WEBVTT 1 00:00:01.360 --> 00:00:06.480 It's Night Side with Dan Ray on Bzy Boston's Radio. 2 00:00:06.879 --> 00:00:10.240 Thank you, Dan Watkins. Just a little over a week ago, 3 00:00:10.320 --> 00:00:13.679 we had this guest that's coming up on with us 4 00:00:14.080 --> 00:00:18.160 and we were had the fortune to talk with doctor 5 00:00:18.239 --> 00:00:22.160 Marshall Rungi, who is the dean of the University of 6 00:00:22.160 --> 00:00:26.039 Michigan Medical School, and I just felt that it would 7 00:00:26.039 --> 00:00:28.079 be great to bring him back, and he is consented 8 00:00:28.079 --> 00:00:31.160 to come back and take some phone calls. Doctor Runky, 9 00:00:31.239 --> 00:00:34.679 welcome back. You have a book that is just about 10 00:00:34.719 --> 00:00:36.640 to come out. I don't know if it's I think 11 00:00:36.640 --> 00:00:41.119 it's public published. Publicity date or published date is May sixth, 12 00:00:41.320 --> 00:00:43.200 coming up May sixth, a couple of weeks from now. 13 00:00:43.240 --> 00:00:43.840 Is that the deal? 14 00:00:44.960 --> 00:00:46.479 Yes, Dan, And it's great to be back on your 15 00:00:46.479 --> 00:00:47.960 show again. Thanks for inviting me. 16 00:00:48.320 --> 00:00:53.320 Oh our pleasure. So your book is The Great Healthcare Disruption. 17 00:00:54.240 --> 00:00:54.679 Uh? 18 00:00:54.719 --> 00:00:57.719 And you this is not your first book as I 19 00:00:57.759 --> 00:00:58.280 understand it. 20 00:00:58.320 --> 00:00:59.840 Correct, No, it's not. 21 00:01:00.840 --> 00:01:04.599 It's a new venture for me. Forges Books called me 22 00:01:04.719 --> 00:01:07.000 up and asked me if I wanted to write a 23 00:01:07.040 --> 00:01:09.519 book about where I thought healthcare was going in the 24 00:01:09.560 --> 00:01:11.879 next five to ten years and pick some important topics. 25 00:01:11.920 --> 00:01:13.120 And it was. 26 00:01:14.879 --> 00:01:16.159 A great project to work on. 27 00:01:16.680 --> 00:01:18.959 Well, my test thinning is that you look at the 28 00:01:19.239 --> 00:01:24.519 recent technological advances, policy changes, and different business models. Let's 29 00:01:24.519 --> 00:01:27.599 break that down a little bit in our conversation to 30 00:01:28.000 --> 00:01:32.560 language that lay people can understand. We talked earlier about 31 00:01:32.599 --> 00:01:36.680 how difficult it is to find a personal care physician 32 00:01:37.439 --> 00:01:41.760 what we call PCBs, PCPs or family doctors back here. 33 00:01:42.439 --> 00:01:46.840 Doctors are retiring at a very fast rate. The doctors 34 00:01:46.920 --> 00:01:51.480 that were produced through the baby boom. They're hanging the 35 00:01:51.519 --> 00:01:56.000 stethoscopes up. I had lunched the other day with a 36 00:01:56.079 --> 00:01:59.000 doctor friend of mine who retired a few years ago, 37 00:01:59.519 --> 00:02:03.120 and irust him about the fact that it's tough to 38 00:02:03.159 --> 00:02:05.879 get a doctor these days, no matter how old you are. 39 00:02:06.239 --> 00:02:09.240 And he was saying that he knew of a PCP, 40 00:02:09.840 --> 00:02:14.479 you know, general practitioner who retired and she cannot find 41 00:02:14.479 --> 00:02:17.919 a doctor herself. So in the midst of all of 42 00:02:17.719 --> 00:02:22.280 the renovations, you know, the new renovations, the technological renovations 43 00:02:22.319 --> 00:02:25.479 that we're that we're talking about, just getting a doctor's tough. 44 00:02:25.520 --> 00:02:29.439 So let's talk about some of these advances. Let's talk 45 00:02:29.439 --> 00:02:33.039 about the good ones first. What are the developments that 46 00:02:33.159 --> 00:02:37.080 you see that are clearly going to be positive going forward. 