Why Medical Knowledge Isn’t Reaching Patients with Dr. Simon Chowdhury

In this episode of Pharma Sessions, host Jonathan Kaskey is joined by Dr. Simon Chowdhury, a Consultant Medical Oncologist based at Guy's and St Thomas' NHS Foundation Trust, to talk about Open Medicine, a platform designed to take what’s inside the minds of the world’s leading oncologists and make it accessible to any clinician on a mobile phone.

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Transcript

SPEAKER_00 0:01

I can remember in November 2019, I was chatting to a guy called Mark Wildgust, who's a pretty senior guy at Jansen, the super, super, super person. And we were talking about how one implemented some of the novel therapies in prostate cancer and what was the comparator. And I said, Well, I was talking about chemotherapy. He sort of said, Simon, no one gets chemotherapy. And I was like, No, they do, Mark, they do. We did these studies, they showed whatever. And he was like, no one gets chother. And he then he showed me some market research, and no one got chemotherapy. And I audited my own practice and it was very low. It was a real eureka moment for me. It was a moment where I realized that just because something's published in the New England Journal of Medicine doesn't mean it's going to make it into the clinic, even my own clinics. And then I said to people in my academic group, how many patients then get chemotherapy? And everyone said 70-80%.

SPEAKER_01 1:40

On today's episode of Pharma Sessions, I am thrilled to welcome Dr. Simon Chowdhury, a medical oncologist and a leader in urological to cancer care, clinical research, and medical education. Dr. Chowdhury has spent his career at the intersection of the frontline oncology practice, clinical trials, translating complex science into better patient care. And what makes his perspective really compelling is his focus on a challenge that is affecting nearly every part of medicine today. How do we get the right knowledge to the right clinicians and patients in a form they can actually use? So we're going to talk a bit today about a project that Simon's working on that's really, really interesting called Open Medicine, which is attempting to bridge the gap between academic expertise, real world care, and provide trusted doctor-led education, really in a world that's absolutely flooded with misinformation. So misinformation, I should say. So I'm pretty excited about this. It's a topic that I have a lot of personal interest in. I think it'll be a great conversation. Simon, did I do an okay job introducing you?

SPEAKER_00 2:41

You were far too kind, Jonathan, far too kind. But thank you very much. And uh I'm really excited to be here and really excited to chat to you about the new project and how that may well fit in and hopefully help shape medical education and improve the sheet.

SPEAKER_01 2:54

All right. So before we get into all of that, I always like to do a quick get to know people. And lately I've been on this kick of uh asking as an icebreaker, what is your go-to or go-to's for karaoke when you're forced to perform?

SPEAKER_00 3:09

Or maybe choose to perform. You come to London. I think Jonathan's actually a very talented musician. There's a guitar in the background. I'm a very enthusiastic uh mute karaoke singer, and I was once told when I was singing very much out of key that I should sing Daydream Believer by the monkeys because they were a manufactured band and it's got a very narrow vocal range. So probably that's one of my songs. And then my goddaughter Adele got me to learn the lyrics to super bass by Nicki Minaj, which is super difficult to learn. Took me four months of walking around London medical conferences doing this wonderful boys and boom system, top-down AC with the cooling system, etc. etc. So those are the ones we'll do, Jonathan, when we love it.

SPEAKER_01 3:46

Unfortunately, I have a lot of enthusiasm for singing. I can play the guitar okay, but I know I'm not tone-deaf because I can hear my own singing and I can hear what it sounds like, but that is just a skill that uh unfortunately passed me by. But I will say that doesn't prevent me from trying to do a Chris Cornell impersonation at at any given moment in time. So, all right, let's start by looking back a bit. Why don't you I know you've done a lot in oncology and research and medical education? Maybe take us through a little bit of your career, but one thing that's always interesting is the motivation, right? What first drew you to this work and and what's kept you committed to it?

