Transforming Health Care: An interview with Cameron Sabet

Many thanks to Cameron Sabet, a second-year medical student at Georgetown University, Washington, DC. Cameron has a deep and insightful view into healthcare as evidenced by his early efforts as an EMT, articles in Time Magazine, The Washington Post, The Daily Mail, multiple peer-reviewed medical publications, and his work with Venture Capital. 

Cameron’s busy studying for his final exams, but I stole him away for this fascinating 25-minute interview. 

During our discussion, Cameron discussed his background as an EMT and how it gave him real-life insight into some of the mundane but fundamental challenges of health care delivery. 

Cameron articulated how journalism is a powerful medium for influencing individuals and public policy. He also illustrated how financial incentives influence healthcare delivery. He also observed that spiritual sensitivities of different ethnic and religious populations must be addressed in order to improve quality of care and bolster faith in the health care system.

Cameron suggested that telehealth is one solution to bringing healthcare to the population. He also shared a formidable reframing of the work/life balance dilemma.

To learn more or contact Cameron, check out his website: www.cameronsabet.com

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Transcript

0:08

(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Welcome to the Art of Medicine, the program that explores the arts, business, and clinical aspects of the practice of medicine. I'm your host, Dr. Andrew Willner. Today, I'm pleased to welcome Cameron Sabbat, a medical student at Georgetown University. I've interviewed more than 100 guests on the Art of Medicine, but Cameron is the first medical student to be on the show. He has a diverse and interesting background as an EMT, well-published researcher, and venture capitalist. Since members of my generation don't seem to have an answer to the inefficiencies and inequities of our current healthcare system, I thought I'd ask a student. But first, a word from our sponsor, locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenants. It's not an agency. LocumStory answers your questions on their website, podcast, webinars, videos, and they even have a Locums 101 crash course. Learn about locums and get insights from real-life physicians, PAs, and NPs at locumstory.com. And now to my guest, welcome Cameron. Happy to be here. Thank you very much for having me. Cameron, it's my pleasure. I saw your bio and I said, oh, this is an interesting guy. And I know you have a particular interest in sort of the healthcare world and how things can work better. So that's a hot topic. In fact, our last episode, I talked with a former congressman who has a company that is working to sort of provide better, more efficient, lower cost healthcare to millions of people. Everyone is struggling to find solutions. So before we get to that, let's find out how you got to where you are. What's your medical background? Certainly. So as you mentioned earlier, I started out as an EMT back in Philadelphia. And what's fascinating about that is that you're seriously on the front lines of healthcare. You know, they talk about doctors being on the front lines and yes, they are. But EMTs actually go into the communities and, you know, we're walking into houses to pick people up and, you know, bringing people to dialysis centers and seeing the real world impacts of the diseases that we write about. And so I then began writing as a journalist. And this was during the COVID pandemic. And I wrote for the Smithsonian Magazine, the Washington Post, all about how can we improve healthcare? How can we improve access and affordability? And not just for medicine, but for medical training as well. And that's where I really fell in love with this whole process of making medicine a little bit less of an untouchable entity that people just accept. And that has for many years reduced medical trust because doctors have been able to do a lot of things with underprivileged communities in the 1950s and even earlier that were just eroding medical trust in communities. And so a lot of my work, including at the National Academy of Sciences, was improving. And I wrote a paper about this, improving the relationship between the medical community and the research, the communities that they benefit. So from there, I shifted more toward, OK, we can write about this all we want, but how can we actually affect change? And this is where I really got into the world of medicine and I wanted to be a doctor. So that's my background. And yeah. OK, so, you know, when you think about EMTs, if you if you really kind of get granular, it's like you jump in the ambulance and then you're, you know, you're going to some apartment complex and maybe not so great part of town and the patient is on the fourth floor, you know, who weighs 300 pounds plus and there's no elevator, you know, and it's dirty and maybe not safe. And and this is kind of a regular thing. I did some medical work in Philadelphia, actually way back when, when I was a medical student. And, you know, it's a it's got an inner city population. And but these people need health care. And just just you talk about health care delivery, just delivering the patient to the health care system can be a big challenge. Well, let's jump right in then. What do you see as the biggest problem? You know, the low hanging fruit. What's the biggest problem in the U.S. health care system? Yeah, so on one side we have and, you know, this is one of the most ambitious things that we've ever done is really health care. Right. Because what we're trying to do is