Here is the transcript of Milind Awale: A Hospitalist’s Perspective on Healthcare. Milind is a millennial who practices medicine in West Virginia. He was born and raised in India before coming to the United States to complete his education as a medical doctor. Below is the interview between Rob Oliver and Milind Awale on the Perspectives on Healthcare Podcast.
Rob Oliver: Welcome to Perspectives on Healthcare, I appreciate you being here today, today we are joined by Milind Awale. He is a hospitalist he works in West Virginia, he is a millennial a generation y person and Melissa thanks for being here today.
Milind Awale: Thanks for having me on this. So it’s really a privilege.
Rob Oliver: So I tell you what, let’s just start right at the beginning and tell me a little bit about yourself and about your role in healthcare.
Milind Awale: So as you mentioned, I am a hospitalist and I’m actually from Indian from a small town called as well call. I was born in 1982 and then was raised up in that small town and growing up, I did realize that we had a lot of patients, that I was able to see when I would volunteer at a local hospital and I would see suffering, and I would see diseases and I was drawn with compassion to those people. That was kind of initiating factor in trying to seek getting into Medical School The other thing that really set it in place was when my uncle had a heart attack and he was taken to the hospital. It was a scary scene, I remember, I was in my eighth grade, and I was really impressed by some of the physicians who helped him who helped him get back and then he underwent surgery so that experience really wanted drew me towards medicine in that practice need to it’s medicine. I started working on got into Medical School and then, when I was done with my Medical School I was contemplating as to what should be the next step, but when I started looking at the US healthcare system, I was really impressed, few things that really impressed me was the integration of technology that’s here and as to how quickly technology has been used in medical field that really impressed me a second thing that impressed me was evidence based medicine. So there are guidelines, there are protocols that are forward and for the most part we don’t do things that seem not to work, we are we guide our protocols based on studies and real the real world data and so that’s why you know you the healthcare in the United States it’s really highly regarded everywhere in the world and people then want to come to the United States to get treatment and that kind of draw me to write us and the leaves and then came here in Pittsburgh got to meet you Rob and then did my residency in Monroeville and then from then on, after doing my residency I went into the field of hospital medicine and since 2014 and been a hospital is that have been at the same place and, and this is where we are now.
Rob Oliver: Fantastic, I appreciate you sharing, giving the insight kind of into the background of how you got into medicine and how you were attracted very interesting. Can you tell me, what does quality healthcare mean to you?
Milind Awale: So you know Rob, we talk a lot about how quality healthcare and we’ve been doing that in the recent years and quality healthcare is simply healthcare so is that is being delivered to support the patient in maintaining and improving their health, so amongst a lot of things, but, basically, that is what it means to me, so it could mean providing a service in a safe way in a timely way in the most efficient way. In a in a way that we, that is equitable to everyone, but I think, also the most important part of that is patient centered care. So we want everything to revolve around the patient and most of the time, and sometimes we tend to forget that but patient is the most important person of the treatment plan and all the treatment and I think in the recent years we have tried, then, to have more of a patient centered care, I think that is what quality healthcare means to me.
Rob Oliver: Yeah and sometimes the patient seems to bother medical professionals and you know, the idea that if you got rid of all the patients, you would get rid of all of the problems in health care, but you would also, of course, get rid of the whole profession of healthcare anyway.
Rob Oliver: Can you give me an example of quality healthcare?
Milind Awale: Okay, a few things that come to mind, one would be maybe it looks talk about the effectiveness. Most of what we practice in the United States is based on scientific knowledge and based on evidence-based practice. So we tried to implicate that which has worked best in the research settings. For example, not providing unnecessary tests are not putting patients on unnecessary medications that likely would not benefit the patient. So we try then to be most effective, for example, now when COVID came out it was new, nobody knew nothing about it and then multiple hospitals went on different research protocols and, based on the research protocols, we then started looking at it closely and started studying it so every hospital design your own protocol and every rare I mean we had that big study from Oxford, which came out and said to 10 days of tech summit zone so we’ve been practicing that and we’ve been seeing that patients are getting better based on those protocols. Now that is effective medicine, if you see the same treatment elsewhere in the world there has been. People are trying different things without any rhyme or reason or any research to back that up, so what happens is it is detrimental to the patient’s health. For example, putting them on high dose steroids, which has not been studied or which has not been shown to be effective in co with then puts patients at risk and they’re susceptible to infections, so that that, so in that sense, this is a quality healthcare measure that we practice.
Rob Oliver: Actually, makes a lot of sense I think it’s a, especially where we are right now coming out of the pandemic. You know, it’s a great illustration of what you’re saying about quality healthcare. As far as being a hospitalist, what do you wish people understood about the role of hospitalists in healthcare.
