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The Everyday Millionaire and Mindset Matters Podcast
TEDM – No Money, No Mission: Nasim Afsar on Sustainable Change in Healthcare (Episode 238)
01:25:00
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Welcome to the Everyday Millionaire podcast. My name is Patrick Francie and I am your host. And I want to begin by saying thank you for listening. On this show, I am having conversations with seemingly ordinary individuals who have achieved some amazing and extraordinary results in both their life and business. My intention is to inspire and help you learn and grow by having my guests share their journey of how they face and overcome their challenges, but also how they celebrate their their many wins. And now let's get on with this show and have a conversation with today's guest. Clarity creates velocity. And in complex systems, confusion is expensive. Most systems don't fail because of bad intentions. They fail because leaders lose clarity. And once clarity is gone, velocity dies. Welcome to the Everyday Millionaire podcast. My guest today, Dr. Nassim Afsar, is a physician, an MBA and one of the few leaders who has actually operated at scale inside healthcare technology and policy. Now, Nassim is a former senior Vice president and Chief Health Officer at Oracle, where she led global health transformation, product and market strategy and built ecosystems connecting providers, payers, retail pharma and public health. She didn't just talk about innovation, she built the operating system that made it usable. Now, before Oracle, she spent over 15 years running large health systems, including as CEO of UCI Health. Accountable for more than a billion dollars in revenue and thousands of employees, she led through complexity. She launched telehealth and hospital at home before it was even fashionable. And she ran emergency response during COVID when clarity mattered the most. She also held senior leadership roles at UCLA Health, shaping national work in quality, safety, population health and patient experience while advising organizations from the White House to the National Academy of Medicine. Now, this conversation isn't about healthcare headlines. It's about decision making in complexity, how leaders cut through noise, how systems actually change, and why clarity is the real accelerant of impact. And without any further delays, let's get this show started. Dr. Nassim Afsar, welcome to the Everyday Millionaire podcast. Thank you so much for joining me.
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Thank you so much for having me, Patrick. I'm so excited about having this conversation today.
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Now, do we go by Dr. Nassim or Dr. Asar?
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You know, I love just going by a first name basis. So Nasim is perfect.
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Okay, so that's great. Well, anyways, Nasim, here's what I like to lead into because of course, you know, I have the intro and your bio and it says so much. And I mean, it's extensive in terms of what you've done and have accomplished in your life. But if you're meeting Somebody for the first time today and you're Dr. Nassim and they look at you and they go, okay, Nassim, what is it that you do? How do you answer that question?
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Yeah, that's a great question, Patrick. And as you were asking that, I was reflecting on a couple of years ago, we had bring your daughter to work day. And I took at that point my daughter who was in third grade and I was the chief operating officer for an academic medical center. And I was like, this is going to be great. She gets to see what I do. And the diligent little person that she was, she actually took notes as she came with me throughout the day, which it's that, that is, it's hanging in my office. I asked her at the end of the day, I was like, hey, so what do you think about what I do? And she said, well, so you just basically sit in meetings all day. I was like, okay, sure, that's that, that's the logistics of it. But there's, but there's more that gets lost in the translation. And so, you know, the what do you do for me has always been, even when I was a young adult, about how can we create and innovate and make large scale impact? At a point in my career that meant taking care of patients who were hospitalized and needed acute care, as an internal medicine hospitalist, as a hospital administrator, that meant how do we build robust systems of care so that we reliably with high quality of care are caring for patients. When I did population health, it was about how do we make sure that we're caring for people from birth through the transitions at the end of life. As a chief operating officer it was more systems wide. How do we actually get beyond the four walls of the hospital and the clinic to people's homes and communities and really be able to embed and advance health for populations. We hit the time of COVID so then that also included how do we build a mobile field hospital and large testing centers and vaccination centers. And then as a health tech executive, when I was the inaugural chief health officer at Oracle, it was around how do we leverage the most powerful tool that we have today? And that's technology to advance health and care for, for healthcare delivery systems across the world for major pharma payers, food and beverage companies, med device companies. And my last chapter in all of this has been writing my book intelligent health, which comes out next March by Wiley, which was around an idea that I had Patrick about 17 years ago. But the technology wasn't there yet and excitedly over the last five years, that technology has made it possible. And so I'm excited to be able.
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To share that as you're walking through all of these things that you've done and accomplished and what you've worked at. Love that. Really impressive. But what stuck out for me is that you started, you know, you mentioned, like, in your career, kind of starting out, you know, young, and you were whatever age you were. My question is, is that you're questioning, how do you scale? Yeah, that is fascinating to me because, you know, for all from as much as you had roles and, you know, you had a job, we'll call it, you know, VPs and, you know, CEO and all of the things that you've done, but you didn't come out of the chute that way. So in other words, where did you get this how do we scale attitude? Because that's not a normal thought process for people in general. It's not even a thought process for the majority of, let's say, entrepreneurs. I guess the question is, what is it in your makeup, do you think or your upbringing that you're thinking scale? Like, how do we make this bigger? How do we reach more people? How do we impact the world in a way bigger way? Because that really is a state of mind or something. What, what, what created that vision or that question for you? You know, is it upbringing? Were your parents entrepreneurial? Were your parents a big deal? Like, is that how you saw the world? Like, I, I, I, I would like to kind of dig into that a little bit. I mean, we're certainly going to talk about a lot of things, but for.
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Me, that's kind of, I have to tell you, Patrick, I'm, I'm, I'm going to take a be because it is incredible to me. We have actually just known each other and talked for under 10 minutes. And what you just highlighted is, is definitely the essence of how I see myself and how I move through the world. And I wish I could say that, that this was done in a very intentional way. But back to your question about where does it come from? It is part of the fiber of who I am, and I, and how I think about things. I come from a family of two very practical engineers. I have a chemical engineer and an industrial engineer. I think that the, so I do think that the systems thinking came from that upbringing. We grew up thinking very methodically. I loved math and science, so that was kind of part of the backbone of my growing up. But to kind of give you an example that Before I could articulate this as an adult, how much this was embed and who I was, I was really involved as a high school student in student body and I was the vice president of the student body. And election time was coming around and everyone assumed I was going to run for president and no one was actually running against me. So it would have been a really easy election. And as I thought about that, I somehow like my 17 year old self was like, that's not where I'm going to make the most impact by running these meetings. I feel like there's something more I can do. And I decided at that point to create a position that was called Commissioner of Community Service. Now, just in case you're not well versed in 1990s high school politics, Pat Beck commissioners were like the lowliest people in student body. And then this was a made up position. So it wasn't even one that really had a lot of responsibilities. I had to create a de novo. I wanted to do that because I felt like our high school was in a highly privileged community and we had no connectivity into the broader LA area. And I felt that we had a responsibility and also the ability to do a lot more in the community. Fast forward the one semester that I got to hold this position until I graduated. We ended up getting 400 people. So it was 25% of the student body involved and engaged in community service. We did everything from donations for clothes and food to having weekly sandwich making sessions. I had a whole certificate program for the number of hours that people had participated and the tiers of community service certification that they got. By the time I left that position, they had to bring in three commissioners to fill that position. And I couldn't articulate back then, Patrick, but now, many years later, I now know I made the right decision. Because what I felt internally was there was a bigger opportunity and a bigger value here by connecting pieces that already existed for us to scale something that was not otherwise being done. And I again kind of tracked that through all of my positions. And this is how I describe it. You and I didn't get a chance to kind of do this intro, but you know, I talk about how I moved from a bedside physician to my administrative roles. I. That transition for me was almost seamless. Even though I love the practice of medicine because I went from taking care of 20 people at a time to hundreds of people, to thousands, to hundreds of thousands, to millions. And my position at Oracle before I, before I transitioned, we had our technologies impact over 350 million people across the globe. And people ask me oftentimes like, do you miss being a physician? And to me, being a physician was just a vehicle by which I could make that positive impact in the world. And every role since then has enabled me to do that more. So it's just an extension of what I set out to do to begin with.
