This 2x Founder Did Something Radical: He Listened to Doctors Before Building Anything

“You really only need to spend a few minutes in an emergency room shadowing a patient-doctor interaction to know that patient stories change very quickly.”

Aniq Rahman has built successful companies in marketing tech, but when it came to healthcare he took a different approach. Before raising money or writing code, he sat in hospital waiting rooms. He shadowed nurses and physicians. He listened. That year of quiet observation helped him understand what most tech founders miss: that the real complexity of healthcare isn’t clinical, it’s human.

In this episode of How I Doctor, Dr. Graham Walker talks with Aniq about what he learned from listening first and why that changed everything he thought he knew about building in healthcare. They explore the structural dysfunctions that make care delivery so hard, the incentives that push physicians to the breaking point, and the potential for technology to serve as a bridge, not a barrier. It’s a conversation that pulls no punches about what’s broken, but still dares to imagine what a better system could look like.

From that conversation, three powerful insights emerged, revealing what’s broken in healthcare today and how thoughtful, human-centered innovation might actually start to fix it.

Listening First Can Redefine the Problem You’re Solving

“You really only need to spend a few minutes in an emergency room shadowing a patient-doctor interaction to know that patient stories change very quickly.”

Before launching Fabric, Aniq spent time shadowing clinicians and sitting in ER waiting rooms. Tot to validate a solution, but to understand the problem. That experience exposed the limitations of building from the outside and helped him see that what’s broken in healthcare isn’t just infrastructure or access. it’s communication, context, and the cascade of human decisions that follow. His approach underscores how transformative it can be when founders lead with humility, not assumptions.

Fragmentation in Digital Health Is Making Things Worse, Not Better

“It’s taken the clipboard problem and proliferated it in digital form.”

Aniq calls out one of healthcare’s most frustrating failures: technology that was supposed to streamline care has often made it more fragmented and repetitive. From symptom checkers to telehealth platforms, many digital tools ask patients to input the same data multiple times, with no continuity across systems. Fabric’s vision is to integrate and orchestrate these experiences, making it easier for patients to navigate care and for providers to actually deliver it.

AI Should Empower, Not Replace, Physicians

“The promise of AI is to give every doctor specialist superpowers… It’s the Iron Man suit.” \

Rather than viewing AI as a threat to clinicians, Aniq sees it as a tool that can offload routine tasks and help physicians operate at the top of their license. From documentation to triage to care navigation, AI has the potential to restore time and focus to providers who are overwhelmed by administrative burden. The goal isn’t to replace the doctor. It’s to build tools that let them be more human with their patients.

Aniq Rahman may have entered healthcare as an outsider, but by listening first and building with intention, he’s offering a blueprint for how the industry can evolve. One that respects the complexity of care and the people at the center of it.

Connect further with Aniq on LinkedIn and click here to learn more about Fabric.

To make sure you don’t miss an episode of How I Doctor, subscribe to the show wherever you listen to podcasts. You can also read the full transcript of the episode below.

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Transcript

Aniq Rahman:

I think also as a technologist, there's so many better industries to go into or ways to build technology if you want go make a quick buck, right? You can't use AI to vibe code into the production at a health system, right? Let alone get through security reviews and integrate it into an EMR.

Graham Walker:

Welcome to How I Doctor, where we're bringing joy back to medicine. Today, I'm joined by someone I've been really curious to talk to. Aniq Rahman is the founder and CEO of Fabric, a company quietly but aggressively building comprehensive of care enablement in healthcare. As an ER doctor and a health tech entrepreneur, I spend my nights and weekends dealing with what happens when care breaks down and doesn't work, and then my days trying to make the system better. And that's why I wanted to talk to Aniq. He's not just chasing buzzwords or building a demo, he's really trying to tackle the messy stuff of healthcare delivery with a builder's mindset. He's stitching together the plumbing and how care actually gets delivered. I'm really enjoying seeing people outside of healthcare and what makes them excited and interested in trying to fix it as well, what's under the hood of Fabric, and why is healthcare a great place to build. Welcome to the show, Aniq Rahman. Thanks for being here.

