The Future of Medicine from the Scientists and Doctors on the Front Lines
How will we detect disease in the future, and how might new technology aid our well-being? In this episode, Dr. Oz sits down with entrepreneur Peter Diamandis and former FDA commissioner Rob Califf inside The Vatican to uncover the truth about the future of medicine. From the latest advances in treatment, to the most cutting edge preventive practices, these foremost experts are giving us all a glimpse into what’s next for healthcare. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.
I call it the effort to stop you from dying from something stupid.
Elegantly stated.
Once a year I go.
I've gone for three years now.
I send my executives and my family.
Once a year I go and I'm digitized.
And if anything is going on in my body, I find out about it right then.
Hey everyone, I'm Dr. Oz and this is the Dr. Oz I'm Dr. Oz and this is the Dr. Oz Podcast.
So, I was at this big meeting in the Vatican that we've been talking about a fair amount, and there was a big introductory session about the future of medicine.
And Peter Diamandis was asked to kick it all off, because he, more than anybody, has the ability to pull together the numbers, the figures, and sort of broaden the vista of opportunities you perceive in So I had the opportunity to sit down with him and I wanted you to hear some of our thoughts.
And just to give you a little background, he was named one of the world's 50 greatest leaders by Fortune magazine.
He's the founder of the XPRIZE Foundation.
At least you've gone to a bunch.
I have.
I used to be a visioneer for them.
A visioneer?
Mm-hmm.
Oh, I like that she's smiling and smirking as she says that.
It was fun.
It was like creative time.
So he's a big-time entrepreneur.
He started 17 companies.
Co-founder of Human Longevity is the one that he talked to me about a fair amount because he really thinks we should all live past 100 without too much question and feel like we're much younger than that.
He's been a New York Times bestselling author of books like Abundance and Bold.
And I tell you, he even has a stamp with his picture on it from the Greek government.
So Peter's been around the block for good reason.
Take a listen to his vision.
So Peter, one of the presentations that caught my attention at the Vatican The conference was your ability to change my perspective on what the future looked like, how fast we were moving.
And I think a lot of people would benefit from a different perspective you offered.
So, I think the reality is we're moving faster than anyone knows.
And it's not during your children's lifetime.
It's not even during your lifetime.
It's the next 10 or 20 years where we're going to see a complete transformation of so many elements of our lives, and most importantly, in healthcare.
So, what's going on?
First of all, our ability to have individuals and small companies, not large governments, not Big, giant pharmaceutical industries, small companies actually take action and solve big problems is greater than ever before.
And so what I mean, it means that all of these exponential technologies, computation, sensors, networks, AI, robotics, 3D printing, synthetic biology, blockchain are now technologies that are available to the individual or the small company.
And because of that, These companies can take shots at the biggest problems on the planet.
Let me back up and talk about a few of these elements.
So, one of the areas that people don't realize is computation and big data is allowing us to have insights We're going very quickly is a point where we are all going to be monitored.
I'm wearing an Aura sleep ring that's monitoring my sleep in detail.
I've got a LiveCore watch that's able to take an EKG. I've got a small embedded RFID chip on my hand over here.
Oh my goodness.
Which only has my business card on it, but eventually it'll have a lot more data.
We're going to have this data input.
And this data gathering capability on our body, in our bodies.
And that information is going to be picking up blood glucose, vitamin D levels, maybe messenger RNA. And where is it going to go?
That data is going to be fed up to an AI. You can think of it as Jarvis from Iron Man.
It's an artificial intelligence that you're wearing on your body.
That you give permission to that AI to listen to all your conversations, look at what you're eating, gather the data from your body, And that AI is constantly processing and looking at you're stressed.
You're eating in a restaurant that just reported an E. coli poisoning yesterday.
You should be careful.
You have these mRNAs in your bloodstream that indicate a potential early onset of a heart attack.
So, you know, we don't realize that in the cars we drive, And in the airplanes we fly in, those systems are being monitored every microsecond for anything out of deviation.
