How Can Clinicians and Entrepreneurs Collaborate to Improve Healthcare?

[00:00:00] Jared: Hello everyone, and welcome to another insightful episode of the med+Design Podcast where we explore the most compelling narratives in healthcare innovation. And today we're extremely excited to welcome Dr. Gary Goldman, an innovator in digital health and the founding partner and CEO of Global Health Impact Network.

Dr. Goldman is a leader in the digital healthcare revolution, leveraging experiences in both medicine and business to navigate the evolving landscape of healthcare from his roots. As a medical practitioner Dr. Goldman has transitioned into a p pivotal figure in digital health and venture capital. He operates at the confluence of healthcare, technology and investment symbolizing the future of the healthcare industry.

His work with Global Health Impact Network is not just pioneering, it's actively shaping the way we understand and approach digital health. Dr. Goldman brings to the table a unique clinician focused perspective, facilitating the integration of healthcare professionals into the digital health tech revolution.

His insights fueled by a deep understanding of the medical field and the financial industry, make him an extraordinary guest for our podcast. We're eager to delve into his journey, explore recent ventures, and discuss how he's contributing to the growth of the digital health landscape. Without further ado, let's begin our conversation with Dr. Gary Goldman.

[00:01:11] Gary: Welcome. Jared. Ty, thank you so much for having me here. That was a lovely introduction. Much appreciated.

[00:01:19] Jared: Yeah, we're happy to have you with us. And I guess just to get started I know you mentioned actually wanting to talk about, how you got to where you are.

I think that's really fascinating. You were an anesthesiologist earlier in your career and now, a venture capitalist, helping these new innovations come out, and you've touched so many lives along the way. And so I guess just to touch on a bit of your journey before we talk about Global Health Impact Network how did you even get here?

Did you always think about working in finance or, being a businessman at the same time as being a physician?

[00:01:48] Gary: It's funny it's a bit hysterical when I look back on it. And if you see my label up there. I know obviously spent a huge amount of money on different professional schools and time being educated.

But I actually started out as a dentist, believe it or not. And it's actually I love to talk about it a bit because first of all, I'm honoring this particular individual, but it was also very influencing for me in those days. I grew up, in Brooklyn, New York. Everyone knows where I'm from if I say water and car.

And I grew up, my parents were relatively poor. I was an only child and I had a dentist who was an innovator and we're talking in the sixties. Okay? So in the sixties, like late, mid sixties, late sixties, his name was Irving Elman, okay? And he had a practice in Brighton, Brooklyn.

And fortunately I didn't have, you know, I had pretty good oral health, but every time I would go to his office, he would always take me into the back, into his lab and show me what he was inventing and working on. It was different instruments, it was different technologies. And in the sixties there wasn't a lot of technology and he was so advanced that in 1968 he had a TV mounted to his dental chair for kids so you could watch like cartoons while you were being worked on.

To me, the dentist was always a positive experience, and plus he also, he used nitrous oxide if he was doing anything significant on you. So that was another interesting experience. But he really had an influence on me. And again, my parents didn't even finish high school for me, as I, grew older and I was in high school and, and I was still going back to him, I really wasn't sure what I wanted to do.

It's one of the reasons that I went into dentistry was because of him. And I wound up going to NYU dental school and had a wonderful experience there. I realized that I'm not very artistic and you have to be very artistic to be like a good dentist, like a pla at a plastic surgeon, things like that.

I don't have those qualities. So I realized that I was much better at the at certain things in dentistry that didn't require the artistry of it. And I got experience while I was there, bellevue Hospitals right across the way from NYU Dental School. And there was an opportunity to do a month of anesthesia as a dentist.

And this is where like all of my interest in doing other things started right here. I had already finished, I did dental school in three years and instead of four and then I was getting out and I'm like, sure, I'll go. How are, when's the next time I'm gonna get a chance to spend a month in the Bellevue OR in anesthesia as a dentist?

So I did it and I had this fascinating experience. Partly because I showed up like the Dental Doogie Hauser of anesthesia because I read the book that the residents read before I showed up cuz I was so nervous about being with medical students. And I showed up and I had the answer to every question.

So by the end of the month, they actually literally were having me put people to sleep with the resident and the attending. And I fell in love with it. But, at that point I said to myself, okay, great. So now I found out how cool it is to be an anesthesiologist from a dentist. How do I put that into action. Turned out there were three places in the country that allowed dentists to do a year of anesthesia with the idea. And again, back in the sixties, there weren't even ambulatory surgery centers in those things. Everything was done in an operating room. But there was a very small union of dentists across the country that were dental anesthesiologists.

And you could go to their office and they would offer more than just local anesthesia, they would offer sedation ways to really relax you in the dental chair, nitrous oxide, all of that. So I wound up doing that year of training. I applied and got in, I went to Philadelphia from New York, and I spent it in a year there doing that, and fell absolutely loved with anesthesia.

So one of my attendings who was a ds anesthesiologist had three offices in Philly, and he asked me to join him in practice. So I did. And what we would do is we have other dentists bring their patients to us. We would take care of the patient from a, an anesthesia perspective, they would do the dentistry.

And then we also, the two of us had our own patients. But it was hysterical because the two of us loved giving anesthesia. We didn't really love the dentistry, so we would've these big arguments every morning as to who would be the dentist and who would be the Anesthesiologist , which was pretty funny. Patients never saw that, but it was a riot.