SPEAKER_00 4:26

I think I was thinking about this, and what drew me to the work was the patients. So, age five, my dad wanted to be the doctor who wanted me to go to Cambridge University and be a doctor at Guy's Hospital. And and that's what I ended up doing. Which one of us more mad? Probably me. And as a very wet, behind the ears 24-year-old, I ended up on the wards at Guys and St. Thomas' Hospital. And the thing that I noticed was how amazing the patients were. You just saw the best of human nature. So I would be coming in on a Monday morning, often having maybe done some karaoke at the weekend, and the patients were like, Oh, it's lovely to see you, Dr. Cherry. How's your mum? How's your dad? How did Manchester United do? Or the Boston Celtics, maybe. And I was just amazed at that the you saw the best of human nature. So it really motivated me to work hard to try and help those people. And I think probably my parents came from very, very simple backgrounds, and they worked very hard, they were very determined, they were smart people, very kind people. And I think they gave me a real I had opportunities that they never had. And so I wanted to do something in an area where there was clearly need. And oncology has was the intersection of need and also just amazing patients. You just see the best of human nature, and you still do, and you see such fortitude. You see the best of human nature, the best of human spirit. So helping cancer patients is just a passion for me, and it's hard because a lot of cancer patients still don't do well, but they're amazing people. I'm very, very privileged to have many of them in my life.

SPEAKER_01 5:52

So yeah, that's absolutely incredible. I mean, you're talking about seeing people going through what is oftentimes probably the hardest thing that they or they families will have to personally deal with. So there must be how do you I guess it's a question, just a personal question for me, but you've been doing this for quite some time. How do you deal with that emotionally, right? So that you're able to provide that support and be vested. But as you say, some of these prognoses are really pretty grim.

SPEAKER_00 6:17

I think I'm probably the worst person to say how to deal with it. I'd probably deal with it a karaoke barn with I think great friends. I've got incredible friends. And I think now I recognize it a lot more. So one of the reasons why I've stepped away to a degree from clinical medicine is got too much for me, to be honest. Got to a point where I was just too emotionally engaged. Um, one of my bosses, who's sadly no longer with us, a guy called Martin Gore from the Boar Marsden, he said to me, You really care, don't you? And I said, Doesn't everyone? He said, No, not everyone does, Simon. And he said, You like me will run into compassion fatigue. And I think I did. And I think now with open medicine and just doing a little bit of clinical medicine, I've got a much better balance. I think the volume of patients I was seeing before was just too much. I look at a lot of my friends, colleagues, in awe of them. And I think one of the things that we're trying to do is to make life easier for doctors and patients, just so that the increasing complexity of science, medicine, therapies, it's really hard to stay on top of that. And I think people are burnt out. So I think if we can simplify things and make life a bit easier for everyone, that's so before we get into open medicine and what you're working on now.

SPEAKER_01 7:24

Uh when you transitioned away from clinical practice or or somewhat, what are you transitioning into? What were you working on prior to this?

SPEAKER_00 7:33

So I was working very much in an academic clinical centre. I was the head of the GU uh department there, which was great. In South London, which I love London. It's a brilliant city, it's got a great vibrancy. It's also got a huge amount of poverty immigrants. My dad was an immigrant to this country to the UK. So I actually really like the mix. I love the diversity of London. There's complex type of diversity for both of our countries. But for me, looking after people from India, Australia, the West Indies, Europe, as well as the indigenous South London population, there's a real authenticity there. I'm always sort of saying to people, I don't particularly want to look after people who don't have real problems. Now I now see that anyone coming to a doctor probably does have a real problem. But I think back in the 90s, I was probably a little bit dismissive of some of the more softer problems and some of some things around mental illness, such as I'd be much more attuned to now. But I think there's an authenticity in that population, and there's an authenticity in oncology that I think is just it really, it really speaks to me. So in the unit there, we built it from quite a small unit up into one of the world leading units, a lot of research. And then I realized that actually to get the research out there, we needed to get the education, and that became a passion for me. Working a lot with with pharma. I think there's a lot of some people are very dismissive of pharma, but I'm certainly not. It's very easy for doctors to make out that we're the that we're the uh we're the angels and they're the devils, whatever, the good guys, the bad guys and girls. It's definitely not like that. We're all on the same team. We we all want the same thing. And I've been so impressed with my pharma colleagues and friends who have a real passion to to improve things.