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Well, it's an extension of who you are, which is so interesting. And, you know, when you look at the theme of this podcast, you know, part of it is seemingly ordinary individuals who have achieved extraordinary results. And when you start to consider. And I've interviewed hundreds of guests over the past nine or 10 years that we've had the podcast. And the reason I kind of shine a light on it because I'm always intrigued by the thought process. Okay. So, you know, arguably you may have come from the lucky sperm club. You got, you know, parents who were engineers, probably doing well in their careers, all the rest of it. And I'm. And I'm. And that's not a. And I'm going, okay, so I've had many guests like that. I've also had those guests that, you know, came up single family, poor, broke, and nobody has positioned. Nobody's ever said that they asked themselves, how can I do this at scale, at 17 or 20 years old? I mean, so that's. That's a very interesting kind of take on the psychology and, you know, the genetic predisposition. I don't know. I just find it really fascinating for anybody to think that way at that young to ask that question. I mean, they can have aspirations, but they don't ask that question, how do I have a bigger impact? How do I make a bigger deal? Because most young people aren't. They don't have the confidence to put themselves out there. They're afraid of judgment. They're afraid of what their. Their peers will think, what their parents will think, whatever the story is. So that's why I asked the question. And I just find it so intriguing, Nassim, that you are built that way and you're thinking in those terms. And being a doctor or being a physician was just a piece of or a part of the puzzle that you needed to expand and achieve the goal that you have, which is to scale whatever that you're working on. Anyways.
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I'm blown away by your ability to pick that up again in such a brief time of connecting. You said another thing, too, Patrick, that I want to double click on, which I forget how you worded it really well. So I'm going to paraphrase but it was around. You have to be comfortable with being uncomfortable when you're doing these things and you're putting yourself out there. You have to be okay with not being the smartest person in the room, which is really hard as high achieving people who can be highly educated, highly trained. And I've always loved that. When I am comfortable in a position, I know it's time for me to leave. When I was a chief operating officer, we had to. We had to build a mobile field hospital in our parking lot to be able to accommodate the COVID numbers. I'd never built a mobile field hospital, but I had engineers and building construction people, all of whom were highly competent, and they told me we needed 86 truckloads of gravel to flatten a parking lot. That really looked flat to me, Patrick. But you ask the right questions and you trust people. And we were able to increase our hospital capacity so that we could care for people in the right settings of care. We had to redo our relationship with campus security and the community. Again, I'm a physician. That's not what I've done. But I had an incredible lieutenant who was genuinely compassionate, thoughtful, incredibly smart and competent. And we thought about how do we approach and do that. And again, when I think about the work that I did in healthcare technology, so much of it, while I had a deep understanding of health care, was stuff that we were thinking about and pushing for, that was setting the standard for how things would be. And in that, you really do have to be comfortable with being uncomfortable and you genuinely have to love surrounding yourself with people who know more than you are, smarter than you. And your ability comes from taking all of that and creating the signal out of the noise. So that's, I think that's a really important point.
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I want to unpack it just a little bit in terms of your, you know, your own awareness or consciousness of, if you will, of. Okay, so the statement being comfortable being uncomfortable. Now, over my years of business years as a business owner and speaker and entrepreneur and all the things that I've done in my life, you get to a place where that becomes a realization that you have to become, you know, you have to be okay being. You have to get comfortable being uncomfortable. Understood that. And because at the end of the day, if you're not uncomfortable, if you're not pushing, you're not growing. That's just the way it is. That's the reality of it. But that realization often comes with maturity and later in life. So I'm asking you this question in that was the. Was your own kind of self talk. The realization that, holy cow, I'm. I'm uncomfortable, but this is exactly what I need to do. Like, what is it? Was there a mindset around it, A conscious thought process, or was it just how you were built? And then in reflection you go, yeah, no, I was just good with it.
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Yeah. I think there is an excitement and an energy and I could even say, like, a high that I get from being uncomfortable that I find really appealing.
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Interesting. So that's so not normal. That's so not normal. We human beings seek comfort.
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That's like, you can't. You can't see my height, so I'm 5 5. And I got it in my head when I. And again, I'm going back to high school because I feel like it just. It has made me realize now, in reflection at this stage in my life, that there were things that were there. I got it in my head that I was going to be on the basketball team, having never played basketball. And I got to tell you, Patrick, it was an uphill battle because I also don't come with natural athletic abilities. I was definitely endowed with more intellectual prowess than athletic capabilities. But, um. But I got on the team and I stayed. And yes, I always played for, like, the 60 to 90 seconds at the end of the game where we had either definitely won or lost. But every single season that I played, I got recognized by my team as the one who really just gave it all, every single practice, every single game. And I. I loved. I didn't mind that I wasn't good at it. I love that I got to be part of a team. I love that I got to build something. I love that I got to have a skill. It was similar to. I went to Caltech for undergrad because of my love for the sciences, but about a year in, because everybody has to take math, physics, biology, chemistry, and an applied physics lab that we had, regardless of your major. And I felt like I was just dying of the amount of sciences that I had to take. And I created an art history major. And they would let you do that in an undergrad of 200 students because we had two curators of art that came and taught at Caltech every single quarter. And I have a bachelor's of science in biology, which is my field of expertise, but I also have a bachelor's of science in art history, which I. Which I find really fascinating. And it's not, again, that that came natural to me was because it was uncomfortable. It was because it was that, that was, that, that's what made it kind of interesting to me to pursue.
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Yeah, this is crazy. This is kind of in my wheelhouse of what I like to investigate, but we're not going to do a bunch of this is so cool. You know, often the question I ask, is it nature or is it nurture? And you know, to this, to the degree that your parents, I'm sure would have supported you, you probably made them a little kooky sometimes. I mean, there's a lot of nature in there, right?
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You know, it was funny to me both growing up in undergrad, medical school, residency training, all the way to now, the most common advice I get from my parents is stop doing stuff, stop working so hard, stop doing so much. Why are you doing. I mean it just so. Yes, definitely, definitely created a little chaos for them. But bless them, they were both, even though they didn't understand why I did what I did and at many stages I couldn't articulate why I was doing it, they were incredibly supportive, which I think a really long way.