47 00:02:37.479 --> 00:02:38.520 In the terms of. 48 00:02:38.479 --> 00:02:44.120 Healthcare, well, I think there are several I do think finally, 49 00:02:44.240 --> 00:02:48.039 after a long time, there's much attention being paid to 50 00:02:48.719 --> 00:02:53.159 how we need to educate more doctors, and particularly those 51 00:02:53.199 --> 00:02:57.000 who are going to do primary care, so family medicine, doctors, 52 00:02:57.039 --> 00:03:01.479 in general internals, general pediatricians. Because if you look at 53 00:03:02.039 --> 00:03:03.919 there are all different kinds of ways to measure it. 54 00:03:03.960 --> 00:03:06.319 But if you look at the number of primary care 55 00:03:06.400 --> 00:03:10.400 physicians per one thousand in the United States, that's about 56 00:03:10.439 --> 00:03:12.919 point three to one. But if you look at our 57 00:03:13.000 --> 00:03:18.080 peer countries, sort of the high income advanced countries, their 58 00:03:18.199 --> 00:03:22.319 numbers are up to five or ten times as many 59 00:03:22.400 --> 00:03:28.120 primary care physicians. And I think that one of the 60 00:03:28.159 --> 00:03:30.199 things that we really need to focus on is helping 61 00:03:30.759 --> 00:03:34.240 people be healthy. Now we have great healthcare. If I'm 62 00:03:34.240 --> 00:03:36.840 going to be terribly sick, I'd rather be in the 63 00:03:36.919 --> 00:03:39.919 United States than anywhere else. But you're absolutely right, it's 64 00:03:39.919 --> 00:03:44.599 hard to find a primary care doctor, and we need 65 00:03:44.639 --> 00:03:46.319 to increase the number of people in those areas, and 66 00:03:46.360 --> 00:03:48.240 I think there are ways to do it, and I 67 00:03:48.280 --> 00:03:52.039 think we need to do more to try to keep 68 00:03:52.080 --> 00:03:54.560 people healthy so they don't have to go to the office, 69 00:03:55.000 --> 00:03:55.360 so that's. 70 00:03:55.280 --> 00:03:58.319 Why they bought. But the number that you just gave, 71 00:03:58.400 --> 00:04:01.360 I want to break that down. You're saying that for 72 00:04:01.520 --> 00:04:06.879 every primary care physician in this country, per one thousand people, 73 00:04:07.639 --> 00:04:10.240 there is zero point three to one. So that means 74 00:04:10.319 --> 00:04:13.599 that every primary care physician in this country, you've got 75 00:04:13.680 --> 00:04:17.319 to triple that thousand. There's one primary care physician for 76 00:04:17.360 --> 00:04:20.319 about every three thousand people, which is crazy. I think 77 00:04:20.560 --> 00:04:24.040 that's y. Yes, that's too much for anyone to handle, 78 00:04:24.360 --> 00:04:29.480 which is why so many people now their primary care 79 00:04:29.519 --> 00:04:32.079 physician is the local emergency room. We've gotten into that 80 00:04:32.240 --> 00:04:35.120 situation too, by the way, which is kind of the 81 00:04:35.160 --> 00:04:37.319 flip side of that ugly coin. 82 00:04:38.360 --> 00:04:43.240 Yes, you're you're absolutely right, Dan. And the other problem 83 00:04:43.319 --> 00:04:46.759 with the merchaningy rooms. I mean, there they provide great care, 84 00:04:46.879 --> 00:04:50.839 but it's very expensive. But the biggest part is you 85 00:04:50.959 --> 00:04:54.160 lose that continuity that you would have with a physician 86 00:04:54.240 --> 00:04:57.600 that you know, a doctor that you know, so because 87 00:04:57.600 --> 00:04:59.120 you go to the Mercury moom, it could be whoever 88 00:04:59.199 --> 00:05:02.439 happens to be working on on that shift. I do 89 00:05:03.000 --> 00:05:03.959 go ahead, let me. 90 00:05:03.959 --> 00:05:08.160 Ask you one question. One of the solutions that I 91 00:05:08.279 --> 00:05:12.439 think the medical community was suggesting UH to make up 92 00:05:12.480 --> 00:05:17.040 for the shortfall of internist pediatricians and primary care physicians, 93 00:05:17.920 --> 00:05:20.040 the doctor who you go to see on a regular basis, 94 00:05:20.600 --> 00:05:24.439 UH is saying, well, we'll graduate people who are known 95 00:05:24.560 --> 00:05:30.639 as UH. You know, medical assistants are are what what 96 00:05:30.839 --> 00:05:32.439 is I'm trying to think of the phrase they're not 97 00:05:32.600 --> 00:05:37.639 quite doctors, but their physicians assistance is the phrase I'm thinking. Yeah, 98 00:05:38.759 --> 00:05:41.279 it's sort of in the spectrum. You know, I love nurses, 99 00:05:41.720 --> 00:05:44.920 but between becoming a doctor or a nurse, they have 100 00:05:45.040 --> 00:05:49.240 these folks are now physicians assistants. Has that experiment run 101 00:05:49.319 --> 00:05:51.839 its course and either succeeded or failed. 