*Now Available* Dead Wrong: Diagnosing and Treating Healthcare’s Misinformation Illness (ft. Dr. Geeta Nayyar)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences.

And now, your host, Ed Marx.

Ed here. Welcome to Digital Voices, and it is a special drop because it's a new book release. So these are my favorite types of special drops. Because I think it's so important that we continue to write and evolve and share ideas and produce books. And so super happy to do that with one of my favorite people in the world, Dr. Geeta Nayar, otherwise known as Dr. G. Dr. G, welcome to Digital Voices.

Thank you so much for having me, Ed. It's wonderful to be with you.

And I know you're just finishing a worldwide tour of your book and you just flew in from London. So we know we got you before the jet lag sets in totally. So thanks for making the time. And yeah, let's jump right into it. So the first time we met, if I get this correct, I can't remember the year, but I do remember you were the CMO of AT&T. And we were in Dallas and I was serving at Texas Health Resources and we were doing every year these TEDx talks, TEDxTHR. And I think it was at the first one, maybe the second one, but you were one of our TEDxTHR speakers. And that's the first time that we met or spent lots of time together.

It was wonderful. And I remember it like it was yesterday. I swear you had more hair. Perhaps I had less. I don't know. Some iteration of that.

Yeah, those were a lot of fun. And then it was great interacting with you as the CMO as well. And so before we get into your playlist, I want to also introduce someone else, a former guest on Digital Voices, my friend and colleague, Will Conaway. So, Will, I want to bring you in and welcome you as well.

Thank you, Ed. Thank you, Dr. G. It's great to be here today.

So Will's going to help me when it comes time to talk about the books because Will— I call Will the professor. So that might be, Will, part of your new brand. I call him the professor because he does all this stuff at Cornell and anyplace else, Will? Is it just Cornell?

Just Cornell.

Yeah, that's pretty big.

Not Gilgamesh Island? Not Gilgamesh Island, Will?

No, nothing else. So, the reason I was bringing Will in at this point, because Geeta, the next— or Dr. G, the next question we have is songs on your playlist. So, like, what do you like to listen to?

Oh my gosh, I listen to all kinds of stuff. So, first of all, I have to say I have an 11-year-old. So most of my playlist is a combination of her playlist and then whatever I can kind of get in there. So, I mean, right now, Lizzo. Lizzo's pretty hot. We listen to a lot of Lizzo. I love U2. I'm a diehard U2 fan. First concert I ever went to. But really eclectic. And then I love jazz. I listen to meditation music sometimes, try to slip that in. So it's really pretty eclectic with me. And then, of course, my Hindi Bollywood comes out at times as well. So I've got a pretty good mix.

Yeah, that's cool. Have you been to the Sphere yet with U2 down in Vegas?

I missed it. Everyone was talking about it. Some of us had to like get our book out there and like get out there and do the tour. So I did not get to, but I definitely was feeling like I missed out.

Yeah, well, they're gonna be there. Will, do you know how long they're gonna be there? They're gonna be there for a few months, I think. I wanna catch them.

Not positive, but I could look that up real quick.

Yeah, no, I, I'm, I'm a big U2 fan too, is the reason I, I mentioned that. And I, I wanted to get out there in the beginning, but the prices were so high. I was like, I'm gonna wait a little while till the— it was like Hamilton. Remember Hamilton? Like everyone's paying like $5,000 for a ticket and now you can get them for about $50. So, um, exactly.

I'm with you. I'm with you. We do it the smart way. Sell a few more books and we'll think about it.

Yeah, there you go. So, what about a life mantra? Is there some words that help guide you, help provide a foundation for who Dr. G is?

You know, I, again, you know this, Ed, I've come from a Southeast Asian upbringing. It's really karma. I mean, I'm just a big believer in what goes around comes around. And as much as we believe in reincarnation, I think it all happens in this lifetime, right? I think it all happens right here.

Yeah.

And so, I try to approach whether it's professional quandaries, personal quandaries. I do. I think you get what you put in. I think you, um, you can't escape it. The good, the good and the bad, right? Like I say that just for just as many blessings as I've been privileged to have. I say it's always the karma. It always comes down to karma. So I'm a big believer in that.

