Bruce Bassi#FuturePsychiatryPodcast discusses novel technology and new ideas in the field of mental health. New episodes are released every Monday on YouTube, Apple Podcasts, etc.
Summary
Dr. Leah Houston and Dr. Mehnaz Hyder, of HPEC speak about the ever increasing problem of administrative overhead and how to solve this issue, through an innovative idea of a decentralized platform for physicians. The platform would allow physicians to store their credentials in an immutable database, free from fraud, where insurance companies and others can draw from to verify identity. Physician (and all clinician) credentialing is a massive problem and requires hours of administrative time, which costs money, and slows patients from being seen earlier. When this issue is fixed, patients also stand to benefit too, not only through costs saved, but by being seen earlier, and by reducing physician burnout.
Chapters / Key Moments
00:00 Preview
01:44 What is HPEC?
04:23 Who is to benefit from a decentralized system?
08:22 Challenges for HPEC
09:09 The need for transparency
17:41 Why keep checking credentials?
21:27 Can someone use the blockchain fraudulently?
23:44 How much time is spent on credentialing?
26:36 Universal problem of identity verification
29:32 How to support HPEC?
31:04 Physician directories
Transcript
[00:00:00] Leah Houston, MD: I believe whenever the middlemen are cut out, the patients benefit the most. Only 30% of every healthcare dollar gets spent on actual patient care. The rest is spent on administrative overhead and to the pockets of executives and shareholders of companies rather than towards patient care. When physicians are free to use their own time to critically think about your medical problems, rather than spending their time as data entry clerks, clicking buttons on EMRs then patients of course will benefit.
[00:00:27] Mehnaz Hyder, MD: Physicians trust patients. But I think patients view their physician as somebody who’s benefiting from this broken, extraordinarily expensive system. That’s actually not true. They don’t realize the degree of physician burnout and the degree of physician disempowerment and disenfranchisement in our careers. Physicians have an extremely high suicide rate, unfortunately even higher than that of our veterans, which means there is a crisis. We are losing about an entire medical school, graduating class worth of physicians every year to suicide.
[00:01:00] Bruce Bassi, MD: All right, so welcome everybody. Today we have Dr. Leah Houston. She’s the CEO at HPEC, which is the Humanitarian Physician’s Empowerment Community.
It’s also part of doctor’s DAO, and I’ll let her do the job of explaining that. We also have Dr. Mehnaz Hyder, who is a physician and psychiatrist and in solo practice and investor in HPEC. So welcome to both.
[00:01:26] Leah Houston, MD: Thank you. Thank you for having us.
[00:01:28] Bruce Bassi, MD: Yeah, so I, I read up a bit about you and watched some of the videos and makes sense to me what you guys are all doing, but it would be probably easiest if you explain it in your own terms, Dr. Houston, what HPEC is, what the mission is, and what you guys are all doing.
[00:01:44] What is HPEC?
[00:01:44] Leah Houston, MD: Well, our autonomy as physicians has been stripped. And if you think about it, you know, our healthcare system, the flow of capital in our healthcare system is directed by our decisions. And so the system, the medical industrial complex, has found ways to control physician behavior pulling levers and creating malaligned incentives, forcing us to see patients quickly to over-prescribe, to rush people through in order to generate revenue for health systems rather than to actually serve patients, which is what we’re here for.
So, you know, we believe that our national and regional medical associations have failed us. So we’ve built a new system, a new association a new organization, a digital Physician’s Guild called HPEC, which stands for you, like you said, the Humanitarian Physicians Empowerment Community.
And it’s a DAO, a decentralized, autonomous organization of physicians. So, if you think about it, the word autonomy is in there. We, as physicians have our digital identities, we govern ourselves, we can create and build our own referral networks, and we can build the future healthcare system that serves our patients rather than the medical industrial complex.
[00:02:50] Bruce Bassi, MD: It makes sense what you’re doing. It kind of begs the question, why didn’t we do this all along? And maybe some of the history there can inform what sort of challenges we might have down the road, because I think a lot of the accrediting bodies and maybe there’s some insurance incentives here. I, I really don’t know, I’m just totally speculating. Are any other parties kind of incentivized to keep it the way it is and, and is that informing like kind of the resistance that you’re getting as a com as an organization?