102 00:05:53.519 --> 00:05:59.759 It has in general succeeded and both for physicians assistants 103 00:05:59.839 --> 00:06:03.319 and and UH. In nursing there are what are called 104 00:06:03.319 --> 00:06:09.040 advanced practice nurses who are nurse practitioners, and that has 105 00:06:09.120 --> 00:06:12.480 been very helpful. And actually, in many rural areas or 106 00:06:12.560 --> 00:06:18.639 underserved areas, they the physician's assistants or nurse practitioners. They're 107 00:06:18.639 --> 00:06:21.199 they're they're they're the primary care provider in those areas 108 00:06:21.279 --> 00:06:24.800 because there just aren't enough doctors to who live there 109 00:06:24.879 --> 00:06:27.839 who want to practice medicine there. So I think it 110 00:06:28.000 --> 00:06:30.920 has been a it's been an important solution, and but 111 00:06:31.040 --> 00:06:36.079 it's not enough. And I think that a problem that 112 00:06:36.199 --> 00:06:38.879 I think we touched on briefly before Dan was that 113 00:06:39.000 --> 00:06:42.439 physicians just feeling worn out, burned out. And there are 114 00:06:42.560 --> 00:06:46.240 some technologies that I think are going to be really helpful. 115 00:06:47.519 --> 00:06:51.120 One of those has to do with AI. So there's 116 00:06:51.199 --> 00:06:56.519 a technology called ambient AI that's used in healthcare. Now, 117 00:06:56.759 --> 00:06:59.399 it's not widely used, but it's we're using it in 118 00:06:59.720 --> 00:07:03.480 the Versus Michigan. What it does is it listens to 119 00:07:03.560 --> 00:07:06.800 the conversation between the doctor and the patient, or the 120 00:07:08.240 --> 00:07:11.560 nurse practitioner or the physician's assistant and the patient, and 121 00:07:12.199 --> 00:07:15.800 it doesn't just transcribe it. It transforms it into a 122 00:07:16.480 --> 00:07:20.680 really high quality medical note. For all of us who've 123 00:07:20.680 --> 00:07:23.000 played around with AI, it's just amazing how it can 124 00:07:23.920 --> 00:07:29.360 summarize things and make it very logical. And so what 125 00:07:29.560 --> 00:07:32.079 that helps with is I don't know about you, but 126 00:07:32.319 --> 00:07:36.680 when I go to see my interness, generally he's facing 127 00:07:36.720 --> 00:07:38.639 the other way. He's a great doctor, he's facing the 128 00:07:38.680 --> 00:07:40.560 other way. He's tpping on his computer trying to keep up. 129 00:07:41.360 --> 00:07:44.800 And most primary care physicians say at the end of 130 00:07:44.800 --> 00:07:47.519 the day, they have two or three hours worth of 131 00:07:47.600 --> 00:07:50.600 documentation left. If they use this technology that I was 132 00:07:50.720 --> 00:07:54.319 just just they could be done when their clinic is done. 133 00:07:54.519 --> 00:07:57.040 Those notes are churned out by the time, but within 134 00:07:58.040 --> 00:07:59.879 a minute or two of when they finish their patient 135 00:08:00.040 --> 00:08:02.639 counter that can prove it, read it, correct it, and 136 00:08:02.839 --> 00:08:05.279 go on to the next questient. So there are technologies 137 00:08:05.360 --> 00:08:07.240 like that that they help, okay, and. 138 00:08:07.279 --> 00:08:13.519 So those that ambient AI produces a document which isn't 139 00:08:13.639 --> 00:08:17.360 just sort of like a verbatim transcription of the entirety 140 00:08:17.399 --> 00:08:21.959 of the conversation. It is able because it's artificial intelligence 141 00:08:22.360 --> 00:08:26.560 to isolate the portions of the conversation that are important 142 00:08:26.600 --> 00:08:29.000 to the doctor and to the patient, and it's then 143 00:08:29.120 --> 00:08:32.120 presented in a form that looks more like a form 144 00:08:32.200 --> 00:08:35.840 that the doctor would would produce, not just the transcript. 145 00:08:36.200 --> 00:08:39.519 How you're doing today, what's going on? Those Tigers keep winning, 146 00:08:40.240 --> 00:08:42.600 They're going to be a good team this year. That 147 00:08:42.919 --> 00:08:44.840 is not what's going to be trans We're going to 148 00:08:44.879 --> 00:08:47.600 be I assumed they're gonna They're gonna separate the wheat 149 00:08:47.639 --> 00:08:49.360 from the chaff, is what I'm trying to say. If 150 00:08:49.360 --> 00:08:54.440 it's if it's it really is artificial intelligence exactly. 