Yeah, that's cool. So one question on your career, and then I want to jump right into the book. So you may have been one of the pioneers for chief medical officers working in big tech. You know, because I don't know how prevalent it was when you first started at AT&T. I don't think it was all that prevalent. Today, you know, it's definitely much more prevalent. So, and you've done this a few times. So you're definitely a veteran at that. So you've been with Salesforce, with AT&T, you know, one or two other companies. So what's next?

You know, I haven't decided that. Definitely, definitely, definitely I would put myself in the class of veterans, but young veterans. Ed, I know you're not calling me old. I would just say that I was like you, right? I think some of it was being in the right place at the right time. I'm of the generation of physicians that went from paper to digital in our residency. So it also was just, I was very much inspired what I thought was going to be the future, and I wanted to inform that. And that's still my current stance. For now, Ed, I am focused on the professional speaking circuit, consulting, and I'm really enjoying So I'm, you know, I'm making a go at it and I'm really being thoughtful about my next move wherever I go, whether I stay independent or make a move to another company, it's going to be with now experience of having done it before, being sure of what I wanna do for the future and having the freedom, opportunity, and budget to make an impact. So I think I'm looking for the thoughtful next step.

Yeah, that was very cool. All right, so this is where Will and I come together and we're gonna be talking about Dead Wrong, So tell us about your book. Let's just start really generic, and then Will and I will ask questions as we move along.

So hot off the presses, and I know your audience can't see it, but it is an EKG, an accurate PQRS, which I actually had to go back to the publisher to fix, and then a flatline. So I'm really loving the COVID But really, it is about misinformation and disinformation in the digital age. So in the era of AI, in the era of TikTok, How does a health system, how does a pharma company, how does a payer, how do we as an industry get it right? And how do we think about this problem? But I am super, super excited. First time author and put a lot of heart and soul into it. My daughter did all the graphics and artwork with a medical student that I'm mentoring at University of Miami. And I hope, I hope everyone enjoys it and learns something.

Yeah, that's great.

So today, October 17th, live on Amazon. Yes. Shipping to your home. And your company.

So what was the impetus? I kind of talked about generically the book, but what was the emphasis for the— impetus for the book?

Sure. And really chapter 1 starts out with this, with me talking about when COVID happened. Let me just preface this to say when COVID happened, I felt like I was back in DC in the early 2000s, which is when I was in residency and it was the height of the HIV/AIDS epidemic. And there was so much confusion about how you get HIV/AIDS. There was so much confusion There was so much stigma. Religious authorities had things to say. Political authorities had things to say. Your neighbor had something to say. Right. And so when COVID-19 happened in 2020, I had a flashback because I thought as a young physician that the HIV/AIDS epidemic thing was a once in a lifetime thing. It was clearly not going to repeat itself. Right. And then when COVID happened, I said, oh my God, is this what happens in healthcare? It rinses and repeats. And so that was really my motivation in writing the book to say, Misinformation, disinformation has been around since the beginning of time. And I go through the history in the book. Social media did not in fact cause it, but it is certainly accelerating it.

Hmm.

Right? And the opportunity we have with artificial intelligence, particularly as healthcare leaders, is to use it for good and not for evil, right? Because these technologies, while they've been harnessed for a lot of misfits out there, and bad news unfortunately spreads faster than good news, we as healthcare leaders need to flip the dynamic. And say, okay, we get the algorithms. Okay, we get what AI can do, but now we have to turn it on because in the absence of good information, mis- and disinformation is spreading like fungus.

Yeah.

Spreading like that mold on your bread, you know? Sorry, I'm a nerd, so I can only come up with gross bacterial—

No, no, no. I think everyone can relate to that for sure.

So, Dr. G, I have to ask you, you've said 2 things here that really grabbed my attention, actually several things here. When you talk about AI and you talk about data, the first thing that popped in my head as you kept talking about was the Mark Twain quote that a lie could travel halfway around the world before the truth is putting its shoes on. So I thought about that, and I guess, where do you see, do you think AI is going to ultimately help This, the situation where people can make quicker decisions and more informed decisions. Obviously, the other thing that worries me is that when you look at things, decision fatigue. You know, the average person makes about 35,000, you know, remotely, I'll call it, conscious decisions each day. I mean, is more data going to help those decisions, or is it going to make things worse? And is there going to be more misconstrued information as we move forward?