[00:03:20] Leah Houston, MD: Well, in my opinion, and I, I don’t speak for all physicians, but in my opinion, in the opinion of most the people who are part of our organization believe that third parties are the problem. You know, we have the doctor and we have the patient, and the rest are middlemen. And some of those middle men serve the doctor-patient relationship, but the majority of them do not.
The majority of them siphon value off the doctor-patient relationship. And you know, I’d love to hear from Dr. Hyder about it too, because like I said, I don’t represent everyone.
[00:03:50] Mehnaz Hyder, MD: Yeah, so, so in my opinion, I will, you know, Dr. Houston talked about why there’s so many intermediaries between the physician and the patient. I think we had read about something like 30 plus people intercept the interaction between the physician and the patient. So naturally that’s gonna cause complications.
One interesting thing that we’ve been thinking about is that a lot of bodies that are supposed to represent doctors and patients might also be benefiting from the way the current system works, which makes it very difficult to them to then change.
[00:04:23] Who is to benefit from a decentralized system?
[00:04:23] Bruce Bassi, MD: Mm-hmm. Before we dive into all the nitty gritty details, I think it might be helpful for some of the audience members, especially patients, to kind of hear how this might potentially benefit them from, everyone kind of knows there’s a huge administrative burden in terms of cost that’s shared and primarily put on the patients and the, at the end of the day, they’re the ones paying for care and it seems like this would improve efficiency and maybe, hopefully the cost saved will be passed on to patients.
Is that true? Is that– or are there more benefits to the patients than that?
[00:04:59] Leah Houston, MD: I believe whenever the middlemen are cut out, the patients benefit the most. You know, we know that only 30% of every healthcare dollar gets spent on actual patient care. The rest is spent on administrative overhead and to the pockets of executives and shareholders of companies rather than towards patient care.
So, when physicians are free to use their own time to critically think about your medical problems, rather than spending their time as data entry clerks, clicking buttons on EMRs then you’re being served. And so if we create a system for physicians to practice freely, Where they can serve their patients rather than the system, then patients of course will benefit.
It is a downstream benefit. It’s not a direct benefit, not at least not immediately. But, you know, eventually we hope that our system integrates into direct patient identity systems where patients can own their data. Where you as a patient, you go to a hospital and you get a CAT scan and you want your primary care doctor to see that CAT scan immediately, you can do that because you can send it to them because it’s yours and your wallet that you control.
Now, you know, it sounds kind of abstract, but if you think about it, the radiologist is the one that generated that CT report. They dictated that note. That’s data that they’ve generated. The physician is the one that created the data about you. You know, similarly, when you’re born, the doctor signs the birth certificate. When you die, the doctor signs the death certificate. We create all of the data in between.
So in the future, if you want to own your data, your right to see the doctor, you choose your right to be able to share your information and to know that your doctor has access to your information. This is, these are the kinds of tools, decentralized identity, the tools that we’re building are the kinds of tools that will allow that to happen.
[00:06:37] Bruce Bassi, MD: Sounds like I’m hearing a couple themes here that patients are also owning their own identity and they’re owning their own data that’s generated about them in terms of healthcare, and then the doctors themselves are owning the data associated with their identity and credentialing process.
Right?
[00:06:54] Leah Houston, MD: We believe that the only way for patients to own their data is for doctors to be able to give it to them and decentralize identity are the protocols that will allow for that future to exist.
[00:07:08] Bruce Bassi, MD: Gotcha. Gotcha. So that, that sounds like another answer to my previous question then, right? I mean, the patients are ultimately going to have more control and ownership over their data. By allowing this to happen, are we kind of seeing already movement towards this? And I know you mentioned in the UK they already have a version of this somewhat?
[00:07:32] Leah Houston, MD: Yeah, I mean, decentralized identity and digital identities are the future. You know, if you Google it today, if you type it into any of the social media platforms, many, many, many resources will pop up because that’s going to be the future of digital interactions where that are more user-centric, that are more controlled by the individual rather than large, centralized entities like Google, like Facebook, like Epic, like Cerner, that currently hoard and control all the data and sell it without our knowledge and consent. Well, at least without our explicit consent you know, in the future, if you want privacy, if you want agency over your personal information, your professional information, your health information, you’re going to need to leverage these tools.
And so we are entering into a new wave of a future. You know, we’re, we’re being given an opportunity to build these tools for ourselves, for the future.