151 00:08:54.840 --> 00:08:58.799 And I'll tell you another interesting factor of what AI 152 00:08:58.960 --> 00:09:04.240 is bringing forward and announces medical records. If you have 153 00:09:04.799 --> 00:09:07.360 requested your medical record, or you look at your medical record, 154 00:09:07.679 --> 00:09:10.320 it can be page after page after page after page 155 00:09:11.519 --> 00:09:14.519 of stuff that's just kind of piled on, and you 156 00:09:14.679 --> 00:09:20.360 can put that into an AI reader and interpreter and 157 00:09:20.480 --> 00:09:24.039 it can come up with a very powerful but concise 158 00:09:25.720 --> 00:09:28.279 summary of all the important things. And so rather than 159 00:09:28.960 --> 00:09:30.879 you having to look through or your doctor having to 160 00:09:30.960 --> 00:09:36.000 looked through fifteen pages, they it's a page and it 161 00:09:36.120 --> 00:09:37.639 has or maybe a page in a half, and it 162 00:09:37.679 --> 00:09:39.000 has everything that you need to do. 163 00:09:39.840 --> 00:09:43.799 Well, you know, doctor Ronki. I'm a keeper of records. 164 00:09:44.240 --> 00:09:49.000 I have in my office my medical records, okay by 165 00:09:49.159 --> 00:09:54.399 year and obviously over time. Some of them do provide 166 00:09:54.559 --> 00:09:59.679 insight out of importance. Others are just repetitive or unnecessary. 167 00:10:00.159 --> 00:10:02.080 And if there was a machine, I could see these 168 00:10:02.200 --> 00:10:05.440 records and I actually make up when I have the time, 169 00:10:06.639 --> 00:10:09.200 charts and graphs for myself, so I can look at, well, 170 00:10:09.240 --> 00:10:11.080 what was my what was my blood pressure? What was 171 00:10:11.120 --> 00:10:14.159 my cholesterol five years ago, ten years ago? Is there 172 00:10:14.279 --> 00:10:17.200 anything that is trending in a bad direction. I assume 173 00:10:17.480 --> 00:10:20.200 this is the sort of artificial intelligence that they could 174 00:10:20.240 --> 00:10:20.919 do that for me. 175 00:10:22.120 --> 00:10:24.720 Yes, But I have to tell you, Dan, you're like 176 00:10:24.799 --> 00:10:27.679 the perfect patient. I'm a cardiologist and for somebody who 177 00:10:27.679 --> 00:10:30.080 wants to follow what they're doing and knows what's going on. 178 00:10:30.639 --> 00:10:33.159 You know that that's my day when I see somebody 179 00:10:33.320 --> 00:10:36.120 like you. But you could try this experiment. You could 180 00:10:36.120 --> 00:10:39.679 take your you know, take a pile of your medical 181 00:10:39.720 --> 00:10:43.799 records and you can make a PDF of it, drag 182 00:10:43.840 --> 00:10:47.080 it over into chat, GPT and FAY summarize the important 183 00:10:47.120 --> 00:10:51.000 components of my medical record, show my blood pressure results 184 00:10:51.039 --> 00:10:54.279 over the past five years or whatever you want to 185 00:10:54.279 --> 00:10:57.399 look at. Are you my blood work, and it'll do it, 186 00:10:57.440 --> 00:10:58.039 and it'll. 187 00:10:57.879 --> 00:10:58.559 Do it in minutes. 188 00:10:58.960 --> 00:11:01.840 It is I try because I was just interested. Does 189 00:11:01.919 --> 00:11:04.240 it really work? And it really works? 190 00:11:06.000 --> 00:11:07.799 You're the dean of a medical school. Of course, you 191 00:11:07.879 --> 00:11:11.559 got to try that. My guest is doctor Marshall Rangy. 192 00:11:11.840 --> 00:11:16.320 His book is The Great health Care Disruption. It's it's 193 00:11:16.399 --> 00:11:19.320 published by Forbes Books. It's coming out on May sixth. 194 00:11:19.360 --> 00:11:22.960 I assume it's available now through Amazon and places like that. 195 00:11:23.399 --> 00:11:25.039 We have a lot to cover. If you'd like to 196 00:11:25.159 --> 00:11:28.000 join the conversation six one, seven, two, five, four ten 197 00:11:28.120 --> 00:11:31.120 thirty six one seven, nine three one ten thirty. It's 198 00:11:31.240 --> 00:11:33.120 not often on night Side, and I've had a lot 199 00:11:33.200 --> 00:11:36.480 of guests over eighteen years. I haven't had too many 200 00:11:36.559 --> 00:11:40.200 deans of medical schools, nor any dean of medical school 201 00:11:40.240 --> 00:11:44.519 who is who is a fluid and as understandable. Uh 202 00:11:44.639 --> 00:11:49.360 