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You know, there's a, there's a, there's a. I just recently interviewed a guest and you know, he is a entrepreneur. He's like, he's very, he works with some really high level level business owners. Etc. Anyways, the, the point was he said, you know, in one of the comments he made, he articulated it really well. I probably won't do it justice but ultimately he said if you wake up, if you're waking up every day going and doing what you feel fulfilled about, then it is never work. It never feels like work. Now I can, that's my life right now. And at 67 years old I'm kind of going, you know, I've had a great life and, and I'm more excited now than ever before about it because I really enjoy and love what I'm difference I can make. And, and, and so for you, I'm sure that when you're wired the way you are, that scale and making an impact and I mean it's got to be pretty, you must see it as quite exciting and fulfilling given the difference that you're making in the world. I mean you're talking tens of millions, hundreds of millions of people. Those are big numbers.
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Yeah, I, you know, I have always felt incredibly privileged in that. Even when I worked 120 hours a week, I felt like I was not working because I felt so immensely aligned with what my purpose, what my purpose is. I will say there is a dark side.
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You say that I'M going to go, okay. What I've learned on one side is it all worked really good over here. You can't have a positive without a negative.
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Exactly, my friend.
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What's your side? So tell us a little bit about your dark side.
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And I, you know, and again, I'm, I'm a, I'm a very positive and optimistic person. And I, and I do, I am driven by, by impact at scale, for sure. The dark side of that is I also go through every moment thinking, are we optimizing and scaling and making an impact to the level that we can? And the reality of it is, while there have been tremendous strides and I'm going to go to now my field of expertise, which is healthcare, while there's tremendous strides that we have made in the last two decades as it comes to the quality and safety of care, as it comes to trying to be more consumer centric, some strides in cost, and we have a lot more to go. We have really not made the impact that we need. People are getting injured at higher rates than they have ever before. We have people getting misdiagnosed. We have people feeling alienated by an industry where they're supposed to feel connected and trust. People are going bankrupt. They are skipping critical care because they can't afford it. And so the dark side of it is while there's a tremendous sense of purpose, there's always a sense of we have to do more and we are not doing nearly enough now. That's what gets me excited in the morning. And I feel very lucky that I'm able to work with really incredible people who share that same energy and vision and continue to strive forward. But, but there are days that I'm like, can I just, can I just like it's, can I turn it off? Can I just have a break today? Good.
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Do you find that, you know, just curious is that, you know, I'm sure you've got lots of team. You know, I interviewed Dr. Honey, who's a brain surgeon here in Vancouver at VGH. He's the head of brain surgery or something. I don't remember the exact. But anyways, he does, but we talked about. He's really intense. You probably don't even know how intense you are. Any comments on your intensity? Because he talks about his team, his OR team and the people that he works with and how he's developed that team over the years, but they're all kind of that way. And it was because his intensity and his drive and what he wanted to achieve and accomplish and all the things that he's done in his life. It was really important that the team was kind of vibrating at that same level again, given who you are, you're really nice on a podcast interview, but then we get in the trenches. Who's Naseem in the trenches? Are you that intense driver or do you see that in yourself or what is it for you? Are you pretty compassionate and empathetic to what's going on in your team?
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Yeah. So it's. I. I can tell you what I strive to be.
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Okay, that's a good start.
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Yeah. I think by nature I'm definitely intense and ambitious because I feel like the goals that we have go beyond the individual to what we're trying to do in advancing health and care across the globe. And I feel very passionate about that. And I think, you know, there are no teams that I've. That I've had where that has not been clear.
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Everybody's there. Yeah. Yeah.
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And that's been the driving force behind what people do. Having said that, I realized that's how I function at my best. And what I love about a team is that different people function differently to be at their best. And I really love that diversity because if I push everyone to be like me, then then we lose what that, what all those different points of views and ways of thinking and as the kids say these days, ways of vibing will will be like. And so I, I think I'm very compassionate and empathetic by nature. I do have high standards. I am very mission driven. But I think maybe as an outcomes driven person, I'll put this out. I've had four teams over the course of my career. And some I've built from the ground up. Others I adopted and evolved. And team number four actually went through four different iterations. So it was technically not just one team, but it evolved. But I have had virtual drinks, brunch, dinner with all of those teams and the spans two decades. And so I think there is something that clicked and bound us together over time that is really special to me. I strongly believe in the power of teams now. Again, sometimes we had to transition team members out to other things that work for them. But I strongly believe in. It's the team that ultimately enables the work to continue over years and decades. And I was recently asked to speak at UCLA Health, which is where I did my training. And I was on faculty for over a decade. I also started their quality and safety program back in the day. And so this was their. They were re kicking off their quality conference and I was the keynote speaker. And it was incredible to me, Patrick, to hear, and I'm going to get emotional about this now, but to hear so many of the people that I recruited that were on the team, first of all, now in leadership positions leading the program. So many people commented about what this program meant to them and not just their education as a, as a physician or nurse, but how they now move through health care and how they are seeing things as a result of this program and now they are part of it. And it was a really, really beautiful kind of full circle moment of this is what happens when you get the right people together and the, and the power of teams that way outlive your time in a place or what you envisioned even for the, for the program. They're doing phenomenal work right now way above and beyond anything that we envisioned, you know, 15 years ago.
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You know, those moments are always, as a leader, are always very humbling and very rewarding kind of at the same time. Right. It's like being able to realize just and be. Honor yourself in that you were a driver of that, that you provided the leadership that they connected to and were able to take it to next level. I always love those circumstances when they show up. When you consider, and I want to go, and I'm going to get in transition. I want to talk about your book and all the things that you've got going on. But I'm curious, in terms of your leadership, Nassim, is that. Do you are as that individual scale and teams and all the rest of it? Is leadership something that you study? Like, is it. Are you that person that's going to read that book or, or listen to that audio or watch that podcast, or are you or, or do you find that your leadership qualities, you're kind of developing in real time because of your awareness of just what results you're getting. How does, how does the leadership for you land? Because I've talked to some who've said no. I just, you know, it's just what I do. And it's not a study for me, it's just something I do. What is it for you?