So, you know, I'm going to say that it's up to us, right? All of this technology, whether we're talking about EHRs, artificial intelligence today, something else new tomorrow, it's all on how we as healthcare leaders implement it. And it's all dependent on how much we understand the humanity that is ultimately the business that we're in, right? Healthcare is a services business. People got a question and we're offering them an answer. And in the absence of that, misfits are filling the space. So, Very similar to the EHR where we thought, gosh, you know, this could really improve data collection. This could really do away with silos. This could really improve the physician experience. Here we are 20 years later. We've made those things worse in many ways, right? We solved one problem. We created 3 new ones. So I think we have to approach artificial intelligence and what I would say is this next phase of health tech with some humility to say, hey, what are the problems today? physician burnout, consumer experience, social media, and this thirst for information. Number one Google search is always a healthcare question, right? And so how does a healthcare system that is bootstrapped from a budget perspective, trying to do value-based care, right, serving and working with partners like the life sciences, how do we come together as an industry and solve for this? And one of the use cases I talk about in the book is the Cleveland Clinic. Cleveland Clinic, Paul Matson, Really did this phenomenally from an enterprise level. He said, "Okay, we're going to own the brand. We're going to drive patient acquisition and retention. We're about value-based care, but we're marketing. We're not clinical. How do I partner with clinical? And then how do I partner with tech? And then how do I get a partner like YouTube?" And they very beautifully came out with their doctors as the experts. Click here for an appointment. Built their brand. And if you're going to Google something, Google evidence-based experts. Spewing science from the Cleveland Clinic. And it's a really beautiful use case of how you do this right, but you can't do it in a silo and you don't have to know everything. You gotta partner internally, externally, and at the enterprise level, whether you're a payer, a provider, a life science company, the message in this book is for you. And it's about how you come together for this undercurrent that we're all really fighting against. It's really that invisible undercurrent, but it's the heart of everything we're doing in healthcare.

Dr. G, it sounds like it's applicable too to the general public. You know, while your, your main audience may be those in the healthcare broader community, but it's like if I were Joe or Jill Public, I would be super interested in this as well, right? Because the impacts that it has on our lives, 'cause we're easily fooled, right, on social media. I get that all the time on different topics. I'm like, oh, this must be true. But then when you research it, it's clearly not.

It's absolutely— and I have to make sure you get a book. If I haven't gotten your address, I'm going to ask you for it. You will, you as well. Yes, absolutely. You know, the publisher makes you pick a category, as you know, as a multi— gosh, I don't know, you're on like 10th book, I think. They make you pick a category. So I had to pick the business category, but it is written both because it's full of so many data points, but with storytelling, right? Each chapter is a story to drive home a data point. And I've been told that from a lot of the moms at Sonia's school. They really love the read. And because look, Everyone has a question about their health. Number one Google search, right? So it really is. And that's part of the conversation that every physician has with their patients. Hey doc, I wanna read about this. I've got a new diagnosis. In my case, deal with lupus rheumatoid arthritis. And I say, do not go to Google. Here is where I actually want you to go. I want you to go to the Arthritis Foundation. I want you to go to the Lupus Foundation. I want you to forget everywhere else that you're going. And then I want you to come back with your questions because we'll have a conversation about what's personally relevant for you, right? There's general information, but then there's information, you know, vitamin D is not good for everyone, right? There are special cases. If you have kidney problems, you have liver problems. So that's where the doctor piece comes in and you wanna understand the difference. And that's where that partnership between you and your physician is really critical.

You know, you noted that one of the quotes I really love that you, you put on your, your website was that building trust and healthcare literacy at scale requires healthcare leaders to take responsibility for the problem and their solutions. As a physician leader, how would you say that you would have to pair and work? And what advice can we get from the book around how healthcare leaders, be it outside of, you know, from the medical part, like the CEO, maybe the CFO, can work with the physician to get the most out of this?