connect experts and specialists who've trained in this for years with some random person who fell on the floor in rural Colorado. How do we get these the marriage of these communities in a way that's able to deliver the best care possible for each person? And you're talking about delivering the patient to the health care system. A lot of work that's being done now is delivering the health care system to the patient, not just through, you know, local tenants, but through where we're seeing a transition to telehealth. And there's this actually very famous doctor now at Harvard, Alastair Martin, and he's doing some really great work with a healthier democracy where he's connecting voting and democracy issues with health care and layering on top of that telehealth. And he's talking about how can we improve access and affordability from both the politics standpoint and from the Internet broadband access standpoint? And so a lot of what he's doing is how can we improve health care access through technology access? And he's saying that is a technological determinant of health. And so there are a lot of dimensions to this that, you know, the health care system is using. And there are a lot of innovative, amazing, very smart, talented people like you who are going out and trying to find from a lot of different stakeholders, including that congressman you were talking about earlier. How can we attack this from standpoints that we've never seen before? And that's what really gets me fired up. Well, we're talking today and I know tomorrow you have your final exams, right, for your second year of medical school. And yet somehow you have time to sort of think about these worldly problems and talk to me. So before we go too much further, how do you find time to, you know, work life balance is pretty prominent these days, too. So how do you find time to do all these things? Yeah, well, that's a very good question. I do have my exam coming up. And if you caught me any other time this week, I would have been studying. But good to know. Yeah, yeah, it's good to know that future physicians aren't just, you know, dilly dallying in the meadows. Now, what I will say is I think I think Jeff Bezos said this once, where it's not necessarily work life balance as much as work life flow. And so some periods of your life, you may be edging more toward work and some periods you may be edging more toward life. It just depends. And to rigidly characterize every element of your day as a certain work or life, you ironically get neither because you're always regimenting your day. And back at UPenn, back at college, there were a lot of very intense people. And they would say, you know, jokingly, of course, I relax harder than you do, you know, work hard, play harder. Well, none of that sounds easy. So, you know, it comes naturally. And I think also and I think Sam Altman of OpenAI said this, when you're on a role and you're actually making things move forward, you don't get burnt out. Burning out comes from not getting what you've worked for. And so if you can consistently produce high quality output, you don't get tired. It actually energizes you. It makes you a lot happier than if you were playing video games for a whole afternoon. You just leave that and you're like even more tired than when you came. So when you're actually seeing the results of what you put out, I think it's very invigorating. And I think you don't necessarily need to think of it in that dichotomy. Wow. You know, that is one of the most, I don't know whether to credit you or Jeff Bezos or who should get the credit for that. But there's a lot of wisdom there because I remember when I was a resident, I did two residencies, three years in internal medicine and three years in neurology and a fellowship. So I did seven years. I don't remember work-life balance ever even coming up because I was having fun. We were working 80, 100 hours a week. There was a joke back then, like your kind of joke there, that for the surgeons, the surgeons were on call every other night. So you work all day, you work that night, you work all the next day, then the next day, you work all day, all night, every other night. And that was their routine. And the joke was the only problem with working every other night is that you miss half the cases. And and it was said kind of half seriously because as a young surgeon to be, you wanted as many cases as you could possibly have because that's how you learn, develop skills so that when you are a full-fledged surgeon, you know what you're doing. And that was the most important thing. So maybe it's really the lack of job satisfaction, that sounds like what you're saying, that leads to this emphasis on, oh, I have to balance it because it really sucks. That that sounds like, you know, why you need the balance and that if you if work was so satisfying and invigorating and gave you energy, well, you wouldn't really need so much balance. I like that a lot. Plus, there are times, right, there are times when you should go on vacation and just like leave it all behind. Oh, very sage. OK, so as a future physician who's already conquered the work-life balance problem, how do you see yourself fitting into the system? That's a very good question. So now, do you say in terms of what specialty I want to choose or what I want to do in my long term? Yeah, well, just broadly, I mean, do you want to be a neurosurgeon and tinker with the brain or do you see yourself getting a master's in public health and doing public policy and working at the CDC or being the next surgeon general? You know, do you have an idea of which direction this is going? Yeah, you know, the health care system is evolving so