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Yeah, I'm going to say an emphatic yes to the first one. I'm the person who loves to read, loves to deliberate, loves to talk to leaders that I admire. So I'm a huge reader and I basically read like 97% nonfiction a lot around leadership, health care and technology. That's the end. For the last couple of years, I've. I've read between 55 to 60 books a year. So. And I do that combination of both reading and audibles. So I am a strong believer in. We live in an amazing world where lots of people with lots of experiences are putting out how they think about things. I don't agree with everything that I read, but I love that because it challenges my thinking and sometimes when I don't agree with stuff, I end up adopting something that pushes me beyond, you know, what I was thinking. I'm also a very experiential person, Patrick. So there is a good part of my leadership that's come out of being in C suites for the last two decades and how do I say this nicely? And seeing what one should not do. And so I think that there are plenty of examples of hey, that's not a way to motivate people, that's not a way we should treat each other, that's not a way to include people. And what are then the ways to turn around and do that? I always ask for feedback. I mean I have had a couple of phenomenal chiefs of staff and we'll go to meetings together and I'd present to the board or to the executive team and when we come out I'll always turn to them and say, hey, what could I have done better? Do you feel like the point resonated looking at how other people responded? Like what, what could have been done differently? And so I think I'm also very try to be self reflective around is, is, is this feeling right? When we do team building activities, I, I always ask the team because I'm like this is important for me. I'm going to spend time doing, you are all going to spend time doing this stuff. So was this activity meaningful? Did it build trust? Did it enable you to connect in a new way? What should we do differently? So I have to say I've, I think that that's, that's been a key piece for me to continue to, to grow. I love it when I have someone who reports to me. So, so we, I've set up this thing for, for the, I know last maybe about 10 to 15 years that I've been in executive positions where we kind of, we affectionately call it the pissed off rule. And I read it somewhere so I didn't come up, come up with this. But the idea is if anyone on the team does something that pisses off another person, the person who got pissed off has 24 hours to reach out and say hey, you did this thing in the team meeting or in wherever. And that really pissed me off. And then they're going to set up a time to talk about it. And this came out of multiple experiences where I realized, especially with folks who'd worked together for a long period of time, there were these friction points that everyone knew, and they would just be like, well, yeah, that's how Susie is. But it made them not want to go to Susie and work with Susie. And Susie similarly had points that she had that. That pissed her off. And so this. This rule kind of put. And everyone has to sign it. It's like a contract. It put the responsibility on the individual who is upset to say, I'm actually going to take responsibility and speak up so that I can have better working relationships. And when it works really well, it is like magic.
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It is.
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I've had people who have had kind of the same friction points that, like, finally have this aha moment. No one's trying to piss anyone off. It's just we have different communication styles or. Yeah, I was kind of rash in that meeting. I'm sorry. I didn't. I didn't mean to do that. And I love it when people give that feedback to me where they're like, hey, in that meeting, you talked about this and you didn't mention my name. Like, that was my program. And that pissed me off. I'm like, you're right. I should have mentioned you.
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B
That's a culture development, and it's so important to develop the culture intentionally. There's a phrase I like to use that I learned many years ago from a coach of mine, a business coach of mine, many years ago. And the phrase is really simple. High performance is a result of low tolerances.
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I love it.
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It's great, isn't it?
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I'm going to take that one.
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Please do. When we think about tolerances and high performance and culture, we look at not only what do we tolerate with ourselves, what do we tolerate with our team, what do we tolerate with, you know, in a meeting, you know, or in a. In a culture, in an environment, if it's not set up intentionally. Right. Like we, within our teams that I built over the years in the culture that we create. And we always linked to high performance as a result of low tolerances. So if we're in a meeting, again, we're all, you know, we can. We all want to get to a goal. We all want to achieve something. And so there's some intensity that can develop in that, disagreements. I think we should do it this way or that way or the budget should be this or that or whatever the. But there's always a fundamental rule within the culture, which is nothing is meant to be taken personally. And so when you start to understand that what's coming at you isn't a personal shot, it's not intentionally personal, then you can start to have way more direct conversation. And that's just an example of, you know, that, that term of high performance as a result of low tolerances, you know, are you, you know, are you a Ford Escort or are you a Porsche 911 or are you a Bucatti? You know, are you, you know, so they're all, every level you get to is higher performance, but it also requires far tighter tolerances. And so that was the kind of the. And as you're speaking, it's kind of what reminding you of you've done that or you are on that path or you've been on that path over the years, just naturally. Right. It just shows up that way intentionally. But that's what you drive. So it's an interesting thought process. And I love culture. I think that's the most important part of any dynamic team is you got to create that culture intentionally. You can't let it unfold on its own. You got to drive that bus.
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A
It's really critical. If you're not intentional about culture, it will get defined. Not wanting to.
- [37:40]
B
Yeah, it goes its own way. So let's, I want to morph a little bit. I mean you talk about the millions and hundreds of thousands and staff and all the things that you've done and again, scale. So now you go and you write a book. Now when we look at healthcare overall, you know, I don't, you know, we'll talk about North America. I mean health care, whether it's in the US or Canada or wherever you go, there's is always a wash, always. But it's often a big issue. And when we consider the pressure that's putting on being put on health care and the volume and the lack of doctors or systems or the costs associated with it, it's really seemingly getting worse. I don't know if it is, but sometimes that's what it seems like. So you want to make an impact at scale. So you go, you write a book, Intelligent Health. Now what would give me the premise of that? I've not had the opportunity to read a summary of it or anything but so give us a little bit of insight into what the intention of the book was. And I mean that is always a way to have a long lasting impact.
- [38:43]
A
Yeah. So the, the idea of the book, Patrick, came about around 17 years ago, when I was in clinical practice and I had an administrative role and I really started to see all the gaps and fractures that we had in our healthcare delivery systems and things that went against some of what I expected. Like I thought, well, you got really bad diabetes or you got colorectal cancer. And I'm thinking about two specific patient cases. You got those because you were uninsured or underinsured, didn't have access to good care. I didn't expect that people who were seeing primary care doctors 12 to 15 times a year would end up having metastatic colorectal cancer because we never got to ask them and push them to get colorectal cancer screening. Completely preventable, completely avoidable. Here you're now fighting for your life in a hospital bed, post surgery, on chemo, or losing your limb again in a hospital bed for diabetes complications where that could have been completely avoided. And so I started to see those gaps, both the ones that we expected, but especially the ones that we didn't expect, and the toll of it on, on human lives and our, our ability and potential to be able to live full lives. And so at that point I had this idea for intelligent health, but I am too practical and operational to write an aspirational book because the technology was not there to building over the last five years. I was like, wow, the technology is actually there. We can make this a reality. We can fundamentally change the fabric of health and care in this country and across the globe, and we can change what that means to the individual and to the society. And so the premise of intelligent health is threefold. The first one is we gotta unify all of your health and care data. Why does that matter? There's about 20% of your health outcomes that gets determined by what happens within a healthcare delivery system, a hospital, a clinic. That's 20%. The 80% of what determines your health is the air you breathe, it's the food you eat, it's the stress you carry, it's your habits, your genetics. Up to this point, we've done a really poor job of integrating the 80 with the 20. Right? We'll wear rings to track sleep and activity, or we wear watches or bands around our wrists. We're looking at these silos of things like nutrition, sleep, activity that are not at all connected to our actual health outcomes, none of which are connected to each other. And so the example I love to use is that there's no other complex thing in the world where you do decision making on just 20% of data. And yet that's how we're making decisions in healthcare. So imagine like if you went to board a plane to get to a destination and the