[00:08:22] Challenges for HPEC
[00:08:22] Bruce Bassi, MD: Yeah. In terms of challenges you have all experienced so far? It seems like there’s probably a couple a) maybe my podcast kind of reflects this too. I think there’s technology kind of gets more of the spotlight in terms of new innovations, new developments, and we focus less on the administrative types of issues within medicine, even though they take up a vast majority of the costs and healthcare expenditures.
And then also there’s kind of a cognitive bias towards not wanting to change maybe the status quo of how things currently are. So, and maybe it, since it’s more difficult for people to imagine or wrap their mind around, is that make it harder for people to kind of get behind this movement.
[00:09:09] The need for transparency
[00:09:09] Mehnaz Hyder, MD: I think what will resonate with people is that transparency is currently completely absent in today’s system. And I think patients deserve to know where their dollars go, where they land, and how, how money is used. So I think that’s something everyone can understand that technology now allows for to expose transparent transactions that take place within the system that’ll not only tell us where the money is going, that’ll tell us what can be cut out, what looks extraneous, what looks kind of not necessarily in the interest of the patient. Because I don’t think there’s very many parties right now who are able to audit the entire healthcare system. I don’t think they themselves know how resources are being used.
[00:09:50] Bruce Bassi, MD: One thing that’s amazing in terms of transparency is how difficult it is to evaluate an EOB that comes back from the hospital. Sometimes they don’t include the CPT codes, what it was for, who is covering it, you might get multiple for even the same visit or same surgery from an anesthesiologist versus the surgeon versus the facility itself.
It’s so difficult, and I see sometimes even physicians, within private physician groups, they post questions onto forums asking like, what is, what does this mean? And so even people within healthcare don’t quite understand what they’re being billed for. Is that kind of what you’re getting at in terms of transparency?
[00:10:29] Mehnaz Hyder, MD: Yeah. On the patient bill side, and then on the spend side all the people who are spending money, whether it’s government, I mean, this is obviously a, a gigantic system but technology now exists that allows for this transparency. There’s not very many people wanting to employ it, but I think two parties that would be very interested in this are doctors and patients. And that’s kind of where we’re going with this. And so what we can do is start building based on our identities based on physician’s identity, which is professional identity and patient identity. There are some healthcare solutions that talk about medical records that can be given to the patient.
But I, I’ve seen some of them and a lot of them, they seem clunky and they don’t appear to serve the doctor-patient relationship. So the way we we look at it is, what’s good for patients is good for doctors, whatever harms patients cannot be good for physicians. We actually have all the same interests. And so we should build a, we should build a system that primarily puts both of us at, at the center, and other services, other administrators should be accessories to that. Right now the system is built to serve the third parties, which is really interesting and which is why there, there’s a lot of frustration with in the patient community and in the physician community and there’s also some mistrust.
Physicians trust patients. But I think patients view their physician as somebody who’s benefiting from this broken, extraordinarily expensive system. That’s actually not true. They don’t realize the degree of physician burnout and the degree of physician disempowerment and disenfranchisement in our careers.
So that’s, that’s a really important point. Physicians have an extremely high suicide rate, unfortunately even higher than that of our veterans, which means there is a crisis. We are losing about an entire medical school, graduating class worth of physicians every year to suicide. Medicine is, is a calling, right?
And so you would think that somebody who’s engaging in a profession that they wanted to dedicate their life to, that they would feel really fulfilled. But clearly that’s not happening. So, so that’s, that’s kind of, that’s kind of what we were thinking about as, as we’re building this.
[00:12:48] Bruce Bassi, MD: And on the topic of suicide, there was a really high profile suicide recently in the news and I know that you interface or help out with the physician’s support line, which is a crisis line that’s free, confidential, and anonymous for physicians, medical students. And just briefly for the listener, the number for that if you’re struggling, is 888-409-0141.
And could either of you speak to that quickly in your experiences with that? And then we’ll go back to the, the credentialing topic.
[00:13:23] Mehnaz Hyder, MD: So the physician support line was created by Dr. Mona Masood during the initial onset of the pandemic. And this is because physicians were all healthcare workers were facing extraordinary pressure, as everyone knows, during the pandemic and physicians and all care, all healthcare workers were entering the pandemic already with a lot of burnout.
This line was created just for physicians other, all the other professionals. They also have dedicated services for them, and so they may also call support lines for them, and if they end up calling us, we can refer them to, to their support line. And this line was created for attending physicians, residents, medical students because there aren’t very many resources and there’s a lot of stigma even within the medical community.