as doctor Rungy and Uh, I'm delighted he's back. We'll 203 00:11:49.360 --> 00:11:52.600 get some phone calls. Any question you might have, feel free. 204 00:11:52.799 --> 00:11:55.159 As I keep telling you that, as I learned in 205 00:11:55.279 --> 00:11:57.799 law school, the only questions that are dumb questions are 206 00:11:57.799 --> 00:12:00.519 the ones that you're too afraid to ask because they 207 00:12:00.559 --> 00:12:03.559 always came up on the midterms or in the final exam. 208 00:12:03.720 --> 00:12:06.399 So if you have any question, you know he's not 209 00:12:06.480 --> 00:12:08.519 going to diagnose you. Over the year. You understand the 210 00:12:08.559 --> 00:12:13.759 ground rules at Nightside that regard to okay, but if 211 00:12:13.799 --> 00:12:16.039 you have a question, feel free. We'll be back on 212 00:12:16.159 --> 00:12:18.240 Nightside with doctor Marshall RUNGI. 213 00:12:18.399 --> 00:12:22.080 Right after this, you're on Night Side with Dan Ray 214 00:12:22.440 --> 00:12:25.039 on wz Boston's news radio. 215 00:12:26.799 --> 00:12:29.039 We will get to phone because I promise, but I 216 00:12:29.200 --> 00:12:32.159 just have one more segment that i'd like to talk 217 00:12:32.240 --> 00:12:34.960 with Doctor Marshall rungy about. He is the dean of 218 00:12:35.000 --> 00:12:38.600 the medical school at the University of Michigan, which is 219 00:12:38.679 --> 00:12:42.279 a great university for anyone who doesn't understand it is 220 00:12:42.360 --> 00:12:47.080 one of the pre eminent universities in this country. I 221 00:12:47.279 --> 00:12:49.840 just want to touch briefly, and we only have about 222 00:12:49.879 --> 00:12:52.440 four minutes until the newscast. Five minutes to the newscast. 223 00:12:52.519 --> 00:12:58.879 Here just to give a perspective, how many students does 224 00:12:58.960 --> 00:13:01.519 the University of Michigan. How many seats do you have 225 00:13:01.679 --> 00:13:05.720 for students coming in as a first year medical student 226 00:13:06.159 --> 00:13:06.879 that you can admit. 227 00:13:07.000 --> 00:13:10.639 Every year, we admit about one hundred and seventy student. 228 00:13:10.720 --> 00:13:12.559 It varies a little bit from year to year, but 229 00:13:12.600 --> 00:13:14.639 one hundred and seventy a year, okay. 230 00:13:15.120 --> 00:13:18.600 And how many students apply for those one hundred and 231 00:13:18.679 --> 00:13:19.399 seventy seats? 232 00:13:20.279 --> 00:13:24.519 Oh golly, I bet it's competitive. It's close to ten 233 00:13:24.600 --> 00:13:27.799 thousand people apply for those Okay. 234 00:13:27.600 --> 00:13:32.559 Very co If it's ten thousand people who apply, most 235 00:13:32.639 --> 00:13:37.799 of whom I assume have conquered organic chemistry. You're talking 236 00:13:37.840 --> 00:13:44.039 about an admission rate of one point seven percent. If 237 00:13:44.080 --> 00:13:45.320 I'm doing my math, if. 238 00:13:45.240 --> 00:13:50.240 I that's probably right. Your math is faster than mine. 239 00:13:50.279 --> 00:13:52.919 But I think that sounds right. Yes, it's a very 240 00:13:52.960 --> 00:13:53.840 low admission, right. 241 00:13:53.840 --> 00:13:56.960 Yeah, if it was a thousand seats for ten thousand, 242 00:13:57.080 --> 00:14:00.320 it would be ten percent. This is this is over 243 00:14:00.399 --> 00:14:04.159 one and a half percent, one point seven percent. And 244 00:14:05.559 --> 00:14:09.919 how many of those students who you because you only 245 00:14:09.960 --> 00:14:14.399 have so many seats, who you cannot physically accept that 246 00:14:14.519 --> 00:14:18.759 you have to reluctantly deny. How many of them do 247 00:14:18.879 --> 00:14:23.799 you think seek a medical career elsewhere, if if at 248 00:14:23.919 --> 00:14:27.360 other medical schools, or if necessary offshore. You and I 249 00:14:27.440 --> 00:14:29.879 have talked about the offshore medical schools before. I just 250 00:14:29.960 --> 00:14:33.399 want people to understand that that these are qualified students. 251 00:14:33.480 --> 00:14:38.360 I mean the you know, I assume that a good 252 00:14:38.480 --> 00:14:44.159 percentage of those students could handle you know, the medical 253 00:14:44.200 --> 00:14:46.679 school experience, but you just don't have the seats. 