Feb. 21, 2023

#87: Breakdown to breakthrough, and how the blockchain and AI and will change veterinary science. With Dr Steve Joslyn

#87: Breakdown to breakthrough, and how the blockchain and AI and will change veterinary science. With Dr Steve Joslyn
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Season 1

Dr Steve Joslyn is a specialist veterinary radiologist and tech enthusiast with more than two decades of experience consulting for referral, teaching, and general practice hospitals on four continents. Steve is highly regarded for his radiology work on designing imaging workflows and clinical 3D printing services, among other ground-breaking projects. Steve’s passion for technology and informatics led him to co-chair a joint American and European Radiology committee exploring the role AI has to play in veterinary diagnostic imaging. With his latest project, Vedi, Steve and his team have created a universal health record that locks patient data to an animal's existing microchip, revolutionizing the way veterinary data is collected and disseminated in an effort to fix what he sees as one of the biggest, yet insidious, problems in the industry today - the "patient-data disconnect." 

In this episode, Dr Steve takes us on a tour of the possibilities, current and coming, that new technologies offer us in the veterinary space. We discuss artificial intelligence in veterinary practice, including the pitfalls to look out for, with a focus on where AI fits into the world of diagnostic imaging. Steve also gives some useful insights for anyone considering a residency, specifically a career in diagnostic imaging, and he shares candidly about his personal experience with a work-related breakdown episode. And of course, we dive deep into why our current ways of managing patient data are broken, and how we're going to fix it. 

(Oh, and just for fun - Steve's bio was written by AI, and an AI image generator designed the episode artwork for this one!)

Time markers for our topics of discussion: 

00:00 - 09:20: Steve’s bad decision / good story answer. 

09:20 - 29:20: Is imaging a dream job? And the residency journey. 

29:20 - 34:50: Breakdown to breakthrough, and the birth of Vedi.

34:50 - 39:20: Love the work, hate the job? What Steve learnt from his experience of a work-related mental breakdown episode. 

39:30 - 60:00: A better way to manage our patient data. 

60:00 - 60:09: Getting better at learning from our mistakes and the benefits of MnM rounds. 

60:09 - 78:00: AI in veterinary science. 

78:00 - 86:00: AI radiology interpretation software.

86:00 - 93:00: Steve’s podcast and book choices.

93:00 - 98:00: The one question.

 

Join the team for Vets For Climate Action for their epic hike on the Larapinta Trek from 28 June - 3 July 2023.

Go to thevetvault.com for show notes and to check out our guests’ favourite books, podcasts and everything else we talk about in the show.

If you want to lift your clinical game, go to vvn.supercast.com for a free 2-week trial of our short and sharp highly practical clinical podcasts.

We love to hear from you. If you have a question for us or you’d like to give us some feedback please get in touch via email at thevetvaultpodcast@gmail.com, or catch up with us on Instagram.

And if you like what you hear then please share the love by clicking on the share button wherever you’re listening and sending a link to someone who you think should hear this. 

 

 

 