But he was twice my age and I was very young. I had skipped two grades in the New York school system. It was easy to do that in those days. So I was very young at that point. And he turned to me one day after about a year, and he goes, Gary, what are you doing here? I'm like what do you mean you're not happy with having me here?

And he goes, no. He says, you're a young man. He says, you are where I was and wanna be. He goes, go back to medical school and become an anesthesiologist. I said, are you crazy? I said, I'm making more in a year now than my dad made in his whole lifetime. If I went back to my dad and said, I want to go back to medical school, he probably would shoot me.

He called my dad and he said, Gary needs to go to medical school. And he goes, and he actually helped me, financially which was incredible. It makes me tear a little bit, even thinking about it. He's passed on since, and his name was Kyle De Martino and So I wound up going back to medical school and it turned out that because I had the dental training, I had to do two more years.

I, I had to do the clinical years and I did it at the place where I did my residency. I was I was actually going backwards cause I went from resident to medical student and and then I went to med school, then wound up, not what I was very lucky I got to go to Harvard, to Brigham and Women's Hospital for my residency and my fellowships met my wonderful wife Janet, who's a high risk obstetrician there and way smarter than I am.

And and she went to med school at UCSF. So she brought us out to California when we finished our training. And that's really when my entrepreneurial career started. Cuz when I got out here it was 1988 and we were living in the Bay Area. We were 35 minutes from Silicon Valley. The bubble was building, in tho those days if you put dot I in front of anything, you could raise money, right?

I was the head of continuing education for our medical staff at the time. I probably didn't show up to a meeting and they put me in charge. So I was doing that. And in those days, to complete your continuing education, you either would've to travel to a course where you would listen to a cassette tape, but it really wasn't that convenient.

And this new internet thing was happening. Now, one of the things I didn't talk about as an undergrad, I went to Stony Brook in New York and I was like a computer minor there, and they have a very big computer program. So I got interested in technology and I wouldn't say personal computers in those days, but had the first Commodore, had the first Mac in my residency program at Brigham and Women's, Jim Philip was one of our attendings who had built a program called Gas Man which toward anesthesiologists had to give inhalation agents which was cool.

And I used to talk to him about it and I was always very interested in it. And then, so when I came out here I was outside Silicon Valley looking at how could I do something on the internet. As an anesthesiologist you have a lot of freedom because you work shifts, right? It's not like I had a, a private practice that where I was like a medi medical physician with a, taking care of patients every day.

I was doing mostly shift work and I had the ability to do other things. So I started consulting. One of my partners, his cousin was at the time of president of Maxwell in Silicon Valley. The hard drive. And he Eric Kelly, and he's amazing. He was a mentor of mine and he helped me conceptualize the idea, write a business plan, and then go out and raise money.

And who knew that I would, I'd have the gift of gab. That's all you really need to get people to get interested in what you're doing. So I started pitching the continuing education channel. As a matter of fact, I can't see it from here, but the plaque is still up there from 1991.

And we started the concept. He helped me build a tech team and we went out and we raised several million dollars from clinicians. Everyone that I spoke to in the doctor's lounge, wherever I would tell 'em about my idea, and everybody said, that's a great idea. It would make it so much easier to do our continuing education.

We be able to track our credits, all of that online. And online then was like, 56 k modem dialing. Wow. So we built the CE channel and the CE channel, it took us about three and a half years. We wound up me selling the platform to a gr a company called Challenger Corporation in Memphis.

Bob Sweeney at the time was a gentleman who was the CEO. And I bring it up only because, to show you how long I keep my relationships, Bob is one of the partners in fund one. He's my co-partner in forming the network. And he's, we still work together close to 30 years later.

So the CE channel was, let's, we'll call it the first exit. And at that point I wasn't sure what I was gonna do next. And then one of my investors came to me and said, what do you know about the nursing shortage? And this is like mid nineties. Wow. And I'm like I know, there is one. But other than that, not a lot.

And he was telling me that, so he was from India originally and he had a network of nursing schools across India from Bombay down to Poin. And he said we could train nurses in India and in China to come to the US in a registry model, teach them culture, teach them how to pass the NCLEX licensing exam.

So that became a very educational process for me because I learned, now I knew a lot about continuing medical education, but now I was learning about the nursing side of it and got interested, introduced to a lot of pretty incredible people. Some of them actually were physicians who were involved in nursing staffing.

So we took our platform and we started training like a Stanley Kaplan. We started training the nurses to pass the exam and we would bring them over on H1B Visa. So we had an immigration group that was working and then we would place them in hospitals. And it was really an incredible experience because that gave me the international business side of experience.

Cuz I was traveling to India, I was traveling to China, I was Norway. It was pretty incredible. And we moved 160 plus nurses across two different companies. And so that was company number two. And while that was going on, Sutter decided I'm with Sutter Healthcare, in Northern California we have 27 hospitals.

I had played up at that point, clinically, I had played roles as a medical director. I was an obstetric anesthesiologist. I'm the epidural guy for anybody whose wife has had a baby. I'm the one that keeps everybody smiling in labor and delivery when people are having a baby. That's what I was doing in the background.

And one of the exact physician executives at Sutter came to me and said, look, you've done all of this, based medical entrepreneurship, and you've got some experience on the IT side. We're about to put this electronic healthcare record in Epic. Wow. Would you get involved? And I said yeah, sure, I'll come in as a consultant.