So I'm a pilot, I fly a CJ-3 and a Cirrus, hundreds of microprocessors, hundreds of sensors, measuring everything in that airplane.
When you fly across the ocean, we're here in Rome, we flew on jumbo jets here.
GE and Rolls-Royce are sending gigabytes of data from their jet engines down to the ground to make sure everything is perfect.
If anything's out of aberration, when the airplane lands, there is an engineering team there to meet that airplane and fix those engines.
Same thing for our cars, right?
Our cars are electronic.
They've got hundreds of processors, hundreds of sensors, monitoring everything, and you know what your car tells you.
Anything's out of aberration.
For most of us, our refrigerators are better wired than we are.
But that's going to change.
It's going to change, and that means we're going from health as a retrospective problem to a prospective problem.
So that's part of the whole sensor, AI suite, monitoring our bodies 24-7, easily, seamlessly, and just telling us when anything's at aberration.
The second thing that's happening right now is, you know, I'm on my 20th company, Human Longevity.
I co-founded with Craig Venter and Bob Rury back five years ago.
And one of the things that we do is we have a facility down in San Diego.
And when you come there, you come for three hours.
The price used to be $25,000.
It's now down to $5,000, dropping from there.
And we digitize you when you come.
So you come, we sequence your genome, all 3.2 billion letters.
We sequence you 30 times to get rid of any aberration.
We look at your microbiome.
We look at 1,100 chemicals in your bloodstream.
We do a full-body MRI at high resolution in a 3T Siemens machine.
We do a vasculature, MRI, look at your brain vasculature, look at your brain.
We do a coronary CT. 150 gigabytes of data are extracted from you in that three hours.
For how much money?
$5,000?
It's $5,000 for the first visit, $3,000 every year thereafter.
And to think that when Craig sequenced the human DNA the first time, what did it cost?
$100 million in nine months of time.
Now it's dropped down dramatically.
But here's the point.
Most of us are walking around and saying, hey, if I asked you or asked anybody here, anything wrong with you?
Do you feel great?
Most of us say, yeah, we feel great.
You have no idea what's going on inside your body.
We really don't.
Not until you end up in the ER saying, Doc, I got this pain.
And guess what?
It didn't happen that morning.
It's been going on for weeks, months, maybe years.
And so the flip of the model here at HLI, the concept is a health nucleus.
And I call it the effort to stop you from dying from something stupid.
Elegantly stated.
Yeah.
Once a year I go.
I've gone for three years now.
I send my executives and my family.
Once a year I go and I'm digitized.
And if anything is going on in my body, I find out about it right then.
And as a result, the day I go, I have a reasonably clean bill of health.
I feel good about it.
And I'll go next year.
My goal is to catch anything at stage zero, right?
We're all going to develop.
I mean, cancer is a normal state of occurrence.
Our immune system fights it when we get it, but sometimes we'll evade or cardiovascular or whatever it might be.
So, can I find something at stage zero and fight it?
You know, people say, I don't want to know.
That's BS. Of course you want to know.
You want to know and you want to solve it right then and there.
And so that's half of the equation of finding it at stage zero and fixing it and doing that every year.
I call it a lifelong, long life process, right?
The second half is in your genome, Is likely written what you're going to die from.
Not necessarily, but probabilistically.
And so I can tell you, listen, this kind of cancer is a higher probability of this kind of heart disease or whatever it might be.
So why don't you look at that more frequently?
And so this is really a prospective part of the equation.
So these combinations of things are not big pharma, they're not government, they're small private companies doing this.
So, ultimately, these are the preventative half of the equation of longevity.
I'm fixated by longevity.
When I was in medical school, I remember seeing a TV show on long-lived sea life.
And I was like, I didn't know this, like whales, turtles, sharks lived hundreds of years, theoretically 700 years.
I'm going, why them and why not us?
And my mental calculation, because I was doing an MD-PhD program in engineering, I said, it's either a software or hardware problem.