Milind Awale: So if people always ask me when I when I sat around the SCI fi in the hospital and they’re like what exactly is a hospitalist and you know, the best way to define, that is basically, I would say two words, one is a surrogate physician or a physician, who is in place of your primary care or one who is an expert in dealing with acutely ill patients when patients are hospitalized and they don’t do anything in the outpatient setting. So when your primary care doesn’t come to the hospital the hospital is take over so they are experts in treating acute illness, so they are the ones making the calls on what tests, you need who which consultants, you need to see. They meet up with case managers, social workers and they start designing a plan about your discharge it’s like a quarterback I would say Rob it’s more of a quarterback that holds the entire team together, you might not always score a touchdown but you’re there to hold the team together, so I think that’s, that is what a hospital is.
Rob Oliver: Okay, I love the illustration, especially being here in Pittsburgh everything relates back to football.
Milind Awale: you’re right.
Rob Oliver: Yeah and you know, the other piece of that you know, giving the illustration of a quarterback may not always score a touchdown but you know you’re moving the team together you’re moving them down the field, it might be a field goal, it might be whatever it is just an adjustment in field position but that’s just me going on and on about football. What excites you about the future of healthcare?
Milind Awale: Yeah so I’ve been I was thinking about this and maybe there are two or three things that excite me about the future of medicine. Unfortunately, many times, when we talk about future we anything that’s attached to revenue that’s attached to finances that that that is money, making this is the direction in which we are going ahead, and I was, I was looking at artificial intelligence as much as there’s so much talk about it, both in a good way and in a way which is concerning. I think artificial intelligence is going to drive the cost of medicine to about like $15 trillion in about 2030 So this has been projected by some of the globalist. So I think artificial intelligence is going to be the future of medicine. So, in terms of artificial intelligence, now there are a few things that can be used as far as artificial intelligence is concerned, one is collecting all the data we live in a world of information technology, we are now capable of collecting lots of data so that data can be crunched and can be used in a useful way Secondly, I think, artificial intelligence is going to be used in imaging technology they’re going to be they’re going to feed all this different diagnosis into probability computers and then you’re going to have this neural network, and they are going to come up with the most probable diagnosis and some places have been using that to diagnose MRIs and more of that. So I think artificial intelligence is going to be big in as far as future of medicine is. The other thing that I was thinking was virtual reality, although some of us use that to play games and all of that virtual reality is being used in medicine and I see that there’s going to be a bigger market for it. I was just talking to one of the neurosurgeons a few days back and he was saying that until now, all they had was two dimensional picture of maybe a tumor or whatever was going on in the brain, but now, with virtual reality they can have a three dimensional view of what’s going on in the brain where exactly the lesion is and how to approach it and they are able to even show that to the patient, so that the patient, will be able to understand the advantage of having a three dimensional picture is you can before you get into the operating room, you can try and see how many different approaches, you can have to that tumor or to death lesion because earlier it used to be just that one approach you make that approach, and there is no turning back and now you were able to view all that, so I think virtual reality is also going to be the future of medicine and then I was also thinking of the aspect which was, I think genetics and I think call would really opened our eyes what was just a concept became a reality with the vaccine when they saw when they when they came up with Mr Mr me maxing I think that was kind of a breakthrough for genetic therapies. It was fascinating because they were able to study the sequence of the virus then make a messenger RNA put it in your body and then produce the same antibodies as what the virus would produce, so instead of having the wireless in your system, you were just having a piece of genetic information, and that would induce antibodies and would protect you, so I think that acceptance of that relaxing that leaving that was given by the FDA and the government is really a big step in in genetic therapy yeah.
Rob Oliver: Alright, so you mentioned genetics, virtual reality and artificial intelligence, so I think fascinating all three of them artificial intelligence, you had me a little bit worried that we were going to have robotic doctors, but it’s the artificial intelligence is assisting the doctors in making a thing, because to me you can’t ever take the human element out of it. But then, with the virtual reality you’re actually able I think what you were saying is you can simulate how to approach things because you’ve got all of the three dimensional picture and then with genetics it’s not putting in a weakened form of the virus. You’re putting in just a genetic, you know, the genetic clip of it which allows them. Yep, fascinate. What is one thing that medical professionals can start doing today to improve the quality of healthcare?
Milind Awale: So change is always a very difficult thing for anyone, and you know, and I, and I see this because I do have a sort of leadership role is to in the place that I work at, and you know for the doctor, what matters most is the patient who’s in front of them and behind that closed door behind those curtains is that relationship between the doctor and the patient, but many times we forget that there’s a bigger and wider picture out there it’s like the health care of the entire communities, the health care of the entire population that we are responsible for and so to affect that that health care of that entire population, there are a few changes that need to come about, and every physician, I think, wants to make the change, but then it sometimes becomes very taxing so The one thing that I think medical professionals can start doing is to participate in the change is to participate in improvements is to do the best that they can to make changes, and I think, because as technology moves ahead, we have to keep up with technology, not just that there are also added responsibilities brought in over you by the government by CMS by all these institutions, and I think the day as well on driving it towards a quality healthcare system, so I think adapting to that change is something that I think every healthcare worker should look forward to, and just great to go with the change.
Rob Oliver: Well said, my friend. Milind Awale, you have been fantastic Thank you so much for sharing your perspective. I appreciate you being with me today and thank you for sharing your perspective on healthcare.
Milind Awale: Thank you Rob, It was a privilege and honor, thank you for having me.