AI anecdotes from the clinic

Today marks the first day of Fasnacht in Basel. A three-day event that starts with the  Morgestraich, a magical moment. Imagine a silent, sleeping city, all electrical lights have been extinguished, then suddenly at 4am, the sound of flutes and drums erupts from every medieval street and square in this beautiful city, as small groups of costumed people illuminated by painted lanterns march slowly through the city and the 13th century houses appear to dance in the flickering lantern light.  

Today’s topics:

  • AI anecdotes from the clinic
  • Counting widgets versus value add
  • Do less sooner 
  • Leadership: In times of uncertainty lessons from Basler Fasnacht

AI anecdotes from the clinic

As a student I typed up radiology reports. We had standard text blocks available for all reports. The radiologists would dictate the patient’s name and date of birth and “normal thorax x-ray” or “normal female abdominal ultrasound” for example, and I would enter the corresponding, pre-prepared text-block into the letter template. Documents were ready in minutes.

The potential for AI to improve access to healthcare and healthcare provision is immense. Many authors believe that AI solutions will enable physicians to spend more time with patients. Intent on reducing staff and improving productivity many clinics are implementing AI solutions for admin type roles. In disciplines where training material is plentiful, such as radiology, successful implementation is comparatively straightforward.

However, not all fields lend themselves equally well to AI support. An oncologist shared her experience with me recently. Instead of human admins the team is now supported by a voice to text functionality. While, she said, AI works beautifully for standard content and communications, it is underperforming in her specific setting. There is huge variability between patients, there is a lot of data for each patient and a wide array of available treatment regimens as patients progress. In this specific setting the performance of the voice to text functionality is poor. The oncologist now spends a lot of time proof-reading and correcting the output. Her request for human admin support has been turned down.

It bears saying again. Tools need to be picked to suit a task. AI is a tool not a magic bullet. AI models need  training and training depends on large data sets. The more diverse and complex your content, the more content you will need to train your model successfully and the longer it will take for your model to perform successfully. In the situation above, implementing a solution that is not fit for purpose, and saving the cost of an admin, is ultimately costing the clinic more, as highly trained oncologists revert to performing admin tasks.

Key take-aways: Implement AI wisely, understand your use case, validate your assumptions with your end-users, check whether your solution is performing. Remember it is an iterative process.

Counting widgets versus value add

Widget definition: The word widget is a placeholder name for an object or, more specifically, a mechanical or other manufactured device. It is an abstract unit of production. The Oxford English Dictionary defines it as “An indefinite name for a gadget or mechanical contrivance, esp. a small, manufactured item” and dates this use back to 1931  (Wikipedia).

In my time I have milked cows, sold eggs door to door, worked in a vegetable and fruit packing plant, washed intestines in the slaughterhouse for later use by surgeons to practice their technique and worked in a clothes factory. While there was no financial need for me to do these jobs I was driven by the desire to be financially independent as well as the curiosity to experience as many different life situations as possible. While at medical school I tutored nurses, worked as a nurse aide, and typed medical reports. Wildly disparate jobs – but they all had one thing in common: my productivity was measured in units: days, hours and egg cartons sold. The last one was made sense and I found it rewarding.

Measuring productivity in units is still pervasive in many industries including pharma, where incentive bonuses are concerned, and targets are defined depending on metrics such as how many  customers a sales representative saw, the number of times an MSL spoke with her key opinion leaders, the number of physicians attending an advisory board etc. or where team performance is measured by the increase in numbers of customer contacts, the speed of response provision, or how many documents were created in the past three months, I think it is worth reflecting in each case, whether the measure used makes sense, what is being measured and whether there are better alternatives.

The truth is that assessing performance by unit is easy, but not necessarily meaningful. The question should not be “how many physicians did a rep/MSL etc. visit this year?” – but “were the interactions useful to our customers?” and “what information will tell me whether stakeholder engagements were meaningful and added value?”

Key take-away:  Time is precious, health care professionals are busy, your employees are talented and valuable, make sure you pick meaningful metrics to measure the value add not the time on task. 