I wish that a I could write these podcast interest for me, like I would just give it the transcript of the episode and it spits out a witty and engaging introduction.It's not that the technology doesn't exist.It does and I did try it with this episode.
I gave jet GPT a few prompts and I told it in Broad Strokes or to be discussed in this conversation.And if you don't know what GPT is yet, you will, by the end of this podcast and it gave me an intro.That was factually correct.But not quite there.I was going to read it to you but it would have had you hitting that skip button like crazy or fall asleep while driving.
So why am I talking about Ai?And why is the word blockchain in?The title for a podcast by veterinarians for veterinarians.That was a line from the chat.GPT intro isn't blockchain for Bitcoin and stuff, we talking about it because while the blockchain is used in cryptocurrency and while a I may write boring.
So this podcast introductions, this way more to it.For example, AI is very good at learning and using facts and our profession is full of those.It sooner or later probably sooner, it'll be better than you.Quite a lot of things.
So, in this episode, we'll explore where we're at with a I invent land, how we can use it.Now, how not to get sucked into the hype and let it land you in trouble, how to turn of analytics into Shakespeare and much more, but with all of these changes will have information even more data than we already have.
Now, lots and lots of data and you may not have noticed, but the systems we currently have to manage data in our vet, businesses kind of suck.So we're taking a look at that in this episode as well.Before you go.I'm not techie.You lost me at data.
This episode isn't for me, hang on, we'll be talking about some really cool ways to improve all the reasons why you currently hate Tech and data management.So, who is Steve and why him for this topic dr.Steve Joslyn is a specialist veteran e radiologist and also a total Tech Enthusiast who's dedicated his career to fixing what he sees, as one of the biggest yet, Insidious problems in the industry today.
The patient data disconnect keep listening to learn what that means with over two decades of experience Consulting for referral teaching and general practice hospitals, on four continents.Steve is highly regarded for his Radiology work on designing Imaging workflows and clinical 3D.
Printing services, among other groundbreaking projects, Steve's passion for technology and informatics laid him to co-chair a joint American and European Radiology committee.Exploring the role that AI has to play in Veterinary diagnostic.Aging.But at this current project very we Steve and his team are using blockchain technology to create a universal health record that locks patient data to an animal's existing microchip.
That's really Making Waves in the industry and revolutionizing the way that veteran data is collected and disseminated will explain how But Steve is not some Solace take point.He's flesh and Bone human with human challenges.So, of course, I pick at The Frayed edges of Steve's, you business to see what we can learn from him.
Steve tells us about his career Journey, including some great insights for someone, considering a residency and specifically a career in radiology and imaging, Steve also Shay's candidly, what he learned from his experience, living through a real-life full-blown, work-related breakdown episode.
So please enjoy what has to be the most eclectic.Of topics we've ever mixed together in a single episode here on the bed Rod.As we dive deep into the mind of this Innovative thinker and disruptor with dr.Steve Jocelyn?But before you jump in, and this isn't an ad and it isn't a sponsored section.
It's just a shout out for a very cool opportunity hosted by a good friend and a previous guest on the podcast.Dr. Jeannette castles back from episode 77.If you listen to that episode, you'll know that Jeanette is the founder and chair of vets for climate action.A charity that focuses on the The role that we as Reds can play in the fight against climate change and specifically around the impacts, that climate change will have on animal populations because, you know, animals are kind of our thing at the end of June Betts for climate action, are hosting an epic fundraising event, with a forward Day, hike at the leper Renta track.
Where the hell is that parental?You ask?Exactly.I say is no way.It's in the middle of this big great continent nearish to Alice Springs and it's Very far away from your everyday life.Fair enough to provide you with the whole New Perspective from where you'll be sleeping under a sky, vast enough to let your soul spread to its fullest extent and it's no Odie.
Love hiking trip challenging.Yes, but also a little bit luxurious with nice hotels.At either end a guide that hikes with you and comfy beds at the end of each day's hike.Think I've just convinced myself to go link as always in the show description.It's for a very good cause and it will be an amazing.
Being experienced so book it.Now even though the space out there is Limitless spaces on this trip.Are not okay, Steve AI breakdowns, career shift, let's go dr.
Steve Jocelyn welcome.Finally to the vid felt.No, I've been on a boat before.Just finally in this capacity.I mean, you've been on the of course the clinical.Okay.Yeah.Just a good point.So welcome to the what we call the Thrive, it felt when we talk about life and not about clinical staff.
That's right.Thank you for having me as a mom.Obviously, a big fan been pretty much your number one fan boy from the beginning.Well, you were literally, we were friends before we even started it.So you had to support it.Likes you or not.So, where shall We Begin?
We Shall We Begin?Did you know?It's the / L?The very famous psychology relationship psychologist, you got a very famous podcast and books books about infidelity and stuff like that podcast is called where shall?We Begin?Which I offered for a psychologist.To talk about relationship stuff often, Think We Shall?
We Begin.Sounds like you're in trouble.It sounds like she's saying yeah, this is gonna be uncomfortable, go and get the lube.Let's get stuck.Cancel my 1:00.I'm intrigued as to what question you're about to ask me.Then has not like this was not like that.
Let's start with the standard question, the bad decisions.If you see that sign, if you drive up, Sterling Highway and Perth on the left is a building that has these beautiful murals on.And at a stage there, Muriel was a big sign that said, bad decisions lead to good stories.
And I like that statement, and I often wonder is that, is that true?You bad decisions.These are good stories.And if you think it is, have you got an example for me?Yeah, I guess bad decisions always lead to stories.
That's that's fairly true.I think, I look at that as Did you get any good learnings out of it?But good stories.Oh man, I like there's so many bad decisions in life that I've made that.I wish I didn't.But yeah they always have a story.
I think if you're not remembering a bad decision that it was probably pretty boring.Yeah, right, yeah.Well we've got to find, what makes a good story?A good story, doesn't mean a happy story.Like some of the, some of the best movies out.There are not happy movies that but it's just them.It's a story, right?
Yeah, for sure, I guess like a lot of the work related bad decisions like you know us deciding a to go a certain direction and it ended up being a bad decision will ship.We learn something out of that that's that's super valuable but the life that decisions.
I mean, yeah, I was just talking to Ella but that question, that, that I knew that you were probably going to ask and it's Oh man, I like I can go through two or three bad decisions, the last couple of years and is their haunting, and I'm not necessarily sure if it's a, it's probably what you wanted to hear.
But like I don't know.Just the car accident I was in and I came down to just taking a shortcut and thinking that I could beat some traffic and that turned into a good couple of years of of pain and anguish that I wish I didn't take that shortcut, you know.
So yeah that's kind of a little bit more dark but in terms of like bad decisions, good stories there almost there almost a good decision then because the story itself will survive if I think about the like business-wise, yeah, bad decision was was quitting cold turkey or I guess quitting, a really good high paying job that allows me to work Beachside and Fremantle and starting a business.
Honest with complete naivety and complete wishful thinking and in the long run that's probably a good decision but at the time that would have been a really bad decision and I think recommend many people do that.So so let's recap that that story.
So put us in that time frame.What is the good job and what did you leave at 4?And then we're going to talk about the y-yeah.Sure that I mean the good job.I was coming back to to Fremantle to Perth in Australia and living five-minute walk to from the beach and a 10-minute walk to work past cafes in the morning and reading teleradiology cases from around the world from Brazil, Hong Kong the US the UK picking up the phone, talking to these people and finishing by sort of 3:00 4:00 in the afternoon, hitting the beach.
And maybe the pub on the way home like that, that was the absolute dream and the bad decision.Economically was giving that up and risking that.I think I have a bunch of privilege in terms of I can always go back to that sort of work, but that was not a calculated business decision or economic decision.
It was just an opportunity that I thought I wanted to take.And so it's, that is the dream job.And, and I think when I tell people, Opal that you can work it, the hours that you want, anywhere, you want and see the most amazing cases, all the time.That's, that's a dream job.
And yeah, the bad decision at the time was giving that up in hindsight.I think it was a great decision, so many places to go, well, let's do this double-click quickly on that dream job for people listening to this.We are talking to vets who make career decisions.
I seriously considered doing Imaging to in Radiology specialization because I pictured it to be that dream job.You know much more flexibility get less dog shit on you and anal gland.Is that a the main reason I didn't do it as I just didn't get the opportunity for a residency or anything like that.
At the time was was too hard and I'm too dumb so that's it wasn't kind of way but What am I a flawed in my thinking that it is that trip because from what you described we could show sounds like a pretty pretty damn good.Dream job.Well the downsides.Yeah, I mean just a couple things are you definitely not too dumb.
I think anybody listening, like it's not a matter of to Dom.It's just how much work you have to put into it.Okay.To Lazy than too lazy.Let's yeah.Or also your life circumstance.Makes it hard like you probably had a family.
Yeah.At the time, right?Yeah.So that's that just makes it super impossible.But yeah, the Dell, I mean, I guess the work to get to that.Dream job is not easy.It's not like, you know, watching Neighbors, when they take three episodes off and maybe come back as a doctor, or a teacher, sort of thing, right?
It's a look, it's a long journey and it's not easy, it's not easy to get a residency especially now it's not easy to get an internship.That Qualifies you for a residency or even sometimes you need a PhD to qualify for the residency.
That is the hardest part and I think that also reflects on what happened at vet school.The hardest part was getting into vet school and of course, vet school is hard and they've been, you know, might take a little while, but the first big hump was getting into that school.And during the residencies, you're on a student stipend.
So you're living very, very basically, you're working extreme out.Is late hours and from a radiology side, that's a lot better than what the poor surgeon.So the Medics or the emergency residents and it's all that is the definite I guess the downside or just the realities of getting there and then the downsides to that dream job.
I mean that was a very specific teleradiology role where you could work anywhere in the world provide the internet was great.But there's a downside of that is like if you're a social person you want to sit over coffees and Talk about cases or interesting things or and you don't get that like the the report comes in at most your interaction with that person is seeing their name on the request and they're frantic sort of urgency to get that report back.
Yeah and then you report it.You saying this is really cool.I'd love to know what you find.Please let me know and you don't hear anything at all and the next time you hear from them is another case.You don't know if that that was correct, you don't know how well that patient.Did you don't know if they're happy?
If you report, I think the fact that they come back to you, for more requests means that they're happy but you just don't it.It starts and stops right there with that report and that that's a little bit, I guess taxing.Yeah.But again, that's the downside to this great job where you can live and work anywhere.