AR:

Graham, thank you so much for having me. I've been following you for a long time as well and have been listening to episodes of the show and just learning a ton. So thank you for doing this.

Aniq’s Unlikely Path to Healthcare Innovation

GW:

Yeah, Aniq, you didn't start out in healthcare. Tell me where this all came from.

AR:

I've had a long-standing kind of love affair with medicine, actually. I've always been curious. I volunteered in hospitals growing up. I was pre-med in college, but very quickly kind of also realized this second passion around technology. I've been a programmer my whole life, and started my first company in college and just went down the rabbit hole of startups. And it's been probably not too dissimilar from the adrenaline rush that you get probably in the emergency department. Building a company feels like that to me, and gone off to build companies in a bunch of other spaces that I had no business building in. Had another company in the digital marketing analytics space called Moat, grew that business, sold it globally. Ended up growing it to a nine-figure ARR profitable business. Sold it to Oracle in 2017.

And then in 2018 my dad called me from the back of an ambulance, turned out that he'd had a heart attack at work. He's fine now, thanks to the frontline heroes, like yourself, that saved his life, but it also was really a front row seat to some of the complexity and chaos and dysfunction of the healthcare system, and it was really, I think, a life to marketing phone call for me, really the call to go serve in the healthcare world with technology. And yeah, we're four years into building Fabric and I'm learning net new things every day.

GW:

It's really interesting. I remember a med school professor telling me, "Hey, remember what it's like right now going through med school because when you graduate, when come out on the other side and you have your MD, you actually will lose the ability, you'll lose the perspective on what it is like to be a patient." And I think that's a really common story I hear is people, something happens around someone's health or their loved one's health and that drives them into healthcare that they didn't really understand deeply or care to understand. I mean, it's a really complex space. So I'm curious, what have you learned being interested and now working in healthcare, but that you didn't come from a healthcare background, you don't have medical training like I do?

Shadowing in the ER: Listening Before Building

AR:

First observation is people that work in healthcare I think are some of the most special people. It's really a very mission-aligned group of people. I spent a lot of time actually in emergency departments kind of sitting in waiting rooms, shadowing nurses, shadowing physicians, sitting in the nurse's station, and I'm just really in awe of folks that sign up to serve. But I also think that the system is not set up in a way where patients, providers, and the experience is really as optimized as it could be. And so when we got to working on building Fabric, we set out to build a technology company, but as you know, healthcare is complex and we wanted to really take a full stack approach to this problem, what we realized is it's so interdisciplinary. You need engineers, product managers, data scientists, designers, but you also need doctors and nurses and administrators and all these various perspectives in order to build things that can solve some of these structural problems in the healthcare system.

I think in thinking about this, one of the largest structural problems in the US is really the misaligned incentives. It's patients, providers, pharma payers. It's really this misalignment between the people who need the care, the people that provide the care, the people that make the treatments and the people that pay for the care. When we set out to build Fabric, we sort of saw an opportunity to use technology to create efficiency, drive the unit cost of care delivery down, but also thread the needle on patient experience, provider experience, and operational efficiency, which historically I think there are tools that have been built around each of those objectives, but doing it as one integrated system, we think healthcare presents some unique challenges in being able to actually deliver that.

Why the Healthcare System Feels Stuck in the Past

GW:

With healthcare people and with healthcare leaders, it's so great that you can always go back and say, "Look, I'm just trying to do the right thing for the patient." Fundamentally, that is always the, or it should be, always the central thesis of anything. And so when you get back down to it, even if somebody's done something that upsets you or they made a mistake or you have a disagreement, fundamentally the goal is like, "Look, I'm always just trying to do the right thing for the patient." It's great that it's mission-driven in that way. And then, I mean, the other thing is, I say this all the time, but no doctor or nurse or NP or pharmacist or anything went into medicine to make a bunch of money or get rich because there's better ways of getting rich than working nights and weekends and dying younger, 'cause working night shifts and stuff like that.