SPEAKER_01 9:12

So I think we all need to work together and just do what we can to get the right therapies to the right people and make the that's been my experience working with pharma too, you know, particularly in medical affairs, is where I've spent a good deal of time. And those people are really just get the right patient to the right drug at the right time. But even, I mean, if we if we're being honest about it, there's a real need for commercial to move faster because at the end of the day, a medicine sitting in a lab doesn't help anybody, right? It needs to get into patients' bodies, and that means there's a lot of stuff that has to happen and it needs to get regulatory approval and all of that. So I think that it's it needs to be give and pull. This is or give and take. This is my personal 100%.

SPEAKER_00 9:56

To be honest, without the commercial world, we wouldn't have the finances to develop these drugs. So I think we need to probably reassess some aspects of it, but I think far too many doctors are dismissive of that side of it. It's a commercial world, and actually, part of our role is to help get those therapies out there because the successful therapies will pay for the trials that lead to other therapies coming through. Uh, I strongly believe that. And, you know, as I say, I work a lot with people in pharma and they're often the smartest and most decent people. And then you have to look at the vaccine programs that happened, you know, that wasn't that long ago, you know. I suppose it's five years ago now. But the the pharma companies did such a brilliant job getting the giving the vaccines out there and doing along those lines. I love bringing patients along to meet colleagues in pharma. And the first thing the patients say is they say, Cyber Science should be thanking you because you're the real reason I'm alive. And it's true. I'm not the person making, you know, the clever therapies in prostate or kidney or bladder cancer. It's the guys and it's guys and girls in the in the pharma industry. So, you know, I think they need to be thought of it.

SPEAKER_01 10:54

Well, that's great. And I feel like that is a whole conversation can be had about that. But I'm actually really interested in this knowledge gap, right? Because even as you are describing the patient populations that you're treating in South London, uh I would assume it's not just that there's an information gap. There's probably many different information gaps depending on who is in your audience and and what types of content they're they have accessible or that they're consuming, or be uh at some point in times being served up to them by the algorithms. So when did you first start to realize there was a big gap between cutting edge knowledge and what actually reaches patients?

SPEAKER_00 11:34

I think it was slowly coming to me because I've got a lot of friends who work in the community and I realized that they were that they just didn't have the privilege that I had. They were seeing far many, many more patients without the infrastructure, nursing, pharmacy, doctors, community with regards to that, the community, academic community there. I was very fortunate I could go to all the meetings. I was invited to do these things, and a lot of stuff was pitched towards me. If there was one moment in time, I can remember in November 2019, I was chatting to a guy called Mark Wildgust, who's a pretty senior guy at Jansen, a super, super, super person. And we were talking about how one implemented some of the novel therapies in prostate cancer and what was the comparator. And I said, Well, I was talking about chemotherapy, and he sort of said, Simon, no one gets chemotherapy. And I said, No, they do, Mark, they do. We did these studies, they showed whatever, and he was like, No one gets and then he showed me some market research and no one got chemotherapy. And I audited my own practice and it was very low. It was a real Eureka moment for me. It was a moment where I realized that just because something's published in the New England Journal of Medicine doesn't mean it's going to make it into the clinic, even my own clinics. And then I said to people in my academic group, well, how much patient how many patients do you think get chemotherapy? And everyone said 70, 80%. And then we did a UK audit and it was 27%. It's a bit lower in the U. But the UK is fortunate and unfortunate in our national healthcare system, which I'm very proud of, but it's very joined up. But it means that implementation of therapies is much more straightforward than, say, in the US. And I go, I'm a big fan of the US. I trained at Dona Farbo, have lots of friends there, my cousin's still there. I'm not one of these Brits who thinks the US is awful, far from. I think we're actually, our healthcare systems could work much more closely together. But I think it's harder to it's harder to initiate and popularise and democratise the therapy in the US because it's a bit more broken down, I think, than the UK. But in the UK, the uptake was low. And so it made me really stop, pause, and focus some energies on how one changes that and how one. And it made me think most people are treated in the community. They're not treated in academic centres like my own or Barber, they're treated out in the community in the UK, the US, Germany, France, etc. Most countries, if not all countries, is like that. And I think, and patients want to be treated in the community. They don't want them, they don't want to come into travel three hours to come into a hot, dirty, sticky London, or traveling to Boston or New York or to Hamburg or Paris, just because those cities, you know, they want to stay close to home. Most of our patients are older, they trust the local doctors quite rightly who have looked after them for a long period of time. And we need to work with those doctors to make life a bit easier.

