Yari Has Questions ...
April 02, 2024
8 min watch
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Yari Mitchell has questions for I. Paul Singh, MD: AI in glaucoma and technology overload
Transcript
Editor's note: This is an automatically generated transcript, which has been slightly edited for clarity. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.
Hi, I'm Yari, I have questions. And I'm here with Dr. Paul Singh, and he has answers. Let's see if they match.
Let's do it!
All right, hey, Paul. Thanks for being here.
Thanks for having me, Yari.
Yeah, so I am so curious about what you are excited about these days. There's so much happening in innovation. What gets you up in the morning?
What gets me up in the morning? Well, I get to hang out with people like you, no joke!
Oh, nice.
What gets me excited is truly, the people. Honestly, I mean, yes, we'll talk about technology and all that good stuff, but people ask me why would I travel so much? Why am I always at meetings every time? Well, it's so easy to get kind of trapped in your practice and feel like, "I'm the best doctor in the world, and I know everything," but then you travel, and you hear about what people are doing in their practices, what people are doing out there, and you're like, "Wow," you know. And I think the collegial atmosphere with the industry, with kind of just our colleagues, it's so amazing that they've become friends. I always joke that meetings are like summer camp.
Yeah.
I mean, seriously! You get to hang out with good friends. You get to learn some stuff, keep your mind occupied, and you go back and do your thing at home, and you go back and do this. But for me, that's number one. Number two, I think the other thing is just the technologies and different subspecialties. As a glaucoma geek, it's constantly evolving, you know, and this idea of not having to wait to treat glaucoma, to keep a high quality of life for our patients and earlier intervene, whether it's lasers, new stenting, new technologies, I mean, every day, I feel like, "Wow, I can actually now help someone to maintain or improve their quality of life in glaucoma." IOLs, the new IOL technologies left and right, I mean, are incredible technologies, new accommodating lenses coming out that are in the future, we have the current light adjustable lenses, you name it. So, I think we have on different fronts the ability to truly not only maintain but improve quality of life for our patients. So, for me, every day, knowing that I can now tailor the technology to the patient better than I ever had before, is just cool because now, it's like you're not stuck anymore. You go to work, you're like, "You know, I can help you. I can help you, and I can help you," and it's just a great feeling to go to work that way as well.
That's very cool.
Yeah.
So, there's so much happening, as you just identified, and I'm curious; how do you digest all of that? How do you make decisions about technologies that will come into your practice? How do you integrate so much incredible stuff? Because I'm sure that a lot of the people that are watching are, you know, looking at different technologies and are also excited, but it can be overwhelming. So how would you advise?
Well, I mean, I think it's important not just to get technology for the sake of it. I mean, that's the thing, right? because we can get inundated with all those technology options. To me, it's, "Do I have a need? Do I have a need in my practice or for my patients," right? Is there a need that I cannot offer right now to a patient? Number two is it’s not only just for the patient's perspective—is it going to help our staff? Is it going to help the office, the flow, or the efficiency as well? Because sometimes, the technology may not be that revolutionary in terms of taking care of a patient, but it can help so much on the end of the efficiency and flow of the practice management perspective as well. And third, is there going to be a financial hit or not? And that kind of helps us understand is it worth it from that perspective as well? But number one is, "Is there something that I can do to help my patients to offer them an option to help them improve their quality of life?" Like we said, number two, “Is it something that can actually help in efficiency and flow in the practice? Is it going to overwhelm me from a financial perspective?” And the fourth thing is, "How much education do I need, and how much education do I have for my staff? Is it going to be overwhelming or not?" And I think lastly, well, my perspective on new technology is don't be afraid to push the envelope, to not be complacent. Because I think we have a skillset that we learn in residency and fellowship and beyond, and if you have that confidence in your skillset, it's not as fearful to try something new; as long as it's safe and you understand the technology, itself, I think you can adopt new technology more than you think.
Yeah, I think that's great, and sometimes, I've had some good advice, like, "Start before you're ready." Sometimes, don't put barriers in front of yourself that limit your opportunity because then, you're just maybe missing out on something that could be really helpful.
Exactly, don't know until you try it.
Truly, truly.