And also a lot of patients may not know this, but mental health of physicians can actually endanger a physician’s license to practice medicine, which, which is, is not logical. And obviously that doesn’t, that doesn’t help very much. That actually worsens the problem and prevents people from seeking help.
And so this, this is a crisis line because who would understand more than a fellow physician how difficult must be that you’re still stuck in the hospital, do doing a hundred charts and you’ve, you’ve been exposed to this new disease that we know nothing at the time that we knew nothing about. And that’s, and, and, and that, that’s kind of helping us, you know, connect with each other.
Another interesting thing that I’m realizing as I’m speaking is there aren’t very many, very many ways for physicians to interface with each other. We don’t really have, we have a personal community. We know who our, who our residency classmates are, and people that we’ve worked with at various institutions.
But there’s actually no direct way for us to reach out to each other. But how would you do it if you wanted to reach out to another physician, look up the insurance? Who, who’s in that insurance network? Or, or would you look up social media like you look up any other professional? that, that’s really interesting, isn’t it?
And shouldn’t we have a network? Shouldn’t we have our own network built by us, built for us that doesn’t involve 500 3rd parties who will dictate?
[00:15:30] Bruce Bassi, MD: I actually just discovered the the Facebook group for physicians in private practice, and there’s a couple other Facebook groups too. And one thing that always strikes me is how often people are posting anonymously because they still feel that they can’t say something honestly and openly about their mental health or about money or about reimbursement without being judged.
And it’s a constant dilemma, I think, in the field of medicine to be able to say that you can be compassionate and care for patients, but also want to be a smart and savvy business person and protect your brand really. So it’s difficult, very difficult. And there’s stigma is still very strong.
[00:16:15] Mehnaz Hyder, MD: Yes, the, the stigma is still very strong. I just wanted to clarify for, for people who would be wondering, why can’t we just meet on Facebook? And we do, actually, there’s many physician groups for every specialty and interest, but Facebook is a third party. Facebook is a technology that could be easily read by, by anybody, by any engineer, by any worker over at Facebook. Right? Which is, which is something that came out on the news the past couple of years we’ve been seeing about how these aren’t encrypted communications, right? So, and also I think if there is a physician network first that we’re, we’re, we all have connections with each other.
Then you can build new groups together to communicate, especially if there’s something that’s, that’s private or privilege or something like that. Facebook is not really built for that. It’s built for socialization. It’s an excellent tool, obviously. We, we, so many of us log onto it every day, but it’s for socialization.
What about physicians who need to problem solve? You can’t do that on LinkedIn either. So we’re talking about identity and the system. But in this system that Dr. Houston is building, there will be transactions between doctors and patients keeping data safe. And there can be interactions between all physicians on our terms, for us not being observed by third parties.
[00:17:36] Bruce Bassi, MD: Yeah, I, I love this conversation. I’m glad we’re having it. It’s very helpful.
[00:17:41] Why keep checking credentials?
[00:17:41] Bruce Bassi, MD: I want to go back to the credentialing idea and Dr. Houston. One thing I heard in one of the talks that you were giving that was on YouTube was wouldn’t it be nice if you can just finish med school and have that be stored in a database somewhere that you completed med school? And we don’t ever have to go back and check because you gave an example of how an individual, they actually couldn’t work anymore because the med school closed and the insurance companies were all trying to reach that med school and then they couldn’t believe that the, whether or not the person actually graduated from school, even though it’s been checked before, and it made me wonder, because a lot of this kind of boils down to fixing this broken process. Why, why do these credentialing bodies have to keep rechecking the process even for the same payer, same clinician, every two to three years? It, it doesn’t, I don’t understand that. Are they going to, do they catch mistakes from previously? Like do you, do you happen to know the reason to that?
[00:18:41] Leah Houston, MD: So, it really has to do with regulatory compliance. So before we had digital verification, everything was kept in file cabinets. And so the current policies and guidelines that were created by these behemoth regulators like the Joint Commission and NCQA and all these people who do the credential checking who you know, sanction hospitals to be hospitals and things like that, they have these old, outdated policy structures that are centered around a world that was not digitized. And it was also centered around a world that didn’t have these new sta new protocols that we are deploying these decentralized identity open standards protocols. . And so, you know, we actually do have a database of, of who graduated from what medical school.