SPEAKER_01 14:13

If that makes a ton of sense. I mean, that even mirrors in the US my own experience of I live uh a couple hours south of Philadelphia. And when people have serious things going on, they go north uh to Philly, right? They're going to Penn, they're going to CHOP, they're going to those real centers of excellence. This need that you've identified, right, to democratize or to essentially spread evidence-based clinical care from academic settings out to the broader clinical world. Tell me a bit about open medicine and motivation and kind of what made you go from that eureka moment to where we are now.

SPEAKER_00 14:49

So I've been working a little bit in medical education, some of it with pharmaceuticals, some of it independently, trying to understand, trying to sort of read myself around about innovation, adoption, looking at things like tech, music, electronics, how they'd done things where people adopt a lot quicker than medicine. Medicine's very conservative. And I think the maxim of do no harm is something that we probably hide behind a little bit. And oncologists are not the best at this. The surgeons are and the hematologists are much better than the medical oncologists. So if you look at the implementation of robotic prostatectomy, that was incredible. And I think our surgical colleagues have to be thanked to a degree with that. The evidence base is low. There's no randomized trial showing that robotic surgery is better than open surgery. But I think they showed that with an energy and an education program, they were able to do that. And that's a tech which is different giving therapies. Open medicine came about from a passion project, really, for myself and one of my fellow founders of Eat Ghost, who's a super, super is our CEO, super intelligent guy, very, very thoughtful. We sort of the yin and the yang. I do a lot of uh, I speak a lot, he thinks a lot. So we're a good uh we're a good couple where that's concerned. But both of us are passionate about education, and we both wanted something that is going to it's a commercial operation, but we also wanted something that's going to benefit beyond that. And we wanted a platform that is completely open, is free at point of access, doesn't have adverts, doesn't have undue bias from anyone. Farmers, the obvious people, but as I said, they're not the enemy. And we wanted to get what's essentially what's in experts' minds. So let's take an expert at Memorial Sloan Care Strong, take what's in that expert's mind and cascade it into a way that is easily accessible on a mobile phone. So that someone in the community or a trainee, that UX experience, they can join the conversations. The one who runs mobile should know they're made possible by the team and see what we're doing.

SPEAKER_01 16:49

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SPEAKER_00 18:25

I think the ultimate goal is really to share knowledge in a way that is truly democratic. I think at the moment we have, I'm an academic or a pseudo-academic. I don't really think of myself as an academic. I like to think of myself as a pragmatic, but I work in academic centers. I'm, you know, have a role at the Medical Research Council in the UK. You know, I go and chat to people at Dana Farber, my cousin's the head of radiation biology there, very smart guy. So I mix with the great and the good. And I think the problem is that often we talk about stuff that is really fine detail. And sometimes, not really amongst my friends so much, but sometimes you see people showing off academically, making it more complicated, showing that they understand the genomic side of things and not making it more accessible. So for me, I want to strip it back. I really like the concept of simple Simon, of sort of saying, sort of saying to someone, if you understand something really well, explain it in a really simple way. When we go to the baseball, Jonathan, I don't understand baseball so well. And you'll strip it back. You are a very good communicator. You'll make it fun and easy. That's what we want to do. We want to make it fun and easy so that people actually enjoy it. I get a lot of my education from X, which surprises people more than more than journals, more than academic meetings. I get it on X and I interact that way. And that's easy for me as a man. I think it's much harder for women on X and much harder for people with more diversity. So we wanted a platform where it's open for everyone, but the content is verified. And also it's a safe place where people are abused, and we're gonna have very strict regulation there. Not regulation, we want debate. We want people to say I do it this way, or this is why I do it this way, but respectful, collegiate debate, not sort of calling people names and stuff. And I've seen a lot of my female friends come off X, and I feel very sad because A, they added a huge amount, and they're some of the smartest people I know. We want somewhere where they can go and feel safe.