Yep, love it. So how does AI factor into that for you? Do you see that as a tool that will be helpful in your practice? You know, you talked about glaucoma, and there's some AI work happening there. What's your take on AI?
What's AI, again? I'm just kidding, I'm kidding, I'm kidding.
Augmented information.
Exactly. So no, I think AI… look, I mean, you've seen it already in the diabetic retinopathy world in terms of just the, I think, being able to screen a lot more patients. I mean, to be honest, there's going to be so many more patients who need help in the next decade, two decades, and we all know about the dearth of ophthalmologists and eye care providers in the next five, 10, 15, 20 years, so we need to have better ability to throughput in the office and also screen more patients to understand, okay, who can wait the extra year, two years, before they have to come in, or who do we have to see earlier? From a glaucoma perspective, we do know now, with a lot of new in-home testing, that can also be tied to AI/machine learning, to understand, "Okay, your probability of progression or an issue is going to be much lower. I can have you wait at home for another year or six months as well." So, I think that's a huge benefit there as well. I think also telemedicine, I think more community types of diagnostic centers, being able to also mass screen for us is going to make a difference as well. And then of course, from a more micro-level in the office, being able to understand, say from glaucoma, disease progression—understanding what will be the best option for this patient based upon taking big data from the number during studies, looking at anatomical structures, and then combining those and saying, "Okay, for this kind of patient at this age with this level of progression already, this is the likelihood, and this is what the best treatment would or could be for that patient." So, I think it's going to be an incredible future for all of us.
Yeah, that's very exciting to think about all these tools or, you know, gene therapy and the ability to apply that, but you need to be able to intervene early, and what's the system that's going to allow you to apply those things effectively?
And find out which patient needs to be treated earlier and which patient needs to be aggressive, because I think if they have glaucoma, for instance, right? There are those fast progressors, and there's those patients who, yeah, they're probably not going to get worse no matter what you do, right? And the question is how do we know which ones there are? We have things like hysteresis and other measurements, but having a better understanding of, "You know what, this patient's younger, but I’ve got to be aggressive right now early on," or, "This patient's young, but you know what, I can hold off and kind of watch for a while," and that will help us understand too, how to segment those populations of patients.
Love it, I love to hear how you think about integrating technology and patient care and advancing that. I do have a couple of other questions that I'm going to pivot that are going to be very important. Since you are so into music, your family's so musical, I want to know, what do you listen to in the OR? What pumps you up for surgery?
Oh, man, I have so many different styles of music. My kind of go-to is a kind of reggae. I'm a big reggae fan. It just keeps me in a good vibe, like you know, holiday vibes, like a chill... It keeps me happy but relaxed, right? Sometimes, I listen to syntho '80s pop. I'll be honest with you, I grew up... You're not going to believe it though, I got into keyboards because I was a Depeche Mode, Erasure, New Order fan.
Nice! Yes, right there. Right there.
I mean, right? Come on, right? So I was in that. Then I joined a band called “Funkadesi,” which mixes Indian, funk and reggae.
So cool.
And it got me to appreciate kind of more of the authentic kind of music from each different culture. And so I try to bridge the gap between syntho-pop dance with more world beat kind of music as well. So that's kind of what my passion is now as well. So I'll mix a lot of those as well, but sometimes, a little '80s pop, sometimes '70s rock, or just pop even now, as well. But reggae kind of keeps me in that zone, just that chill zone.
It's the right cadence, the right rhythm.
I just kind of vibe.
Just keep it easy.
How about you? What's your style of music?
Oh, my goodness, wow. Well, it depends on what I'm doing. If I'm doing, like a Peloton ride, it's probably going to be EDM. If I'm working and just really need to focus, I'm a huge fan of just kind of chill, mellow… You know, Fleetwood Mac really gets me in the zone. It is just nice background music, but anything that has a danceable beat, I'm here for.
My dad used to sing to his patients after cataract surgery. You know that song that would say—he was like, “I can see clearly now the gray is gone. Phacoemulsification has taken place.” I mean, he would have this whole song and he would sing to every single patient at the end of the case.
Oh, that's amazing.
So, I kind of learned from my dad.
I love it, I love it. Well, thank you for joining us, Paul. I really appreciate your insights and you know; we'll be watching for more music happening from you online.
