The Exchanges

Q maybe it's by the label or something else, and there's a bunch of stuff that's a bit more TBD in terms of those kind of trials that may connect each other a little bit, or maybe other information that may be a bit more sporadic. How do you, how do you deal with that third bucket of ambiguity, and how do you think and tell about capturing that broader knowledge?

A So the first way to deal with that third bucket of ambiguity is ensure that your users are physicians and not patients. And we've made that strategic decision. And we keep thinking we're going to change that decision. And, uh, we've been talking about changing that decision since the inception of the company and so far have not changed that decision for all the reasons implicit in your question. There's an enormous luxury that we have as builders, um, in having doctors as users because the MD is attached to their name. Right. So they need to protect that MD and they're going to use us as a tool in the same way as a Wall Street trader might use a Bloomberg terminal. If a Bloomberg terminal, for example, produced, you know, an inaccurate quote on a bond that was very obviously inaccurate, you know, it was off by an order of magnitude and the, and the trader, you know, in a hedge fund just sort of, well, I mean, that's odd.

AI assessment note: “ensure that your users are physicians and not patients”

Q Do you actively seek to find more motivation for yourself?

A No. Uh, I, I, I, and, and actually the opposite. One of the things I think is unhelpful about the contemporary cult of psychoanalysis and in psychology and psychiatry that sort of traces its origins to early 20th century and Freud and these guys is, um, it doesn't appreciate that in the, Analysis and description of something, you kill it. So I've actually resisted exploring trauma. I've resisted going back to the origins of my motivation. I've resisted going back to the origins of my aggression. I have kind of like a partially developed map from childhood and other experiences, but the second I feel myself going close to analyzing it, I, I, I resist the urge to analyze it because in, in the, in the analysis of something, um, Is, is the deletion of it, in a way.

AI assessment note: “No. Uh, I, I, I, and, and actually the opposite.”

Q It's all just kind of based into sort of AI-driven tooling or things like that that help augment that?

A The hope, and this is kind of where we're in the midst of this, is that, um, In under-resourced areas, as an example, um, you know, we have, uh, we, we, we have physicians using open evidence in, in every state electoral county and zip code in the United States, including rural Alaska and southwestern Georgia. And, you know, we, we get letters from doctors because when you, when you make something awesome, that's free. When you make something awesome that has a subscription, I think people like it, but they don't send you fan mail. When you make something awesome that's free, they send you fan mail. So we get fan mail from, you know, southwestern rural Georgia from an oncologist who's like, I'm one of two oncologists in a 50 mile radius serving a 75% African-American population with a median household income of 43,000 dollars a year, and I use open evidence as my curbside consult, which he, by which he means, you know, as my panel of other. So that starts to bridge it, uh, and, and I think increasingly, certainly in rural areas and healthcare deserts at the fringes and edges of healthcare in the United States. That's absolutely how certainly open evidence is being used and how I think broadly is going to be used at least to sort of bridge, bridge that gap. Um, and, and I think that's a, that's a real clear silver lining or positive side of, of AI right now.

AI assessment note: “I use open evidence as my curbside consult... That starts to bridge it”

Q This is a different type of AI application, um, and you are getting adoption with a type of knowledge worker where people are surprised by the pace, generally considered conservative industry, has fake papers, everything that you described earlier. Um, does it, What do you believe about what would happen, what can happen in other fields? Or like, are there lessons for lots of entrepreneurs that listen to this podcast?

A While medicine is obviously very specific, the human psychology is not. And everything that was true and that we've seen through the sort of hyper pace consumer internet growth curve adoption by the most traditionally skeptical knowledge workers shows that in any Um, industry or subfields that tech might want to touch, um, the same basic rules of the game psychologically apply, which is if you address people, um, as people and as consumers, and if you speak to them in a way that we've spoken to before and it sort of hit them different, you know, in a way that no one's ever kind of come at them in that way before, um, That at minimum will be very refreshing and different and will lead to them considering the thing with an open mind and in all likelihood will break the mold that has typically been the rate limit of the adoption curve of whatever had defined that industry.

AI assessment note: “in any Um, industry or subfields that tech might want to touch, um, the same basic rules”

Q I want to remind for a minute, you were already a successful entrepreneur before you started Open Evidence. Um, you wanted to build an impact-driven company. Like, you wanted to work in health. What was the moment of decision to serve physicians versus consumers? Because you also think a lot like a consumer entrepreneur in terms of growth.

A Well, I served both. So this was a hack. I wanted to build a consumer internet company for knowledge workers. And I don't think that had ever been done before. So I didn't want to build a healthcare company, uh, at all. Uh, I love, uh, Sequoia's quote that, um, Open Evidence is a consumer internet company masquerading as a healthcare company. Uh, I had zero interest in building a healthcare company. Open Evidence is not a healthcare company. I wanted to build a consumer in a company, but I wanted to do something that no one had ever done before, which is treat knowledge workers like consumers. So my whole career had been, you know, prior to this dealing with knowledge workers, right? And, and People have a reductive view of consumers. They think of, you know, they think of, like, fourteen-year-olds on TikTok, and that tends to be, like, their archetype of what a consumer is. And it's one type of consumer. Um, but, you know, traders on Wall Street are consumers and people. Lawyers are consumers and people. And doctors are consumers and people. And what I realized is no one had ever treated doctors that way before. Doctors were just kind of Treat it as these appendages of health systems. I was like, hmm, it's an interesting way to organize the medical system and the health system. And, you know, you start to investigate and pull the thread a little bit, and you start to understan…

AI assessment note: “Well, I served both. So this was a hack. I wanted to build a consumer”

Q So are you doing a lot with the chatbots, right? In other words, there are people who effectively view themselves as being in relationships with.

A Yeah. They don't have bodies yet. I mean, you could start to reason by analogy. Would there be any more of a mass public movement to have Computers land planes. If in, if you still had a cockpit, if you just remove the two seats, no one wants that, ok? What if you keep the two seats, but they're empty? I still think no one wants that. What if you keep the two seats and there are mannequins, essentially, that act as visual surrogates for the computer system and what it's doing? I think if you were to poll people, that'd be the first time you see this little uptick in willingness. I think it would still be the minority.

AI assessment note: “Yeah. They don't have bodies yet. I mean, you could start to reason”