And we're going to be able to fix that.
And so I believe that now, what I mean now, I mean over the next decade, we're going to see extraordinary breakthroughs that will add at least 10, maybe 20 or 30 healthy years in our lives.
But guess what?
Those extra 10, 20, 30 years allow you in this exponential growth of technology To intercept all these other technologies, right?
Nanorobots or some of the amazing companies that I brought here in our XPRIZE longevity adventure trip.
Companies like United Neuroscience and Samumet and Moderna and what George Church is doing, CRISPR 2.0.
I mean, these are revolutionary companies that you know about, most people don't know about, that are, in my mind, completely changing my view of longevity.
And the potential for a lot of these things are not expensive, they just need to be gotten to marketplace.
Since we're at the Vatican, it's fascinating to have my mind blown apart as you expand my horizons and the vista of opportunities I see.
Leadership sometimes has a hard time keeping up with technology, yet they ground us in ways that are incredibly powerful.
As an example, a lot of listeners now are concerned about the role of technology in, interestingly, isolating us.
As much as we're hyper-connected, we emotionally often feel disconnected, especially for the younger generation who, and there's a class you may have heard of this, teaching young college students, males, how to ask girls on dates.
Because they've never had to actually look them in the eyes and ask them for data.
And that's sort of the first step to courtship.
So how do you reconcile the role of faith in an ever-expanding world based on science?
Listen, there's a number of elements here.
We can talk about it for days.
The reality is that the human race is changing.
And I think people like to believe that Things remain constant, and the way it is now is the way it should be.
But it's changed dramatically over hundreds of years.
People say, oh, in the good old days.
Well, in the good old days, you would die from TB at age 35. In the good old days, you would work 80 hours a week just to survive.
I think we're living the most extraordinary time ever in human history.
And as a result of that, I think perspective needs to realize that, yes, we have trades.
Technology, I live in Santa Monica.
I have two seven-year-old boys.
My mom lives in Florida.
They don't physically see each other often enough, but FaceTime or Skype or, you know, Beam robots allow them to connect on a more regular basis.
And I can talk to anybody instantly, any place on the planet.
Other thing is, here in the Vatican, I'm going to be on a conversation tomorrow on the morality of immortality.
I like to flip it and say the immorality of mortality.
Right.
But, listen, our moral ethics change, and people say, well, what do you mean?
So, listen, if I went back a thousand years to ancient Greece, to my great-great-great-great-grandfathers, and I said, listen, this guy over here...
I thought you were Turkish.
No, it's Greek.
My grandfather actually was born in Turkey, but my family's from Lesbos.
Humor me, humor me, please.
We're Gian brothers.
Okay.
So if I said, listen, this guy got gored by a bull and died.
This guy over here has a myocarditis.
I'm going to take the heart out of the dead man and put it into this other person here.
Today, it's a miracle.
Back then, I'd be burned at the proverbial stake for something that was crazy.
The idea of surrogate pregnancy today is a miracle.
Back, you know, years ago.
So morals change over time.
And we're going to start to see a lot of testing.
I think about what is the extreme case here, and I think about things like gene editing.
We're going to be hearing from amazing individuals, from George Church and others.
You know, people, the whole designer baby revolution that was talked about.
Listen, I know as a parent, I want my children to have the best food, the best clothing, the best education.
Why wouldn't you start with the best genetic information for them if you could?
Is that immoral?
Moral?
Maybe later on it's immoral not to do that.
How could you not give your kids the best intelligence genes?
I mean, come on.
We're going to explore these things.
And the only thing I can guarantee is that the only constant is change and the rate of change is accelerating.
And it's going to make for a fascinating future.
Thank you very much, my friend.
We have a lot more to talk about, but first, let's take a quick break.
Now, it's hard to top Peter Diamandis, but I tell you, there's someone that I really think the world of who was also at the conference, and I want to give him a chance to be heard Rob Califf is his name, and he's a physician, vice chancellor of health data science at Duke University.