But yeah, that would be fascinating because that would gimme some education about that whole new evolving electronic healthcare record. And that was when Clinton was in the president and Hillary was pushing universal healthcare and they were making EHRs, mandatory. And that's when this concept really happened because, I started because we were one of the largest implementations other than Kaiser of Epic.

I got a chance to consult across the country at many very large academic centers and in the area of anesthesia and perioperative services for Epic. So I was, I became a physician informaticist. And everywhere that I went, I would go to work with subject matter experts at those institutions who were developing something similar to what we developed at Sutter.

We had a six person anesthesiology group working with a group of Sutter Epic analysts, and we built the anesthesia section of Epic out and in anesthesia. It's a, it's, I'll call it different. Many of my colleagues would argue with me, but the reality is that anesthesiologists are the only clinicians that work do what they do and document concurrent.

Most clinicians do a procedure and then they go sit down at the nurses' station and they type in the procedure and the post-op note and all of that. We are actually documenting, capturing vital signs. We're like a pilot and a cockpit and so anything that distracts us from taking care of the patient cuz they have to turn to a computer or I have to add workflow that I didn't have before was not a positive thing.

So we spent almost a year and a half building the platform to make it so that, we would offer up gift cards to the people on our team. Just if you could reduce a workflow by two or three clicks, because that's a distraction, right? Because I have to turn to the keyboard and type it in.

So if you think about it, you don't want your pilot distracted, right? If you've ever seen that show manifest. I've been watching that religiously of how this plane flies into a, into a white light. And the pilots are all distracted. It's a great story. It reminds me of that.

So we spent a lot of time doing that and building out that side of the platform. And it was fascinating because it's one of the products, at least in the Sutter system, that we've had very positive feedback from our colleagues about how it's made their life easier in many ways. Cause all the information is now device integrated, so it goes into the record without us having to write it down.

So we don't have to worry about that. So I got a chance again, going back to consulting, and I was consulting all over the country and everywhere that I went, I didn't only work with anesthesiologists, I worked with surgeons, I worked with nurses. Every clinician was disenfranchised.

They couldn't, they didn't like the way the electronic healthcare records were designed in general. It was very clear that, and again, I love, Judy Faulkner and Epic, and I've been to Verona, Wisconsin several times, incredible company. But the reality is that she probably didn't have a clinician in the garage where she developed Epic within a thousand miles.

And it was quite obvious that the platform was originally built to be a revenue cycle management, full hospital, management technology. But it really wasn't built for clinical documentation. So to me that's when you know, okay, I could start another company. Or I could do something that made sense that would allow clinicians to, or promote clinicians to actively participate in the process.

And it was clear that at that point in time, so this is now in the early to mid two thousands the idea of creating that environment. But again, having spent, at this point started two companies. I know the doctors, I know clinicians, I know how to raise money from them with great ideas.

So I said to myself the only way to get a bunch of clinicians in a room is to give them free continuing medical education food and offer them an opportunity to invest in something that they know. If you do that you can fill the auditorium with clinicians. I started to think about it and I said the first thing is, What was the last time?

Here I am in Silicon Valley. When was the last time Kleiner Perkins knocked on my front door and said, we've got the next Google in healthcare. You wanna invest in our venture fund? No. And my first two companies, we didn't ever raise any money from VC was all organic growth from, and investments from individuals.

So I really had no experience with venture capital. So you asked me, did I really want to be a venture capitalist? No, not at all. As a matter of fact, it wasn't even on my radar to, to become a vc. But it made sense that at that point, what the reason was is because I had very little exposure to venture capitalists as a clinician, as an entrepreneur.

Yes. But it wasn't necessary for me. So what we decided is let's start a venture fund where all the investors are clinicians. Now, that's not an easy path because it's no different than starting a company. Cuz now that clinician by click clinician, you have to pitch them.

And get them to invest and put it into the venture capital fund. So it was a lot of work. And my eldest boy was an MBA from ucla and he had been working at a VC in San Francisco and he knew about it. And, and they're all my kids. I have four kids and they're all used to me with my crazy ideas.

So I called them up one day and I said, I said, Hey Dave, how hard is it to start up a venture capital fund? And he said it's not that hard dad. He says, you gotta raise the money. And I said what do you think about the idea of raising the money from clinicians? And he's, God, they're all sick of hearing me pitch doctors all the time.

I would invite somebody over the house for a beer and the next thing I know, I'm pitching them from one of my companies. So they were used to be doing that. So he said, yeah, he says, I think it's a reasonable idea. It's gonna be a lot of work. But I, it's a really cool concept because right now there is nothing like that.

But in the background where I was going was, is look, I know how to get them in a room. I know how to get them an opportunity to invest. But then the next step was, okay, due diligence. What's the process? You invest the money, then you do your due diligence and you pick your portfolio companies, you make your investments.

And that's where this, the Global Health Impact Network came because the venture part, the raising money was the easy part. Picking the right companies, identifying. The right companies that clinicians thought were good platforms, that were market disruptive ways to change the delivery of healthcare globally, which is one of the amazing things about digital health is, at the end of the day, the future of healthcare is data.

And we've, that's where we've evolved at this point. But in those days, probably even six, seven years ago, it became quite obvious that what we really needed was a network of subject matter experts. All these clinicians that I was, talking to while I was consulting around the country, I would say to them you're sitting here complaining about it, you've seen me.