It’s at your medical school. And they own it. And they control it, and they’re the gatekeepers. And that’s one of the millions of things that a medical school has to do is to continuously verify that you are who you say you are to every person that you work with. The way that our system that we’re building is different is that we, we leverage these new open standards protocols.
And when I say open standards, I mean it’s a similar type of protocol that we use for email. You know, the way that Yahoo and Gmail can talk to each other is because they’re using the same protocols. So even though they’re competing companies, they still are able to communicate.
And so, these are even more decentralized protocols that allow you as an individual to communicate directly with another individual or an entity. And so with these new open standards protocols, the first time in history that we can actually solve this problem, from the day that you graduate, from the day that you’re issued that credential, that credential can be digitized and made automatically, verifiable. And the way it becomes automatically verifiable is that proof that that event happened is hashed or documented onto a blockchain, which is an immutable ledger, which means that it cannot be erased and it’s distributed, meaning it’s kept private and secure by thousands of eyes that are looking at this network.
And so, you know, when you now share this digital verifiable credential, they can read the blockchain and know for a fact that it was actually issued by your school. So it’s changing this four to six month process of checking these 30 to 70 credentials into moments. And so it’s going to really change and automate workforce mobility for doctors.
And you know, you talk about all these things that are happening, the administrative burden, the burnout, the abuse of the being forced to pre perform redundant, uncompensated, non care tasks. Well, if you’re a doctor working in a system like that and now your credentials can be checked instantaneously, you can easily leave. So it’s empowering the physicians to work and move freely. And that’s what we’re really excited about.
[00:21:27] Can someone use the blockchain fraudulently?
[00:21:27] Bruce Bassi, MD: I think an average listener would say that cryptocurrencies reputation took a hit recently. I think we all know why , Sam Bankman-Fried probably pulled off a pretty extraordinary fraud. How does this work to somebody who maybe doesn’t quite know all the details about blockchain and hash and all those terminology? Why can somebody not actually have a fraudulent type of motivation when using your system?
[00:21:55] Leah Houston, MD: So I wanna clarify the situation that happened with Sam Bankman-Fried and ftx, he did not invest any of the money into crypto. He took the money and spent it fraudulently on you know, penthouse dinners and galas and orgies with his staff. He did not actually invest the money in crypto. He just invested some of it in things that were not cryptocurrency not truly decentralized protocols.
And then he spent a bunch of it, so he’s more like a Bernie Madoff. It wasn’t the, you know– Bitcoin has never been hacked. The Bitcoin blockchain has never been hacked. So, truly decentralized systems have never been hacked. And so, you know, and we aren’t actually talking about cryptocurrency when we are talking about decentralized identity. It’s a similar kind of protocol. With these protocols, instead of currency data, which is what cryptocurrency protocols do we are transferring other pieces of data and it’s a different format in the form of a verifiable credential. You might have heard Vitalik Buterin, if you’re in the blockchain crypto world, use the term “soul bound tokens.”
I’ve used the term NF ntts, non fungible, non-transferable tokens only valuable when tied to your identity. So for example, my medical degree, it’s only valuable when I’m using it. I can’t give somebody else my medical degree and they, now they’re a doctor. And so these types of data points that are tied to your humanity are, are what decentralized identity protocols are used to authenticate.
And so we need them as doctors for our medical licenses and our medical degrees. Patients need them for their birth certificates and their radiology reports. And, you know, moving forward for the future of Web three, these are these, these are new open standards protocols that are gonna be ubiquitously applied across industries.
[00:23:40] Bruce Bassi, MD: That’s so cool. Thank you for clarifying that. I didn’t know that, so I appreciate that explanation.
[00:23:44] How much time is spent on credentialing?
[00:23:44] Bruce Bassi, MD: How much time and effort would this actually save administrators, physicians? Do you have any sense of that?
[00:23:53] Leah Houston, MD: Well each time you get a new job, it takes an average of four to six months to credential. Now, I’ve heard two months for people that are purposely rushed through because they’re a surgeon who’s really urgently needed and they actually, you know, skip some steps and do some later, which puts the hospital at risk.
And then there’s some that are saying, you know, 18 months, 11 months to credentials. So when we can shrink that time to moments, we can get doctors back to work. You know, as, as a physician, I’ve lost months of, of income sitting around twiddling my thumbs, oh, it’s gonna be ready next month. It’s gonna be ready next month. I’m not working, I’m not making income.
