In this interview, I speak to Dr. Lloyd B. Minor, Dean of the Stanford School of Medicine & Co-Lead of Stanford Health, a $13 billion-dollar health enterprise comprising Stanford School of Medicine, Stanford Health Care & Stanford Medicine Children’s Health. His book, “Discovering Precision Health,” describes the shift to more preventive, personalised health care and highlights how biomedical advances are dramatically improving our ability to treat and cure complex diseases. We discuss how AI, computing and synthetic biology are transforming the future of life sciences and biomedicine, and how that will change our health outcomes in the future.
Q: How do you adapt training and delivering medicine, to cope with an entrepreneurial environment?
[Dean Lloyd B. Minor, MD]: At Stanford University School of Medicine, we seek individuals who are not only masters in their current roles but also visionaries passionate about shaping the future of their fields. We value those who strive to turn their visions into reality. Moreover, we prioritise collaboration. It’s crucial to have team members who, while honing their skills daily, are also bold enough to think outside the box—or even question its existence. This mindset is key to foreseeing future possibilities.
This blend of expertise and innovative thinking, sometimes found within a single individual, is increasingly seen as a product of a collaborative ecosystem. Our community, consisting of scholars, practitioners, scientists, engineers, and management experts, operates as an ecosystem. This environment is not just a collective of individuals but a dynamic entity that drives innovation. It ensures that we deliver the highest quality of care today while paving the way for future advancements.
Q: What is the impact AI will make on healthcare?
[Dean Lloyd B. Minor, MD]: In discussing the responsible deployment of AI in healthcare, I believe there are three key areas where it can create significant impact. First, AI should enhance healthcare equity. Second, it should increase efficiency. And third, it should improve effectiveness. Let’s delve into each of these areas.
Regarding equity, even in a developed nation like the United States, access to healthcare, particularly specialty care, is uneven across regions and demographic groups. AI has the potential to dismantle these barriers by providing specialty consultations and informed expertise remotely, thereby making healthcare more accessible and equitable. Furthermore, AI can play a crucial role in designing and conducting clinical trials that are demographically representative of diverse populations, addressing historical imbalances in research.
In terms of efficiency, AI, when applied effectively, can eliminate redundancies in healthcare. This includes reducing repetitive tests and ensuring that patients receive appropriate diagnostic studies and treatments in a timely manner. By streamlining processes, AI can greatly enhance the efficiency of healthcare delivery.
Finally, on the effectiveness front, AI is ushering in a new era of drug discovery and development. Moving away from a “one size fits all” approach, particularly in fields like breast cancer treatment, we’re seeing therapies increasingly tailored to individual patients’ needs and conditions. AI’s capability to personalize treatment extends not only to disease management but also to preventive care, offering a more effective approach to healthcare.
These three areas—equitable, efficient, and effective healthcare—represent the profound impact AI is poised to have on our field.
Q: How should we think about synthetic biology in our future?
[Dean Lloyd B. Minor, MD]: Synthetic biology, broadly defined, is the process of engineering life. It involves redesigning living organisms to perform new or altered functions. This field is not a recent innovation; it has roots in the earliest days of biotechnology, where bacteria were engineered to produce human proteins for treating diseases like diabetes or hormonal deficiencies.
Today, advancements like CRISPR technology have opened new horizons for synthetic biology. We can now consider projects like engineering plants with deeper roots for enhanced carbon capture, or bacteria that can break down plastics, addressing environmental waste issues. Additionally, synthetic biology holds promise for developing sustainable and economically viable biofuels.
When we integrate synthetic biology with artificial intelligence, the potential expands further. AI can guide synthetic biology applications towards areas of greatest impact and assist in designing organisms—be it bacteria or others—that perform their intended functions effectively while minimising adverse or unintended effects. This integration represents a promising avenue for future developments in both synthetic biology and AI.
Q: How do we place the appropriate safeguards on these technologies?
[Dean Lloyd B. Minor, MD]: In our discussion today, we’ve largely focused on the positive potential of AI and synthetic biology. However, it’s crucial to acknowledge their potential for harm and destruction. Biosecurity is an immensely important issue in this context. As an example, consider nuclear technology. While it has beneficial applications in healthcare, it can also be used for more nefarious purposes. This dual potential is similarly present in the field of engineering life.
Monitoring nuclear technology to ensure safety is feasible; we can track the components and usage of nuclear weapons to prevent misuse. In biotechnology, although this is theoretically possible, the practical challenges are more complex. Engineering life is often less demanding than creating a nuclear weapon, making monitoring more challenging. This complexity underscores the need for the scientific community to actively engage in establishing robust safeguards and developing strategies to prevent bioterrorism, such as efficient vaccination and therapeutic approaches.
The rapid development and deployment of mRNA vaccines during the COVID-19 pandemic is a prime example of the positive impact of these technologies. It demonstrates what can be achieved in a short time frame. Looking forward, we must aim to do even more. By enhancing our capabilities and safeguards, we can prevent the adverse consequences that arise from the misuse of these technologies.
Q: How do we get over the public trust issue of new technologies?
[Dean Lloyd B. Minor, MD]: Yes, I firmly believe in the importance of building trust, especially in the realms of AI and synthetic biology. There’s a relevant saying across various industries and life aspects: “Change proceeds at the speed of trust.” Building this trust, particularly in the context of AI and synthetic biology, starts with open information exchange, discussion, and dialogue. It’s about creating a shared understanding of our capabilities, responsible deployment of technology, and acknowledging the associated risks.