I walked the walk. But I'm the one out of 10,000. I would say to them why don't you become an advisor or a consultant to some of these companies? You know, What they would give to get access to you, your a cardiologist practicing 20 years or a pulmonologist practicing 15 years, or you're an RN, MBA who's an executive, in the executive in the C-suite.

I said, what they would give to get access to you, but they don't have access. Cuz first of all, we're all really busy and this is pre pandemic. But there's also not a good way to get the clinicians, I said, so what do you think about the idea of investing, but more importantly, actively participating?

Giving them the opportunity to actively participate as an advisor. Okay, so you bring them in and you say, look, we're looking at this company. We invested in 11 different companies across a lot of different verticals through the fund.

But it was important that when we invested, our theme was to invest in companies that were synergistic with each other. Because, healthcare is very siloed, right? So the idea is that we would bring in the appropriate subject matter experts, pitch them about the company, ask them to participate clinically, so a very clinical heavy due diligence process.

And then we would come up with a report and decide yay or nay if we were gonna invest. And of course, the general partners at that point in our fund would do that. And at that point we had a neurosurgeon. We had myself, we had Bob Sweeney from Challenger. And then we had this group of advisors and we would make a decision.

And then invariably, all of the advisors that participated would want to invest because that's the one thing that usually is not given as an opportunity. Maybe they'll throw you a bone and give you a little bit of equity, but not to really put some money into the company. So that was where the fund evolved.

Then I was very lucky because at the same time that all this was happening, believe it or not, in the background, I was approached by, we were bringing CPMC, the hospital in San Francisco, in the Sutter system Live. And it was a very big implementation. So we found a group from Sentara Healthcare System in the southeast.

Which had, I think about 10 hospitals, I can't remember exactly, but they were much further ahead from us. And there was a general surgeon there. His name is Kirk Heath, who's a, he's a good friend of mine now, and we've done things together. He is part of the network and investor in our fund. And Kirk approached me during this go live.

He had a great idea and that in those days, credentialing of clinicians was a nightmare. It was all paper based. It was very inefficient. So he and an anesthesiologist, a gentleman named James Alexa were, had started a company which was bringing the nurses and the physicians that were in their healthcare system as part of the implementation team.

He put together, they, the two of them put together a company where they were. Bringing this army of clinicians like me, I was one of those consultants that would go to hospitals to train. So we were using that, that solution. But he had an idea to build a cloud-based provider data management credentialing platform, which would, at the time there was only HealthStream had one solution that was out there and it was a competitor, but not really for what we were doing.

And we wound up starting company number three and I became one of the co-founders. I invested in it and that company was about to exit when we started the fund. So we were very lucky because a lot of physicians were investors in that company and they did very well from that exit. So many of them put money into the fund.

So we raised the money in the fund fairly quickly over a couple of years. So it made it easier and we were able to deploy that capital. And really build out this proprietary due diligence and investment process. So that's the history behind the fund and how the network started to grow. And then, organically, there's a lot of clinicians who just didn't necessarily have the money to invest but wanted to participate.

So that's when the network started to grow. I'll stop there and that's how we get to this point. As I said, it's a long story, but Yeah. But

[00:24:38] Ty: what an incredible story you've just told. That's phenomenal. How you got from like the mentoring of your dentist who just showed you like a different way of doing things.

He must have been so unique and what an incredible mentor. And then to see how you've carried those early life lessons forward to really build a community of entrepreneurial doctors, physicians, clinicians, it's incredible what you've been able to accomplish.

[00:25:00] Gary: Yeah. Thank you. It's great. It's been fun.

It's a fun ride. It's very rewarding. And it really we're at the precipice of a digital health revolution. So it's really the appropriate timing for this. And I'm not the only one out there doing this pretty much nowadays, but but it's very interesting to have the opportunity and there's so much that we could talk about in terms of what we're doing now moving forward and how the network is evolved.

That'd be a good direction to take it of like we've done past, but then do you mind sharing a vision for where you see, you mentioned like the digital health transformation. Like where do you see

[00:25:39] Gary: the future going?

Yeah it's interesting how it has evolved too. And the one thing that I will talk about just quickly is, the concept of building a network is really not as straightforward as it appears. If you look at the Facebooks and you look at the LinkedIns and all of that, those companies spent hundreds of million dollars over, 10 years to build the networks that they had. And, we were not in a position to be able to spend that kind of money. And what we were doing is it was almost more of a non-for-profit concept. The idea of taking, building an ecosystem within a network that could provide all of the resources to innovate, accelerate, commercialize, and then from an investment perspective, exit those companies.

Because, again, it's not like we were the first person, first group of people to ever do that. But we were the first group to do that with only clinicians who had no experience. Again, if you look at most clinicians, we usually, and again, sorry, doctor and dentist and clinician world, but we're not the best business people or we have typically not been.

Now, if you look at the evolution right now, there is, it's an incredible how many clinicians are getting MBAs and getting more involved because we've let healthcare in general the control of it's no longer by the clinicians. And the pendulum has swung back and forth over the 35 years that I was in practice.

But as it evolved, it was quite obvious that what we were creating was an opportunity for us to start to take back more control, especially if you become the investors and the advisors and the innovators of a lot of this technology. So we started to create this ecosystem, but I didn't know how I was gonna do this because what was I gonna do?

