Tal Zaks
speaker
203 appearances
1 recordings
1 series
first heard Jan 2025
last heard Jan 2025
Tal Zaks’s voice in public audio — every appearance, attributed to the second.
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And so what he did is he teamed up with one of the Israeli health care networks to collect information on, I don't know, a quarter million people over a decade. And he took that same blood work and he asked himself, well, if I correct somebody's blood work for other parameters that the machine measures, but I don't even know what they are, can I reduce the variability?
How much of the variability in the normal is actually true variance versus things we could correct for that are based on you? And it turns out that about half the variance is. of the distribution of what normal is, is actually false distribution.
If we could correct it relative to your factors, it would make that distribution much narrower, which means that we could now pick up things that otherwise look normal, but based on all those other things that the machine can figure out, this is a perfect application of AI. because I can start to pick up abnormalities much sooner.
Now, the question is, does that lead to interventions that we know will be of benefit sooner? Well, that's where a whole world of drug development has to come in. But that's where I agree with the folks that have been saying that we've got a sick care system as opposed to a health care system.
And look, my greatest learning as a physician from the COVID vaccine, I started this journey as a medical oncologist. Now, what's a medical oncologist? Somebody who deals with somebody who's got cancer. What's my vision for a patient that comes into my office? We started talking about vision. Well, my vision for that patient is their past. Think of that.
The best I can envision for somebody is to be as healthy as they were before they had cancer. Now, think of a vaccine. What does a vaccine do? It actually takes a healthy person and makes them healthier in the future.
A serious medical doctor like myself in the previous era, if you told me that I would be interested in spending time making healthy people healthier, I would have looked at you strange and said, yeah, no, the people who do that are the yoga instructors, the quacks, and the nutritionists. I mean, I'm a serious doctor. I don't make healthy people healthier. If you're healthy, get out of my office.
I got sick people lining up. I don't do that. But actually... That's what vaccines do. And that's what this new age of technology is going to enable us to do. Now, how do we deploy that information? I think in the 10-year horizon, you're going to see some of those insights now becoming institutionalized. I think it's going to take a long time because it will...
bring a profound change in what it is to be a physician. I think that change is already occurring. If you look in the last 10 or 20 years in the US, we talk about physician burnout.
Well, physicians have gone from having agency making decisions, spending time with the patient and earning a return on their time to now being employees of large healthcare systems whereby the treatment they meet out is a function of algorithms. The quality control is a function of algorithms.
and the reimbursement, what they can actually prescribe as a function of what the healthcare system will tell them. And by the way, they're all employees of the healthcare system to begin with. So all of the agency has been taken out. The time that they're able to spend with people has been trimmed and trimmed and trimmed.
And so the role of what it is to be an internal medicine doctor has changed. I think that with the system of knowledge that AI is gearing up to be, it will continue to evolve. And the role of the physician will change into being the translator for people of some of this wisdom, as opposed to the person who is entrusted with having all that wisdom in their head.
I think in the 20 to 30-year horizon, they will experience healthcare very different than we are experiencing healthcare. I think what it means to go into the hospital, what it means to sit with a physician, what it means to get diagnosed and treated will be different. I think it will have more interventions far earlier.
I hope that there will be an emphasis on maintaining health and promoting health as opposed to treating illness. Illness is always going to be with us, and we will need to evolve our tools of treating with it. But yes, I do believe it's going to be different.
Now, that being said, we are also living in a time where, and this is what makes my unique job so fascinating, technology today can do more than our ecosystem has figured out how to integrate. And I say this both as an investor and a consumer. There are programs that can scan a pathology slide and give you a more accurate reading than a pathologist, hands down, they're FDA approved.
But the problem is that less than one slides of any tissue microsection ever gets read by a computer. We still have microscopes and people looking down the microscope. Who's going to pay for changing all those microscopes to be digital? And who's going to get a return on that investment?
So you can see everywhere you look, bottlenecks in the ecosystem of applying a technology that's already here today and continues to improve. And it's also true of drug development. And one of the examples I gave at that National Academy and I think is true and is a warning sign for me, is the failure to develop antibiotics.
So back in my dad's era, he benefited from drugs that are today generics, but when he went into the hospital with an infection, doctors had an antibiotic off the shelf that worked against the bugs in the hospital. We don't have those today. This is a growing problem. The likelihood of dying from significant infections continues to go up.
And it's not a lack of scientific tools to understand bacteria and how to make better drugs. They're just a complete lack of commercial incentive to do so. I've got colleagues, I'm working on some rare diseases, and I've got colleagues who ask me, oh, you know, what do you think? Because pharma's pulled back a little bit from rare diseases. That can be a challenge.
And I use this example to say that it's not a given. that the economic incentives will always be there.
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