Well, again, remember, we don't have to go too far. Remember COVID, right? What was everybody doing during COVID at the C-suite? They were working together. And I will tell you, even at Salesforce, right? It was the first time I met the Chief Marketing Officer. But what were they marketing? They were marketing closing the office, opening the office. It was internal communications, external communications around what we were doing internally, right? And so, we have to do that. If the CFO is responsible for driving up revenues, cost protection of the hospital, Then who is the person that is responsible for patient acquisition and retention? Likely the CIO, likely the chief marketing, likely many different stakeholders, right? So those metrics are across the C-suite. And when you have risk contracts, if you are a group, if you are an organization that is not a concierge practice and doing value-based care or trying to do at-risk contracting, those metrics are aligned. But who's the person out there in charge of the actual brand loyalty, patient acquisition and retention external to the org, that's gonna be your chief marketing officer. So it's really the chief marketing officer working with the chief medical officer, working with the CIO. It really is a C-suite imperative. And listen, I'm not naive. There's no health system out there, there's no life science company out there, there's no payer out there that's saying you're in charge of the misinformation disinformation strategy. That's not the case. I know that. We've hid them in places like patient engagement, acquisition, Brand loyalty, physician burnout strategies. What we have to recognize as an industry—the call to action in the book—is the undercurrent to all of that is that consumers don't know where to go, have lost trust in the system. Other shinier objects and TikTok dance moves are catching their trust. And so, how do we as a health system displace that and have a better, more cohesive enterprise strategy to meet the customer? Where they want. Again, we're a services business. People have questions. They're looking at the healthcare industry and the experts to solve them. No different from accountants, no different from lawyers. So our currency is information. And if we don't treat it as such and someone else is out there spewing that information, I promise at the end of the misinformation train is a doctor meeting you in the emergency room and it's expensive and it never turns out well. Never turns out well. So we pay for it. We pay for it in the end.

Yeah, that's a really good, that's a really good point. And it sounds like, Dr. G, your book would be great if, you know, um, health system or hospital leadership, they kind of bought a book for everyone and, you know, use it at a management team meeting, like a book review. I'm not saying that just fits a book, cuz I'm really, I'm excited for you to, for, for that book to get in many people's hands, but it's so practical. So it's like, and like you said, it's full of stories, like real stories.

Yeah. It is. Thank you for that. No, I do appreciate that. And I do, I think physicians would appreciate it. I think consumers would appreciate it. I think administrators would, because I also think, you know, COVID's over. I get that. But you can't go very far in any conversation about healthcare without talking about COVID In the post-pandemic world we're in, a lot went down. A lot went down and the healthcare world got tipped over on its head. And so did the consumer experience in healthcare. Yeah. And so the opportunity now is this post-pandemic reflection of, okay, what did I learn? What went wrong? What can we do better? And yeah, this comes down to dollars. Ultimately, if you're doing value-based care, guess what? Prevention is the name of the game. And how do you prevent? You've got to tell people this is why you should get a mammogram. This is why the colonoscopy is better than colon cancer. So if you don't have the trust and that true connection with the patient, Whether you're the payer, whether you're the provider, whether you're a life science company, patient's not gonna take the pill, but they will take that $1,000 supplement that someone on TikTok sold them because they trusted them and they were available 24/7. So that's, that's really it, right? So it is, it is meant for all of those audiences, but inspire us to think about it very differently than we ever have in a post-pandemic world. Yeah, nobody wants to— I know you guys are laughing, your audience can't see this. We're all laughing. Like nobody wants to pay their $50 copay, but $1,000 vitamin C supplement. No. You got it. You got that.

I smile too, because I mean, it's not just healthcare, as we've already established, where this happens, especially like you said so eloquently, Dr. G, in the beginning about social media has just exasperated the situation, accelerated the situation. But I think about fitness, you know, 'cause, uh, 'cause my, the people I hang with are like in super fitness and, uh, you know, they'll watch a TikTok video and suddenly go out and buy these expensive stuff that's probably garbage, you know, without having done any research, you know? So that's why I smile. And we do the same with our own healthcare. And like you said, at the end of that train could be a physician in the ED. And that's the train I don't want to ride on.

And not just that, right? But your physician, the alignment of your physician with your health is very different. And I've had plenty of patients ask me that exact question. Should I take this supplement or that supplement? And, you know, I live here in South Florida. I say, you got an orange? You got an apple? It's like 50 cents, even at Whole Foods. Pretty reasonable. Maybe it's a dollar. And no one likes that answer, but it's the truth.

It is the truth.