SPEAKER_01 20:16

It's great. And especially if you're trying to do this from a professional setting where you're hoping to further patient care, the last thing you want is heaps of abuse coming at you. So I at one point in my career I'd I had worked for this company in the US, it was called Cermo. And what we had was a network of physicians, and we had a pretty decent size chunk, at least at the time, of the US practicing physicians. And we were seeing some of this happening, and what what we ultimately found was that it did, it wasn't necessarily a censorship. Like I can't actually even remember a time where we had to tell people to rein it in. It was more about creating an environment where there were places to talk about clinical issues, there were places to talk about the business of running a small practice, essentially a small business in the US and dealing with insurance agencies and all of the like. So I've spent some time on open medicine. What I had seen was really flow charts, right? And this graphical simplified interface. I'd encourage people that are interested to check it out as a way to see how science can be communicated. Is your vision that this becomes a community environment for having back and forth discussions around the recommended treatment protocols?

SPEAKER_00 21:37

I think ultimately what we've got at the moment, and you described it really well, is what we call living algorithms. So we found from our research that actually what people wanted was these flowcharts that would guide them through a clinical problem. So let's say something in my area, say advanced castrate sensitive prostate cancer. How does how does say Nearaj Agual, one of the world's leaders, address that? And Niraj is one of our thought leaders. He helped us to design an algorithm, and it's a click-through thing. What we noticed was these algorithms that were kind of like PowerPoint slides hadn't changed in the last 30 years. And I think that horrified my fellow founders who are brilliant at software, at website design, at AI, about search engine engine optimization. And I'm learning so much from them. The other founders are not doctors, thank goodness. So we wanted to build something that's interactive, has really great user experience, but takes the best expertise in a disease area, but puts it in a format that is user-friendly. And I think what we have at the moment is we're full of a world of PDFs, we're full of a world of that's text heavy. And I think as you will know, and as I will know from the younger people I work with, that isn't their world anymore. They've grown up on X, Instagram, Facebook, whatever. They want rolling content. They want content that is much more visual friendly and much more, much less more consumable, right?

SPEAKER_01 23:00

More yes.

SPEAKER_00 23:02

Well, sort of depth is more interactive. I think I now look at it, I read quite a lot of papers and things because I'm still interested, I still write them. But I sometimes, yeah, my heart sinks when someone sends me a 30-page paper, I'm like, okay, that's gonna be three, four hours of my life I won't get back. And it's sort of, I would much rather have it in a in a in a short format. So it's sort of like an even on X, when someone does a tutorial that's like 20 tweets long, I don't really think that's they, I think they're missing the point. There was a brilliant one by uh Ashish, one of our foundation circle, is a leading bladder cancer, and he did it in three tweets. And I just said, oncologist, take note, because that's what I want us to have. To come back to your question, and sorry I didn't answer about community. I think ultimately we won't be there quite yet. To start off with, we'll have content that is more sort of where the interaction is from the user with the website. But ultimately, we really want people's comments, want people to say that I'm using and her to find out how do you find the interstitial lung disease? What's the what's the nuance? So I think when I'm taking what's in people's brains, I'm very lucky when I you know I trained a dip to my training at Dana Far, but some of the best GU people in the world were there and are still there. And I could phone up someone like Tony Schwery, who's the head of the unit, there, and say, Tony, I'm about to use Nirvolamab for the first time. What should I be looking out for? And Tony said, bring them back in two weeks' time, make sure you check their thyroid function, warn them about diarrhea, etc. And you can't necessarily get that from the paper. Reading a paper that's just got grading on there, it it sort of works, doesn't work. And I think sometimes some of the grade one, two toxicities are underplayed. So I think having someone who's got real wealth of experience take you through it, and ultimately we will embed diagrams, videos, etc., within the algorithms. So I think I think it's the equivalent of being able to phone up the best people in the world and get them to take you through it.

SPEAKER_01 24:47

Yeah, and I think that is expertise and it's communication. I sometimes think of like I think a famous example of this is Steve Jobs on stage introducing the iPhone where it's like, it's your music on your phone. It's your music on your phone. He says it three or four times. He's like, Are you getting it? It's your music on your phone, right? Like this is one of the most successful product launches ever. And he boils it down to one sentence. So this is uh this is my segue because he's also the person that I think of when I think of some of the potential impacts of misinformation. And because this is something that we talked about going in, was one of the goals of this is to combat misinformation. And I think it's a an a very interesting example because I'm sure you know much more about this than I do. But my understanding of it is that he essentially had a treatable cancer that he was attempting to treat with like organic fruit juices, basically. And by the time he was ready for real treatment, uh it was too late and he died. And it has nothing to do with intelligence, right? Nobody would argue he's not a smart, brilliant guy and and well or connections or access or anything else. So tell me a bit about what you're seeing out there for in or misinformation and what you think that doctors' responsibilities are in this space.