pilot came on and they're like, ladies and gentlemen, just want to let you know we only have access to 20% of the data that's going to get you to your destination safely. But don't worry, we're very well intentioned, we're highly trained. I could be like, I'm getting off of this, I'm getting off of this plane, I'm not going to be here. It's crazy to me that we have tolerated this, Patrick. And I think the reason it's gotten tolerated is that healthcare is very broken and siloed. And so instead of looking at how do we integrate this, the market and bless the market has come up with lots of other solutions for you to be able to get access to the health data, the 80% that you need. But it's time for us to unify it and leveraging cloud technology along with other technologies. I address in the book, like there's the cloud and this is all meant for, for a lay audience. But I'm like, just so you know, like the technology is there. This is very, this is very feasible to do. So that's number one is you got to unify it. Number two is you have to apply intelligence to it. And you know, I feel like the world woke up to AI with generative AI, But AI as a broader field with all of its subcategories has been around and developed over decades with tremendous capabilities. Gen AI gave us an ability to bring some stuff together and make it really nice for the consumer interface that you need. But we have tremendous opportunities now from computer vision to be able to look at wounds and tell you if it was infected or not, to being able to understand unstructured text to be able to pull things together. So we got to apply intelligence to it because then otherwise we got a bunch of data points that, you know, that don't make sense. And kind of what that enables us to do by having that intelligence layer is to have what is evidence based practice, which again, as a scientist and a physician like you, you want things that are based on robust evidence as well as real world evidence, which we have, we, we have collected and report on some but have not been able to do robustly. Where is that important? We kind of do one size fits all medicine. It's like Patrick, walk 10,000 steps a day, drink eight cups of water, take turmeric. It's really good. Like, you know, does Maybe Patrick needs to walk 5,000 steps a day and the C needs to walk 15,000. Based on my health profile, maybe I need to drink 3 cups of water a day and you need to drink 10. Maybe turmeric works for me, but doesn't work for you. Like being able to collect that real world evidence by having people just kind of do what they do when they go through living life and being able to give us kind of personalized what actually works. It's personalized, it's predictive, it's proactive. And then the last part of intelligent health is once you've unified data, once you've applied intelligence, it really needs to be consumer owned and consumer driven. And there's a key reason for that, which is we have built such a large, complex system of health and care where there are so many stakeholders with so many billions of dollars at stake that we cannot blow up the system. I would love to be able to blow up components of it, but we cannot do that because there are lives at stake. We can only evolve it. And the way that we evolve it is that we get all stakeholders, whether it's delivery systems, it's pharma, it's payers, med device, it's regulatory, all of them now al around the consumer, the person who is consuming health and care. And through that, people still get to make money, but they get to make money by making me the healthiest I can be. The other reason this needs to be consumer owned, consumer driven, is that we need to have human goals for our health and care. Right now, if I tell you give me a goal that you have, and I've done this in big audiences and people will say I'm trying to get my blood pressure under control or diabetes or weight management. Those are medical things we're trying to do. They're clinical things we're trying to do. They're not human goals. My human goal is I want to wake up in the morning energized. I want to go through my day not having a foggy head. I want to age gracefully and not have musculoskeletal pain, not be cognitively impaired. There are, there are human goals that we have. And now if I get to decide that, not people who are looking at this from a medical or clinical perspective, we can leverage that data with intelligence to say, how do we help Nassim achieve those goals? There's a combination of my medical conditions along with my health conditions that come together and then can enable us to do that. So that's kind of the premise of intelligent health, unify, apply intelligence, make it consumer owned and consumer driven.
- [47:18]
B
When you think about. So when you look at health care in general, you know, I'm, I'm a little bit, I don't know what, what I am. I'll call myself a little bit skeptical about health care. I say, you know, really, is it health care? To me it's disease care. It's like, you're right, it's too, you know, like. And that isn't the fault of, well, maybe arguably it's, you know, the medical system has something to do with it. But, you know, how do you get people to take responsibility for what, eat, managing their weight. And then of course, then you run into the problem of, okay, well, lowering can come, can't afford. It's, you know, cheaper to eat at McDonald's than it is to go to us, to a store and buy healthy food. And there's, it's, it's complicated. I get all that. And then you look in and then you, in the US you got Kennedy coming out and he's turning things upside down and, and really being critical of the system overall in changing it. I don't, and I don't pay that close of attention to it, but I do pay attention. I watch it. I'm very health conscious myself and have always been that way. When you look at healthcare as it is today, do you see a space for you in terms of what you're doing, aside from the book you're writing, but just how you're approaching it? Is there a part of it where you're saying, how do we support people in taking responsibility for their health so that if they're coming in, it isn't because they're, you know, 100 pounds overweight. They're, they're, they're actually making a concerted effort to be active and eat right and do all those things so that the health care is there because whatever, you know, a genetic predisposition or you fell off your chair or whatever the story. I don't know if that's an accurate, good question, but are you following the train of thought?
- [49:01]
A
Yeah, that, that's actually, that's a great question. And I want to go back actually to something that you said which I think is at the crux of this. And you said it's complicated. And you're absolutely right, Patrick, it's complicated. Now what I will push back and say is, does it have to be. And my answer is it does not have to be complicated. We have made it complicated. So I will give You a personal anecdote. When I was in my global position, there'd be times where I would start off my day with Zoom meetings at 5am Again, you're kind of going across the globe. I'd have 21, 22 back to back zoom meetings. And I realized that when my day started at 5 and I had about 17 to 22 meetings, that by about 10am I would reach from my phone and under the table. I would go to my favorite food delivery app and I would be like, hey, do I, I feel like this fancy donut, a slice of chocolate cake, like there's many, so many great options that could be delivered right to my door. And, and, and I would order something, right? So on days that that was not the case, I could go on and I could order the salmon bowl that I loved. There was a lentil dish that I also really liked. There was a salad with chicken that I really loved. What occurred to me is that all of this data actually exists. My calendar is digital. My ordering behaviors are digital. The app actually knows when I order between 10 and 11, statistically what it's likely to be versus when I'm ordering between 12 and 2. All of this could be connected and I could get a ping on a particularly rough day saying something like, hey, Nassim, it looks like you're having a really rough day. Can I order you a salmon bowl at this place that you really like? I still have the choice as a consumer to say, no, I really want the donut. Even if half the time, Patrick, I pick the salmon versus the donut. That really builds over a lifetime. And so I talk a lot in the book because again, getting to work with lots of different communities across the US but also globally, I'm very sensitive to the fact that not everyone has access to everything. But technology can say, hey, you don't live in a safe neighborhood where you could take a walk. Let me, let me give you a dance routine you could do at home. Let me give you some chair exercises where you could do resistance training or your work. You're going to go to work 10 minutes early and walk around your work because that's a safer neighborhood, or the church that's close, or, you know, so you can figure that stuff out. You don't have access to fresh foods and vegetables, but the baked potato chips better than the regular potato chips or the low salt one. And again, the consumer still gets to choose. But if it's made easier so that we don't have to take the cognitive burden of all the different things that we have to do because that's not our goal should not be to manage this stuff. It should be to live life. If technology can facilitate that, that unlocks such tremendous potential for us to then be able to put resources to where we actually need to support people most. So I love that question about it is complicated. I don't think it needs to be this complicated. And I think technology is, can, can help us uncomplicate this.
- [52:57]
B
Yeah, it is interesting about technology. A couple, you know, my own comments around a couple things is that, you know, I always say bureaucracy begets bureaucracy and sadly what happens is there's layers and layers of it and it's the nature of bureaucracy. And I'm, and I'm very critical of bureaucracy. It's, I have really, really great emotional fitness. Like it takes a lot for me to be overly reactive or piss me off. But what pushes my buttons is bureaucracy and the layers of it and just the inefficiency of it, the ineffectiveness of it, the arrogance of the bureaucrats that, who justify their position. So you can see even in what I'm saying is it's a button for me. So when I, when I, I can.