254 00:14:48.519 --> 00:14:52.399 Yes, that's correct, Dan. We on an average year, we 255 00:14:52.519 --> 00:14:57.399 feel there are five or six hundred very high quality candidates, 256 00:14:57.960 --> 00:14:59.480 you know, after we go to this pool. But the 257 00:14:59.600 --> 00:15:04.279 number is so high because now, as with college applications, 258 00:15:05.000 --> 00:15:08.360 a person can apply to thirty different places, and so 259 00:15:08.519 --> 00:15:09.799 we get a lot of there are a lot of 260 00:15:09.840 --> 00:15:13.919 people applying to different medical schools. But I would estimate 261 00:15:14.120 --> 00:15:19.919 the number of highly qualified candidates in the United States 262 00:15:20.440 --> 00:15:24.120 exceeds the number of positions in US medical schools by 263 00:15:25.759 --> 00:15:28.960 at least two or threefolds. 264 00:15:28.480 --> 00:15:28.559 So. 265 00:15:30.399 --> 00:15:30.840 Much higher. 266 00:15:31.399 --> 00:15:33.039 And a lot of those folks end up going to 267 00:15:33.240 --> 00:15:36.240 medical schools that are called offshore medical schools. I guess 268 00:15:36.279 --> 00:15:39.120 they can go to schools in Canada if those schools 269 00:15:39.320 --> 00:15:43.320 are available, they are Canadian residents. How do we rectify this? 270 00:15:43.480 --> 00:15:46.120 How do we get in this situation where there are 271 00:15:46.240 --> 00:15:48.279 kids who are who are knocking at the door and 272 00:15:48.639 --> 00:15:51.600 they and they want to be doctors, and we don't 273 00:15:51.639 --> 00:15:55.919 have the capacity to educate them well. University of Michigan, 274 00:15:55.960 --> 00:15:57.360 I'm talking about we as a society. 275 00:15:58.159 --> 00:16:00.639 Yes, I think there are a couple of issues. One 276 00:16:00.759 --> 00:16:06.840 is medical school education, like all education, who's gotten highly regulated. 277 00:16:07.519 --> 00:16:10.159 And some of that's positive and some of it's not 278 00:16:10.279 --> 00:16:12.720 a positive. But one of the things that has resulted 279 00:16:12.759 --> 00:16:16.559 in is I think our medical school classes are smaller 280 00:16:16.639 --> 00:16:19.600 than they could be. I think we have the capacity 281 00:16:19.879 --> 00:16:24.600 the University of Michigan, both the capacity for the more 282 00:16:24.639 --> 00:16:27.759 scientific parts of it as well as the capacity to 283 00:16:27.879 --> 00:16:32.120 train in different practice locations, different hospitals. We could train 284 00:16:32.240 --> 00:16:35.639 twice as many people and I think that's probably true 285 00:16:36.519 --> 00:16:42.200 in most medical schools. But there's concern about is that 286 00:16:42.279 --> 00:16:44.399 too many, too many students for us to give the 287 00:16:44.519 --> 00:16:51.600 knobable experience. The regulatory agencies, the Licensing commit Commission for 288 00:16:51.720 --> 00:16:56.559 Medical Education LCME, it's very difficult to increase the size 289 00:16:56.600 --> 00:16:58.840 of your class, and so I think we need to 290 00:16:58.879 --> 00:17:01.039 take a look at that and say, why can't we 291 00:17:01.120 --> 00:17:03.840 do more? Because we need more physicians, really, really in 292 00:17:04.160 --> 00:17:08.839 every specialty. The number of physicians is inadequate in the 293 00:17:08.920 --> 00:17:11.880 United States. And this dates back, oh more than twenty 294 00:17:11.960 --> 00:17:16.200 years when studies were done under the belief that certain 295 00:17:16.240 --> 00:17:19.599 changes in healthcare were going to result in far much 296 00:17:19.680 --> 00:17:21.920 lower need for physicians. And that just turned out to 297 00:17:21.960 --> 00:17:26.079 be a wrong assumption. So we need direct that and 298 00:17:26.359 --> 00:17:28.440 part of that's on us. Part of it's on me. 299 00:17:28.519 --> 00:17:30.759 I've been trying to get us to increase the size 300 00:17:30.799 --> 00:17:35.079 of our medical school class. But it's a state Hills time. 301 00:17:35.640 --> 00:17:38.880 Well, your class at the University of Michigan admits one 302 00:17:38.960 --> 00:17:43.920 hundred and seventy Here in Massachusetts, Michael Collins is the 303 00:17:44.000 --> 00:17:47.400 dean out there, and doctor Collins tells me it's a 304 00:17:47.440 --> 00:17:50.039 hard cap at one and twenty. Now I know Michigan's 305 00:17:50.039 --> 00:17:54.119 a bigger state than Massachusetts. But I think that that 306 00:17:54.279 --> 00:17:58.240 you're doing pretty well compared to Massachusetts. And whoever came 307 00:17:58.359 --> 00:18:01.079 up with that idea that they would need fewer doctors 308 00:18:01.799 --> 00:18:05.839 with the baby boomers now aging wasn't. Didn't anybody look 309 00:18:05.880 --> 00:18:08.680 at the birth certificates from the birth rates from the 310 00:18:08.759 --> 00:18:11.799 late forties and early fifties and do some man on that. 311 00:18:12.960 --> 00:18:16.680 I mean, clearly, I can only plead innocent. I wasn't 312 00:18:16.720 --> 00:18:17.519 part of those studies. 313 00:18:18.039 --> 00:18:19.799 No, I'm sure you were. I'm sure you weren't. But 314 00:18:20.000 --> 00:18:23.440 whoever was, I think that they did do some calculations. 315 00:18:23.519 --> 00:18:25.039 Were getting to take a break at it to get 316 00:18:25.079 --> 00:18:28.599 some news here will we want to talk more with 317 00:18:28.759 --> 00:18:32.200 doctor Marshall Runggy. He's the dean of the University of 318 00:18:32.359 --> 00:18:35.559 Michigan Medical School, a great medical school. His book The 319 00:18:35.640 --> 00:18:40.359 Great Healthcare Disruption, published by Forbes Books, available May sixth, 320 00:18:40.559 --> 00:18:42.640 twenty twenty five. I'm sure you can get it through 321 00:18:42.720 --> 00:18:45.440 Forbes Books. You can get it at Amazon. You can 322 00:18:45.640 --> 00:18:48.720 order it. It's coming out on May sixth. That probably 323 00:18:48.799 --> 00:18:51.680 there's there's pre orders available. We're going to talk a 324 00:18:51.759 --> 00:18:54.160 little bit about the book two when we get back 325 00:18:55.240 --> 00:19:01.680 some of the transformation that doctor Rungi said is really necessary. 326 00:19:01.759 --> 00:19:03.480 We'll get to all of that and also get to 327 00:19:03.559 --> 00:19:05.759 some phone calls. I promise if you'd like to get 328 00:19:05.799 --> 00:19:08.319 on board now, you'll be guaranteed to get a chance 329 00:19:08.400 --> 00:19:11.039 to chat. If you wait, you may we may run 330 00:19:11.079 --> 00:19:14.759 out of time because we have Professor Stephen Pinker of 331 00:19:15.160 --> 00:19:18.480 Harvard University psychologists at Harvard University joining us at ten 332 00:19:18.480 --> 00:19:22.920 o'clock to talk about the Trump administration's efforts or threats 333 00:19:23.400 --> 00:19:28.759 to take the tax exempt status away from Harvard University. 334 00:19:29.079 --> 00:19:31.880 Steve Pinker has been on the show before. He is 335 00:19:32.359 --> 00:19:35.759 no flaming radical at all. He's been very critical of 336 00:19:35.880 --> 00:19:40.039 some of the actions of the administration at Harvard, particularly 337 00:19:40.160 --> 00:19:43.640 as it related to some of the demonstration's last spring, 338 00:19:44.240 --> 00:19:47.039 the EI initiatives, et cetera. But he feels that it 339 00:19:47.160 --> 00:19:51.160 is an overstretch, overreach for the government to begin to 340 00:19:51.680 --> 00:19:55.480 withdraw tax exempt status from an institution like Harvard, for 341 00:19:55.599 --> 00:20:01.319 that matter, for really almost any institution, health care, facilit university, 342 00:20:01.920 --> 00:20:03.640 a place of worship. We'll get to all of that, 343 00:20:03.759 --> 00:20:08.119 I promise, if you'd like to jump on board six one, seven, two, five, four, ten, 344 00:20:08.240 --> 00:20:11.200 thirty six one seven, nine three, one, ten thirty. And 345 00:20:11.240 --> 00:20:13.799 if you are a college student out there who might 346 00:20:13.839 --> 00:20:17.279 be listening and are thinking about practicing medicine, this is 347 00:20:17.279 --> 00:20:19.920 an opportunity not to plead your case for acceptance to 348 00:20:19.920 --> 00:20:21.920 the University of Michigan, but you certainly can ask the 349 00:20:22.000 --> 00:20:27.640 dean what courses perhaps are would be most helpful to 350 00:20:27.759 --> 00:20:30.440 see on your resume and what you might be able 351 00:20:30.480 --> 00:20:34.160 to do at an extracurricular basis which might stand you 352 00:20:34.359 --> 00:20:37.319 out apart from all of the other highly qualified applicants. 