There's stories of these Telly Radiologists that are living in Bali, or castles and Scotland and moving around the world because they can.So, you know, the company I was working for Or they sponsor and move Radiologists to Australia.And it's like, wow, you get to move to this beautiful place in retrospect for me because I like scanning.
I got like Altra sound but I thought I liked it because I liked ultrasound but I didn't I'd like that piece of the puzzle of solving a clinical case.But when I started digging deep with the radiologist to going learning, I was like, yeah I get annoyed with the level of detail and specificity that you have Have as an actual image isshin.
And then the same for radiology, it's a lot of in retrospect and now and doing what I do now where I sit at a desk staring at a screen quite a lot.I go, yeah, that sounds like a great idea.When you working 10-hour days on your feet, 12, hour days, and your feet.
And it's lots of people and noise and stress and problems.And the idea of sitting in a room by myself working in a quiet environment, sounded super appealing reality is actually not exactly right.He saying it can't we get really Lonesome almost and staring at a screed and high level of detail in typing out detailed reports actually doesn't suit my personality.
So what suits my personality is remote work when I want and and a good salary and works.But the actual work baby died.Yeah, there's three things there.You said, diagnostic images ssion.It's more diagnostic imaginer.I think rather than magician, but the The yeah, I think some of these companies recognize this as well and they'll recommend you have one day of clinical work.
So where you work for a university?One day, a week or referral hospital, and that provides a lot more balance, but also that the teller aetiology was so busy and they would take you 10 days a week if they could.And, wow, it's just not sustainable that way.
It's just exploding on the world is so much work.And also need for more radiologist despite all the tech that's coming but not enough training positions at universities because you know, a university clinician is going to work for a University stet salary but knowing that private practice or teleradiology is going to pay him two or three times the salary to sit in Bali and it's very hard to keep academic Radiologists institutions training.
And so now they're really looking at how we train radiologist.Like, do we need To be at the University.There's 100 million cases out there.Surely, a teleradiology center could support a new training, sort of schedule.Because what we look at, we can load that same case up exactly how the radiologist sees it for a resident, two years later, and then surgery and Medicine.
You kind of can't do that.Like it's very obviously Hands-On and case-by-case, physical experience doing that.So it's going to be interesting how they start training radiologist, next four years, but massive, And for it.It's a great job.I definitely recommend it to anybody said let's talk about and I stopped doing it.
Yeah we'll get to that.Don't you worry.But let's quickly talk about your journey.For somebody who is listening to this guy here.Yep.That sounds like me.I want to do that the process.And is you alluded to the idea that maybe a couple of years from now that it'll be a whole different process.
But for now, what did your journey look?Like, because I'll tell you part of the reason I didn't do it.I joked and said Said I was too damaged to lazy but exactly that I had a family.Eldest was about to start school.I had a community of friends around me that I liked living and my options were, there was one in Melbourne that I could have applied for.
I don't think I would have gotten it because I didn't have the PHD and the internship in Allah.I memberships, or I could've had an opportunity actually to potentially go do it back in South Africa, but at my life stage, I was Isn't moving countries and selling my home and doing all of that to go and do it.
So what did yours look like that?You have to move.What did you sacrifice to get to this point?Yeah, incredibly fortunate.Should I start back at that school?Because I think that radiology thing kind of it all started there.So it actually starts earlier.
I was really fascinated by physics in high school and that was really my bread-and-butter sort of classes that.So you've always been a nerd.Yeah.Yeah, definitely definitely.What's that left side of the brain person and yes, that's what's up.
Just makes sense to me numbers and that are not not trying to brag.It's just that the other side of it, the emotional intelligence or the creative side.Horrible instruments.No art, no, not at all.So, when I got to vet school and I was fascinated with medicine and it's either gonna be doctor or bad, but I saw event practice.
It was extremely, chill, and fun.And every time I went to the Seemed like the most serious place in the world, so that was really what got me to vet school at vet school.I didn't see any physics at all, really, until fourth year.And fifth year, when you start studying other fluid dynamics in the anesthesia or particle physics in radiology and that just instantly captivated me.
And I also had some pretty amazing radiologist at the time.So he had Vicki Johnson from pet-ct, she was teaching us at the time and we had Belinda Hopper and Zoe.Lee and they were super enthusiastic about that work and it was almost infectious.
And that's a kind of decided, that's exactly what I wanted to do yet.All of them said, hey, maybe go get some clinical experience because this is a big decision.You're kind of making your life on right now and so I thought that's a great idea.I'll go and do echoing practice for a couple years.
That was a horrible decision.Actually what the egg, white breakfast.I love that coin practice.Like it was so much fun.I was working Sunshine Coast at the racetrack practice there.I learned a bunch.You driving around seeing different properties, having lunch on the road or people make you lunch.
Sometimes that was amazing but then I'm like, cool.I want to do a radiology residency.Now, I'm just, you know, like neighbors of all head away for a couple months and come back as a radiologist.Why do they call it?The movies, cue the Montage to Tanana.So then I get to the UK and Oh my gift, Cooling and apply for some residencies.
And I remember speaking to Andrew Holloway at Animal Health dress, I went to visit there and he just flat-out told me and this I hated at the time, but it was probably some of the most helpful advice time.You said, you're never going to get a residency.And I was like, well, like that's pretty confronting I came here to visit and he's like, just think about this logically.
You're a net coin, practitioner with no small animal experience.Most, if not all the Radiology, programs are 90% small animal and we have 70 applicants every year and they've all done clinical experience and small animal internship and they were top of the class.
They're just saying.He's just like the odds are against him.I'm really sorry.And that was incredibly painful to hear but also incredibly helpful because I knew that I had to do something different and at the same time I kind of lost a little bit of my enthusiasm for realizing how hard this was going to work.
And I had the the metaphoric Kick up the backside by my wife who said, I think I came home and her sister and Locum work, and I just wasn't really.This is in the UK.We're living at Cambridge at the time.You know, I was kind of lumping on the couch between Locum job.
She says, what are we doing here?Let's go back home, or you get a residency, and that was kind of it and actually heard something similar at the RV.See, Paul Mahoney said the same thing.He's just like right now, there's again, 70 applicants for the Radiology residency.
Most of them are doing internships, you're going to need an internship, and it has to be a small animal internship and then I go, hey great equine vet going back to small animal, I'll just apply for the RVC internship and he said, you're not going to get that either.Like there's 120 applicants from all around the world who are top of their class and you know, they might have some small animal experience so you're not going to get it and oh my God Jesus.
So this is this, this montage is getting harder by the, but each Is that I go to.So at the time I was looking for internships and you know, there's referral hospital setting up and one of the referral hospitals, which Southern counties, vet specialist in Ringwood, they didn't have a start date.
They're like, we need to advertise, but we're not sure when we're going to start.And I said guys, I don't care when you start, just call me and I'll be there because I'm doing local market, doesn't matter and that was helpful for them because Have to plan an intern but also all the other interns couldn't wait that long.
I was one of the only interns at the start and they called me one day saying, hey, we're opening up on Monday.I'm like, I'll be there.And I became a small animal intern with no small animal experience at all.I was picking up 18, 16 gauge needles for a tiny little cat.
Like it was just it was a bit comical, but the nurses at scbs were really amazing and they also made fun of me a lot.I could just see Steve trotting, a cat in the backyard lounging it.See where the lameness has?
Tried it up, throw it up and it was neat.And during that time, they were setting up their Imaging workflow and their packs, how they manage all their medical imaging and they also have the MRI truck show up once a week, they had a CT scanner that they bought didn't know how to use.
So, I spent my evenings, you know, scanning my eye Phone or a microphone or my lunch and just working out how to use the CT scanner and that was about the time, I think Vicki came back to do some training and and she saw what we were doing there.
And, you know, after a year of that internship, I used that experience and Vicki's recommendation and start applying to Radiology.Residencies, and the ironic thing there is the One place I had.Never visited was the only place of gave me.
The job is because I hadn't made you your thing.Yeah, I think so.Like, we just did you go, where did you do your residency?University of Glasgow ask.Okay.And then once I was in The Residency, you know, you're kind of you're over that next threshold.
You know, you work hard, you'll get the diploma which was an instant but yeah that that was that stage.I've got to Circle back to sentence that you said before, that was painful, but it was helpful because it made me realize that I had to do something different and I like that a lot, I think maybe that's where my journey change because it was a lot of people.
Get stuck with, oh, that's really painful.I'm going to step away from that pain and do something else because I don't like that feeling.What was that?Something different to interview you guys decided I've got to chase their residency but I've kind of I thought you were kind of chasing them already.
What did you do differently to see what harder?I think.I think what ended up working was finding that internship because okay, all I needed was an internship, right, okay.And the I had to be a little bit more creative and flexible to get that internship.
Okay.So instead of sitting around moping going, or fact can't find a residency there.This sucks life is against me going.Well, this isn't going to work.If I really want this find the find the door.Yeah, yeah, exactly.
So that was three years in Glasgow and that was obviously an amazing time.I think Glasgow became our second home.Like we would happily live in Glasgow or person Australia like two opposite ends of really every Spectrum But ultimately I didn't pass.
The board exams the first time and I was very jaded and, you know, see, it's everybody else's fault, but mine and not that, that's true.It's just like at the time, very, very pissed off.And then my first job, as a radiologist was at University of Illinois.
I took that obsolete as a nun, boarded residency, trained radiologist.And when I got to Illinois, that was a absolutely eye-opening in terms of the, I guess that how how busy that hospital in the middle of nowhere is and the training program itself and the the caliber of the residents leading up through the years.
It was just, I learned so much from my senior resident who I'm supposed to be supervising.I learned more from them than I did in my entire presidency and ultimately, you know, with the help of my box as well.I went back and rewrote the next year.
And I felt like it was a totally different story.It was an easy exam.Ali.I felt confident and I knew the process.And yeah, very grateful for that time and Elena.Two-minute Interruption to plug a clinical podcasts.
Steve talks here about being in an environment where he was surrounded by smart talented enthusiastic people and how that made something that was impossible before almost effortless.This reminds me of a truism that I like you are the average of The Five People You spend most of your time with the problem is that when it comes to your vet work, unless you work in a large weight Institute, you don't get much say in this.