I always say that. Why do you need a supplement if you have the actual raw produce available to you right now? If, you know, if you're in a position where you can't, or something might expire, you don't go to the store, whatever, okay, you use a supplement. But we don't even propagate that, right? And because we don't profit, physicians are not profiting over whether you buy the apple Or the supplement. And that's really the difference is also understanding who is giving you that information and where's the incentive and understanding that we don't, we don't make any money. We're actually in it for you and your health.

That's nice. I have to ask you one question, cuz I, I have to imagine that, you know, I, I have not written a book and I know both of you have, but at the end of the day, I'm just gonna just direct it at Dr. G today on this one.

What did you learn about yourself Gosh, what did I learn about myself? You know, I knew this about myself, but I think it just only, uh, validated it for me. I just can't do anything halfway. I am like an all-in or all-out person. I probably could have got this book out quicker, but I just put so much heart and soul into it. Again, I brought in my daughter, one of the medical students at University of Miami that I mentor, and I, the whole time I just was How do I bring them into this business book, an 11-year-old and like a 20-year-old? And then we came up with graphics. And then I thought about how do I bring my family into this? And I put in some family pictures and sort of weaved our family story as immigrant physicians into the book. I don't know that every writer would've done that, but I very much approached it as this is gonna live forever and I wanted it to be the best it could be, but it took time. I mean, it took time. So I think I just learned that I wasn't able to put the button. I wasn't able to hit submit till I was sure. Maybe that's good. Maybe that's bad. I'm not sure. Ed has a lot more experience than me. How many books have you written, Ed? Because I feel like every 6 months you have a book out. Am I wrong?

I'm not really sure, but it's really because I have these co-authors that really do all the heavy lifting and I just put my name on it. So no.

Oh, he's being humble. He's being humble in the true Ed way.

This is amazing. I think based on what I already knew and what you shared, I mean, there's a huge gap, and this really— this book really addresses that gap and provides that bridge across the gap. And I'm glad you say it like it is. I know I love your style, Dr. G. You're like a very straightforward person, and you say it like it is. And so, I really appreciate that, and I know that that's the way the book will come across as well. So, we talked a lot about the book. Is there something that we missed, Dr. G, or something we talked about that you want to double down on?

I think the most important thing for people to remember is that artificial intelligence is incredibly exciting, right? This is the number one thing everyone wants to talk about. And I, you know, I am absolutely pro-tech, but I'm a pro-person. This technology will only be as good as what we put into it. So whether it's our biases, whether it's the way we implement it, we can't approach this the same way we did the EHR There is a lot of hype versus the reality. And so I would definitely say that if you're in charge of an AI strategy or plan, please read this book first. It's really critical that this time, both post-pandemic and post-EHR, 20-some years later after HITECH Act, that we be really thoughtful about how we implement these new technologies and really focus on the low-hanging fruit, prior auth, documentation, We don't have to focus on AI replacing the doctor. That's simply not a reality, right? And it's like saying we need a time machine for healthcare. It's putting this crazy kind of concept before the simple realities that could fundamentally change patient care today. If we solve simply prior auth, which is one of the biggest administrative burdens physicians have, that's billions of dollars and it would be more efficient. care, earlier diagnostics, earlier treatments. It would drive outcomes. It would save a lot of costs. So I would say that we just have to be really mindful and that we're in a new era of tech, which is absolutely exciting and fascinating, but it's only gonna be as good as the leadership that implements these technologies.

Yeah, that's very well said. And Dr. G, can you just let everyone know where's the best place? I know I'm looking, I looked it up myself. It's all over the place online, but where's the best place that people should go? And Will mentioned your website.

Thank you. My website, I would say, is first, drgeethanair.com. I know that rolls off the tongue. Second best place is probably just Amazon, just where most of us buy books, but it's in every retailer— Target, Barnes& Noble, all the retailers you guys know and love. And would love your feedback when you do read it. Please let me know what you think, and I'd love to, love to, love to hear what you think.

Yeah, for sure. So go out. Will and I, we provide our stamp of approval, right, Will? Absolutely. I appreciate Will joining me and helping ask provocative questions to get at the heart of the book. And Dr. G, of course, for you coming on, for you writing the book and sharing with our audience. Dead Wrong: Diagnosing and Treating Healthcare's Misinformation Illness by Wiley. And just thank you for doing it, and thank you for being on. Digital Voices.

Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review.

And most importantly, thanks again for listening.