Health systems are also losing revenue. They could be generating revenue. An average of 1.2 million is lost per doctor per credentialing event when a new doctor is brought onto a hospital. And so, and not to mention the fraud. You know, if you are in charge of who is billing under your name, if you’re able to see what is being billed under your name, if you’re able to revoke access to those credentials, the likelihood that health systems private equity, who own physician practices, being able to behind the scenes in closed books bill under your name without you knowing is reduced to zero.
So it also can reduce fraud and waste and abuse. And so, you know, overall these, these tools are gonna be you know, really, really powerful to kind of optimize processes moving forward.
[00:25:15] Bruce Bassi, MD: And these are re real case examples that you’re describing, right? Like this has happened where a physician leaves a hospital and the hospital continues to bill under this physician who’s credentialed with Medicare, right?
[00:25:28] Leah Houston, MD: That happened to me. And I happened to have not no longer been licensed in that state.
[00:25:33] Bruce Bassi, MD: So are you still responsible or is it the hospital or who, who do they point the finger at?
[00:25:37] Leah Houston, MD: Well, this is a very interesting thing. The doctor’s always responsible. You know, I actually had a call yesterday with someone whose uncle he, his, he was a physician and one of his physician colleagues was, you know, essentially somebody was billing fraudulently under his name when he wasn’t working there.
And the judge says, you’re the doctor. You need to be responsible. You should know what’s going on with your own licenses. And the guy was put in jail for 10 years and the 10th year that he was in jail or towards the end, he was sick and he knew what was going on; he’s a physician and they wouldn’t listen to him. They wouldn’t listen to his symptoms. And he died from a heart attack in jail. And so I hear, as a founder of this company, I hear tons of these stories all the time because people come to me, they’re like, oh my God, this happened. Is this gonna fix that? I’m like, yes. The problem is these, these stories aren’t published.
They’re not widely known or understood. They’re kind of in the shadows and people are suffering in silence, you know? And so it’s time to you know, fix these problems now.
[00:26:36] Universal problem of identity verification
[00:26:36] Bruce Bassi, MD: The problem with identity verification is universal. I mean, couldn’t– out outside of physicians and we’re not unique to this, having this challenge, couldn’t this be applied to psychologists, lawyers, basically any professional out there who needs to verify their credentials for the next step, the next job, et cetera.
[00:26:58] Leah Houston, MD: Absolutely. And that’s actually, you know, when we’re talking now about the future of work, you know, most people don’t wanna have jobs anymore. They don’t wanna have full-time jobs, they don’t wanna be employed, they wanna have more job, autonomy, freedom of mobility. So how are you able to authenticate that you’re competent other than claiming that you worked on that project at that big X, Y, Z company, and then having a reference that’s gonna vet you and say that you did.
How are we authenticating that we did what we did? How are we authenticating that we are who we say we are?
[00:27:27] Bruce Bassi, MD: I hired somebody who said they graduated from college in public health, I think, and it made no sense why they were coming to work as a clerical staff, and I ended up finding the, the diploma that they sent me was just taken from the internet and they just photoshopped their name over it and it looked very clear. It was the same exact photo and I kind of take back what I said only for being for professionals, it could be for anybody seeking employment really.
[00:27:56] Mehnaz Hyder, MD: Yeah, it could be, it could be for anybody seeking employment. I think the general public doesn’t realize that physician credentials are really onerous. And like Dr. Houston’s saying, it takes months. So for my physician job with the government, it took about four months to establish who I am and that I am really who I say I am.
Most professions don’t have that type verification of every academic, academic experience they’ve ever had. We have to disclose all the states we’ve worked in, which licenses we have any, any malpractice in any other state. And this is, this is in the interest of patients, not in the interest of, of anyone else, right? Most, most professions, thankfully, don’t have that burden. So, so this is, this is something really important to understand that this can be simplified into, into an experience that will take minutes or hours to verify all these credentials once, why isn’t it being done yet? Because it’s not in the system’s interest in particular.
They’re not the ones hurting because credentialing is taking so long for the physician. And so we should re think about who has skin in the game, in the system, it’s the patients and the doctors. I believe that what serves one party also serves, serves us.
