1. Many physicians view becoming an attending physician as the destination. Looking back, when did you realize that becoming a physician was actually the beginning of a much broader professional journey?

When I first stepped onto the Stanford campus, it became clear to me that I was probably limited only by my imagination. There were amazing medical students starting companies, attending physicians who also worked in venture capital and our Program Director, Kelley Skeff, MD, was a world-renowned educator with a Clinical Educator Training Program that drew in professors from around the globe. All of these people were good at their primary roles and then they sort of elevated and expanded beyond the original scope of attending physician. In my mind, this meant I needed to do everything I could to be a great doctor, healer, educator first… and then I could earn the privilege to broaden my professional journey.

2. Your career has evolved from academic medicine to digital health leadership and healthcare innovation. Despite these changes, what aspects of your identity as a physician have remained constant throughout your journey?

My dad ran a sole provider practice for 38 years in the Central Valley. He always said that his goal with each patient was simple, “I want each patient to walk away from me feeling better than they did when they walked up to me.” That is a pretty simple and maybe obvious concept, but medicine and doctor-patient relationships can get very complex. I always carry his wisdom and humility with me. Sometimes it may make me stand out like a choir boy in board meetings or corporate leadership meetings, but I think the principles of medical ethics of “do no harm, act in the interest of your patients, champion justice and what is right and respect individual patient choice and dignity” are strong principles for any industry. My medical school friends and I used to ask: Are you comfortable with that showing up on the front page of the New York Times? Or, is it good enough that I would use it for my grandmother? These may be superficial examples, but they have guided me through many difficult professional decisions.

3. Every career is shaped not only by pivotal decisions but also by pivotal people. Looking back, what moments, and perhaps more importantly, which mentors or individuals most influenced the direction of your career?

What qualities should young physicians look for in a mentor as they navigate their own evolving careers? My grandmother was one of the first Black nurses to be a chief floor nurse in the Kaiser Permanente Hospital in San Francisco. Her supervisor actually lied and listed her as Portuguese, because Black women were not allowed to be in supervisor roles. She was smart and very down to earth. She was kind, but also could flare up and let you know when you were out of line. She was a tough woman. She taught me it was important to know right from wrong and how to be a professional. My Father was also a strong mentor. He showed me how being a hard worker could make up for any lack of privilege. But I think it is important that I acknowledge a mentor whom I barely knew. I sought him out as a mentor, because he didn’t know me and therefore I knew he had no preconceived notion of what my interests or my biases were. He showed me that a great mentor sometimes asks questions rather than answers them, listens rather than tells and always assesses what you already know or can see before he tells you what he sees. Look for the people who are curious about you and how you think, not what you have accomplished.

4. Many physicians measure their impact by the number of patients they personally care for. At what point did your definition of “making an impact” begin to change, and how do you think physicians should think about impact today?

Oh, I think that is a mistake to measure impact in quantity. In fact, I might suggest it is a mistake to even attempt to measure your own impact. I currently work for a venture capital firm. I have a colleague who is about 14 years my junior. We have now worked together for four years, but she was in the audience for a panel I gave 14 years ago. When I joined Foresite Labs, she reminded me that she walked up to me after the panel and she told me I gave her amazing advice and it inspired her to pursue her path in health care startups. Given that the interaction was so brief, I cannot recall to this day what I said to her. If I didn’t work with her now, I can assure you I would have no idea that interaction meant anything at all to anyone. I would say that physicians can always take extra time with a patient if they sense the need. They can just stay human and never forget that the relationships
with patients are a privilege. Maybe never underestimate the power of time and caring. You are probably making a bigger impact than you are giving yourself credit for.

5. Several times in your career, you chose paths that were less conventional and undoubtedly involved some uncertainty. How did you decide when it was worth taking a professional risk, and what advice would you give young physicians who are hesitant to step beyond the traditional career path?

A mentor once told me that altering one’s path is a lot like being at a party. All your friends are there, the music is playing, the drinks are flowing and you are standing at the door of the apartment where the party is being held looking out down a long dark hallway with a flickering light bulb in the distance. It looks cold out there and everyone you know and love is in the apartment. So why would you leave? Well, it is hard to change paths, but when you close that door behind you and start walking down the hall the lights go on, the music starts back up and you look around and the same people are there all around you having a great time. That happens because it is YOU!

6. Looking back over your own career, every generation of physicians has had to adapt to major changes in medicine. For today’s generation, AI may be that defining change. If you were starting residency again today, what would you do differently knowing what AI is likely to bring over the next decade?

Hahaha! I might have taken the time to do another residency in psychiatry or maybe have gotten training in psychology. No, seriously, I think I would place more value on developing my motivational skills so that I could help my patients with behavior change. So much of what harms patients is poor understanding of the root cause of their behaviors. I just feel I would be a better clinician and more valuable in a post-AI workplace if my people and behavioral health skills were more magical. I suspect AI will democratize knowledge work enough that the best outcomes will be found where clinicians and patients have the strongest and most trusting relationships.

7. You’ve spent your career working both inside and outside traditional healthcare organizations. What do you wish physicians understood earlier about leadership, communication, or business that isn’t typically taught during medical training?

I may be unique as a multi-ethnic physician answering this question, but I really think physicians need to embrace the fact that we all carry implicit bias. It is just unavoidable, and acknowledging it and learning where it impacts our patients is one of the most important practice innovations that could ever occur in my opinion. We owe this to women, LGBTQIA+ and BIPOC members of our communities. Recognizing our biases is just too important and it has been neglected for too long.

8. If you could sit down with your younger self on the first day of residency, knowing everything you’ve learned over the past two decades, what conversation would you have?

I might say you have so much to learn so don’t be afraid or impatient. Don’t doubt yourself or give up on being better everyday. Medicine and science are not about what we know. They are about what we don’t know and great clinicians honestly seek the answers or the tradeoffs with humility while always maintaining their patients’ dignity.

9. At NexBioHealth, we believe that a physician’s career continues to evolve long after training is complete. What does the phrase “The Evolving Physician” mean to you, and what do you hope it will mean for the next generation of physicians?

“The Evolving Physician” is a great concept, because each of us is on an individual journey of growth and change, but we are also walking alongside each other evolving as a collective as well. I hope future physicians respect, modify and maintain some of the valuable healing rituals of those who have come before. Holding a patient’s hand in silence as she contemplates her cancer diagnosis is a privilege and a moment only humans can share. No AI or “bot” can replace human touch and empathy. We need science and knowledge to evolve, but maintain your humanity.