SPEAKER_00 25:58

I think that's a really good example. I don't know the details of his case too much, but that's my understanding of it. I think what we're seeing more and more of, and I think doctors have to look at themselves a bit here. It's very easy for us to criticize patients and say, oh, these people, they don't under, they don't get there's a reason they're not trusting doctors so much, and there's a reason they're looking for alternative sources. And some of, as you said, is some of the alternative sources are excellent communicators and also listeners, not my strongest point. So I think what we're hoping to do with open medicine is is listen, but also provide a trusted source. So it's interesting. I like generative AI. I think Chat GPT, etc., is actually a very good resource. But it's interesting, my friend's son that there's a meningitis outbreak in the UK where there was a couple of months ago, and lots of young kids were dying, which is very sad. And my friend, his son, who's in the sort of target age group, the kissing age group, 17-year-old boy, and he's in the area where there was the highest, the highest instance. What do you think? And I started looking on ChatGPT, and I thought I'm gonna phone someone up because I thought I'm not gonna take any chances with my godson Tom. So I think what we want to have is the best source of resource, but something so what that showed me is that I like generative I, but I was gonna trust my friend's son on with it. So we want to have something that's trustworthy, where you can get that voice. So our content is going to be high quality, but also both in terms of the spec, but also in terms of the actual knowledge on there. So I think that's the bit where we want to have a trusted resource. At the moment, our target audience is doctors, but by the end of the year, we hope to have patient-related resources. And I think there's going to be more empowerment of patients. I've always been someone that's never, never, never minded patients coming in with information and things like that. It's very hard when you've got a cancer, it's very scary. And there's a lot of very smart patients out there. I learn from my patients every day, if not every week. It's a question of harnessing what's out there. I'm very happy when patients come and they're educated and they've they've educated themselves. It's concerning what that there are a lot of people out there trying to make money from patients, and that I think is awful. And there's a lot of poor information out there. So I hope what we will be is a filter for good information.

SPEAKER_01 28:08

Right. It's almost, you know, I think of it as you're in the States, you know, you could get your information from Instagram, you could get it from TikTok, you could get it from the Mayo Clinic, you can go and uh you could do a PubMed search, which I which is what I I'm not I'm not smart enough to read the actual papers, but I'll often look for a meta-analysis because that's kind of a nice, just give me the summary of all of the research. And I feel like creating that level of understanding, of recognizing what is a good and trusted source and and what might not be. I feel like that is a real challenge and opportunity for for you all. So, how how are you looking to build that brand of open medicine as, hey, these are not people trying to sell you a supplement or or whatever alternative cure. This is truly a trusted source of information.

SPEAKER_00 29:00

That's a really good point. Let me just go back to something you said there, because you said you're not smart enough. You're plenty smart enough. And I think this is this is the way that academic academics, not just medicine, academic English graduates, we make it, we pitch it so we make you feel that you're not smart enough. The smart people would explain it in a way that made it explainable to our patients and to our trainees and to our colleagues. Because Einstein who said, if you really understand something, you can explain it simply. So it's not about you not being smart enough, Jonathan. It's about us creating a structure that is exclusive, not inclusive. So we want to do something that's really inclusive. To come back to what you were saying about a trusted source, I feel really, really very fortunate being the chief medical officer. I'd be able to go out and pick the team. So I've gone out, there's people that I know, I've got a big network, but there's also people I've thought, that person's brilliant at explaining stuff. So we've gone to some of the usual suspects, as it were, but we're really actually trying to get people, trainees, people in the community. I think community oncologists have been really talked about badly by a lot of buzz in academia. And I think these are good people. They're seeing the bulk of the patients, they're doing it under often less than ideal circumstances. We need to really make an effort to make sure that what we're the content we're providing, the way we're working, matches what they need. Not what we think they need, or not what we need, but the other way around. So exactly what you're saying on PubMed, I'm not X and Y. Well, it's PubMed's fault, it's not yours. And PubMed needs to change. Well, it is changing, isn't it, with most funding things. But so I think for us, it's about providing something that Jonathan can go to in six months' time and say, this is actually really good. And if you've got a friend who's going through something difficult, you can you feel comfortable signposting that way. So we're fortunate, we've got a foundation circle of some of the best people from around the world. Probably I think we almost hit 50 in oncology, and now we're going to metabolic medicine. So I think it's around that, but but I think we must never in our side make people feel that they're not smart enough or make them feel that they're that we're not providing stuff they can engage with. In my old hospital, we used to hand out 30-page written summaries of, say, dose of taxal and chemotherapy, prostate cancer. Almost half the people coming had a reading age less than 10. A lot of people couldn't read. That's not because they're stupid, it's just because they'd had less advantage than people and myself. But we carried on handing out the written information, the written information. We need to change that mentality.