He's also director for integrated health data there.
The guy's just an icon.
He's a professor of cardiology, my specialty, and I know him from there.
And originally wrote some of the biggest papers in our field, proving some things that a lot of people thought were true, but no one could really prove.
But then he left organized medicine and started working for President Barack Obama as deputy commissioner for medical products and tobacco at the FDA.
And then became the head commissioner of the FDA, which is important because that means he was the one who had to decide if a drug or food should be allowed to be shared with the American public.
And then when the president left office, President Obama, he went to work as an advisor to Verily Life Sciences.
That's a member of the Alphabet family of companies that Google owns.
So they'll go back.
He's at one of the best and biggest universities, an iconic researcher, ran the FDA, and now is working with Google.
So this man can touch a lot of different parts of our lives.
And he's been able to talk a lot of Americans through the complex array of What the future looks like out there.
So if Peter Diamandis' vision of the future is intact, Rob Caleb is going to help you understand how you'll get to experience it yourself.
Take a listen.
So Rob, you've been an icon in the field of medicine, leading major government institutions at Duke University, the efforts you've made in technology now at Google.
It is interesting for me to watch your career and see you keep your fingers on the pulse of what's happening in society, the zeitgeist, what's the pulse of the nation.
Walk me through your career trajectory.
What have you learned along the way?
I started out really as sort of a simple country doctor, really.
I wanted to be a pediatrician.
Then I saw somebody defibrillated, and I said, wow, I want to be a cardiologist.
Ended up in the cardiac care unit when we figured out what caused heart attacks, which it's amazing for people to think in 1980 we didn't know what caused heart attacks.
You became a cardiac surgeon.
Very similar kind of stuff, I'm sure, happened to you.
But when we figured out it was blood clots, the race was on to develop a treatment, and it immediately became a global activity.
So I went from sort of running one intensive care unit to working with people all over the world to get a treatment for heart attack.
Now your risk of being dead is half of what it was when we started.
Not because of me, but because of all the collaboration.
I'm going to interrupt for a second.
False humbleness here.
Because without you leading huge clinical trials, which in cardiac disease changed the face of the ailment, but it actually created a role model for other big chronic illnesses.
Because in heart disease, we have binary outcomes a lot of times, right?
They lived or they died.
That's so clear in a lot of other ailments.
But imitating some of the things that you and your colleagues pioneered, we began to advance all arms of medicine.
Sorry.
Well, I'm glad you see it that way, and it is exciting.
You learn it really by working together.
I don't think individuals typically have the unique idea.
Things evolve.
People talk to each other.
You learn, and it's sort of iterative.
And then, all of a sudden, a big idea comes about, usually in a group of people, really, if you look at the way it happens.
So when the chance came to run the FDA for me, that was like the epitome because most of my career had been evaluating treatments.
Always from the base of being a doctor and seeing what happened to people and wanting to make it better is a key part of my professional role.
Finishing the FDA, I came out and said, you know, the internet is a big thing.
It's affecting us all.
I want to have a foot at Google.
We need a disruptive force there.
And...
Because the major problems are happening in mainstream America where life expectancy is going the wrong direction.
I wanted to say the university anchored in the southeast where there are a lot of difficulties right now.
And your accent would flow right nicely.
So having spent a little time at Duke in my formative years, I was always impressed at how the team efforts worked well there.
The FDA is a challenging task because you've got to come up with ways of figuring out which of the Offered opportunities works the best.
One of the speakers here at the Vatican said that most of the ideas that may have been you that came through the FDA really weren't as good as people had hoped.
Is that your impression?
Well, it's not just an impression.
It's quantitative.
It's been figured out.
Ninety percent of drugs that get into phase one clinical trials.
Remember what it takes to get into phase one.
You've got to raise money.
You've got to convince a lot of people.
You've got to do all the preclinical work.
Before you ever go into a human being, 90% of the time the treatment fails, either because of unexpected toxicity or it just doesn't work.
So if we don't test these things, we're really at risk of hurting people.