So certainly I think healthcare attracts people that really want to give and help other people, which is wonderful that you have this selection bias for people that are going to be dedicated to this industry that's fundamentally, hopefully, mission-driven still. And then the other thing that you said that I thought was interesting is just how, yeah, the incentives aren't aligned, but fundamentally the way I think about that is we're still working in a system that really has existed to solve the problems of the 1910s and 1920s, the way that we do residency training.

The reason that residents are mostly trained in hospitals, even though most care is outpatient care, that we were trained in ways to cure diseases as opposed to manage conditions. I mean, the problems of today's healthcare are fundamentally not addressed by the healthcare system because the healthcare system has not changed in a hundred years, and part of that's due to incentives and part of that's due to the education system and the training system. But fundamentally, we're working from a model that's a hundred years old and solved really good important 1910s problems, like penicillin and taking out your appendix, but doesn't fundamentally, I think, work very well when you're managing chronic conditions and managing dilemmas that by definition don't have a cure.

AR:

Our education system just generally I think probably does a disservice in preparing folks to be physicians or frontline clinicians or really even be healthy educated patients. I think if you think about the modern education system, it is, there's a lot of vestigial elements of agrarianism, imperialism, just the world order that was set way before the last hundred years. If you look at a lot of the systemic issues that lead to the health outcomes that we have today, a lot of it kind of starts with not educating people around what to eat or how to take care of yourself or basic financial literacy. That actually plays such a huge role in our healthcare system that it's hard to quantify. But I think, similarly, there's an opportunity that's presented by some of this with technology. So healthcare, as you mentioned, it's not for the faint of heart to be a practitioner. I think also as a technologist, like there's so many better industries to go into or ways to build technology if you want to go make a quick buck, right?

You can't use AI to vibe code into the production at a health system and let alone get through security reviews and integrate it into an EMR. I think when I reflect on my career, Moat was a great journey. We built a great company, scaled it globally, had lots of really great customers, but we sold it when I was 30. Maybe it was just because I was entering a new decade in life, but it also sort of forced me to reflect on some of the cardinal problems, right? Like I wanted to go do something that either touched healthcare, climate, education, one of these things that felt like a multi-generational problem and you don't really want your obituary to read that you helped measure ads. So I think I feel honestly extremely grateful to be able to serve in this industry and work with incredibly bright mission-driven people. And I think coming into it with an outsider perspective also gave me the license to just go ask really dumb questions and partner with real experts.

GW:

That is one thing doctors often will not do. I love that. That's a great answer. Yeah.

AR:

Hospitals, for example, get to employ tons of really bright people, but it's hard to... You don't always get to see engineers, product managers, data scientists, designers in those frontline environments. In Silicon Valley, you can, you know, Google started in a garage, Apple started in a garage. I don't think you can build a transformational healthcare company in a garage. You need to sort of be in the frontline environment and learn, and there's a lot of things that, I know you're an emergency medicine physician, but a lot of things that we saw just sitting in the ER waiting room. You see the numbers around left without being seen rates or time to elope, but you can literally hear patients voice their frustrations around the reasons why they're leaving, where they're going to, how long they've been waiting for. You don't have to just-

GW:

Yeah, they will tell you. Yeah.

AR:

Exactly. The emergency room is one of those venues where we started with. And it almost felt like the internet didn't exist when you walk into most ERs, right? Patients are just sitting in the waiting room, they're on their phones in many cases, but otherwise, there's so much opportunity to take that downtime and engage that patient asynchronously to go through and do things like their whole nurse intake on their phone, and then have that right to the flow sheets, that saves the nurse's time. Maybe there's an opportunity to take some of these existing paradigms and apply them.

GW:

Well, yeah, Aniq, let's dive into that. So maybe tell our listeners what you're building at Fabric and then maybe what's your vision for what you want to build at Fabric.

Designing Fabric: A Full-Stack Approach to Access and Efficiency

AR:

The business that we've constructed really over time has come to sort of mirror the longitudinal journey of a patient. We started in the emergency department as sort of our first site of care, but when we realized a lot of the patients, there's a lot of those ESI fours and fives and some of the threes as well-

GW:

Kind of lower acuity patients who often aren't having a life threatening emergency but are seeking care. They need some help with something.