I love it, I love it. Thank you so much for having me.
You bet.
Have fun, everybody.
Hi, I'm Yari, I have questions. And I'm here with Dr. Paul Singh, and he has answers. Let's see if they match.
Let's do it!
All right, hey, Paul. Thanks for being here.
Thanks for having me, Yari.
Yeah, so I am so curious about what you are excited about these days. There's so much happening in innovation. What gets you up in the morning?
What gets me up in the morning? Well, I get to hang out with people like you, no joke!
Oh, nice.
What gets me excited is truly, the people. Honestly, I mean, yes, we'll talk about technology and all that good stuff, but people ask me why would I travel so much? Why am I always at meetings every time? Well, it's so easy to get kind of trapped in your practice and feel like, "I'm the best doctor in the world, and I know everything," but then you travel, and you hear about what people are doing in their practices, what people are doing out there, and you're like, "Wow," you know. And I think the collegial atmosphere with the industry, with kind of just our colleagues, it's so amazing that they've become friends. I always joke that meetings are like summer camp.
Yeah.
I mean, seriously! You get to hang out with good friends. You get to learn some stuff, keep your mind occupied, and you go back and do your thing at home, and you go back and do this. But for me, that's number one. Number two, I think the other thing is just the technologies and different subspecialties. As a glaucoma geek, it's constantly evolving, you know, and this idea of not having to wait to treat glaucoma, to keep a high quality of life for our patients and earlier intervene, whether it's lasers, new stenting, new technologies, I mean, every day, I feel like, "Wow, I can actually now help someone to maintain or improve their quality of life in glaucoma." IOLs, the new IOL technologies left and right, I mean, are incredible technologies, new accommodating lenses coming out that are in the future, we have the current light adjustable lenses, you name it. So, I think we have on different fronts the ability to truly not only maintain but improve quality of life for our patients. So, for me, every day, knowing that I can now tailor the technology to the patient better than I ever had before, is just cool because now, it's like you're not stuck anymore. You go to work, you're like, "You know, I can help you. I can help you, and I can help you," and it's just a great feeling to go to work that way as well.
That's very cool.
Yeah.
So, there's so much happening, as you just identified, and I'm curious; how do you digest all of that? How do you make decisions about technologies that will come into your practice? How do you integrate so much incredible stuff? Because I'm sure that a lot of the people that are watching are, you know, looking at different technologies and are also excited, but it can be overwhelming. So how would you advise?
Well, I mean, I think it's important not just to get technology for the sake of it. I mean, that's the thing, right? because we can get inundated with all those technology options. To me, it's, "Do I have a need? Do I have a need in my practice or for my patients," right? Is there a need that I cannot offer right now to a patient? Number two is it’s not only just for the patient's perspective—is it going to help our staff? Is it going to help the office, the flow, or the efficiency as well? Because sometimes, the technology may not be that revolutionary in terms of taking care of a patient, but it can help so much on the end of the efficiency and flow of the practice management perspective as well. And third, is there going to be a financial hit or not? And that kind of helps us understand is it worth it from that perspective as well? But number one is, "Is there something that I can do to help my patients to offer them an option to help them improve their quality of life?" Like we said, number two, “Is it something that can actually help in efficiency and flow in the practice? Is it going to overwhelm me from a financial perspective?” And the fourth thing is, "How much education do I need, and how much education do I have for my staff? Is it going to be overwhelming or not?" And I think lastly, well, my perspective on new technology is don't be afraid to push the envelope, to not be complacent. Because I think we have a skillset that we learn in residency and fellowship and beyond, and if you have that confidence in your skillset, it's not as fearful to try something new; as long as it's safe and you understand the technology, itself, I think you can adopt new technology more than you think.
Yeah, I think that's great, and sometimes, I've had some good advice, like, "Start before you're ready." Sometimes, don't put barriers in front of yourself that limit your opportunity because then, you're just maybe missing out on something that could be really helpful.
Exactly, don't know until you try it.
Truly, truly.
Yep, love it. So how does AI factor into that for you? Do you see that as a tool that will be helpful in your practice? You know, you talked about glaucoma, and there's some AI work happening there. What's your take on AI?