I was gonna take LinkedIn, slack, Dropbox, zoom, stitch 'em all together, and create a network that promoted collaboration, communication, investment, a process like a CRM process to follow the investments and track them. And that was not something that I had any desire to do at that stage in my life.

I was, when I started all this, I was in my, mid to late fifties. I was very lucky cuz, and I'll do a shout out to SoPE Society for Physician Entrepreneurs Arlen Meyers and his group. And when I first started the fund, there was the Silicon Valley chapter of SoPE was going on, and Uli Chettipally.

Another shout out is an ed doc from Kaiser who started Innovator md, but he, at the time was the president of the Silicon Valley group of SoPE and he invited me to this meeting and we had the fund up and running at that point, but we were still conceptualizing the network part of it, and it was like divine intervention.

I show up at this meeting and there's a company called Handzin H A N D Z I N and hands in there were a group from Tata Industries in India. Who had been brought in from Cisco and from other some of the other startups at the time to build tata's collaborative communication platform. So they, this group got together and that's what they had been doing for eight or nine years.

So it was a platform that was really quite a scalable concept, but it wasn't Handzin, it was just the back end of it. So this group, there's three gentlemen. Who came out of it, Mike Galvin, who's from London, and then Brian Isaac who was from the Bay Area and Henry Gooden, who was the CTO, who's in Australia in Adelaide.

I met two of them at this SoPE meeting and I'm talking to him and I thought they were physicians at first cause it was mostly the, clinicians there. And they started telling me about Handzin and this platform. And I was like, oh my God. What's the chances of me like. Meeting them randomly at this meeting because I said, Hey, I'm trying to build this network.

So the marriage was made at that meeting and we wound up investing in Handzin because it was a, they were focusing on federated, non-for-profit healthcare organizations and building a network environment which promoted collaboration, communication and innovation in that arena. And we fell into that even though we were not a non-for-profit.

So we made Global Health Impact Network with Global Health Impact Fund, the MVP, for Handzin. And again, we could spend a whole nother session like looking at that, but it's an amazing platform and it's like taking LinkedIn, slack, Dropbox, and Zoom and putting it into a HIPAA compliant environment or a HIPAA compliant possible environment.

But it includes all the functionality for video for messaging like Slack. And the social network side of it, like a LinkedIn, all of that functionality is there, but it's in a very secure, safe environment. And the one thing that you learn about healthcare is when you get a group of clinicians together the safe environment, secure aspect of it is very important.

I remember when Clubhouse first came out at the beginning of pandemic. Wow. And I'd get on some of these calls and there would be discussions about some really sensitive clinical issues. And you didn't know who was in the room. You just didn't know, and to me, I was very uncomfortable with the way some of those conversations went.

Cause there were a lot of subject matter experts throwing out opinions about things to a group of people. They didn't even know who, it could have been news reporters for a week. So it made me very uncomfortable. So when I saw the Handzin platform, I'm like, yes, this is what we need because here's what happens at the hospital.

Okay. Every morning on labor and delivery, we all get together, okay? And we get in a room and it's the nurses, the doctors, the techs, everyone sits there. We go over all 24 rooms and we talk about each patient. We figure out a plan as a group, okay? Team approach. And this way, if anything happens, everybody has situational awareness about what's going on.

That's a very educational process. It came from the airline industry and the cockpit with pilots. That's where it all originated, that whole team approach. So I'm trained, I've been doing that for, to at least 20 years. And when you learn that what happens is that they all get together and they all get to agree, but then the meeting ends and everybody goes to their room, right?

They go to the nurses go to the nurse's station room and and the doctors go to the doctor's lounge, and all they do is. Yap, yap. Yap. Complaining about the other groups when they're in their own little group, that's the safe area where there's no one there. And that concept really applies to collaboration and life and healthcare.

So in on the network, what we were able to do with the Handzin platform was to create a network of communities that were focused around professions and specialties, subspecialties, and then special interest areas, blockchain, ai, vr. And it was a way to create a community that was safe. Okay. Of clinicians, only clinicians that were interested in certain areas.

And like we had an ai call it a sub network, and then there's gastroenterology and then there's cardiology, and then those groups are just cardiologists or just, gastroenterologist. But then there's the bigger AI group. Which has to collaborate and it's really important. And that's one of the things that doesn't happen in healthcare is it's very siloed and no one's really talking to each other.

And that's why we are where we are in a way. So the network promotes collaboration and intercommunication between all of the different communities, professions, subject matter ideas. So there's a lot happening in the background, but it's also not easy to promote active participation engagement, cuz these are all busy clinicians that are doing 12 other things and they're consulting with companies now.

So how do you force that? So what we've struggled with on the network side is engagement, right? How do we get people to come in and we're doing a lot of optimization, of the Handzin platform and of the network to make that happen. But that's a bit of a struggle too, cuz the money has to come from somewhere.

We don't ever charge any members, a anything for being in network. When we provide education, the ability to communicate, the immune ability to collaborate. Now we, we have opportunities for credentialing and all sorts of crazy things.

[00:34:05] Ty: Gary, just to jump in there's a question from Dr. Harvey Castro.