Do less sooner

“You need to do less sooner; you’re always doing too much, late.” – Ray Hunt
Ray Hunt’s wisdom extends beyond horsemanship, to leadership, relationships, and business. The underlying principle involves anticipating situations before they arise.

In the pharmaceutical industry, success hinges on a profound understanding of stakeholders, markets, prescribing practices, reimbursement, and regional nuance. Effective product development requires well-designed clinical trials and clinical endpoints that are relevant to patients, healthcare professionals, regulatory authorities, and payers across geographical locations. Customer engagement relies on comprehending stakeholder needs and partnering with the right clinicians and hospitals in a meaningful way. The outcome includes establishing a brand that adds value,  trusting relationships and the foundation for the correct clinical use of medicine.

However, knowledge generation is resource-intensive and is often challenging to directly link to a financial return on investment. In the current economic climate, most organisations are prioritising cost savings and emphasising activities clearly linked to income generation. Unfortunately, this focus often results in reduced budgets and personnel in areas seemingly unrelated to income generation which may prove detrimental to the business in the long term.

Happily, while it is hard to link knowledge acquisition and generation directly to financial gain, it is often quite easy to correlate operating in absence of sufficient knowledge to a financial cost. This provides  an avenue for framing budget requests. Most non-commercial teams submit proposals focusing on the aspects they consider business-critical:  improved compliance, safety, customer engagement, efficiency, effectiveness, customer satisfaction, launch-preparedness, clinical trial recruitment etc. It is essential to highlight  the potential financial impact if a situation is inadequately addressed as the costs can be astronomical. Therefore, I recommend: “do less sooner to avoid doing more later and the risk of major upheaval in the long term.” If you’d like to discuss, give me a call.

Key take-away: Old English saying “a stitch in time, saves nine

Leadership: Leading in times of uncertainty lessons from the Basler Fasnacht

It is Fasnacht in Basel. The event is anticipated with great joy by people of all ages and has been documented since the 14th century. The city is filled with the sound of flutes and drums and marching bands. Small groups of costumed locals march together, playing the same carnival tunes year after year. Children run joyfully through streets that are covered in flowers and confetti. Everyone is welcome to enjoy Fasnacht or join one of the many groups organizing it. There are roles for artists, with many large lanterns hand-painted each year, as well as opportunities for poets, writers, musicians, and those wanting to participate by carrying a lantern or walking ahead of a clique.

Restaurants are bustling, serving the same meals every year, and most of the city’s inhabitants participate in some way. Interestingly, while Fasnacht embraces tradition, including traditional costumes, food, wine, and music, along with poems following a specific style and lanterns adhering to certain rules, a key focus is commenting on current affairs. Participants select a subject and then design costumes, write poems, and paint their lanterns with this theme in mind. Topics may include recent events like the pandemic, the World Economic Forum, NATO, international, national, and local politics or even the British Royal family.

During periods of uncertainty and upheaval, both globally and within the rapidly evolving business landscape, individuals seek comfort and stability in rituals and tradition. Basler Fasnacht is particularly interesting in this context; while firmly rooted in tradition, participants leverage this foundation and stability to comment on current affairs. I think there is an important lesson here for leaders guiding teams through uncertain times.

Many companies have weathered numerous changes over the years, and it can be worth emphasizing that, while the company has fundamentally changed over time, it has also endured and that there is thus a more stable foundation than individuals may perceive at any given moment.

Additionally, establishing fixed reference points for your team in the workplace can help them navigate dynamic environments. Basic practices, such as conducting weekly meetings, with a consistent format and focus, at the same time and in the same location, can provide employees with a reassuring sense of stability. This becomes especially crucial when companies undergo frequent reorganizations and reimagine teams, reporting lines, matrix organizations, and other structures with very loose boundaries

Key takeaways: In times of upheaval, implementing certain fix-points and regular practices, can help provide stability and support teams through change.

I hope my blog provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help? Find out what clients say about working with me via this link.

My very best wishes

Isabelle C. Widmer MD

Image credit: Fabrice Prost, Morgestraich 2024