We’re actually on the same side. We’re not on opposite sides. And, and very important point, Dr. Houston made that physicians who are really burnt out if their credentialing is made easier, it’s easier to walk away. It’s immediate leverage in a system that you might think is burning you out or could be hostile or predatory to you in some way. It increases mobility that helps, that helps the people who count, which are doctors and patients.
[00:29:32] How to support HPEC?
[00:29:32] Bruce Bassi, MD: So how would a physician who’s listening or any professional who’s listening support you all in your endeavors? Is there something to sign up for? And what would they expect? What would their experience be when, when going to HPEC?
[00:29:45] Leah Houston, MD: Well, if you are a physician we welcome you to join us today. The app is in production. It’s in very early beta, so there’s a lot of features that we haven’t built yet, but you can join today. We authenticate who you are as a doctor and we authenticate your identity as you onboard because we want to keep this network physician only.
You can also sign up for our newsletter on our website. You can follow us on social media at HPEC ID. At me, I’m at Leah Houston MD across socials and join the conversation, learn more about this, understand how we are building this for us in a world that it’s gonna be built anyway.
So this is an early opportunity for us to get in on the ground floor and to design the future for ourselves.
[00:30:22] Mehnaz Hyder, MD: Yes, if we don’t build this ourselves, so this is already being built, but not with doctors and patients in mind. This is being built by anyone else who can benefit from this information, which could be private equity groups, insurance companies, et cetera, et cetera, who will be holding all of our data and probably owning it and being able to sell it or share it at their own discretion.
And, and same with patient data. So this is an opportunity for us to quickly build from the ground up, ground up a technology and a system where our identities come first. And so we interact with each other and with patients on behalf of our digital identity that that’s established as the truth of who we are.
[00:31:04] Physician directories
[00:31:04] Bruce Bassi, MD: You know Dr. Heider, when you were mentioning that, the way you phrased that, it made me think of the 10 plus physician directories out there, where they have a– their entire business model predicated around the fact that they’re driving web traffic of patients who are searching for the physicians and looking at reviews, looking at that person’s data and making a decision whether or not they wanna see them.
You know, invariably when, if you Google search my name, I would say at least 10 of the top 20 search results are one of those directories. And I don’t, I don’t know any physician out there who is happy with their experience in dealing with these directories. Either it’s pointing to the wrong person or there’s a somebody who left a review who wasn’t actually a patient, or it’s something else that’s inaccurate, or it’s a very poor representation of their actual patient load for whatever reason, it’s just a couple people who maybe saw them once, but you know the 99,000 people that they’ve treated that actually went well, they don’t leave a review. Is there any sort of maybe direct or indirect implications as to affecting these, these directories? Because like you said, this is a very valuable set of data that I, I clearly a lot of companies already realize that it’s, it’s very valuable.
[00:32:27] Mehnaz Hyder, MD: And do you even remember signing up for it? Like do you remember signing up
[00:32:30] Bruce Bassi, MD: No, never.
[00:32:31] Leah Houston, MD: No, it was never. And, and one of the things, so, you know, we talk about the digital guild, we talk about us, our governance, and what we’re going to do. And one of the things that we’ve actually discussed between the close to 900 physician members that we have so far is creating a cease and desist for these companies and putting in a request that they revoke all of our professional– and we can each sign it and we can send it to them, and we can force them to remove our information. It’s not their place. We did not give them permission, and that is something that we can collectively do as an organization, but as individuals, it’s very onerous for us to take the time to do that.
[00:33:06] Bruce Bassi, MD: Right. Yep. And very costly. If you were doing it one-on-one, if it was just you trying to submit a cease and desist letter. I had an experience where one of these companies had a profile of me, but it was the wrong person. It was a physician in Iowa and it had nothing to do with me, and it very clearly had my name, but the credentials were of that person in Iowa and we had a similar name, but it wasn’t me.
And we went back and forth and they pointed it to me. Eventually they fixed it, and then they suggested that I, I claim it so that I can add to it, and they want me to essentially use it. And they were, they were trying to coerce me into using their business. I’m like, I don’t want anything to do with you guys, this is not something I wanted in the first place. And the only reason I reached out to you was because it was inaccurate. It was giving my patients a, a poor representation of who I am. So, That’s a whole nother podcast, I think.
[00:34:08] Leah Houston, MD: It’s all about digital sovereignty. You know, the future is about digital sovereignty. It’s about privacy. It’s about agency over your digital interactions and that’s, that’s what these tools provide, you know? And so I’m really excited to be able to talk about this and to share this with everyone, to give people an opportunity to learn about it cuz it’s coming whether we pay attention or not.