[00:34:08] Gary: Oh, Harvey. Yeah, I know Harvey. And

[00:34:11] Ty: since you brought up ai he actually had a question related to that, which is, how the Global Health Impact Network evaluates the startup companies with respect to AI and healthcare. Maybe if you can, it circles back to the evaluation criteria, but you brought up AI as it relates to Handzin, but maybe just speak to, cause that's, definitely been the hype cycle is huge on ai and of course, Dr. Harvey Castro had been

[00:34:34] Jared: right there in the center of it

[00:34:35] Gary: Harvey's great. Harvey is, he is like the perfect one to talk about in terms of our network accomplishing what I've tried to accomplish. So Harvey and I, sorry, Harvey, but I'm gonna talk about you a little bit, is when we first met.

So Harvey's an ed doc. Okay. And Harvey was running a chain or a series of freestanding emergency rooms, urgent care, but they were beyond urgent care. They were real emergency rooms. And that's how we met because he was an emergency room physician, subject matter expert for us. Okay. And the first company that bought my company Challenger that we talked about, they were very focused.

That was a company that was started by Ed Docs also. Okay. And he was helping us with some things that we were doing with Challenger at the time. And when I found out about his company we started to talk about it and he was telling me how he was looking at possibly selling this, organization that he had built.

And here's a guy who's started out as an ED physician, got an mba, and clearly was on that track, but he was a good example of a clinician who goes out, gets an mba, but then what's the next step? I'm a busy doc, I'm running a business, I'm doing all those things. How can I do anything else? But by pulling him into our network, he was able to help us with some of the things that we were doing.

We got a chance to see what he was doing, and we were promoting what he was doing on the network. So with that kind of workflow, that's what happens. But he's another Gary type, right? But there's a lot of clinicians out there that don't have the time nor the desire to spend all that time doing it.

But what we've learned over the five years that we have the network is a lot of the clinicians, you get your toe in the water, I'm an open water swimmer, I've swam Alcatraz 50 times, right? But you don't start doing. You start by going to aquatic park and dipping your toe in the water and swimming a hundred yards and coming back and going, oh my God, that's so cold.

This is crazy. But then the next thing you know that you're doing a little bit more and a little bit more and a little bit more the network is very much like that. You have the opportunity to dip your toe in the water. And maybe that's as an investor, that's as an advisor, not an innovator. But then you start to work with the other clinicians and other innovators and you start to learn from them their path and how they got there.

And I've watched and seen people like Harvey who've started out as Ed Dots started a business and now look at him. Harvey is all over LinkedIn. He's lecturing, he's interviewing I think next week the president of the AMA, he's even been a guest on the med+Design podcast. He's just become an Exactly, he's become an incredible presence in healthcare and an incredible asset to artificial intelligence Chat GPT, I've learned a lot from him just on Chat GPT and see, what I do is Gary goes out and goes, okay, Harvey, all right. Now what I want you to do is start a Chat GPT community in the network. Okay? Make it available to clinicians across multiple specialties with the idea, like with ai, that we can start to form sub-communities and different specialties and professions around it.

But he, we have now a global expert who can oversee it. And then in the background, what we start to do is build the education into it as well. So you can get educated on the technology, on what the possibilities are in healthcare, and then what are the global possibilities, right? And that's such a hot area.

We could probably spend four hours on that topic, but he's the poster child of what I've tried to create in the network.

[00:38:20] Ty: Maybe you mentioned global, and there was a question from Dr. Val Torres, which is how are you actively pursuing improvement of health outcomes and reduction of disparities using healthcare entrepreneurship in the US internationally, like Latin America, for example?

[00:38:34] Gary: Example. I love it. This is my whole network here. They're all, you're all here. So here's some more shout outs. So how did I meet Val? I met Val from Raji. Okay. So I met when I met Raji, again, fresh outta medical school, but incredible from a business development standpoint. Loves working with different ideas and concepts, and he's interested in medical education.

Like I was, he started a company called Med Cloud and he's focused in on Chat GPT-4 and all this other technology and education, which is all separate conversation. But he also said, look, I wanna help you build this network. And he's come in to help me. I seen Natonya up there also. He's made all these introductions to me.

So when I met Val and Mauricio and a bunch of other group that had connections to LATAM, the first thing I said was, look, we're trying to build Global Health Impact Network. We built it domestically. We've then gone, we went to Africa and started working with a clinician there that has a lot of experience and we wanna build sub networks in different regions with the idea to promote technology and healthcare from those regions.

To those regions and provide opportunities for investment into those regions. So Val and his group Rob Fletcher are helping me cuz they have connections to 13 latam countries that have clinicians and innovators that want to participate. So now we're working together to create GHIN latam.

[00:40:13] Jared: Wow. Even we're getting even more questions that are awesome too. So I think let's just fire away at some of these, some more of these questions.

[00:40:20] Gary: So here's, I'm just gonna throw something out. Here's a little plug. Okay. Mike, Brian and Henry, plug for Handzin. So one of the things that we do on Handzin is a perfect example and we should talk about this after about what you guys are doing.

Cause we like what we would do is we create a community around this podcast and then we post the podcast. On the community, right? And we create a thread for each different talk, like a talk for this. So all the attendees and all listeners who participated or listened could then join that community and post discussion, have post discussion, collaboration, and innovation on that topic.

And it could also be done pre, so now all the people who are interested could get on there with the speaker and pose questions to them just like you're doing here before the talk. So we get an idea of what are some of the questions that we should talk about even before they're posted in the chat.

[00:41:19] Ty: So sounds like we, that we've got Dr. Brittany Busey coming up with health. She's on the schedule, so we should prototype that in Handzin and just keep reinforcing the network here.

