would've changed and things have happened. And so I thought there's a risk versus reward and there's a give and take.

I'm trying my best and as I become better, I'm gonna put out better stuff. But at the same time, I think there is something like to Ty, he loves reading books, to just do a small book and the bones of it to get the understanding, because again, to your point, you don't have to write a thousand pages to get maybe 10 pages across.

So maybe better to write 50 pages and it have the bones to someone like you that's going through oh, this is a good idea. Oh, this is a good idea. And then now you're sparking a conversation. And that's my whole goal.

[00:28:32] Ty: Yeah. Such a great use case for that. And of course, you could see moments in where like Chat GPT inspired the book.

And so I think for any other, topic maybe that wouldn't work as well. But the fact that you were using the tool to like help to spur your thinking and then I think we're all figuring out what are the implications of this new technology. Because for anybody who started to play with it, it's mind blowing what it can do and then what it can't do.

And we're all trying to figure out what the limitations are and and the kind of the broader context for society of how we integrate this. So the topic is of course is Chat GPT and healthcare, and you're seeing GPT-4 come out. Are you still optimistic about where this technology is going, because I think we all are having that moment where this is the best thing ever. It's too good. What are the like runaway use cases for this where I'm a little scared now, but I'm curious. I just raised a can of worms there.

[00:29:28] Harvey: So take another deep breath there on that one. I feel like the following, yes. On the ethical side, on the bias side, there's a lot of things that people need to be aware. Obviously, Chat GPT is only as good as the input that it was put in. And so if you are out in West Africa and you're asking about certain particular healthcare that's particular to West Africa, Chat GPT may not have it in the sense that it hasn't been studied and the databases that are out there or research dollars behind it hasn't been placed, and therefore, indirectly it wasn't added to the database. So when you ask Chat GPT, it's giving you the generic answer that someone unknowing that bias may say, oh, this applies to me, and in reality it doesn't.

The other danger I always talk about and worry is in third world countries or countries that you can go to the pharmacy and just pick up any drug. I worry because people will go in and self-diagnose and then go into the pharmacy and take a drug that, A, they may not need. B, they may kill themselves or hurt themselves, or C, just been told they have this horrible diagnosis and horrible emotional intelligence to the point where they're like depressed or suicidal and reality they don't.

And so I worry about technology going down that path. As far as the optimism, man I'm like a little kid when it comes to this thing. I think it's amazing. And I know there's a lot of naysayers thinking, oh my gosh, it's gonna take my job. I'm gonna, the whole world is gonna crumble now because of this.

And I see that side of it. My famous statement that I say over and over is Chat GPT is not going to take your job, but not using Chat GPT is gonna take your job. And so there's gonna be other people out there that are gonna take this tool, use it, become very efficient, do more, and then me as an employer are gonna look back and say, Ooh, this person's killing it.

They're doing so much more than this other person, but they both have the same degree, yet this one over here is being more productive. You know what? I'm gonna hire this guy over here. Or girl woman, because they're killing it. And so I really believe that's the case.

[00:31:28] Ty: So actually if you had a use case, and actually this was one of the use cases I was thoroughly entertained by where this popped up on Twitter, which is you can assign it like a system command to adopt a certain persona. and my favorite one was that . Okay, you are now Hustle GPT.

I want you to give me instructions for how to set up and run a business. Here's my parameters. I only have $5,000. , help me understand how best to do my next step. And you look at the difference between GPT-3 and it's like a mediocre MBA student giving you the answers. GPT-4 is proposing new things that I'm impressed by, which it's fascinating from like a reasoning standpoint, but then when you get to any kind of financial analysis, it just crumbles.

It's yeah, no, you tell me the answer. I can't do that. So it's interesting to see where it's gaps are.

[00:32:18] Harvey: I personally use it as a brainstorming session. I know that sounds weird. I know we talk about having a mentor, having someone to teach you. I feel like I've had enough good, bad, the ugly in life that I know when chat GPT is hallucinating, or I feel like I know that the information coming out and it's not correct.

I could be wrong. Again, that's one of the issues that it can tell you half truth and it's actually wrong, but you believe it. And so my point with the brainstorming session, I'm loving it because I'm using it as a peripheral brain to augment my creativity. I'm not saying, Hey, Chat GPT here, go tell me what to do.

I'm doing the opposite. I'm like guiding it, prompting it, giving it background, pushing it certain angles and creating new products. In that way, and I'm having a lot of fun and I encourage people just to play with it. Just like the 10,000 hour rule out there that the more you spend, the more you become an expert.

Same thing. The more time you spend on certain technology, the more you know the good, the bad, the ugly, and the more you'll be successful at that tool.