- [53:44]
A
Feel your blood pressure rising just a little bit.
- [53:46]
B
So the point of it is, is that as we're dealing with, you know, the scale and the scope of the issues and, and healthcare is just being one of them. Could be government, could be anything. That part of it leaves me a little bit disheartened because I go, there's no way to break through that. Those layers seemingly to me as the layman, I'm going, listen, I'm not even going near that because it's not ever going to change. And that's to be a little bit. I was given the phrase be skeptical, not cynical. But that is one area where I get a little bit cynical is that, gosh, there's not going to change. But I'm going to ask you this question and your observation. When we look at technology and we embrace it, and I love technology, I'm an early adopter of technology, I always have been. But from a health point of view, you know, we're, especially since 2020, when the world changed forever, we're sitting in front of our computers more, we're less active is my sense of it. I know myself, I'm intentionally having to do very conscious. I got to get out and do things. You know, it's not like we're farmers working out in the field anym. So do you, have you noticed even in the past five years, with the data supported that there's been an increase in the demands on healthcare in terms of the need for it. Are we as a society, are we in fact getting less healthy because of technology and the fact that we have to do less? We're not as active, we're sitting around more? I don't know the answer to that. I'm just curious, is that even a thing?
- [55:18]
A
Yeah, absolutely. A couple of major reasons, Patrick, I think one that you mentioned, which is for a large number of adults, the move to the virtual platform for work made us far more sedentary because there was value in getting up and going to the proverbial water cooler and standing around, stretching, balancing, building those muscles in the back and centrally, those muscles, if they don't get used to support you standing, they atrophy. And your muscles are the biggest kind of sink for taking up things like glucose that then regulate your blood sugar. So there's all these kind of unintended consequences of being sedentary. I think the other major challenge with COVID is that we had a number of people who delayed care. And so we, you know, start to see the sequelae of not getting the care that was needed. And then the reality of it is, and this is kind of the last point, if I reflect on kind of the. If I step back even outside of COVID to the last two decades of my career, disease states have evolved and we have gotten sicker. But also we're treating a lot of things that used to get people earlier. So people are now having more complex chronic illnesses, for example, while cardiovascular disease continues to be the major reason for mortality and morbidity, we are treating things so much better now. So people get to age to be older, and when you get older, you have other things that happen, like cancers and inflammatory diseases that maybe you wouldn't have gotten. If you get a heart attack at a younger age and have a resulting death from that, I think that's the other piece of that. One good thing that has come out of it, I will say, is I do think for those of us who have choice, and I do want to underline that because this is not true for everyone. But for those of us who have choice, we have become more intentional about making sure that we are being healthy. And I think that's the proliferation of the consumer health and care market. Everything. And I'm not endorsing this because I think there's a lot out there that honestly, it is not advancing health or care in any way. There's some stuff that's harming it. But there is some stuff that, that's, that's helping. But I think if you look at everything from lab tests to, you know, scans to monitoring biometrics, there are more abilities to be intentional about what can I do to care for myself? Which, which is, I think that's, that's a good thing. We now just need to reign some sanity onto this giant wellness market, which is why I think data will be incredibly powerful and being able to get real time data on what and what's helping and what's not will be really, really impactful in the future. I think you should decide on your wearable or the supplements that you take based on what works for you or people like you versus you're getting something that's the latest fad, which is there's.
- [58:56]
B
Lots of that out there. Where does AI fit into this picture that you're kind of the vision that you have in terms of having a bigger and a global impact. Where does, you know, artificial intelligence? I mean it's, it's, it just continues to grow and expand and get smarter. And I mean it's, I, I in it daily and I'm blown away always at the results and the efficiencies of it. I had this conversation with a good friend of mine, business partner the other day is, I go, what did we do before? Look, it's, it's, we've only been at it for a couple of years like we were early adopters of chat GPT for example, he's gone on, he's younger than I am, but he's, he's gone on, he's looking at all the other AI platforms that are out there and working with them. But you look at it and you start to see it. I mean, are you kind of planning, do you work with it in terms of, do you see the vision for it and that you're actually implementing as part of your own technology thought process of how it will apply to what you want to achieve.
- [60:00]
A
Yeah, absolutely. So I am a heavy user of large language models and I'm regularly in three major ones. I found over time I use different ones for different reasons and I try and be thoughtful about not sending the same query to both because there is a significant environmental impact in the compute power that we use and I do want to use it, but be responsible. But I've done over time now a lot of compare and contrast everything Patrick, from going to my fridge and being like, hey, I've got mushrooms, I've got chicken and I'VE got onions. I want a recipe that's simple and can be ready in 30 minutes. And getting a recipe to oh my gosh, I hope my kids don't watch this. But I do go to LLMs when they ask me a question from school and I'm like, I don't remember this math. So I like, literally I will take a picture when they're not there and I ask it to explain it to me so that I can explain it to my kids and sound really smart. And then I use it professionally constantly, because I think it is if you look at large language models, I absolutely think they have the power to transform what we do in health and care. I will say this caveat though. It is a tool. It is not the end all, be all.
- [61:23]
B
Yeah, it's a tool.
- [61:24]
A
Yeah, it's a tool. And why that is important is because you still today and this may change. So get up. If we're having this conversation in five years, Patrick, it may be different, but sitting here today, it is fallible. And there are places where that fallibility, especially again in my field of health and care, can genuinely harm people. So it is a tool in that same as you can drive a car responsibly and you can drive a car drunk and those have very different outcomes for both you and society. You can use large language models responsibly and be able to see the world and do things that you could never do before and transform how you function and move through the world. Or you could use it in irresponsibly and harm yourself and others. And so that's where I do think it's really critical again in intelligent health. The core part of the intelligence is artificial intelligence, but the interface is generative AI because again, it has a really nice consumer centric way in the way that you want to listen to things and continues to learn and grow the way AI models, ML models do. So I think it absolutely is central to the advancement of health and care. It also gives us ability to be able to care for individuals and provide information to individuals who don't have access to health and care otherwise. So being able to reach rural communities, being able to support people who are may need help at 2am or at 6am who may be miles and miles and miles away from healthcare. But again, it's a tool so you have to use it appropriately.