So what we try to do with our clinical podcast series is to give you the opportunity to spend a bit of time, 3 times 20 minutes every week to be more exact with some of the smartest and most enthusiastic fits you could possibly hope to find and I want to guarantee that by hanging out with our guest specialist every week that those smarts will rub off on you.
It's almost like a diffusion, gradient way high levels of information permeates through your eardrums into an area of low information.Not saying that your brain is an area of low.Information or anything but you get what I'm saying and then before, you know it those hard things become almost easy as Steve puts it.
And when work is easy, work is fun.And when work is fun, you're happier.Try it for free for two weeks at VV.N dot.Super cast.com.All right.Left turn so your specialist, you qualify as a specialist, you get a job as a specialist radiologist.
You live the dream live in.Adil knocking off at 4:00 in the afternoon and going to the beach and then you decide to throw it all the way.What for?And why?Yeah, it was.Alright, so a few things came together at the same time.
I was obviously enjoying the work, but I wasn't necessarily enjoying the job and really, you know, the company I was working for had this office in wa, but we were incredibly busy, there are so many cases to look at, but when I was hired, part of my role was to convene, doing extra sort of reporting activities, you know, liaising with research studies from universities, almost being sort of a customer success and RD Outreach sort of role as well, and it really to build the business case, but we're so busy that there was a lot of pressures to keep reporting and I was kind of being pulled between the global office in the Australian off.
And that just, they really started to weigh down on me and I burnt out, and I remember having a little bit of a thinking, nervous breakdown, or a not nervous breakdown, a anxiety attack.And, and that was really reflecting my subconscious feeling towards that work environment.
And I took a bunch of time off.And at the same time over the those sort of few years, I was really thinking about some of these issues that We have in veterinary medicine and human medicine to illness just around medical data.
And I felt that there's a lot of things that frustrated me and the work that I did as a radiologist and all my friends as vets.And I was just like, why is this not being solved?And we looked at going digital.
I mean you were probably working when clinics were transitioning from Sir paper folder records in File cabinets.Why did we offended by that comment?But yes, you're right.No, I was too like I was too.There's still a lot of clinics that were paper based at the time and and you know, a very organized cabinet system with all the different color numbers on the files.
Like that was a bit of a pride into how organizes clinks word that we were promised that the world going digital and practice software was going to solve all these problems.Things would connect information Nation will be their systems would be efficient and automated.
And you know, 20 years later, I'm still looking at the, you know, the University of Glasgow is admin department and their crunching through printed pieces of paper and faxes, and typing out forms on to some other computer.And I just thought this is crazy.And then working in Radiology, I get sent an x-ray of a dog from London and they sent it yesterday, but it's on my list, too.
Or the next day and I'm looking at it and then the history pops up next to it as a PDF and looking at us, like wait a second, the history says this is a cat but what I'm looking at is very much a dog and I'm like, they have the same name there's from the same Clinic that, you know, they were seen roughly about the same time.
And also how is this happening that I'm looking at the wrong history for this patient and it's kind of getting contrasted at the same time with the medical imaging so that x-ray pops up.It's A.com file, I can see exactly what time which Clinic which firmware on the X-ray machine is being used to create that image so I can see all this metadata that tells me so much about that Imaging study, even like the the KV and Mas setting, sometimes I can see that from from Perth.
And at the, at the same time, I'm looking at the wrong history for the patient.That's not.How are these two worlds coexisting and why is the medical data?Not perfect?Like, why can I not see?Exactly where that animal was before.All of its previous Imaging studies, like why is this not possible?
Technically, it probably is possible.What?Why are we not there?And I started thinking about a few Solutions, especially some tech that was come on the scenes, the last couple of years.And I thought this probably a better way to do this.Let me take that quick, neighbors Montage, moment and build a new system.
And, and at the time, so, So, obviously, I'm quite stressed with the job that hasn't turned into what I wanted it to be and seeing this problem and seeing some solutions that aren't being utilized.
I thought, you know, I probably should look at this and my wife said, there's a start-up weekend competition here in Perth is like, why don't you go and Pitch the idea and and into the competition.And so that was super, can I just say that your wife sounds amazing?She keeps pushing the right buttons that there.
Right?I know she does she does and she's probably can hear me talking about it now.But no, she's amazing and you know exactly why pushing at the right time and took a bit of a leap of faith and ended up finding some interesting people to join my startup team on that weekend and we won that startup competition.
So I hang on, I want to recap some of this story's interesting sentence.Again I was enjoying the work but I wasn't enjoying the job.I feel like that's a common thing, I think if you like there's a lot of people who go actually don't like being a vet.
But it's not necessarily the work.It's the job, you agree.Yeah, yeah.And that was pretty relevant to the work related, stress that I experienced and speaking to a clean psych afterwards, especially as I had.
That sort of work-related stress event, they explained to me, is that something in my body?In my physiology is not happy with that work environment and it goes in different scales.So you You can feel this stress just in that office doing the job that you love and to fix it, you just move to another office or get away from the stress and might be a person and might be a, you know, like cats and might be the construction across the street.
Most of the time, it's probably a personality difference with somebody else.But then if he don't catch it in time, the work-related stress sort of starts to engulf the job with that company and then If you don't catch it in time again, it starts to involve and engulf the job that you do, regardless of the company and then eventually it'll golf the the industry that you're in.
So I caught it at a stage of, you know this is not a right fit for me within this job in this environment.But today I can still read cases.I love it.So like I love the actual work, I just I did catch it in time.
That's really fascinating.So one component of unpleasant emotions, strong unpleasant emotions tied with one thing.With in a situation can start spilling over and tainting everything that your mind Associates with that environment.Yeah.
So I had like a anxiety attack walking to the office and it was my I just didn't want to be in that office and it was very hard to explain at the time.And I've always heard about people with Work-related stress before and I just thought, you know, it in my naive mind and I was like, come on hard up like it's you know go for a walk like all this sort of stupid shit that probably probably Boomers say but I think experiencing it really opened my mind and there was nothing I could do to make that journey and easier or exist in that office.
And I remember going to see a doc right away because I thought I was, you know, I thought I was having a heart attack and when they said this is work-related stress.You got Weeks off mate, I'm signing you off for two weeks and the nice thing about that is that it instantly lifted.
Like as in I felt instantly better knowing I don't have to go back to that office for for two weeks.Was almost a perfect example of that.That is the problem and we got rid of the problem and now you feel better and it made me think a little bit the time.
What do I do?What do I need to change here like it?Do I need two different office different company.Different job.And that that was was playing up my head.But at the same time I took a plunge with this startup idea.So just to liturgist in that, in that two-week period, that you started hatching this, It was the Saturday after that Thursday.
I think it was two days later we started thinking hey this wow, isn't it incredible your mind just needs a bit of Brie breathing space.Yeah I was thinking about a lot of the solution to a problem that I know everybody experiences and it was just that the timing worked out well and forced me really to think about a lot of aspects like this this startup competition forces you to think about business and business plans.
And An Amex and business models.It's just it was really neat to experience and totally foreign but it was enough of a mental break as well.And I came back from that two weeks and said, don't think this is right from it.I'm going to resign and take some time off.
And during that time off, I was going to focus on this.So that was, it was just, it was amazing, sort of Coincidence of timing.Especially with the fact that, you know, they haven't run one of those weekends.In Perth for a while.So it happened to be the one year that I was walking on my way to work, having a panic attack.
Now, let's talk about Jewel, the problem that you're trying to solve.So it's a data management problem.And it's when you were describing that feeling that you got with this excellent technology, but it's not quite there and it's such a strong emotion for me, because I get that so often with so much.
Take you go, just a supposed to be so good.But there's just something missing that infuriates me and I want to do, you always do what I say.Well I just wonder friggin card system because it's not going to crash something about.Hang, it's not gonna because it actually worked better actually caused me less stress that took us acknowledge is amazing when it's not working.
It's freaking space.Not working for sure.Yeah.Or the promises that was given the way something is going to work and it doesn't.So yeah, the problem that were solving is all around.Veterinary Medical Data and it's interesting because everybody knows how bad it is.
You can they all say a bunch of things and everybody I think here will agree it's just that nobody has time to really sit down and assess it.Nobody has time to acknowledge it and instead with the way that the veterinary world is Nurses and vets and receptionist.
And, you know, admin people were so busy that we don't have time to go home whenever there's a better way.I want to thank you can do some things like, no, I wasn't going to disagree.You could you say, everybody registry data?Everybody knows it's so bad.And I want to disagree and go.I know that we do because we just, you used to it being this way, and that's the way you sir.
So, why give me examples if you say, you've given the example of Radiologists to get reports?That's not most of us.So, in every day, veteran, life, why is it bad?What's bad, or what could it look like?Yeah, sure.So I mean we'll go through some examples in emergency clinic the Animal arrives.
It's a six year old dog.And you have no information whatsoever on that animal.Except from what you can get from the Frantic owner, the, which is always amazing.It is amazing.Is it on any medications?Yeah.Yeah.It's some tablets or, I think it's, it's pink.I think it's for his incontinence, but maybe it's for his heart like, yeah, that helps helps a lot.
And, you know, like these animals were seen by their vet two hours before that they had blood tests, they Had everything but this is not available.And so that's one example.And even if it is available, say that they do have access to the history or that's printed out or maybe they have it, it's full of mistakes as well because like, you know, we are human and we're typing in information and we're typing it in with errors.
I'll just skip forward a little bit when we look at a practice and there the medical data, 60% of the medical records have mistakes even in with the patient identifiers.So so, if the husband brings in a cat in say March, The wife brings it in an April.
There's two different records for that, and we'll, because it came in with two different people.And now, we have this splitting of, and its name is probably spelled differently.It's spelled differently.Yeah.Or they put in the microchip 11 year and they forgot one of those zeros, we have like a story of the husband brings it in for vaccination.
In March, the wife, brings it in an August.And the vet goes this this cat hasn't been vaccinated in like four years.Is like, I tell the Buddy husband, every time he goes to the vet clinic every time and he always forgets poor, the poor cats been vaccinated eight times in two years, right?