On average, you're better off getting placebo than you are active treatment.
So, you know, when people talk about clinical trials, it really is a volunteer effort to help yourself in a lot of ways because you get great standard of care in a clinical trial, but also to help your relatives and future children, etc.
Fellow man.
So let me transition from the traditional things that medical leaders do to something you've engaged in now, which is working with Google.
And I want to use this as a mechanism of getting into the deeper challenges that technology offers.
I think most of us are aware of the power behind technology.
Google's famous ability to predict flu epidemics before the CDC could predict them.
What stimulated you to want to work with them?
Well, almost everyone in the world does searches.
And we go on the internet to find out what's going on.
It's the most powerful medium for learning things.
And part of the stimulation, frankly, was that a lot of what's on there is not very accurate.
So...
I think truthful information on the internet related to health may be the most underused and most important public health tool you can imagine.
I was really thrilled when people at Google said, yeah, please come work with us.
We'll work with you on it.
And there's a lot in progress now.
So I've always enjoyed interacting with the leadership of Google, and I'm most respectful of the big challenges they face.
And I'll bend your ear on a topic that I spoke of today, which is fake advertising.
And most folks listening to this podcast know that I don't sell products online with these fake ads, but I think most Americans don't know.
In fact, that's the best data I have.
And there's a reason for that.
These ads are so beautifully crafted.
They're so believable that most people don't watch daytime television are going to be exposed to me in that way.
But I'm not alone.
Almost every other person that I know of who is influential has had some run-in with a false presentation of what they believed.
But these are actually done on purpose to make money.
And one of the biggest challenges, of course, is the lack of transparency in the entire process.
So if you were to look at the entire ecosystem you're playing in, and you just pointed out that the lack of integrity of some of the data is something that's worrying to Google, how do we begin to get our arms around this problem?
Well, I mean, a simple way to think about it is for every question a person has about their health, there is an answer on the Internet.
And we now know that if someone makes it up, it's more satisfying to the brain, as you pointed out in your lecture.
But also, there's empirical work.
Lies on the Internet reach more people faster and last longer than truth.
Because truth on the internet has to include the scientific caveats, the uncertainties, etc., which are a little bit less satisfying.
So we've got to figure this out.
But I don't believe any of us want Google or Amazon or Facebook to be the censor on the internet, except for things like terrorism and suicide, where I think we all agree societally.
So, doctors, universities, we all need to figure out a set of societal rules.
And, you know, as I told you, ethics is too important to lead to ethicists.
Internet behavior is too important to lead to tech companies.
We all need to be involved.
I would love it if there was a swarm of doctors that descended upon anyone who put a fake ad or was selling stem cells that had not been proven on the Internet for cash, descended on those people and put them out of business.
I really think that's what needs to happen.
There's a lot more to come after the break.
The remarkable thing that I realized with my viewers is the person they trust the most is their nurse, actually.
But then the doctor right after that.
And when they leave the physician's office, they are Googling second thoughts, other opinions, which, of course, is infuriating to a lot of physicians because you spend your whole life trying to learn how to treat heart disease and you're trusting what some guy wrote that you don't even know or more likely going down to the health food store and believing what they're saying.
What they're saying may be valid, by the way.
I think empowering doctors would allow them to more proactively take charge of this information flow.
Do you have any vision for what this might look like in five years?
You know, after I left the FDA, I've talked to some 40,000 practitioners because you're asked to give a lot of lectures.
Almost 100%, first of all, have done at least one search in the last 24 hours themselves.
And almost 100% would love it if people could just go home and Google and get accurate information.
So we are working on that.
You know, I don't control it.
I'm part of the team working on search.
It's a big team.
It's a global effort.
But there's a thing called a knowledge panel, which is a curated...
Thank you.
Someone saw me in clinic and I said, "You have angina.
Go home and Google angina." When they Googled angina, they would get a link to the American Heart Association so they could work together, a list of good clinical trials that they could participate in, and a good explanation for the possible treatments that could be used that was curated.