fast and there's so many stakeholders that it's hard to really pinpoint a specific group. And so I want to follow this path and see so far I've noticed that a lot of the fastest breakthroughs occur, not even just in entrepreneurship, but specifically venture capital. And the reason I say this is early on in your career and I'm speaking to anyone in the audience who's in my my shoes right now as a medical student early on in your career. The goal is to kind of inspire yourself by meeting as many people as possible. And the way I've found out that you can do this is both through journalism and through venture capital. So I first want to talk about journalism because these are both paths I want to take in the future to affect change, because I've noticed that when I write an editorial and it lands in Time magazine, for instance, I wrote a piece on Gaza and it ended up in Time magazine. I was like, wow, thousands of maybe millions of people are reading this. And when I publish a research paper, unless it is of sufficient global magnitude and attacks a big enough global problem, if I just find something interesting and write about it, it's less likely to make it in the top area because it's not a personal opinion. It's not as engaging for an audience and a little more detached. Right. When you do journalism, the whole goal is to put it in front of people. That's how you're rewarded. I mean, when you get an honorarium, that's how you're rewarded. So you connect with people and when you connect with people, you can affect change and you put seeds in people's heads on different ideas. And so what I've started to do is, you know, with journalism during the covid pandemic, I interviewed a lot of experts on vaccines and other things for the Smithsonian, and I was able to see how do they think at the highest levels of administration? How do these people think about these problems and in a very systematic way? And what are the when you see a leader and their public health leader and you say, oh, that was a terrible decision? Well, yeah, that was in retrospect. But when they talk to you about all the steps that led to that rationale, it may seem like the best possible idea given the circumstances. And so when when when I'm in my journalist pose, I get to meet a lot of people. I get to see all the stakeholders. And when I'm in the venture capital pose, I see the factors of that change, not just the regulators, but the doers. And it's it's it's fascinating to see what the frontline of innovation looks like in any given field. And in venture capital, you become somewhat of a generalist because if you subspecialize too much, you miss out on some other opportunities, brilliant opportunities in medicine. So that's the amazing part about venture capital is I've met some fascinating people, including one oncology startup that's trying to automate some of the decisions to reduce the burden of the cognitive load on a lot of oncologists. So there is a lot of movement going on in those two spaces, and I highly encourage anyone who's in medicine to check out those fields and consider it as a an add on to their own career as a physician. Going to be a little contrary here, you know, the venture capital has a reputation of going out and buying medical groups and then cutting resources with their only goal of being profit rather than improving what's going on. There may be some efficiency kind of attitude, but it's to serve the bottom line rather than to serve the patient. At least this is certainly going on in certain areas. So I think that might be the downside of an economic approach. Comment? Yes, yes. And I was just about to request a comment for that. So I've noticed also that when I speak about venture capital in medical communities, people typically have a similar response. What I'll say to that is venture capital is not private equity. And this is something that I think is really important to dichotomize here. Private equity is a late stage mergers and acquisitions, buyouts, you know, these large groups trying to buy out different physician practices. That's private equity. Venture capital is this guy who graduated college all of a sudden wants to start a company and he sees an inefficiency. Now, I'll give you an example. Mark Cuban, granted, he is a billionaire. But when he looked at the pharmacy benefit managers here in the US, he said, I want to disrupt that industry. And that's venture capital is fundamentally a competitive industry. And private equity is fundamentally a monopolistic industry. And so when you're adding on that layer of competition, you're breaking down a lot of the monopolies that exist. For instance, with pharmacy benefit managers, they're just raising the prices for all these drugs and just sapping the dollars out of the health care system versus Mark Cuban, who's developed the cost plus pharmacy, where he eliminates the middleman entirely. And he's cutting down the prices of these drugs by like 32x. The minute you introduce competition, it's the minute you reduce prices. And fundamentally, that is a positive for the consumer. So I would say it's the exact opposite, in fact, of private equity in that respect. Well, that's very helpful. I learned something. So venture capital is some guy loaning Steve Jobs in his garage, you know, a thousand bucks so he can develop his company. And private equity, as you say, is a late stage, whole different operation. I think those of us that aren't too financially sophisticated may not have realized the difference. So that's very, very helpful. And I agree in my discussion with Mr. Andrews, the former congressman, we talked about there are too many people in the middle. And that sounds like what