[00:33:19] Ty: Yeah. I've been having fun just mentally anthropomorphizing Chat GPT as a liar and a sociopath. But a useful liar in a sociopath. So as long cuz they're having to manually code in the ethics into it can define those parameters.

And then that's where I think that interesting ethics discussion comes in is how do we co-create and define those boundaries because, if you listen to the podcast with Sam Altman on the Lex Fridman podcast. He talked about how they're iterating and having this as a public discussion and they're reacting to the use cases that are being proposed.

And that's where, I made a comment that I think that physicians are uniquely positioned to help define that because they're the really should be the gatekeepers by which patients are, interacted with this ai, that it's influencing healthcare and that it's, these ethical decisions.

We shouldn't be taking a backseat to it, but rather that, like Harvey, you and your colleagues should be helping to shape this and I'm so glad you're taking a leadership role in that.

[00:34:19] Harvey: I appreciate you saying that. Honestly, that was my main goal with Chat GPT and healthcare wasn't a business mind behind it.

Honestly, it was a public service announcement in my brain. I thought, at the end of the day, someone's gotta drive this ship. It's gonna be either corporate America driving this ship, Microsoft that owns 49% of this, or it's gonna be administrators, doctors and healthcare that have a true passion for healthcare.

And they're gonna be the ones that are gonna say, no, we're not using that technology this way. We're gonna use it this other way and we're gonna promote it. And so when it comes to corporations saying, no, we're not using this, then it's gonna be the doctors, healthcare providers, patients that are gonna wave the flag saying, no, this is how it's gonna be done.

And my big picture of helping people, I thought, if I can help drive, price of healthcare down. If I can make the quality of healthcare go up, obviously it's not me, but if I can help propose and train the future doctors and doctors that are out there and patients, then I'm actually helping society.

Now, am I personally profiting from it? No. The book sales is not like this is making my breakfast every day or dinner. It's not. But my goal is not that. My goal is honestly, how can we help. And that's why I take time to do these podcasts, to help, cuz I wanna inspire someone out there that's listening that says, you know what, I am the hospital administrator.

You know what? I don't own x Y but I am inspired to do this and I'm gonna create a better product. And who knows? Maybe your product that we're talking about today is gonna actually help me when I'm old or when I need it.

[00:35:52] Jared: I sure hope so. Dr. Raji Akileh. Nice to see you here. He had some really interesting comments and he's basically commenting on the posts that you made earlier today from all those innovators, basically saying, we need to halt work on AI that, GPT-5, we don't even understand the implications of GPT-4.

And is that a sentiment you agree with? Do you think that society needs to figure it out first before we even advance it farther?

[00:36:16] Harvey: Unfortunately that can of worms has been opened. And it's not gonna be stopped unless someone else stops. And so to my earlier point, we need leaders out there to push that ship and to protect us and guide it.

I don't believe in halting personally the AI in any way. I see it more as if there is the unknown. All of us don't like the unknown. We wanna be educated on it. And so I think it's a twofold answer. One, there's gotta be individuals like myself that are out there educating others on the good, the bad, the ugly, and then the ugly and the bad:

we need to legislate possibly, or we need to fix or address or in my opinion, to Ty's point Chat GPT 3 or 3.5 versus 4, it's different in the sense, in a good way, it's actually has higher USMLE scores on 4. And so in theory you could argue that progressing 5 might be better than 4 and it may help.

Now, as far as legislation and all that stuff I think it needs to happen to some degree, but not to the degree where we're gonna halt anything. I just think we need to be responsible. And again, I think it's the unknown. With that said, I always question people in a sense if they want to pause, not I'm playing devil's advocate here when I say that.

Do they want to pause so that they have six months to catch up or do they want to pause to actually help and I'm just gonna plant that seed.

It's interesting. Yeah. Maybe they're threatened to some degree as well. Their business models are gonna get upended, who knows. So speaking of business, we have 15 minutes left and we have a lot of good questions to get to, but I do understand that you have an upcoming book coming out on AI and entrepreneurship. And maybe if you could just talk to us a little bit about what inspired the book what's it called? What are people gonna learn? What impact are you hoping that it's

gonna have?

Yeah. So I got blessed in that just by coincidence, the book got released completely last night. The book is called The AI Driven Entrepreneur, unleashing The Power of Artificial Intelligence for Business Success by Harvey Castro and with Chat GPT-4. And I know people like Holy Cow, Chat GPT wrote Oh, there it is! Thank you for supporting.

[00:38:30] Ty: Thanks for the tip. I was able to download it last night. Yep.

[00:38:35] Harvey: Cool. So yeah, I was real, I'm like a little kid. I saw it on Amazon as ebook and I was like texting Ty. I was like, do you need to check this out? It's cool. But I figure if I'm gonna. What is it? Walk, talk, the talk. I need to walk the talk or whatever. I figured you know what?