In the case of AI, a fundamental aspect of building trust involves ensuring the privacy of health records and sensitive health data. This requires ongoing dialogue. Through our initiative, RAISE-Health (Responsible AI for Safe and Equitable Health), one of our primary objectives is to engage both the public and experts in this conversation. It’s crucial that this dialogue extends beyond expert circles to include the public, fostering a broader understanding and consensus on how we can responsibly utilize these technologies.
Q: How will more ubiquitous technology transform how healthcare works for consumer?
[Dean Lloyd B. Minor, MD]: … this represents both a significant opportunity and a crucial need, particularly in the United States. Our nation boasts an exceptional system for treating acute illnesses, leveraging technology in remarkable ways. However, where we fall short is in the areas of prediction and prevention of diseases. This is where our focus needs to shift, and AI offers numerous tools that can enhance our capabilities in these domains.
Furthermore, the advent of generative AI represents a transformative shift in how medical information is accessed and understood by the public. We’ve all experienced the era of ‘Dr. Google’, where search engines like Google have made medical knowledge widely accessible. This has been largely beneficial, empowering individuals to take an active role in understanding their health and the factors influencing it. Generative AI is poised to elevate this understanding even further. It will enable people to learn more deeply about their bodies, lifestyles, and the ways they can preserve and maintain their health. This is one of the key opportunities AI presents in healthcare – enhancing individual knowledge and engagement in personal health.
Q: Will technology finally start to tackle some of our most challenging health conditions and issues?
[Dean Lloyd B. Minor, MD]: There are numerous instances where AI is beginning to show its potential, and it’s crucial that its deployment is responsible and trust-building, especially in medical treatments. Take cognitive behavioural therapy (CBT), for example. AI, perhaps in the form of a chatbot, can play a significant role here. The intention is not to replace the psychologist, psychiatrist, or mental health professional, but rather to augment and extend the therapy in ways that a single therapist could not achieve. We’re already seeing promising developments in how CBT can be enhanced through AI.
Similarly, when we consider degenerative neurological diseases like Alzheimer’s and Parkinson’s, one of the major challenges has been the lack of a comprehensive understanding of their biological drivers. Here, AI’s role in biological discovery is invaluable. It offers the potential to deepen our understanding of these diseases, which is a critical step towards developing more effective treatments or preventive strategies. These are just a couple of examples of how AI is starting to make a difference in the medical field.
Q: How will we get medical professionals to trust AI & synthetic biology technologies?
[Dean Lloyd B. Minor, MD]: Indeed, there are existing examples that can help us navigate the challenges associated with the integration of technology in healthcare. In countries like the UK and the United States, almost all health records have now been digitised. The era of handwritten prescriptions, which patients then took to a pharmacy, is largely behind us. Today, most prescriptions are ordered electronically, which has enhanced both the safety and effectiveness of healthcare delivery. This transition has reduced medication errors and enabled better monitoring of drug interactions, which was difficult when we relied on paper prescriptions.
This shift towards electronic health records (EHRs) faced initial resistance. Early versions of EHRs were not particularly user-friendly, but they have since improved significantly. Healthcare providers have begun to recognize that these digital systems enhance the quality of care they provide.
I foresee a similar trajectory for the deployment of AI in healthcare. For instance, I don’t believe human radiologists will ever be completely replaced. However, there will be a clear distinction between radiologists who adeptly use AI in their practice and those who don’t. Ultimately, those who embrace AI will likely lead the field. This transformation won’t happen overnight and will encounter obstacles, but I believe this is the direction we’re heading in.
[Vikas: …will this impact the cost of healthcare too?]
[Dean Lloyd B. Minor, MD]: Our primary objective must be to maintain a steadfast focus on enhancing the human interaction at the heart of healthcare delivery. This is, after all, what both patients and healthcare providers desire.
In recent years, especially over the last 15, the infusion of information technology into healthcare has, paradoxically, often acted as a barrier between the healthcare provider and the patient. A common experience for many patients is to enter a consultation only to find the provider focused on typing notes into a computer, rather than making eye contact or truly connecting. This situation raises doubts about the possibility of establishing a genuine connection while simultaneously engaging with technology.
The implementation of AI in healthcare should be directed towards overcoming this barrier. The goal is to foster a real connection between physician and patient, where technology aids and enhances the interaction, rather than obstructs it. AI should serve as a tool that supports and improves the quality of this vital human connection in healthcare.
Q: What does legacy mean to you?
[Dean Lloyd B. Minor, MD]: When I reflect on the concept of legacy, it fundamentally centres around the people I’ve had the honour of working with, learning from, and, in turn, imparting my own expertise and knowledge. My aim has always been to contribute positively to their journeys. Leadership, at its core, is about people. It’s about empowering individuals to realize their fullest potential and fostering communities that are transformative, both in individual lives and within society.
A leader’s role is to unite people, aiding them in problem-solving and setting aspirational goals that encourage looking beyond the present to the future. It’s about inspiring others to have a lasting impact, to create a vision that extends into the future. This, to me, is the essence of leadership and the heart of my legacy – the cultivation of a community where each person is enabled to thrive and collectively, we strive to make a meaningful difference.