So and he's doing his job, but he can't remember is I swear to God, they got vaccinated so it's just stuff like that.And or like you look at how many times you're filling out forms or calling hospitals for like, hey, we've just got fluffy here.That's moved from Adelaide.
Can you send the history?They're busy because we got a normal job to do.It's just when you think about what you're asking for and what is available or two different things but we don't have time to think about it.It's the status quo.It's just that it's quite as archaic.
It's an archaic way and we have lots of different software that doesn't talk.And if it does it doesn't map very well.I think if you look back and say you know we should probably redesign this better That's sort of the approach I took and I thought, you know, I didn't think it was going to be easy or simple, but it's definitely a better way to do this.
And that's sort of where we've come to with what we created with Betty and see what we're solving.So, to boil it down, very simply, we figured out a way to lock the patient's medical data to its existing microchip.So the microchip that's always their American listeners.
Might they do with microchips.All the But it's just not as prevalent in the US but in the UK and most of Europe in Australia, it's a mandatory requirement for cats and dogs, have a microchip.So we thought, if we could tie all the medical data to that microchip, wherever that animal goes scanning, that microchip would open up access to this information, but we kind of left with another problem there, it's like cool.
You could put a million different pieces of information in there, that it doesn't really matter to the end user and less, they can trust implicitly that that information.Correct.Because if it's wrong and full of these mistakes and these duplicates and the wrong patient, got the wrong blood results, then they're left at the start again and they have to repeat everything and now they've gone through all this process and it's not and helpful.
So, the other part of what we do is make sure that every piece of data, getting associate to that microchip and locked to.That patient is not only true and accurate, but verifiable by the person Downstream.And what I mean by that is that the person And that's dealing with that information.
When they scan that microchip can see exactly when that data was made by who and allows them the confidence, just move on.So the example that would be Hendra virus in Australia, so I'm sure most listeners know about Hendra virus, especially you where you are.
It is a viral disease.It goes from bats to horses, and then horses humans can catch up on horses and can die.Yeah.So 50% mortality rate, right?So when we're talking about trust and integrity and vaccines certificates, nothing's more important than a 50% mortality rate now, right now, before us the way that the vets It would certify.
This is that they would write down that microchip number and because the human this mistakes that would go on to a registry and sometimes it's CSV up loads of horses from a paddock.Nobody knows a two horses left, three days ago, and they weren't vaccinated and two more came during that time, but they haven't been updated on the list but the registry says that they're vaccinated.
And so I think for something that's got such a massive biosecurity and zoonotic risk.That's not a Great stain.That's just the far extreme.So we came in and said, hey the Vets, can this microchip and we have absolute proof that it was done here in the hinterland of the Gold Coast at this time of this place and this microchips can, but they also scanned the vaccine vial, and there's a GPS location with that image and time-stamped event with the cert that the vet has done on their device at that time location.
And then we also use nerdy Tech and I don't want to get too nerdy because it is but you also use a blockchain timestamp.And what that does is it says that this information in terms of this horse was here at this time with this vaccine vial and this vet, it gets packaged up and locked at that time.
So when somebody else two years later or one year later scans that microchip, they know with absolute mathematical certainty that their friend, the vet was there two years ago, vaccinating that animal and so you know we've got images of grotty Will's holding 100 vaccine with the GPS location and so it's just provides automated certainty of an event happening.
And none of that required somebody to enter a microchip number or write soda piece of paper.All they had to do is scan, the microchip is, can the vaccine while we do the rest, that means that.Now we have oversight into a vaccinated population or we can see which batch numbers are going to which animals is so much more that's activated when you have clean verify.
Isabel automated data, it almost changes the world.And that's sort of the the thought process behind we're doing and I don't want to get too into the woods about that, but we Supply that to everything else we do in the Small Animal Clinic will save the Vets time because it's removing the human entry and the errors associated with that.
But we're giving the downstream vets are owners something that they don't need to question it automatically plugs into the system.So I guess Clinical Pathology is another one.The Vets can the my Chip and they scan a blood tube with the barcode on it.We marry the two.All have to do is choose the test and now there's traceability of that blood tube to the lab.
It's compatible with the sushi trains of analyzers at the lab and the results come back.We time stamp those.So it's just like everything's automated and we know everything about that animal from a scan of a microchip.You know, who owns the animal, what sort of breed age everything there?
We know the vet that came from.We're not going to ask them to fill out a form.We know all that information on the form.So we just say, hey what test do you want to do?And give us some history if you want.But now we're going to attract the sample which belongs to this exact animal and the lab has all the data they need and then the results come back we lock that to the microchip as well.
So that if that animal goes to, The Artsy Center at 3:00 in the morning scanning that microchip will show the last Blood results or the last 10 and all of it was done instantly without all this data entry that It's we're at a good spot there, like, makes me very happy because that, would you say, they, we already have all the days I often, especially with us, with human stuff with them government things, or texts, or hospitals, or things like that and you fill in the same information, everyone always it.
And I'm like, but you already know this, I guarantee you that if I commit a crime you're going to find that information about 3 seconds.But but now you put the onus on me to provide it again and again and again.It sounded.So this basically says yeah.We know that we know these things about you and area and and everything new.
We learn about you, we're going to keep it in one place.So the next time somebody wants to know it, they could scan your microchip.We go.Yep, here's what we know.Let me add some mortality and there's an aspect.There is like we're not just passing this information out willy-nilly.We're basically saying prove to us that you're a vet and when you scan this information, the previous vets want you to have this.
So you know, we're not saying go to the dog park and scan all these dogs and get their Details and give them 50% off.They know, they have to one prove that they are the attending vet and the vet that manages that owner.But at the same time, we're going to tell anybody.
Hey, this animal is vaccinated for rabies or canine, influenza or Hendra, like that's information that every vet wants every other vet to know or any animal health worker.So that's, yeah.And going back to it, your question about like to the vets know this.
I think the Vets know the problem because exactly, right. like they are frustrated writing out, something again that they know is saved on their practice software or in like if you think about it like yeah, sure like there's some amazing practice software out there They handle a lot of things but the service providers still want you to fill out a form?
They still want you to like.And the reason they do that is that the service providers, can't trust the data that comes from the practice software.It's full of mistakes, they don't know when it is a mistake or not.So they say, you know what, screw that, let the vet, fill it out again properly, and that way we can ignore the burden of data Integrity back on the vet before they submit this form, otherwise we're just be chaos.
So we're kind of That perfect balance there of we know everything about this animal has been its owner from the start.That's not ask the vet for the same questions again.Let's just plug them into the next service that wants to use that provable verifiable data.
And that's it's a it almost in hindsight a lot of people saying, this is, why wasn't this done at the start and, you know, practice software in the vet World practice software became both the health record and the billing and the Drilling and the appointments and the stock and everything.
And now they're starting to realize that, that animal goes between different Services all the time.Either.It's data does or it actually visits a referral and emergency the GP Hospital down south on holiday or it moves to a delay, like the healthy.Don't really does kennels.
Yep.There's a lot of people that need to see that that Health Data but the practice software while under locks it up and just that service and they're not doing this.But let's It's just, they offered a service of how to do clinical notes, but we're offering is a universal health record, that allows that to go with the animal and go with where the Vets want that data to go.
That's where we come in.We are not becoming a practice software at all.We're just becoming that health record.That's going to bridge between all of them.One thing I just need to point out and I know this and that's why I think it's important to mention.So it's not.
It's not like you have some magical, special microchip.It receives all the information and stores information on the microchip.Right?That's not what your normal everyday microchip.It's not the vid I microchip that.That is very special.No, it definitely wouldn't work if we had to reintroduce a new microchip.
So you know it's the existing microchips that are there.And what we do here is that we use it as a lock and key.If that animal was there and the vet scans it proving to us that animals they're like they can't type this number and they have to scan it.That unlocks the world of which that Status store, I guess the way to explain this, they've unlocked access to the animals data.
That might be stored in the cloud and they've done so by scanning that microchip.And then, obviously, the ability to add information to.It gets locked again, when an animal leaves and just having that time-stamped verification of they can say, well, I can see exactly when that PDF is made.
So think about the rabies certificates in the UK or in Australia.Right now, you have a vet that nobody knows during a vaccine certificate for rabies and they scribble their signature and when it's due next and put that sticker, that's already smudging on the card.
And they say to the owner, keep this with the dog and the microchip sticker in there, too.So we'll look at that.Then it goes to a, like, sort of a district government vet who gives it a stamp of approval.And then it goes to the exporting vet and maybe the logistics vet makes down checking the documents and then it arrives on the doorstep and Australia are UK.
And that's the first time that they know about this happening and they have to trust the Integrity of the first vet clinic or so, the first event and the district vets that they've signed and checked.All these details as actually happened.What we're saying is that let's put the importing Authority or the, you know, the people that need to see that this animals vaccinated, let's put them into the console room at the start.
We're going to show them the image that was used the proof of the microchips can.So we know the animal was There we know the vet that was there because they're using the app to scan all this information and we time-stamped it so that this couldn't occur at any other time.
And we showing that the certificate as a digital timestamp as well.So that when they see it when it arrives in Australia and the UK they know that it's not a forged document.It's you know it's true and verifiable back to that date.I just want to encapsulated one more time just doing this to make sure I understand what this does.
So tell me if this picture that I've got in my head so all the patient data you said data or data I got data but I've got the Canadian accent so I prefer data just like I sound like I'm fake when I say that this a video video.