If I'm advocating for ai, then I need to use AI to help me write the book, to help me brainstorm, to help me create it. And so not that the whole book is written by it, I guided it. I use my creativity, I use my experience, my background. And then I came to the quandrum. Do I make this a hundred page book, or do I create a very short book, or do I make it like an encyclopedia?

And I know personally, I've read so many books that I'm like, man, this thing could have been a cliff note. So I thought, let me create a quick intro to all these things to plant the seed, because I feel like a lot of people already know a lot of this stuff. But then it's good review and I divided the book up into just phases, entrepreneurship, just basics, and then more advanced and then using AI and then just 10,000 feet high. Cause I feel like it's the creativity of all of us that really makes us successful. And I created a podcast called GPT Podcast and it's all AI driven, which is crazy, but it's basically my voice synthesized and I go through different lessons and I put it in there and the AI creates this conversation with my business partner and I, we have this total conversation, but it's all AI generated and it's all driven by what we put in it.

So it's crazy. But I thought, this is cool. If I'm gonna again promote this, then I need to use this.

[00:40:00] Ty: Wait, hold on. That's wild. When is the podcast dropping? Yeah, .

[00:40:04] Harvey: Oh, it's out. Yeah it's out. We have four or five, I don't know, I kept, I can't keep track, but we have several episodes.

If you go to thegptpodcast.com, I took a Bill Gates blog that he just put out and I put it into Chat GPT made a summary and then my business partner and I have a conversation based on that blog and you can listen to it. It's crazy. That is

[00:40:26] Jared: crazy. , that's hard to wrap my head around. .

[00:40:30] Ty: I'm gonna have to check this out.

This is awesome. Make sure you drop a link into the show next.

[00:40:32] Harvey: Yeah. So we have several episodes coming and it's in the book at the back, but then obviously go to my LinkedIn and it's on there. But it's, again, I feel like if I'm doing this kind of stuff, I really need to use it and show proof of concept and see how it's done and explain and educate.

That way we all win here.

Absolutely. And I know you mentioned that the book is dedicated to your son as well, if

you wanted to touch on that.

Yeah. I'm gonna have to get my son, Zachary, to listen to this part of the show, the whole show. Growing up, I didn't have a father, it was my mom and I love her to death.

She's alive. She's both my mother and dad and mentor, my first mentor. And with that said, she gave me the tools to success. And I thought I'd be a horrible parent if I don't give those tools that I have learned and gifts to my own children. And so I tell the story of, I know this sounds a little geekish, my first son, I would have him on my lap and we would look at stocks and he was five.

And I would have him interpret candlesticks and if the market going up or down, is it time to sell or buy? And with that time, he at five, he was telling me, yeah, it looks like we need to sell or it looks like we need to buy. And I'm not sure about this graph and he was actually right on all of it, cuz I trained him.

I taught him, I know it sounds geekish, but then I thought, let me be the fun dad. So we would go on road trips and I'd say, okay guys, look out the window. Tell me a business. And they would say, oh there's a gas station. I'm like, okay guys how can we make that gas station more money?

And we'd go over supplying demand. But I'd make it really fun. I didn't go over the, I never said supply and demand. I never said Rich dad, poor dad. I'd always talk about passive income, but explain that in other words and and growing up my second son, and first they really love business, but my second has to me, feels like he's more like me.

And so I dedicate this book because he wants to be an entrepreneur. He's 19 and he's talking about passive income and different business ideas and obviously he's still a teenager at heart, but he's got a brain in him that I think he is gonna be a mini me in the future. He will be that person.

And so I wanted him to dedicate this book as he reads through, to inspire him to continue doing what he's doing. He's actually majoring in entrepreneurship.

That's incredible. The next generation man is on the way.

we need somebody to take care of us. Exactly. Younger. Yeah.

[00:42:47] Jared: So we do have a couple more questions from folks that are coming in and so maybe we could touch on these a little bit.

And so one of 'em is what are your thoughts regarding the present status of change management and stakeholder engagement related to AI and healthcare? And maybe what could be improved?

[00:43:03] Harvey: I'm reading the question too. I think the change in management and stakeholders a little tough.

Again, I'm gonna generalize when I make this statement, I feel like certain people learn to do business a certain way and they stick hard to doing business a certain way, and unfortunately that's been good for them in a way because it's made them successful, but times are changing. And I truly believe that if you don't change with times or look at business a little tad differently, you're gonna be closed.

You're gonna be the next blockbuster that had a million dollar idea that no longer exists and you're dominated by Netflix. And so as far as engagement in the management field I would highly encourage using this technology in healthcare, but the problem is healthcare is not marketing.