353 00:20:37.359 --> 00:20:39.599 Back on Nightside the number six one, seven, two, five 354 00:20:39.680 --> 00:20:42.000 four ten thirty or six one, seven, nine three one 355 00:20:42.119 --> 00:20:44.480 ten thirty. Back on Nightside right after the news. 356 00:20:46.400 --> 00:20:48.480 So you're on night Side with Dan Ray. 357 00:20:48.880 --> 00:20:53.640 I'm w b Z, Boston's news Radio, delighted to have 358 00:20:53.839 --> 00:20:56.640 with us as my guest this hour, doctor Marshall Rungi. 359 00:20:56.759 --> 00:21:00.400 He is the dean of the University of Michigan Medical School. 360 00:21:00.799 --> 00:21:00.880 Uh. 361 00:21:01.079 --> 00:21:04.640 Doctor Ronki, we actually have listeners in Michigan, and I'm 362 00:21:04.720 --> 00:21:06.480 hoping one or two of them might pick up the 363 00:21:06.599 --> 00:21:10.559 phone tonight just so they that you will believe what 364 00:21:10.640 --> 00:21:13.000 I'm talking about. We have listened all over the country. 365 00:21:13.519 --> 00:21:13.640 Uh. 366 00:21:13.880 --> 00:21:17.079 And this is a problem that does exist all over 367 00:21:17.160 --> 00:21:21.079 the country. Is there anywhere in America, in your opinion 368 00:21:21.279 --> 00:21:24.400 or within your knowledge, where it is easier to get 369 00:21:25.160 --> 00:21:28.000 a new doctor if your doctor happens to retire or 370 00:21:28.519 --> 00:21:31.680 move move the practice out of town, or is this 371 00:21:32.079 --> 00:21:33.920 a problem that exists almost everywhere? 372 00:21:35.640 --> 00:21:40.359 Then I think it's almost everywhere, and in particular to 373 00:21:40.480 --> 00:21:43.920 get a new primary care doctor. Now, in many cities 374 00:21:44.759 --> 00:21:47.839 there's a more of a concentration of specialists, and it 375 00:21:47.920 --> 00:21:51.960 may be easier to find a specialist in large cities 376 00:21:52.000 --> 00:21:56.160 than it is in smaller, smaller towns or rural areas. 377 00:21:56.640 --> 00:21:59.960 But the problem with finding the primary care doctor is everywhere. 378 00:22:00.960 --> 00:22:05.200 Yeah. And that is the foundation upon which any person 379 00:22:05.480 --> 00:22:10.319 needs to build their medical care in my opinion, because 380 00:22:10.319 --> 00:22:13.640 it's that primary care doctor that is going to spot 381 00:22:13.759 --> 00:22:18.240 things in your on your chart or just during your 382 00:22:18.480 --> 00:22:22.400 annual visit or your semi annual visit with the blood 383 00:22:22.440 --> 00:22:24.880 test and see some number is going in the wrong direction. 384 00:22:25.279 --> 00:22:28.359 Let me let's let's get some callers in here as 385 00:22:28.440 --> 00:22:31.440 well as our conversation. If it's okay, We're going to 386 00:22:31.519 --> 00:22:34.160 go first to Frank, who is calling not from Michigan 387 00:22:34.240 --> 00:22:37.720 but from South Boston. Frank, You're on with doctor Marshall Roungy. 388 00:22:38.279 --> 00:22:41.160 He's the dean of the University of Michigan Medical School 389 00:22:41.240 --> 00:22:43.920 and the author of a new book, The Great Healthcare Disruption. 390 00:22:45.480 --> 00:22:49.960 Hey, Dan, thank you for taking my call, and thank 391 00:22:50.039 --> 00:22:52.319 you doctor Rungi for doing this. I think this is 392 00:22:52.359 --> 00:22:55.640 a great topic and very interesting. It's very close to me. 393 00:22:56.799 --> 00:23:01.279 I'd like to preface this with all about a year ago, Dan, 394 00:23:01.839 --> 00:23:04.160 I spent twenty one years in prison on a wrong 395 00:23:04.240 --> 00:23:08.240 for conviction. I've been out for twenty four years, but 396 00:23:08.400 --> 00:23:10.640 I've been so foretratulation. 397 00:23:10.839 --> 00:23:14.039 Did you know you're over there with Fred Weichel in 398 00:23:14.119 --> 00:23:17.039 South Boston who was in the same situation or a 399 00:23:17.160 --> 00:23:20.160 similar situation. And I'm sure you know the cases that 400 00:23:20.240 --> 00:23:22.799 I worked on, the Silvadi Lamoni case. Did you get 401 00:23:24.160 --> 00:23:27.839