It's very but it started in terms of its name idea, came from sort of the Jedi, the force, the force being everywhere.I thought that I but Buddy sort of changed it to vent because it sounded more midi like me life.I love that the force.
So basically, the data is in the force, in The Ether, in the cloud it's they're available at access points where anybody might want access to that patient's data.So that's at the vet clinic at the emergency clinic at the kennels at State, Vet that needs to verify anything, but I can't get it.
Until the key comes into physical proximity to be and the key.Under the skin of that animal, in the form of a 16 digit code, the animal comes and it says, scan it with your magical scan and now the doors open and I can see what's there, and I can add to it.
And then we're done the doors shut.And that dried, that's almost 100%.I'd say that there's still aspects of the animals data that will travel without the animal.So like medical images will go without the animal and, you know, results and certificates but But that's the premise is that to be able to access and add in work.
Interact with this high-quality medical record.They have to prove the animals there that affords.All these automations.Yeah.And obviously we're not complete with the medical history yet.We're building strategically and logically.Like we started with the vaccination certificate because that was the point of entry that we thought we could deliver and we looked at Insurance claim forms or Council registrations but There's a 53% chance of the animal walks into that GP clinic for vaccination or vaccinations can be done during that consult and the owners were leaving with a paper certificate that you know, by the time they walked out the door they've lost it and then they're calling a Christmas saying, hey can I have a certificate?
I'm going to the kennels or and so we just said, you know, let's lock that the microchip.If it goes to the kennels, they can scan the microchip and see it and we solved something instantly for the owner and we also solve something.For the front of house staff.The receptionist we've solved it for the vet and we had to say, all right, so they like it, let's just make sure that this is super instant.
So the Vets, all they have to do is scan the vaccine vial and we'll pull everything else up.That was the first step.And once we were in with vaccinations in, that was paperless version of this, you know, we still have emailed certificates, but still, this is far more valuable and stays with the animal for life.
But a very quickly we have to build upon On this.And so the next logical place for us to go is clinical pathology with reference labs and so we built that system and now we're on to our fourth or fifth system that's in development now.So we're you know, emergency check in and access and referral triaging.
So, you know, that wants to send this for a referral instead of filling out web forms for five different referral hospitals.We can automate all that, right?So we have an end-of-life module which works with the crematorium Here.So we have the largest death.
Registry.I mean, how many times does a receptionist fielded a phone?Call from a, an owner that said you've sent me a vaccine reminder for my animal that you put to sleep last week and it's like, oh my God, I'm so sorry, it's horrible.But it happens and it happens because information is not being available or being used properly and it's a tedious process to keep on top of this.
So if we see that animal is deceased, we will broadcast that out to all the clinics that I've scanned it before.So Hey mrs.Johnson's just lost her dog.Don't send her a vaccine reminder, you know, set it up as a deceased animal, that's the sort of a more going in.
We're building upon that all the time.If we started this conversation with that reference to KY to lube, this is it.You kind of have it is kind of the KY for moving data around.Right makes accessing data frictionless and pain free.
Yeah, I think the what I've learned is that business stuff that we're never taught about school is incredibly hard and my good ideas.I think, you know, coming from an academic background.I publish a paper, it's got a p-value of whatever there for the rest of the radiologist start doing this thing.
And it sort of permeates through how we teach residents that doesn't happen in business.I like hey, I got this thing that saves us time and does all this.I was like cool and you expect everybody to blow and go?Thank God, we could waive it.Go take out money, definitely doesn't work like that.
So what else?What else did you learn?Because that's a hell of a long way from Reading x-rays.It's been a journey that let's make it applicable for a veterinarian sake.What have you learned in this journey?That let's say you get sick of this or it doesn't work or something and you have to go back to gpv practice and if you learned over the last five myself at myself, as GPU has to go back to work, And as a vet, I feel bad for all the nurses and the animals that have to just be subjected to that.
I think I've really enjoyed not knowing a solution and trying to figure it out and trying to it's a challenge for us because we're the first to do what were claiming and trying to do here but that just means that we have to forge our own path.
I guess we come up with issues all the time.And the team and myself, we actually really enjoy trying to figure out and spending our time going down rabbit holes with some tech that might be fruitful of the end might not, I think that is been fun.
It's almost like puzzle-solving.I guess it's like working up a case, you don't know what the answer is going to be.What else have I learned?I've kind of learned that to accept no and even criticism, like a lot of people have said, what we're doing is crazy or Critiquing and giving negative feedback and why they don't want to use it or why they stopped using it like that, that really hurt at the start, but now, I love it.
I love the negative feedback.I love the annoyance, web something that's not working, because at least I'm hearing about it, and I'm hearing about it.Therefore, it gets fixed and we can address it.And that was the learning for me.Like, you know, the criticism before this.I didn't handle very well.
So, how did you make that shift?Because I again, I'm trying to apply this to, to my life.If and listeners lives.So the complaint though, the case that doesn't go well.How do you make that shift from taking it personally to going?Well, maybe there's something to that.
What can I do for ya?It's a little bit.Maybe there's some similarities there, but it's different because it's business.Like the the group is just saying, we don't get this or we don't want to use this or it didn't work.And for me, it was almost like an attack on my life and passion putting into this business or this technology and my Business partner.
Ross is very good.It's like, they just gave you free criticism or free advice or free things that you can solve.That is super valuable the telling you why it's not working.So let's make it work and that was it but I guess going back to the bad cases that have happened.And you know, I've definitely been involved with something that where I was completely wrong and maybe had a negative outcome with that.
Patient that stuff.And I think really what made that manageable is that We were doing our absolute best at the time, with information at hand, and that information on hand might be somewhat inexperienced information.
Like maybe I've had a wrong call or still do but that's all I had at the time and as long as I'm not being malicious or irresponsible, and I'm trying my best and I'm documenting how well I'm trying then it's it feels horrible when it happens, but that's part of I guess.
Is being a vet and you know if you get pulled up in front of the board but you've done everything, you can to document why you've made a decision and what brought you there, then you've done everything that you can.They're not going to find you at fault.The other side to it as well as I've been part of Institutions that have had put Pride into their morbidity and mortality rounds and I think I don't know how often I've seen that in general practice, but it basically is a chance for someone to say this case, screwed up, I was involved with it.
This is why I did that and I'm opening it up to the floor to tell me where I went wrong and people that aren't part of that case, get to hear and learn and people that are part of the case, get to learn as well and the experience.Let's get to say, this is what I think's happened.This is how you can learn and that is really tough because I remember you're standing up presenting to your peers, you know, at this stage here, like, hey, everybody look at my pipes and also, because like everybody is high Achievers, and they've never failed an exam before their lives.
Like they're looked at by the students as these amazing people that are following a training path.And also new sitting up there going, I screwed up Up and I'm telling the world and or I have to tell the world because my week to do Eminem rounds, that was amazing.And I think if there's if there are general practice hospitals, that do that, I think that would be really neat to see.
I've worried that some of these cases are sort of swept under the rug if the owner and the old apologies but nobody wants to talk about it, it's fine to have because we I have often thought this, and it's happened to me.And at the time you think you appreciate it but when something goes wrong and you approach colleagues support of colleagues and Friends within the kind of a community about and saying ah and this case I did this and this and offer the responses are look, don't worry about it, you did great.
You're trying to base which is lovely, you need that support, but then it's left at that instead of saying, but let's look at what you do.Back off, and it'll be like, it's not your fault, it's not your fault and then we all go.Alright, my friends all said, I'm off the hook and let's move on to the next thing and then you don't learn from it.
And where is he sending?I'm not asking for reassurance that I'm not a bad person and I'm not a bad person, but in this instant, I wasn't the best at my job that I could be.Why not this?Look at.Why?Not?Because I don't want to do the same next time.Yeah, I remember the other side to that as well as the humility and honesty from the people that are passing their constructive criticism or their constructive judgment.
That is super important because a lot of times it might be the young vets that are eager to learn how they can be better but maybe the older vets don't have too much pride to acknowledge when they are wrong.And so the Eminem rounds that I think worked in back in Glasgow I remembered the Anita's was the first one to go and I think he was highlighting a case that, you know, this God of an anesthesia screwed up and, you know, wasn't as simple as that, but it was just enough to see that, like, you know, we're all human and they've taken the first step to kind of show where something's gone wrong and where they went wrong, and what they've done and learned since then and that, that open up the door.
I think, for some really interesting honesty and it's one of my pet peeves, is Eminence based medicine and evidence based medicine.Like I remember a case and it was being worked up a few different times in the history.Was suggesting an ectopic ureter and I'm looking at him.
I don't see this as a topic.They didn't fit with an ectopic ureter and the suggestions that came back when I ran it up, the flagpole was just not definitely a topic because this person said it was and I are the eminent specialist on this and that was so frustrated because I'd come up with these reasons why I don't think it was there was just batten down as know he's the expert.
So we go with the expert.And that's that was a little bit disheartening, I think.So I'll of obviously the honesty that comes with that there's there's an interesting not to plug somebody else's podcast, but Toby trembles got a podcast interviewing.
I think I think her last name is Milne or she talks about Eminence and evidence-based medicine practice and that's a really good besides all the vet V podcast which are We're here in a phenomenal.That's another very interesting one on evidence-based practice.Cool.
Listen, I didn't cut that bit out so no mention.Of course, this is why we're here for.We had to learn.Not to grow the penalty.Hey, I want to ask you if you got time.Has your time going?
Well, I've got loads of time.Yeah, go.Yeah, so you're into take, obviously, for your business.You have to keep your finger on the pulse of what's new and What's happening?In fact, related to take the anything else out there that excites you, or that you're into or that you're curious about.
Yeah, I guess the vet specific stuff and it's probably a lot on a lot of people's minds is AI.Artificial intelligence and machine learning.Hmm.I really love that aspect.And I'm involved with the education and awareness piece with the European College in the American college, sort of introducing best practice and caveats to AI.