[00:41:29] Gary: Absolutely. Yeah. Brittany's another perfect example. Her and Doug Sum Moraga started ViTelHealth, which we invested in, and they've created this incredible platform for private practices which allows the deployment of remote patient monitoring for practices and all that.

And Brit's another great innovator physician that has welled up through our network and they've done a great job. And there's Arlen. Yeah.

[00:41:56] Jared: Hello Arlen. Nice to see you there.

[00:41:58] Gary: This is like old home week. I love it.

[00:42:02] Jared: Got the community here today.

[00:42:03] Gary: Oh thank you for showing up.

[00:42:06] Jared: Yeah. I think, so a question from Natanya.

So she said, when healthcare providers are looking to expand either their practice or their side hustle, I guess what advice or kinds of companies. Do you have, or people do you recommend that they begin to collaborate with, to help them achieve I guess profitability with either their practice itself or the side hustle?

[00:42:26] Gary: Yeah, Natonya, that's a great question. And again, there's more, more shout out to Arlen and there are a lot of organizations out there that deal with clinicians and we'll call it side hustles or side gigs Dana Cor and so me, those, if you haven't interviewed her, you definitely have to interview Dana.

And what she does is, and what Arlen has been doing for years is working with those clinicians out there that are interested in doing these other kind of things, right? It's not just being an innovator and starting a company. It's a lot of different things that clinicians can do and get involved in on the business side, on the healthcare development side which is a side hustle.

So what I would recommend is that any clinicians that are out there, and you can always start at our network because we have a presence of all these organizations within our network, is it gives you an opportunity to talk to other clinicians who have walked the walk. Because to me that's the best way to accomplish it.

Talk to someone who's already been there, who has experienced to be a mentor and help you do it. And Dana, what she does, Is her organization works with these clinicians. It's a small membership fee, but it's not a lot but then what they do is they work with you. Let's say you wanna be an author, or you wanna be a podcaster, or you want to be a life coach.

All of those opportunities are there within these networks to develop yourself, promote yourself, and then they show you how to leverage social media, to present yourself on LinkedIn, on Facebook, on our network to make, to make yourself available to all of your colleagues and what's out there.

So that's what I would recommend for Natonya and the group that she's talking about.

[00:44:09] Jared: That's incredible. Thank you for that one. And we've actually got two questions about ai. Maybe we'll just try to they're a little bit different though. One was asking about how AI startups can negotiate with hospitals smartly and, so how they can get the right data to train the AI algorithms.

I think that's really fascinating. I think we've heard even Harvey talk about that a little bit. And then with from Andrew Paul McIntosh how might AI help physicians have more autonomy over their practices while reducing stress inefficiencies? I think that's totally Chat GPT right there and some of the other stuff that can help you automate things.

[00:44:42] Gary: Yeah. And again, what comes outta that initially from Gary is, sounds like we need another hour on just ai right? And come to our AI community in the network. Again, a shout out to our network. It's very easy to join our network. If you just go to Global Health Impact Network, to our website, it gives you access to join our network and it's free.

And, some of the communities are private and protected, so if you're an anesthesiologist, they won't let you into the cardiology community. Cuz they wanna talk about it. But Arlen actually brought up a very valuable thank you Arlen for posting. That is Anthony Chang's, MI10. Okay.

Which it's the artificial intelligence healthcare community that or network that they, he started, and Anthony's been doing this for a long time. I know Arlen, they recently had a meeting in Southern California. I wasn't able to attend cause I had some family issues, but Arlen and all of the bigwigs were there.

And it's completely focused on AI and healthcare and it's subdivided into different specialties and professions. There's a lot going on. Again, we have communities in our network that are like that. AI is, it's an interesting topic and we're seeing. What it reminds me of a little bit, and maybe I'll go on a little bit of a soapbox here for 10 seconds, is that you look at the mess that we created with electronic healthcare records.

Sorry, Judy, but we've come a long way and it's getting better and it's getting better because clinicians are now getting involved and creating companies that are targeted, siloed, subspecialty solutions for different areas. And that concept is what should have happened at the beginning. We have an opportunity with AI, with Chat GPT right now to do that, to bring in the appropriate clinicians to start working on solutions.

And again, I really don't like the AI term. If you wanna clear a room out of clinicians, walk in there and start talking about artificial intelligence, cuz everybody sees their jobs going out the window. Okay? It's assisted intelligence, okay? It's intended to be a tool to help clinicians be better clinicians, but it's never gonna replace the clinicians, especially the proceduralists.

Some people might argue with that. So for me, when it comes to ai, we have to be careful again, like that data is very important, right? So if you look at the current world of evolving genomics, Phenomics, the Phenomics is electronic healthcare records. The patient's history. Who owns that information?

The patient owns the information, right? Then how we utilize that information is extremely important and how we control the use of that information is extremely important. So when you get into the AI and the Chat GPT side of things, we have to be very careful about how we deploy these solutions, which at the end of the day, the most important thing is the patient provider.

I call it the collaborative interface. Okay? When a patient or provider get together and they're working together as a team to take care of that patient, which is what's important in that particular relationship, anything that can improve the efficiency. And improve the ability of the patient to be a better provider of care for themselves is a benefit.

But there are certain things that, certain ways and systems that could happen that misuse the data, misuse the information that's being collected, and then now it's being used garbage in, garbage out. If it's being used properly, it's beneficial. Genomics is a great example. Okay. We're at the precipice of a genomics revolution and opportunity.