- [63:25]
B
Yeah, you have to learn how to use the tool well. And because of the way AI answers, I was just reading or watching something on this and the way AI answers it, it's so definitive. It's like it knows exact. Actually the answer. Yet if you query it a little bit further and go, you know, how confident are you in that answer? Or you actually say, show me your research, or show me how you came to that conclusion, all of a sudden, oh, okay. Well, it was more of a guess than it was anything else. Like, it is interesting. So it is a tool, and you got to learn how to use it. I got an inquiry for you. A query for you is that this was interesting showed up. And you may have seen it, but it was a. A recent professor calls this girl out in his class, and they'd gotten. They'd been university or college, whatever it was, but they had gotten results from an exam back. And he called her out in front of the class, and he goes, you finished this exam in 22 minutes. You got 92%. You cheated. And she goes, I didn't cheat. And so there's some kid in the back room, of course, videoing, right? And. And they. They're getting into this discussion, and this professor's really show. Calling her out. And he goes, you cheated. She goes, I did not cheat. And he goes, you're part of a sorority, aren't you? And she goes, yes. And he goes, I'm. I'm. I'm going to do an investigation in the sorority and. Or sorority, I should say. And. And that's, you know, because you guys are all cheating. And she goes, I didn't cheat. And he says, well, then you tell me how you finished that exam in 22 minutes or whatever it was. And she goes, well, she pulls up her laptop and she used the iai. And he says, well, that's cheating. And she goes, no, it's not. She goes, I don't agree. And she really debated with him. And she says, I know. I had to know what questions to ask, how to inquire. She said I had to question the research that was giving me the answers, and if I had no idea what the answers were, I wouldn't have been able to say, yes, that. Okay, got it. That's the answer. She said I wouldn't have been able to do any of that. So she said, as much as I used AI, she said it was just a tool. And she says, I was very efficient in it because the answers are my answers. At the end of the day, she said, I'm not using AI to give you the answers. I'm confirming those answers. And there was a written component. So she had a really stellar argument debate with her professor. And I Have to say that I give credit to the professor. He, he didn't apologize, but he backed down and he kind of validated her point. So all to say.
- [65:56]
A
Yeah, that's the, you know, being comfortable with discomfort. I do wonder quite a bit, Patrick, as someone who's done a lot of traditional education, I do wonder what the value of traditional education is in the way that we are doing it today, which is we're still like heavily testing people, memorizing facts, which is, is that is no longer a skill set that's important. It's that critical thinking. It's the questioning what you get to see. So I do think there's a whole nother set of skills that we need to teach this generation where it doesn't matter if you're using the generative AI model because it's not about. You do have to know so that you can pressure test. You have to be able to ask, you know, ask critical questions. But it's no longer about, can I, you know, what's the knowledge I can contain?
- [66:55]
B
What do I have to remember? What is the memory? So in my story that I tell myself is, again, it's a tool. It is a, you know, critical thinking skills are not all that common, it seems these days. So I think that's something that we have to educate more on. But I think about back, you know, I'm old enough that, that, you know, I paid $185 for a calculator that I used in chemistry and biology and math. And it was like, you can't use. Yeah, it's just like, that's cheating and you're not learning what you need to learn. And I'm going, no, I think I'm doing okay. Like, this makes sense to me. And, and of course now, you know, that same calculator is three bucks or they give them away for free at an event, you know, and, and it becomes like you're. They're on your phone, they're everywhere. I mean, why do you need to know math? It's like, it's, it's the concept. If you understand the concept of math, then this is just, you know, a calculator is a tool to me. If you understand, to the student's point of view, she understood. She really knew what questions to ask. She knew what answers were right when she got them, what weren't. And she did it efficiently and effectively. And I'm going, I don't know. There's got, there's a lot to be said about the efficiency and the effectiveness back to my friend and I are going, what did we do before? And, and I said to him, I, you know, I said, I wonder, are producing more faster? Like are we being more efficient, getting results? Are we actually accomplishing more because of that? My, my kind of answer is I think so. But I, you know, we're, I don't know what the benchmark is anymore because just, you know, as owner business, we're just doing stuff. So I don't know, it's, it's just a weird world that we live in. And I think about how important AI could potentially and probably is in the background in the healthcare system with our doctors. I went to a doctor for a condition. It was really simple. I walked in there and my doctor and I said this and this and this. And I said when I did my research on it, this is what I came up with. And he goes, oh, he says, okay, great, I'm glad you did that because you said I don't have to explain it to you. But he said, yes, you're right on point. Like he was very appreciative of I came in already, I loved it.
- [69:05]
A
It's back in the day when people would go to Google like that, you know, when that was a thing and I had colleagues saying, gosh, it's so frustrating. People are coming with all this research that they did on Google and then having to go through it with them. I'm like, how amazing is that for a person to care enough and be engaged enough. And I think that's where generative AI to me can be so powerful. We want people to be informed and engaged. And I think this is where we again, these are the skills you now need to teach professionals at this stage. Instead of being upset that you have to spend time going through why something is not practical, we should coach and teach people how they can distinguish what is actually fact versus fiction or what they can ask to be able to distinguish that. Like those are in the role of, not the patriarch of the healthcare system, but the coach of someone's health. That's something that we should be empowering and educating them around. And again, that's part of why so much of. Again, even though I come from traditional health care backgrounds, the premise of the book is around the consumer and the person is you have to give the right tools and the know how around. How do you actually navigate this for the better? And I do think that if you're intentional about it, whether it's it's in business, finance, law or healthcare, you can absolutely do more. But you have to be intentional. You know, you can't just kind of use it again for anything and everything. You have to be thoughtful and intentional about where and when you're using it.
- [70:57]
B
Okay, so I'm going to take this conversation in a different direction as we start to wind down. You've been really generous with your time and I'm not finished yet. But I want to ask you this fundamental question for me was because I, I've myself have been a business owner for over 40 years, entrepreneur, capitalist, whatever other description you might want to add. And often I'm, most often that's the guests that I have on my show. And it's interesting that we've had this conversation. We've been very kind of all over the place in terms of your career and health and all the things that you've done. Money hasn't shown up in this conversation. If I'm talking to and having conversations with people, it's, you know, the benchmark is, you know, I got a, you know, my business did 100 million or a billion or 300 million. And there's always a conversation about achievement in terms of making a difference in the world, always. But it's always attached to dollars. Now it hasn't shown up in this conversation. So I'm curious. You're making a huge difference in the world. In the difference in the world, you're thinking global and scale and all of the things that you're doing. Where does dollars and cents land for you? You're, I'm sure you're very high income, but are you is in behind all this? Are you going, how are we making money? Like, I don't know. I don't want to put words in your mouth or thought process because we haven't touched on Share with me.
- [72:26]
A
Yeah. So I, I think money and the economic of healthcare are absolutely essential to our ability to be able to deliver on the mission. We always say, no money, no mission. Right. I think I was again back to, did you learn this or were you wired this way? I think I was always wired to think about how do we build systems that are financially sustainable and thriving. So my very first executive role at UCLA Health, I kind of got that. I was a junior faculty member. I mean, I was like six months into being a faculty. We had physicians who went to the C suite and they said, hey, we gotta do this because it's the right thing to do. And I went to the C suite and I said, hey, we gotta do this because it's the right thing to do for patients and it's going to save you 0.25 bed days, which translates to folks X dollars annualized, it's Y dollars. So now give me one, ten, thousands of that to be able to run this program and then hold me accountable to the outcomes because I'm confident I can deliver this. I actually end up going and getting my MBA seven years after I was in practice, specifically because I was spending so much time in finance and operations and that was not my background. And so I felt that that would be beneficial, go and do that robustly. And again, becoming a chief operating officer was, I realized for us to actually do right by the individual and society, I had to have a deep understanding and with that control over where and how we're spending money because the money is there, but how you get to spend it and the responsibility towards making it sustainable and is absolutely critical. So I think when it comes to systems in healthcare, and again, I'll say there's an entire section in the book around how this $5 trillion system gets restructured because we can't blow it up. The finances of that are absolutely essential. It's just how you are directing it and restructuring the alignment so that it's advancing health versus doing sick care, as you pointed out, Patrick, becomes the critical piece. It has to be made sustainable. I mean, we are robbing our national potential by instead of again investing in R and D and technology and research and infrastructure and education, all the things that we need to do to have a robust US society, we're investing it in sick care. And that sick care, the population of people who have higher burdens of disease, are not able to be as productive, are not able to have the quality of life that they want and the type of life that they want. So that cycle has to get broken. And again, the financial side of it is at the heart of that. I don't know if that answered that, answered your question.