It took about a I I see, there's a lot of chat, huh?Chad, Chad Deputy the the AI?What do you call them?That you can write that you could give a prompt and it write something.And I've seen actually seen on some of the VIPs social media chatter, that some people actually using it for various trees to help them write history since no, you found utility for it.
So let's quick rundown for anybody who hasn't come across that yet.Give us a quick rundown of what this stuff is.So I stopped broader or jump into the chat.Gbto.Let's start brought.Yeah, sure.So the easy thing here is that AI machine learning is just statistics and I'll give its statistics and rehashing an algorithm based on an outcome that happened before that's training.
So the training something, to recognize a cow in a paddock, if you give it one picture, it's not going to know how to look at that.Cow when its head on.And so you got to train it with lots.Information and tell it.This is a cat.This is a cow.This is how this is not a cow and that's sort of it.
It's statistics and modeling and classifiers that it getting better with more and more information, the information.If you're giving it poor lead standard information then it's going to learn off of that.So the information that you used to train, AI has to be absolute gold standard, what you can at the time.
So if we fast-forward chat GPT, as, where they have, Rained this language model based off of a of tons and tons of data on the internet.In terms of how people are speaking, how things are being written, you know, they have the full works of Shakespeare, they have all the lyrics, every song they have all the encyclopedias, the PHD papers that might be publicly available.
They have everything and they've trained this language model to respond in a way that feels like you're talking to a person on a chat page and So if you ask it saying listen can you write me the lyrics of my favorite song which is called called Team Spirit by Nirvana?
But do it in the style of Shakespeare it will rehash that entire thing in the style Shakespeare and it will be a brilliantly accurate in terms of like you'll be wow blown away.If you ask the English professor in Oxford about this the standard of that Shakespearean poem they would be horrified and they might say this is lazy.
This is crap but For what it's doing is pretty amazing.Can I quickly just what's up?What was your favorite Nirvana song?Did you say?Because I want to do that exercise.Thank you.So Smells Like Teen Spirit, like smells like this Vernon Runner verily.I bring a song of youthful disdain of rebellion against the ways of old, engane a Battle Cry.
A call to Arms in spirit form against the dullness that dot, our youth deform and I think skipping forward to loading up some Biochemistry and hematology results and some clinical signs into chat.Gbt and saying, give me a list of differentials.
It will do an amazing job, but you won't know when it's screwed up and I tested this the other day, I wrote in my Radiology report and just said, I'm interested to see what the differentials it would come from here and it got a couple it suggested one I hadn't thought of.
But I'm still not sure if that's applicable but it got some completely wrong.And I think what it's done, there's it's made an association between a common disease and a common Imaging feature, but it hasn't recognized that I might have the opposite Imaging feature or whatever and it's grouped those associations and put it into a nice, spit out of text and to the untrained eye.
You would potentially copy and paste that into report and that would be absolutely detrimental.So I would say that it's useful for bulking up some processes.And some text, but it does need some critical thinking and assessment before, use that to anything and I would, you know, very much be interested in what some Medics and oncologists a with some of this stuff as well.
Just because I reckon they would see major flaws in.It doesn't mean that it will be perfect in 10 years time.It might be absolutely perfect.But right now it's a mash-up of language that it thinks is appropriate for what your clinical cases in front of you the way.
Way.We're using it.In our business is a lot less riskier.So we have a new webpage or a new app interface that comes up, and we need a style guide adapted for that page.And instead of going through line by line, we asked chat GPT to rehash the style guide for this page and it'll do 99% of it and it might screw up for B but you got to fix for B and you get to see it but load it explain what you're in my style guide like what sort of prom so The developers will make a app interface do a certain function but they're not necessarily creative so it doesn't look great.
It does what it needs to do.But it requires a designer or ux designer to make the buttons around it, to make them, you know, haptic feedback.When you click on it, the thing vibrates like all that stuff is part of the user experience and that's the color.
The pixel size, the font what chat GPT can take the style guide from the ER and apply it to this set of interfaces in a faster way than somebody actually coding it up and adding this pixel this rounded Edge and that takes away a bunch of the effort but still need somebody to check the end of it and that's a risk of very low risk of patient outcome, right?
But it's super helpful, I used it recently so I do a lot of are table and Excel stuff and I was like, I need a formula.That's going to extract this patient named.It's always after It's always before this.But it could be somewhere in this big line of text and I said exactly that what I've just said to chat TPT and it created this are table formula.
This Excel formula perfect.Like it was just put your field here and then I copied it into Excel and it worked perfectly.It was exactly what I needed.Yeah, so if you think about stuff like that it's amazing using it as a tool to augment and challenge what you've decided is good.
I would still choose Challenge it.So yeah, it was actually interesting.Somebody wrote some history for a dog with Horner's syndrome and it didn't quite fit in my head and I was like, wait a second.This should be a left side of leisure.Not right side of the Asian.And I asked chat GPT and I said, I just copied the clinical signs in there and I said, hey give me some neural localizations for this and it also got it.
What I thought was wrong and it was the same size as that.And then I said shouldn't I just asked, shouldn't that be the left side and it I said check GPT those I'm so sorry you're right.If this is a lot of yeah the other thing you can do with that is you can load up actually this is a bit of a admission of not cheating so I recently posted a LinkedIn post on the vet radiology and ultrasounds new issue on AI and machine learning and Radiology, I loaded up chatbot with the a cvrs position statement.
The committee that I'm on Our findings are suggestions the preface to the the journal by Ryan Appleby and I also got vets et's.Recent position statement would echoed all of our feelings and I also told it my favorite paper in there was by Nikki castle.
And I said, write me a LinkedIn post that honors obviously the guest editor, but also all the other authors and mentions, all of these things and it wrote it out.It had tagged all the author's.It gave me hashtags, I copied, and pasted the whole thing and put into LinkedIn.It, it makes me look like, I This amazing work and it's actually you had to prime it a little bit, but you can use it to some Advantage.
But there it's like if I got some facts wrong, doesn't matter if we're doing clinical cases and differentials and recommendations, that's where it's just not wise.I think you can definitely use it to challenge and but make sure you're thinking about everything it says.
Alright.So I say I and Radiology go.Yeah, so this is where some of the challenges come so It's such an exciting technology that's come out.You know, it started back 2012 and now we're starting to see the fruits of some of this amazing algorithmic research.
But the problem is that there are businesses out there that are trying to promote their AI, to do some radiological triage and basic differentials or conclusions.Now, if a drug company came out and said we have a new anti-inflammatory drug, it works.
It's amazing on dogs and cats, especially post-op post Orthopedic procedures, but we can't tell you how it works and we can't tell you how we've tested it.And we can tell you anything in there.
But for $10, each time you can use it and it's kind of it's crazy that we find that absurd.But at the same time, we're going, hey!Hey, I company, how have you tested trained and And this technology and the reason why that's important is that they might say that they've tested it on 10,000 thoracic studies out of, I don't know some institution.
What are the chances that your thoracic study, your three views of the thorax, maybe even two views?What are the chances?That's the same quality as what they've trained the algorithm.So if an algorithm comes out of the University of Tennessee, you know, research and academic institution, their x-rays are Probably 99% perfect and they've trained this algorithm to recognize off of perfect studies.
If I give it, you know, a standard GP practice where they're, you know, they're working two hours late and understaffed and it's a little bit rotated and the dogs conscious and halfway moving its neck during the X-ray and that's and bag that.Yeah this is Sam big that algorithm is going to say this is abnormal, or this is a mass because it's only trained to Go normal or abnormal.
And if it's at home, well, Pneumonia, Mass aspiration pneumonia Meg, esophagus fibrosis and Asthma and it doesn't have a setting that goes rotated and conscious dog.Like it doesn't have that.
So it's going to come up with a answer and the answer is going to be based off of the fact that it's expecting gold standard x-rays.But the thing is, we don't know.And a lot of these companies aren't publishing, what they've trained it on and how they train it and where the biases are.
So the bias example here is that if this say we were in Tibet and we have a lot of Tibetan Mastiffs to train off of again, I don't even know if Tibet mass is actually come from Tibet, I assume so.
So so now we're going to train it saying.Here's a normal, Tibetan Mastiff.A normal, a normal.This is an abnormal with a big heart abnormal with a big heart.This is an abnormal with some disease, that's only seen in Tibet and we train it a hundred thousand times.And then we get a Tibetan mastiff in America, it doesn't get that disease but when it gets something similar, also the eyes going, you have this rare disease, that's only found in Tibet and that's it.
Boom, write home to your to, your owner and the Vets.Don't necessarily know that there's that hidden bias in there and the contraindication about using that API.So ideally the AI groups and there are a lot of groups that are taking this latter approach where they're saying Saying this is how we've trained this AI.
We've trained it on brought Wyler's Labradors Dalmatians basically big dogs.If you give it a small dog it will have less performance.It will have some challenges so just it won't know it and will tell you but just be aware that this works really well on Labradors.
This doesn't work so well on Cory's and that's the sort of transparency that I think is needed.And then lastly, their All this information on all these x-rays.But how are they validating it?Are they going to another institution to get x-rays from something that they don't know, like these uncertain views?
And are they coming back to see how all the algorithms performing, or they testing it on the same stalk of images that they've used to train it?You imagine if I train you on how to spot a foreign body and I give you the exact same x-ray.Again you're going to like the form body, I've trained on it.
I know where that is where as if I give you a different dog from a different location and you're going to apply By the principles.That's a different story.So it's really neat seeing commercial interests, get a interesting technology out to the veterinary professionals who are absolutely asking for more support.
Like, there's not enough radiologist, there's more x-ray, machines is more images, we need something.But how do we do that in a balanced logical and careful process that we're not going to have negative patient outcomes without knowing that we're creating that sort of environment and that's that's Challenge right now.
I really, you know, is a I going to be here and helping us with our x-ray Radiology reports and two years five years, ten years.Yes, to all of that.It's just making sure we're doing it in a honest transparent way.And there are some companies that are forging ahead with that path and there's some other companies that are keeping everything very contained and I'll just give an example where this goes bad.
Hmm a dog That is seen by a colleague and this is a few years ago and they find a nipple on the X-ray that looks like a nodule big module.In any case, it's dismissed as a nipple because it is a nipple and it goes away and comes back with a radiology report done by an AI company.