There would still be an opportunity, I think, in the ideal world for people to advertise and do the things that they want to do.
That's part of American life.
But it ought to be complemented by a source of information that people could really believe in is scientifically accurate.
What I would personally love, just going to run it by you here, we're brainstorming, is to know where the sources of revenue for the site are.
So if you're making money from running ads, you know, that's one way of making money.
It makes me sensitive to some things, like maybe trying to get clickbait.
If you're selling an actual product and the whole preamble is to lead me to buy that product, it does put my SpideySense antenna up.
And I don't think that would be too difficult.
Do you?
It wouldn't be difficult, and I resonate to that.
I'll just tell you something about my experience at the FDA. A lot of the shoddy operations that we saw in manufacturing, for example, when you would look at the corporation, you say, this is a corporation with certain executives.
If you trace back to where the money actually came from, it was often coming from A leading company with a very good reputation.
Corporate lawyers have figured out how to create shell corporation after shell corporation, so you really have to work to figure out what the real source of the cash is.
I think in many sources of current life, if you actually knew where the money came from, I could mention politics as another example, it would be much better for people.
We have to get to a system where the truth dominates, and that's not what we have right now.
I'm reminded 20 years ago there was a big sneaker company that got blamed for allowing their sneakers to be made in sweatshops in Southeast Asia, and they didn't even really know, in part because they didn't ask.
And when they finally were outed on this and they began to check themselves, they realized that they were allowing some of their work to be done because they were just saying, you know what, make me the sneakers.
I don't want to get involved in the details.
And they realized they couldn't say that anymore.
I think we're approaching a time in the web when the large companies, including Google, are probably going to have to say, you know, I really don't want to get into the nitty gritty and expose myself to all the litigation of being responsible for cleaning up the web.
Plus people like Dr. Califf don't think it's the best thing.
And I sort of agree with you.
It should be done by folks outside of high-tech industry.
That stated, if you don't allow the supply chains to be double-checked and triple-checked and you have confidence about who's actually paying who what, it makes it really easy to cheat the system, which ultimately cheats you, me, and the listener.
Couldn't agree more.
You know, two things to mention about that.
And one, cardiac surgeons learned about this a long time ago, right?
Because there was a time when no one knew what the results were of cardiac surgery.
Government said, if you want to get paid, you're going to have to collect your results.
The surgeons deserve credit for doing it themselves.
Kicking and screaming, by the way.
That's right.
And some bad things happen, like people got shy about operating on tough cases and all, but ultimately, bad surgeons had to stop operating, and it became a mechanism for making surgery better because things were measured all the time.
Second thing I'd just say is I think in this ecosystem of truth, universities are not doing the job that they should be doing.
If you think about universities, they should be all about information and about seeking the truth, people congregating to find out about the truth.
They're sort of ignoring this when the biggest source of information, even for university students, is the good old internet.
And yet, here we have schools of law, ethics departments, medical schools.
We really need to use the not-for-profit universities to play some of this clean up the internet function.
You threw out an idea which you enticed me about, which is to actually write something for our biggest journal, JAMA, that might address, for example, fake advertising and how it hacks the brain and what physicians who do read JAMA need to know.
You've written a bunch of these.
How does that have impact?
Well, typically, you know, I've written a lot of papers, and some of them are just put on the shelf.
But if you write a really good paper, what happens is people read it and they get ideas, and then you'll bump into somebody a year later, and they'll say, you know, that paper you wrote, that stimulated me to do something different, and here's what I've created.
I think right now this is the topic of our time, and writing something that really got people worked up would have a very good effect.
We'll publish it, hopefully with your help, and we'll get it out there online as well.
Plus, of course, social, so all you at home can read it.
All right.
Thank you.
God bless you for your leadership.
Thanks.
So you can see these are big thinkers.
And Rob Califf, who's been able to create a lot of the groundbreaking research, also understands how that research can influence people's lives.