SPEAKER_01 31:20

I have a story along these lines that I think is kind of interesting, right? Where you had brought up the generative AI earlier, but I had previously worked at a company that was doing a lot of work around some of the documentation that goes along with getting all these drugs to market. So one of the projects we were proposing was using generative AI essentially to take a clinical trial protocol and turn it into an ICF, an informed consent form, which is a requirement to document that's meant to be at basically a fifth grade, fourth, fifth grade reading level. So for those in the UK, what is that, like 10, 11-year-old person? And that's meant to help people truly understand what they're signing up for if they volunteer for a clinical trial or want to participate in one. And we were running into all types of pushback with the legal review team about doing this from the pharma company, it was big pharma. And what ended up getting that one pushed forward was they found out that the nurses at the trial sites themselves were saying, This is ridiculous. I'm gonna just take this thing and I'm gonna put it into Chat GPT and I'm gonna have it generate my own ICF, something my patients can actually understand. So I think that that then gets into a whole nother set of some ways like the cat's out of the bag or the horses left the barn or whatever animal analogy you want to use, but is getting control of this, right? And and focus on simplification, focus on communication is actually a huge opportunity for doctors, for pharma, for anybody who's looking to really further medical care.

SPEAKER_00 32:51

Yeah, no, absolutely. The the nurses get it, and and the patients go to the nurses because they're better communicators than the doctors, myself included. They're less intimidating. So we need to have something that is much more like that, less intimidating for everyone. You can make things my cousin I says, the head of genomics uh that Dana Farbuck, or the head of radiation bowlers, and genomic stability, he's a brilliant communicator because he strips it back. He takes it to a level for his audience, not for him. He can debate at a Nobel Prize level if he wants to, but actually he communicated, did a lot of work for refugee kids in in Syria, very, very proud of him. And you know, he was teaching 14-year-olds there who refugee kids, poor kids. And that takes a real talent to engage an audience like that. That's much harder than engage an audience at Harvard, in my opinion.

SPEAKER_01 33:38

Absolutely. Uh very good story. So, all right, so let's end with a bit of a forward-looking question. So if this vision succeeds, what changes for the average patient? And what would you think the real world impact would look like a few years from now?

SPEAKER_00 33:55

I think ultimately it's all about better improving patient care. So in cancer care, patients living longer and living better, so less side effects of treatment, better use of drugs, right dosing, so people get the right drug at the right time, at the right dose with the right supportive care. And it might be they don't need to have a therapy. We over-treat a lot in prostate cancer. So it might be someone with localized prostate cancer goes on to active surveillance. That would be a that would be a great win. They don't unnecessarily have a treatment, be it a drug treatment like I give that is the lowest testosterone or a surgical treatment that may cause incontinence or impotence or radiotherapy, which can cause bowel and bladder problems and potency problems. So I think ultimately, if open medicine works as we hope it will, it will be better patient care and improved quality and quantity of life for many, many patients. Global let.

SPEAKER_01 34:47

All right, Simon, we'll leave it there. Hopefully, we'll next time. And that's a wrap on today's episode of Pharma Sessions with me, Jonathan Kaske. If you enjoyed today's conversation, don't forget to hit follow or subscribe and share it with someone else in the pharma world who might need to hear it. For more on pharma trends, career growth, and business strategies, connect with me, Jonathan Kaske, on LinkedIn. Until next time, thanks for listening.