Mark Cuban visualized also. Now, another angle I know you're interested in of health care is spirituality. Where where does that fit in? Yeah, so back in college, I kind of saw this through a very. When I was in college, I originally entered and I was like, OK, I'm just going to put my head down and be a doctor. And I then took a class on Native American studies with the only Native American professor at UPenn. And she talked a lot about their culture and their religion and underpinning the religion part is the epistemic values, the underpinnings of their societies. And they're no monolith. There are many, many cultures and they believe in so many different things across the U.S. And what happened is she walked us through step by step in this graduate course, all of the different decisions that the health care system made throughout time and how that may have influenced the relationship between certain Native American communities and American medicine. And it got to the point where there was a Crow Nation tribal member who entered a hospital system and he was having a heart attack and he just fell on the floor and he said, I would rather die than get treated by you because you guys are the colonizers. Get out. And this was a moment where I realized, wow, the health care system really hasn't taken into account a lot of the belief systems that a lot of other people have. And that ties in with cultural values and that ties in with end of life care. And so through all this, through this graduate course, I decided to do a master's in religion at UPenn and I studied bioethics and I studied actually half of my classes were in bioethics. And so I started to really get engrossed in, for instance, this concept of recruitmentology, where you try to recruit people from underprivileged backgrounds as much as possible. And you do that through whatever means possible, money, et cetera. And as you can imagine, that poses a lot of ethical questions. And so how do you approach that from various religious standpoints? And then finally, I'll leave you with this. In the religious studies department, I did my one of my papers on Buddhist bioethics and we were talking about how in a lot of these health care systems, they're chaplains, but there are no experts on dedicated experts to Buddhism, for instance. And so what do you do when someone has been trained in the Judeo-Christian or Abrahamic traditions and someone else comes in from the Eastern religions and says, now, wait a minute, we're not looking up to God, we're looking down toward trying to eliminate the ego entirely. And we say that there is there are many gods or there is no soul, for instance, in Buddhism. How do you tell a mother who just lost her son that he has no soul? And so the question then becomes, well, how do we comfort the mother in that moment? And in at least in the Buddhist tradition, you can say that son had five skandhas or aggregates that make up the human body. And, you know, his smile, for instance, lives on in other people. And so when you see a smile in another person, that's a part of your son. And so these are elements of the health care system that may be overlooked in current spiritual infrastructure that's put in place in a lot of these hospital systems. And I think as the U.S. gets more and more immigration, our country was founded on immigration. We're going to need to be a lot more spiritually inclusive to improve trust in the health care system. Cameron, this is a fascinating discussion, and I think we could talk all day. I have a lot of questions, but I know you have an exam of an important exam to prepare for tomorrow. So we're going to leave it there. Anything you'd like to add before we close? No, I really appreciate you having me on call and you are an excellent interviewer, just amazing, amazing time. And I will be sure to watch a lot of your other podcasts as well. Cameron Sabbat, thanks for joining me on the Art of Medicine. And now a final thanks to our sponsor, locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenants. It's not an agency. Locumstory exists to answer your question about the how-tos of locums on their website, podcast, webinars and videos. They even have a locums 101 crash course. At locumstory.com, you can discover if locum tenants make sense for you and your career goals. What makes locumstory.com unique is that it's a peer to peer platform with real physicians sharing their experiences and stories, both the good and bad about working locum tenants. Hence the name locum story. Locumstory.com is a self-service tool that you can explore at your own pace with no pressure or obligation. It's completely free. Thanks again to locumstory.com for sponsoring this episode of the Art of Medicine. I'm Dr. Andrew Wilner. See you next time. This program is hosted, edited and produced by Andrew Wilner, MD, FACP, FAAN. Guests receive no financial compensation for their appearance on the Art of Medicine. Andrew Wilner, MD, is Associate Professor of Neurology at the University of Tennessee Health Science Center, Memphis, Tennessee. Views, thoughts and opinions expressed on this program belong solely to Dr. Wilner and his guests and not necessarily to their employers, organizations or other group or individual. While this program intends to be informative, it is meant for entertainment purposes only. The Art of Medicine does not offer professional financial, legal or medical advice. Dr. Wilner and his guests assume no responsibility or liability for any damages, financial or otherwise, that arise in connection with consuming this program's content. Thanks for watching. For more episodes of the Art of Medicine, please subscribe. www.andrewwilner.com