- [75:52]
B
It does, to the degree, yes. Yes, it does. It was. It's just that it. There's always a financial part of it that you know, for, you know, when the, in the context of the show is that, you know, we often look at and we go, okay, well what's, what's driving this? What is driving us? And you know, when we look at the programs and the cost of healthcare and the people that are in place and I go, okay, but what drives you is, you know, is there's a dollars and cents component to it where you say, hey, this is an opportunity for increasing my income, driving revenue, you know, that was that's really it like but for you there seems to be a little bit more idealism around it or. Yeah, I'll leave it at that.
- [76:35]
A
There is for sure. There is for sure Patrick. And I think that the other part is that I, I've been blessed in that the things that I've been very passionate and purpose driven about have enabled me to have the lifestyle that I want to have and that is part of the calculus and I think one would be dishonest to not say that that's really, that that comes into play. So I think again that has always aligned really well and I think with, with the broader scale as I've gone through positions that's also brought more financial freedom.
- [77:20]
B
Sure. Compensation is always important when you're making that big a difference in the world. Right. So I love that. Okay, so again we'll wind down a little bit and I've loved this conversation. I could talk to you a long time to seem like.
- [77:31]
A
Because they're likewise part two. Patrick.
- [77:38]
B
So I'm going to ask. So this is a part of the show where I just have a little bit of fun and we call them rapid fire questions that are never quite so rapid but are you ready for some, you know, some light hearted and not too deep? Okay. I was start with an easy one. You know your technology. So I'm interested though because you are very corporate. Apple or Android?
- [77:59]
A
Apple.
- [78:00]
B
I'm surprised by that. Good for you. I'm proud of you. Okay. Because that's not usually on, you know that's not usually the case in the corporate world often is the systems that go to Android. So that aside. Okay.
- [78:13]
A
I think there, it's, there's a sentimental reason there but again maybe we talk about that in part two, but part two. Okay, I'm sorry, I'm gonna try and stay on point.
- [78:22]
B
Okay. Favorite tune band. Do you have a genre of music or favorite band or music that you go to too?
- [78:29]
A
I love music. I love lots of different music. I will say you're gonna, you're gonna laugh and this just has to to do with the stage of life that I'm in. So K pop is very, very popular in our household right now because that's, that's what the cool kids are listening to. And so that is, that is the, that is the genre. I, I am, I am a. You know I listened to 70s, 80s, 90s for different reasons but I brought, I love music and I love live music. So. Yeah, but, but I'm saying, I'm saying for today asking Me at this moment, January 2026 K Pop is going to be the answer.
- [79:14]
B
Favorite movie?
- [79:16]
A
Oh gosh. Depends on my mood.
- [79:21]
B
It could be. Yeah. It doesn't have to be a.
- [79:23]
A
Depends on my mood. So I'll say this like I'm a big sci fi person because I love. And when I read nonfiction. I'm sorry, when I read fiction, that's what I read. I read sci fi. So I love like Apollo 13, I loved the Martian. Even things like, like Dune. Yeah, I just, I love things that kind of pressure test how you think about how you think about the world, how you think about surviving through the world. Project Hail Mary, which was a book I absolutely loved. The movie's coming out this year. I'm super excited about that. So I'd say if I was to pick a favorite one, it would be like in that, in that genre.
- [80:13]
B
Etc. Now you read a lot so this is going to be a tougher question for you, but is there a particular book that stands out for you that might have been a, you know, created a fork in the road moment for you or a, you know, like a ding, it was big. Or is there a book that you refer to often or tell people to read?
- [80:31]
A
So I have to say because I read so much, I always have a long list of stuff that I recommend. I will tell you one of my favorite books over the last year that I read was Humankind. It's by an author from the Netherlands. And the premise of it is that we as human beings are really good by nature and are biologically built to cooperate and work together. And that it is kind of these external layers that aim to manipulate us and get something out of us that bring out the things that we see that are negative. And he makes a very compelling argument for this with examples from world wars all the way to the tragedy 911 to Covid around the goodness of humanity and all the ways that it comes out and then the times that again that we get manipulated either because of politics, media, ways for people to make money off of us that then get us to act differently. And it's not that there isn't bad or evil in the world. It's, it's not, it's definitely not a. It is, it is not a Pollyannish book. But I, I, I really loved it because I feel like that's how I felt I thought about the world and his. He makes this one point and I'll and I'll stop after this. I strongly recommend the book was that when, when people say, you know Be realistic. We really mean be pessimistic. And it kind of shifts this thinking of. It's not that, like, you're being optimistic, and it's like, oh, be realistic. And it's that optimism is actually what's real. And when you're saying be realistic, you're actually pulling people towards pessimism. And again, that. That was kind of a mind for me, too, as I looked at how. How the world functions. But I. I really enjoyed that book. I was. I was really surprised. And it was. It was. It was a really great book.
- [82:45]
B
Cool. If God exists, what do you want to hear him or her say when.
- [82:50]
A
You get to the gates to tell me specifically? Or is it like something that I. I want just arrived.
- [82:56]
B
God is welcoming you. What's he saying?
- [83:00]
A
You left the world a little bit better than you entered it.
- [83:03]
B
Beautiful. And final question, what are you grateful for?
- [83:10]
A
Oh, love that. I have a pretty robust gratefulness routine. I'll say. It's my family, hands down. It's my kids, my amazing partner, my husband, and my family every single day. Like, it's the. The world is a better place because they are. They are in it, and I'm grateful for them. They. They get my most grateful points regularly.
- [83:42]
B
That's beautiful. I am grateful for the opportunity this show provides me to meet amazing individuals like yourself. I've thoroughly enjoyed the conversation and I'm so grateful for having had the opportunity to have this conversation. Like you, I am so grateful for my amazing wife and my grandchildren and my daughter and all of the things that family brings and some amazing friends that we have. So thank you for joining me on the show today. It's been great, Nasim. It's been really, really great, and I appreciate you.
- [84:17]
A
Thank you so much, Patrick. I really loved our time together.
- [84:22]
B
Ladies and gentlemen, thank you for listening. If you found value in the podcast, please take the time to rate and review and share with others. Share with your friends as it is my goal to always improve and to provide the highest value for you, the listener. If you have any comments, suggestions, or questions you'd like answered, please email me@ceoraincanada.com that's ceor.com I look forward to hearing from you. And until next time, Patrick goes.