[00:34:29] Bruce Bassi, MD: Absolutely.
[00:34:30] Leah Houston, MD: You know, the thing about physician reviews also is that legally we’re not allowed to respond to them. You know.
[00:34:36] Bruce Bassi, MD: In a, in a general way, right.
[00:34:38] Leah Houston, MD: Yeah, it’s, it’s a HIPAA violation. So unlike a restaurant owner who can say, oh, this customer came in and he spit at the waitress and we kicked him out and he wasn’t welcome here, and nobody like, that’s welcome here.
We’re not allowed to say that, you know, so it changes also, you know, we we’re not allowed to even. You know, admit that the patient was a patient. So even if they’re not our patient, we’re not allowed to say that. So it’s just, it’s the system is rigged against us, is really, you know what I think, and that’s why we need to collectively work together to peel back the layers of oppression so that we can be free to do our job and to serve our patients the way we’re supposed to.
[00:35:15] Mehnaz Hyder, MD: And you brought up a really good point about the power of people coming together to address certain things with some of these entities, right? So HPEC being a digital guild can allow kind of movements within medicine where we’re all in one place and we can digitally sign onto a proposal or a petition, and hundreds or thousands of us can sign something and send it to a body that we think is needs to change or needs to hear our voice.
There’s no current technology like that available and the only ways that we are, we’re allowed to interact with each other are platforms that belong to other people. So, so we can do a lot if we’re allowed to directly interact with each other. And, and technology is obviously the great equalizer and it reduces the friction, which allows us to do it at, at a larger scale than if we were all calling each other and, you know, sending letters to each other by snail mail and then, and then taking action.
[00:36:16] Bruce Bassi, MD: Right.
[00:36:17] Mehnaz Hyder, MD: That could become really, really high yield. Mm-hmm.
[00:36:20] Bruce Bassi, MD: That made me think of another way that patients will benefit from this is because every time that we switch jobs, and obviously that happens probably a few times in our careers, there’s some downtime there, like you said, Dr. Houston, and that’s downtime where yeah, you’re not making income and also patients aren’t getting treated.
And that’s underutilized talent that’s happening across America at maybe what, five to 10% of physicians who are in that interim period where they’re not able to see anybody. And so obviously wouldn’t a patient who is on a three month wait list want that physician to get on board much more quickly so that they can actually start seeing patients and moving, moving the list of people through.
So I think it definitely makes sense for patients to also support this mission.
[00:37:15] Leah Houston, MD: Yeah, I mean, I, I call it a workforce mobility marketplace, but it’s a physician access engine. You know, it, it elevates and improves access to doctors because we’re not wasting our time doing nonsense. We’re actually sitting in front of patients caring for them.
[00:37:31] Mehnaz Hyder, MD: Which is the, which is the cure for physician burnout. And physician a moral injury. Literally, what we want to do is take care of our patients. There aren’t any other agendas.
[00:37:43] Leah Houston, MD: Yep. Correct. Yeah.
[00:37:46] Bruce Bassi, MD: Well, I love this topic and I, I like the fact that it also kind of rounds out the podcast because a lot of it is spent talking about technology and things that will directly interface with patients in terms of new treatments. And I think as a society we have a little bit of bias towards wanting to, you know, pay attention to the most sparkly and attractive new product and AI that’s out there.
But this will also impact patients in a very positive way, and also improve physicians’ livelihood and mental health, which in turn allows them to be more engaged in doctor-patient interaction too. So there’s, there’s so much here that is not getting the credit that it deserves. And I hope that the listeners out there who want to support this do head over to HPEC, and sign up and also follow on social media.
Thank. Thank you so much.
[00:38:42] Leah Houston, MD: That’s it. Thank you for having us. Thanks for listening. Thanks for considering the possibility.
[00:38:47] Bruce Bassi, MD: All I appreciate it.
[00:38:48] Bruce Bassi: As a reminder, if you’d like to support this show, one way you can help us is by subscribing to the channel on YouTube and leave a comment if you’d like.
It’d also mean the world to me. If you can share it with your social media network. Maybe there’s somebody out there who might be interested in the podcast. Hope to see you next week, next Monday. New episodes are released every Monday morning. Thanks a lot. Take care.
Resources
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