Healthcare has to do with people's lives. There's HIPAA, there's privacy laws all over the world. So we can't just jump into this technology. And there's obviously ethics we've talked about and bias, and there's errors and I agree and I get it. But I think the goal is what can we do today to help our patients that maybe we don't have to worry about HIPAA?

And let me explain cuz that sounds horrible, but meaning maybe we use Chat GPT to help build your website, to educate your patients. Maybe we use Chat GPT to create a database on a particular disease. And then you, the doctor that is a specialist in that disease, you bless that information and now you're using it in your marketing.

You're using it in your website. You're using to educate and improve your patients. The next level that I see, I love this example, it makes me excited. So a company in England, and I'll make it short it's a hospital. They basically took asthma discharge instructions. They put it to Ty's point into a fifth graders level and changed the discharge instruction to speak as if it was a fifth grader. Then they used DALL-E that made a coloring book. They put it all together, handed it to the fifth grader and said, you have asthma, and these are discharge instructions. And now the kid can color, I think it was five years old, my bad, not fifth grade, five years old and color, ask questions. Now they're taking it to their level. They're understanding, they comply with the medicine, they comply with their disease process. Now they're taking it to another level. That to me is Chat GPT healthcare. That to me is helping technology, taking it to the next level. It's not a threat. You're not gonna lose your job. You're actually helping someone. You're making a better product. And that's how I see Chat GPT being used.

[00:45:31] Ty: That's such a great use case and example cuz I think you have that burden of knowledge. Of the words you think about in healthcare, which can be, in some cases, like hard for somebody with a, fifth grade education to even comprehend the words that are being said, but rather using stories, using analogies, and using the creativity of the model to help distill down and have that as a benchmark for this has to relate to a five year old. And that's something that seems like the generative large language models seem to excel at. Provided there's somebody also gut checking and saying maybe I wouldn't use that analogy, but this analogy proposed might be a better one. It's that curation instead of having to be like the a hundred percent creator.

[00:46:11] Harvey: Yeah. And I know we only got four minutes cause I do have a hard stop coming, so I'd love to answer whatever else questions you have. Yeah.

[00:46:19] Jared: How do you convince your fellow healthcare professionals who are totally skeptical and cynical about AI and healthcare? How do you make the case for it?

[00:46:26] Harvey: To me I love education. I fall back to education. And I think honestly, a lot of problems in life can be just fixed with education. And so I would talk to them and ask 'em, what scares you about it? What don't you like? What is it? What do you object? And then attack those in a positive way.

And if you need to use Chat GPT to help you with the argument back. Obviously, a lot of it is the unknown, and if you uncover the unknown and really make it known and then use applications like the ones I just gave, then it becomes a easier pill to swallow. Then they see the bigger picture and they're more likely to do it.

With that said, you need a back 10,000 feet and say, okay, is this person born in the sixties, born in the seventies, cuz I know, chuckle. But it's gonna influence the way they see life, the way they accept technology. Maybe they were burned personally. So then I would take it to another level and see what is it that scares them, and then go from that point.

[00:47:17] Jared: Awesome. Thank you for that. And then I think just wrapping up here. First and foremost, just thank you so much for, sharing all your insights and experiences with us and, just what is some advice that you have to physician entrepreneurs that are earlier in their career than you, but they want the success

that you've had.

[00:47:33] Harvey: I tell my kids the same thing. I want you to learn the easy way. Go through texts, go through positive leaders, go through TED Talks, educate yourself. But unfortunately, I know the truth is you're gonna have to fall on your face, unfortunately, on some things. And that's the only way you're gonna learn.

But hopefully that's not the case. My advice is just keep buffing up on these things. And we mentioned earlier, having that work husband or work spouse equivalent to help you to see things a little differently. I think it's important. I would highly encourage you, and even if you're not opening up a business today, just having that growth obviously follow, I'm gonna be biased and say, follow me on LinkedIn.

Learn more from all of us. But I and everybody on this panel, and even the people I'm looking on, the comments, attendees, they're all great leaders, so just latch onto someone and learn.

[00:48:17] Jared: Awesome. Yeah. Thank you so much for that. And Dr. Harvey Castro, thank you for your time today. Thank you for being a leader in this space. We need more leaders like you out there. And for everybody that you know joined us today, and we didn't get to answer your question, Dr. Castro, he's there on LinkedIn. You can ask him these questions. He's fielding questions all day over there. And also we'll be linking his book, the AI-Driven Entrepreneur when we post this as well later this week.

Look for that and yeah, just thank you so much for joining us. We really appreciate it.

[00:48:42] Harvey: Thank you everyone, and I hope everyone has a blessed day and give your loved ones a hug today.

[00:48:46] Jared: Wonderful. Thank you Dr. Castro.