As commissioner of the FDA, that was his job to say, yeah, it's not quite well enough proven we won't pay for it.
Or, you know what, that's close enough.
We're going to make sure everyone has access to it.
And here's some of the things that I learned, both from these two gentlemen, but other speakers at the conference.
Your major mortality predictors turn out to be your zip code and your credit score, which I'm stunned by.
Not your blood sugar level, although that's important too.
But where you live, because you're hanging with healthy people or not, and how much money you have, or at least how good you've been with your money, are key predictors, in part because seven out of the top ten stressors seem to be financial mediated.
And if you're stressed out, that's a major ager.
And What I'm hearing more and more is the rule ought to be no outcome, no income.
If you go to a hospital and you get an operation and it doesn't work, then no one ought to be paid.
Or at least they ought to give you a money-back guarantee, which actually was talked about.
How would that be if you went to get a treatment for some heart arrhythmia you're having and you don't get any better?
Would that be something you take advantage of?
I'm a little concerned that people wouldn't do cases where there's a possibility of them not getting paid.
Because open-heart surgery, what's the bill for the hospital?
$50,000, let's say.
$50,000, right.
So are you going to take that risk as a hospital if there's a possibility that you're going to be in the red for the entire year?
Yeah, but now you have the opposite incentive, which there's no downside for me just to give my best shot.
I could pay $50,000 for my hospital just to give it a shot.
What's the harm?
Well, there is harm.
Because if you multiply that by a lot of people who are sick, you have huge bills generated.
And because these people are ill, the true expense goes up even more.
Because now you're creating complications that no one agreed to pay for ahead of time.
And I'm respectful of the possibility you might not get as aggressive surgery.
But we are seeing the opposite now.
You pay to play and so everyone plays and people get paid.
And I'm not even saying it has to be across the board.
Maybe there's some exemptions, but take the more traditional procedures.
If I'm doing a knee replacement operation and my results are better than yours, then I ought to get paid more or you ought to get paid less.
Also, how do you decide?
It just becomes an arbitration nightmare.
How do you decide if it was effective or not?
Because maybe for the purposes of the physician, they're going to say it worked, but it didn't work as well as you wanted it to work.
So then someone's going to litigate.
It's a nightmare.
That's exactly how things don't get done, because it seems difficult.
But I'll tell you, there are probably 10 major problems that drive most of the expense.
So once you understand that, just figure those 10 things out, which is doable.
Anyway, here's my perspective.
90% of drugs fail at development.
90%.
That's what Rob Califf said.
At the FDA, 9 out of 10 drugs aren't going to make it.
So their job is to try to get rid of those 9 quickly so the 10th one that really saves a lot of lives gets out there more rapidly.
We have to get faster at that.
And I got to say, we were at the Vatican talking about God a fair amount.
God's gift...
Of randomization.
Ought to be respected.
We have the ability to randomize whether it works or not work.
You know, they do this on the internet, right?
A versus B testing.
Serve up two different kinds of ads.
Which one do people resonate to?
Whichever one seems to work better, go that way.
That's what big companies advertise to you and me like that right now.
We need to do that more and more in medicine.
And we can do it on procedures.
So if I use this technique in one state, not another state, and it improves outcomes, that's a good thing for all of us.
But I got to say, reporters focus always on mental health and, I mean, sorry, on physical health issues, but I think we need to focus more on mental health issues because the mental health issues, which everyone's skeptical about and doesn't respect as much of a problem, it's driving a lot of our issues as well.
And I think when we look at this entire field, we're going to get wiser and smarter by challenging ourselves, pushing ourselves to get into the areas that we thought are too murky to get involved.
And especially since technology is offering us ways of inferring what ailments are.
I mean, take my phone.
My cell phone right now, if I turned it on, if I turned the ShareCare app on, I could actually have someone audit my voice and tell me if I'm feeling depressed or even more problematic.
I think that's one of the opportunities we have as Americans is use technology to improve all of our health and we haven't unveiled that as much we need to.