And the AI company says, that's a metastatic lesion as in the algorithm says, it's a metastatic nodule And they dismiss it and then subsequently comes back.Two years later and its lungs are full of Mets and now I'll sudden this vets in trouble for missing something that they were questioned on.
But in actual fact it was always a nipple, it coincidentally, develop metastatic disease probably because I haven't bone tumor but this event was pulled in front of the veterinary board because of something that happened after the fact.And say I assumed it was out of the start and that sort of Oversight and education is needed to say what happened here?
What are the claims coming and what are the limitations and was that accurate?And I think the, the sort of blind claims are dangerous to both patient outcomes and Professional Standards.And, but I'm excited.I'm super excited.So where we are now turning 20, 30 people, are they a i Radiology?
Reading software is available, can I go and look for something now and install it in my practice and run my red.So you say, He actually probably find about five or six commercial companies that offer a i reading of thorax and abdomen X-rays and at this stage so we are we know February 20, 23, any of those good enough to be really useful I think no I don't want to do that.
I think they're all doing really exciting stuff I think because it's such it's an industry and a technology in its infant stages.They're not necessarily The open to saying what their limitations are and where the country negations are and where their biases are because they're trying to sell a product and they're trying to claim, I used to sell something like that, it's easy to say we are just as good as a radiologist, or better than the average for all that.
But in five years time, they might be able to say that.But at this stage, it's just potentially challenging and dangerous to do.So, especially not when they need to Sort of explain how their algorithms work and how they won't work.
And the commercial interests are too large to say, we're not going to divulge that information so we're just at a bit of a loggerhead.Well, okay, it feels like a proposition.We've probably got to wrap it up at some point.Let's do what are you listening to it?The moment podcasts or audiobooks or anything, or Have you listened to in the last few months that needs to go on the playlist.
One of the pockets are this into, and I think it could potentially get some heat.Hang on, you know, a lot of this knee-jerk reaction sort of stuff that kind of permeates through pop culture right now.But I'd like to all in podcast and the all in podcast is a group of, they happen to be mostly billionaires, but they come from a broad spectrum of political positions.
Some of them are Republicans, some of them are democratic, but they cut through a lot of the current world events and business and sort of economic events giving perspective.Actives from opposite sides.And they argue they discuss, they challenged and they call people out on that.
And it's really refreshing to see that instead of it being a circle jerk, or a hive mind in an echo form.It just feels more, feels nice.Listening to different perspectives and actually saying, wow, I didn't know like, again, I don't agree with everything.It's just enough to.
I just don't like hearing so much of the same unchallenged or all these biased arguments, I'm just kind of sick of that.I really like hearing contradicting viewpoints and just even if I disagree with it, still at the end.At least I've kind of heard something.I like that a lot.
The that's sort of the non Veterinary side and then the veterinary side.I just I do like all the podcasts.You know, obviously not to plug yours but I like I enjoy hearing perspectives from a clinical and non-clinical experience as well we give us give us a plug but is your other most favorite rebroadcast?
I'm happy to like I guess who Who I'm cheating on whom she know.I mean my love of my life will always be the best ball but I do.I do listen to other places know.I've enjoying Toby trimble's podcast right now.Okay I'm I like the vet Innovation podcast.
Yeah with the talking to ya was that Sean and Ivan Ivan is also got a consolidate that orgasm.Jim really interesting.It seems like there's a lot of galaxies stuff going in there right now but it's just a really neat.Experiences on how independent practices can sort of compete against the consolidating business, corporate world.
I think those are probably the main Veterinary progress.I listened to religiously and audio books are really like called a traction stuff.So Traction in the genome.Wickman books are really good for business, so getting an oversight and finger on your entire business because I felt completely out of control, and these things are due and this thing pops up like this, just kind of brings that down and I'm out.
Terrible place.So if anybody doing anything business-related, in fact, I think a lot of Veterinary groups have sort of adopted this track.I'm sorry I lost city to it's phenomenal.There's a really good book by Reed Hastings from Netflix and Susan Mayer.
They wrote a book about workplace culture and talent density and the example which is great.They said, you know, a plumber If you hired the best plumber in the world they're probably Maybe five times or at most 10 times better than the average plumber.
But if you hire the world's best software developer, they might be 25 thought like twenty-five thousand times better than the average.Like they might just be so dialed into what they can achieve but you don't have to pay them 25,000 times the salary you can pay them twice or three times, the salary and you get all this additive petition.
So they're just talked about hiring and paying well or above average for Really good people and you get all the benefits of what they are compared to the average.Is that no rules rules?Yes, no rules rules.It's just just phenomenal.
And and it, you don't have to worry about what your staff are doing because you've hired appropriately.Like they're not going to take holiday out when it's not an appropriate time for you.And the business, you've hired them and they have all of this in mind and you can put any one of your staff in front of a partner or an investor or anybody.
You know, that you're going to be taken care of, but a lot of that sort of conversation from other businesses.So, some of these business books, I find really interesting and then you look at the way profession.Are you go?Yeah, I'd love to hire people like that, but I kind of refer to anyone, not even, anyone never mind the perfect besides, it's interesting.
And I like this is where I agree with Sam.I think you talked about this on your podcast once as well.It's like, They'll like, for example, if you're struggling to find a vet and you like, I cannot fire.It's like The Simpsons when Flanders is parents, are needing help for their parenting there.
Like we've tried nothing and we're all out of ideas.It's like I mean, sure like they get to a certain point.They're like well what why don't you pay like, let's just jump a big percentage of like, pay them a lot more.Like, well, what sort of precedent in my setting here?
It's like you're going to be working.With another vet while you're not working with under staff.It's like you're closing on Wednesday because you can't find the staff because you don't want to pay that extra twenty twenty-five, thirty percent and sure like that doesn't mean that you're always going to be paying everybody 20-25 percent more than the market, but the market forces change as well and all sudden you're going to find yourself if it goes the other way.
It's like, well, we have less owners coming in.It's a recession, we can't afford this that we need to kind of find this happy medium.But Just hear a lot of that's when we can't find anyone.And I'm like, what are you paying?And it's like market right?Yeah I had a conversation this week with a guy in a completely different business and having major issues with transport can find truck drivers can find trucks and then he said yeah like the reason that a lot of the private truck companies can't find drivers is the minds of playing people hundred and forty K.
Yeah I think that's a fair point like if you're totally out competed.So another person is struggling to get a CT Tech and you know the CT techs are in demand.These are human trained medical like physics specialist to operate a CT and MRI and they can't get them to run their CT and I said, so what are you doing there?
Like we just had to close down like aren't they in demand from immigration side?And he's, I don't know.And like, hey, like I pretty sure they're in demand.You can sponsor one from the Philippines or from Thailand and these are human trained.
Experience that run CT, CTS in their hospitals, their sponsor them to come out, pay them appropriately and you know, like it's just like I feel like again, I don't have a Veterinary visits so I can't really talk to where to find good staff.I just, I think if the first person to take the plunge and pay above Ward rate and steal that vet and treat them well and steal that vet nurse and treat them.
Well, I think is maybe it's maybe I'm not you phone, I'm sure I am.Sure, people can get really pissed off of me, but they would be laughing because they're they're not closed on Wednesday.Yeah.Yeah.All right.So you're one question and a bit conference, you have well, you're on a Venturi podcast.
One of your favorite ones.I don't know which one you can see and have the opportunity to give a message to all of that great really new grads in the world.And what's your message?I'd say that the message is that there. 100,000 different types of Veterinary, jobs out there.
And when I graduated, or before I graduated, my idea was, you could be a small animal, vet a horse fed cattle that or specialist and that was it.And I think now, looking back there are at least from my vets that I graduated with, and others that I've met along the way there, so many different jobs across so many industries that are Loosely or directly refill it with animal health.
'The and some of these people have super fulfilling lives, like, I've got a mate that audits wildlife and in across Australia and then they pay him to go out and dark camels and figure out what sort of ecological effect.A certain species has on and like I would have never known that exists and you know the fact that he's a vet, he's using Controlled Substances for darting these animals and and that's just like super cool.
He gets a camp every day and I've other vet colleagues or at least people, I know that they Veterinary business cases or Veterinary Technologies for like startups, like myself and their vet background and Commercial background, helps them.Look at how viable, a Veterinary solution is got Chief Veterinary officer, 's for other companies, you got people that work in, I mean, it's I think what I thought was I heard about government vessel you sitting in a desk in a cubicle, but some of these governments are working in Borneo and they're working on.
Like, I think it's just amazing to see there's so many options and jobs out there.Don't necessarily think that it's restricted to just that clinic in that, that small console room with the fluorescent light.And like, I think there's just so many things out there that can make us happy and hopefully, you know, talking from some privilege.
Hopefully, everybody has an opportunity to find that David.They've missed out chats made.This was epic.Thank you, so so, much for your time.Thanks for having me.And then we're going to do this live.When you come to Queensland, right?Going to do some live broadcasting.Yes.
How are you feeling about work?For the year ahead, we started this podcast to help you find ways to make your Victory and the career, you build around it fit with the life you want to live or if that's too ambitious.Then at the very least to make work not suck.And I personally thought that the answers to a fulfilling happy carrier, as of it, lay in personal growth and better.
Workplaces, and all of the other non-clinical stuff that we talked about, which is true.But something that's Surprise me when we started doing the clinical podcast, was how big a role that played in my personal enjoyment of work and judging by the feedback we get from our listeners.It's a common occurrence.
Here's why I think it is.It sucks to feel in the dark with your cases to feel green or Rusty in your knowledge, you feel guilty because you feel like you should know more and you should be learning more but you're also trying to have a life outside of it.So ongoing learning Falls by the wayside On the flip side, it's a really nice feeling to know your stuff when you get that case to know the answer or if there is an answer to know that it's not because of your lack of knowledge.
It's just one of those cases competence breeds confidence, and confidence is key.And our clinical podcasts is, the easiest way to work on your competence little bits of growth every week with minimal effort on your part, try it works.
Join our growing.Community have it felt in it and get your mojo back at VD in the super cast is not coffee.Community have it felt in it and get your mojo back at VD in the super cast is not coffee.

steve

Dr Steve Joslyn