What's AI, again? I'm just kidding, I'm kidding, I'm kidding.
Augmented information.
Exactly. So no, I think AI… look, I mean, you've seen it already in the diabetic retinopathy world in terms of just the, I think, being able to screen a lot more patients. I mean, to be honest, there's going to be so many more patients who need help in the next decade, two decades, and we all know about the dearth of ophthalmologists and eye care providers in the next five, 10, 15, 20 years, so we need to have better ability to throughput in the office and also screen more patients to understand, okay, who can wait the extra year, two years, before they have to come in, or who do we have to see earlier? From a glaucoma perspective, we do know now, with a lot of new in-home testing, that can also be tied to AI/machine learning, to understand, "Okay, your probability of progression or an issue is going to be much lower. I can have you wait at home for another year or six months as well." So, I think that's a huge benefit there as well. I think also telemedicine, I think more community types of diagnostic centers, being able to also mass screen for us is going to make a difference as well. And then of course, from a more micro-level in the office, being able to understand, say from glaucoma, disease progression—understanding what will be the best option for this patient based upon taking big data from the number during studies, looking at anatomical structures, and then combining those and saying, "Okay, for this kind of patient at this age with this level of progression already, this is the likelihood, and this is what the best treatment would or could be for that patient." So, I think it's going to be an incredible future for all of us.
Yeah, that's very exciting to think about all these tools or, you know, gene therapy and the ability to apply that, but you need to be able to intervene early, and what's the system that's going to allow you to apply those things effectively?
And find out which patient needs to be treated earlier and which patient needs to be aggressive, because I think if they have glaucoma, for instance, right? There are those fast progressors, and there's those patients who, yeah, they're probably not going to get worse no matter what you do, right? And the question is how do we know which ones there are? We have things like hysteresis and other measurements, but having a better understanding of, "You know what, this patient's younger, but I’ve got to be aggressive right now early on," or, "This patient's young, but you know what, I can hold off and kind of watch for a while," and that will help us understand too, how to segment those populations of patients.
Love it, I love to hear how you think about integrating technology and patient care and advancing that. I do have a couple of other questions that I'm going to pivot that are going to be very important. Since you are so into music, your family's so musical, I want to know, what do you listen to in the OR? What pumps you up for surgery?
Oh, man, I have so many different styles of music. My kind of go-to is a kind of reggae. I'm a big reggae fan. It just keeps me in a good vibe, like you know, holiday vibes, like a chill... It keeps me happy but relaxed, right? Sometimes, I listen to syntho '80s pop. I'll be honest with you, I grew up... You're not going to believe it though, I got into keyboards because I was a Depeche Mode, Erasure, New Order fan.
Nice! Yes, right there. Right there.
I mean, right? Come on, right? So I was in that. Then I joined a band called “Funkadesi,” which mixes Indian, funk and reggae.
So cool.
And it got me to appreciate kind of more of the authentic kind of music from each different culture. And so I try to bridge the gap between syntho-pop dance with more world beat kind of music as well. So that's kind of what my passion is now as well. So I'll mix a lot of those as well, but sometimes, a little '80s pop, sometimes '70s rock, or just pop even now, as well. But reggae kind of keeps me in that zone, just that chill zone.
It's the right cadence, the right rhythm.
I just kind of vibe.
Just keep it easy.
How about you? What's your style of music?
Oh, my goodness, wow. Well, it depends on what I'm doing. If I'm doing, like a Peloton ride, it's probably going to be EDM. If I'm working and just really need to focus, I'm a huge fan of just kind of chill, mellow… You know, Fleetwood Mac really gets me in the zone. It is just nice background music, but anything that has a danceable beat, I'm here for.
My dad used to sing to his patients after cataract surgery. You know that song that would say—he was like, “I can see clearly now the gray is gone. Phacoemulsification has taken place.” I mean, he would have this whole song and he would sing to every single patient at the end of the case.
Oh, that's amazing.
So, I kind of learned from my dad.
I love it, I love it. Well, thank you for joining us, Paul. I really appreciate your insights and you know; we'll be watching for more music happening from you online.
I love it, I love it. Thank you so much for having me.
You bet.
Have fun, everybody.