We're gonna get to a point 10 years from, from now, and hopefully I'll still be around to take advantage of it. That if you develop a disease, they can sub classify you into a population of patients for that particular chronic disease set based on your genomic digital twin profile to say that this is the treatment regimen and lifestyle that you need to conduct.

To make yourself a better patient, improve your health and increase your longevity. And it's all based on data, right? But we're just starting to collect that data. But who owns the data? Where does it go? How do we use it? How do we develop it in a way that filters out the garbage and allows us to use the valuable information to improve care for patients?

We have a long way to go, and it's our responsibility as providers and our responsibility as healthcare system to ensure that it's done properly moving forward. And it goes way beyond just the clinicians and the patients, right? There's the governments and all the other levels that, layers that have to be addressed.

So I think we have an opportunity, but my response to all of these questions is you need to be actively involved in the process. Can'y be voyeurs.

[00:49:53] Ty: Great. That brings up, one of the, my favorite rabbit holes have been going down lately is human-centered artificial intelligence. And so this is a domain of thought leadership that Ben Schneiderman, who's a computer scientist he invented the hyperlink.

So he came up with the UI for that. He's been, conceptualizing human-centered artificial intelligence. As the ability for his catchphrase for it is humans in the group. AI in the loop, meaning that you're not giving up control to the ai, rather you're enhancing the human connections and having AI be a part of the conversation.

And the analogy would probably be like Star Trek generations where you have data, the character in the room as the AI who's interacting and providing information and helping the bridge make better decisions. That's probably the best conceptualization of how we can utilize AI in all these different contexts.

Not, like not disempowering clinicians, but rather enabling and making our workflows better and more efficient.

[00:50:54] Gary: And that's that assisted intelligence. As opposed to Exactly artificial intelligence. At the end of the day, I would prefer that we just trash the whole AI term and use deep learning machine learning, and you, that's what, when I talk about these topics, that's the words that, the descriptions that I use because It really is. To me it's a little bit dangerous that we use the word because everyone, when you now, especially with all of the compensations that are going on, and Harvey's been leading a lot of these conversations, there's a lot of concern coming about it. How we're using this data, and how we're gonna control the use of the data.

And, the Terminator concepts, the computers are gonna come back and get rid of all the humans. Maybe realistic, maybe not, but certainly, it's in the forefront of our minds because of Hollywood. We have to be careful and we do, but the only way it's gonna happen is if we're actively participating in it, not just watching it evolve in the background.

[00:51:49] Jared: Man, this could have been a three hour conversation easily. I wish it was. I guess since we're, really at the end of things here I do like to ask just, what kind of advice do you have for those early stage innovators, entrepreneurs that are clinicians that are basically where you were 30 years ago, 35 years ago?

What kind of advice do you have for them to get off the ground and try to reach the heights that you've gotten to?

[00:52:12] Gary: As I said earlier, I would, I feel very strongly that unlike 30 years ago, there are incredible resources. We have the internet and we have the cell phones, and now we've got apples, VR coming out.

All the technology is there. And the access to the technology is there as well. Through what Arlen's doing with SoPE, what we're doing with the network, what Dana's doing with, so docs utilize it, take advantage of it, don't be the biggest obstacle for most individuals to get from point A to point B is fear, okay, I don't know anything about this.

How do I learn about it? One of the amazing things about what we are doing, I always laugh about this, is I said, we're blessed. Here we are. We've created a network. Great, but we've created a network of individuals. Look to become a nurse or a doctor or you have to be relatively intelligent.

You have to be incredibly motivated. And here we are coming at a post pandemic and there's a reason that a lot of us are burned out is because they're all incredibly dedicated. Okay. Dedicated to taking care of people. But the quality of dedication, motivation and being a hard worker is all you need to be a successful entrepreneur.

You have to throw your ego in the garbage and be willing to consult the subject matter experts and people who have been there and learn from their mistakes. But you don't have to make the same mistakes. Don't be afraid to make a mistake cuz you can always pivot. You have to be flexible and if you can have those qualities, anyone could be an entrepreneur.

It's not that difficult. It just takes time and effort.

[00:54:05] Jared: That's incredible. Thank you for that. I feel inspired just listening to you. I know everyone else does. Dr. Goldman, thank you so much for your time today. Thank you so much for what you do for the greater community as well.

We're really excited to see what happens with Global Health Impact Network over time, and we have to have you back. I don't, I feel like this wasn't enough.

[00:54:22] Gary: Anytime. I'm happy to come back, we could even, bring in, we have so many people in our network that we can bring in to have discussions with about these different topics.

And again I would really encourage us, all of us to work together through the network to create communities around these areas because this shouldn't be a one and done. This should stimulate a lot of individuals to come and wanna participate and collaborate. And they can easily do it on our network.

Absolutely.

[00:54:50] Jared: Let's get there, everybody we'll just see you in Handzin as well. And yeah, just thank you so much Dr.

[00:54:55] Gary: Goldman. Thank you and thank you both for what you do, cuz this is a great podcast. As I said I'm constantly in the background listening. When you do these events. So thank you for what you do and thank you everybody for what all of you do for patients, for providers, for healthcare. I'm proud to be part of. That's incredible.

[00:55:16] Ty: All right close from here, but thanks everybody.