AR:

Yeah, exactly. And they might be in the ER because it's 701 and urgent care is closed or because they don't know where to go. But what we also realized is that a lot of those patients could be treated in a virtual urgent care setting, and so that led us down the path of exploring, building our own asynchronous telemedicine technology. We ended up sort of chancing upon a company called Zipnosis that had been around for a while and had been deployed at a bunch of health systems and realized that we wanted to get to these patients upstream before they landed in the emergency department. And then we, at the beginning of last year, acquired a business called Gyant, which is in the conversational AI space.

Gyant has these AI chatbots and AI assistants that are deployed largely across health systems and health plans that also have clinical triage capabilities into it. So it allowed us to better get to these patients even further upstream and help route them to the most appropriate site of care, whether it was in-person or virtual. And then last year we also acquired two other businesses. We bought a medical group. We bought 50-state PC actually from Team Health, largely emergency medicine-focused contract management group. So they had a virtual care division that we acquired from, and that us, a team of emergency medicine-trained virtual urgent care physicians and APPs.

And then we also bought Walmart's virtual care division from them last year when they announced they were shutting down their clinic business. They had bought a company called MeMD in 2021 that was largely focused on the employer and payer vertical. And so that allowed us to diversify our business from purely kind of the provider side of things and started working more with payers and employers as well, but also give us the ability to bring over their provider group as well. And we staff that on behalf of our employer and payer customers, as well as adding additional physician capacity or clinician capacity to our health systems. Many of whom are provider constrained or have thousands of doctors, but maybe only operate in one state, and we're looking for 50-state coverage, and so it gives us a way of, allowing us to be a good partner to them and augmenting that.

GW:

So you can either offer options on the, you know, my employer subscribes to Fabric, and now this is an added benefit that I can now have as an employee to access all sorts of virtual care. And then you can also up staff a health system that needs some additional support as well.

The Problem with Point Solutions

AR:

Correct. Yeah. So we've built a range of tools now that are deployed at health systems that allows you to do chat bot, patient scheduling, provider directory, virtual care pathways. What we've realized is that there are a lot of different tools in the healthcare landscape, lots of point solutions. I think this extends to the tools that doctors have, but also just tools just across the provider ecosystem. And the laws of physics in healthcare make it harder to build. I think there's a lot of inertia in building tools for doctors and providers. There's a lot of legacy tools that you have to displace a lot of capabilities that you have to integrate with, whether it's an EMR or CRM or ERP, prevention systems. And so just the inherent complexity of selling into provider orgs and integrating with those systems and getting through procurement, security reviews, et cetera, I think, makes it difficult to build platform solutions.

So a lot of folks just end up building these point solutions, but that also leads to a more fragmented experience for everybody, the patients and the providers. When we think about this on the patient side, the things that we're replacing are on the chat bot. For example, today, if you ask most of these health system chat bots or health plant chat bots, anything clinical like, "I have a UTI," or, "My tummy hurts," or, "I have pink eye," it'll either say, "I don't understand what that means," or it'll route you to a symptom checker. Then the patient goes to the symptom checker, enters their information in, and then they get routed-

GW:

Again, entering the same information a second time. Yeah.

AR:

Exactly, and then it gets better. Once you enter that information in, it'll route you to maybe virtual care where you have to go enter in that information all over again or say it to your doctor. And so it's kind of taken the clipboard problem but proliferated it in digital form, and we're just like, "This makes no sense. We should have an integrated ecosystem that also doesn't have a narrow view on what the patient should do." It should allow you to go to virtual care, go get triage, go schedule an appointment. If you can't get the appointment scheduled in person, maybe we can get you in virtually, and kind of help navigate the patient through the system so that you don't get ping-ponged across multiple phone trees and multiple departments and multiple systems potentially.

GW:

What is the problem that Fabric is solving? I agree, you're definitely solving a problem, but is there a... If you zoom out, what's the fundamental tension or problem that you're like, "We are fixing this..."

AR:

It's probably like three or four problems, honestly, but I'll try to...

GW:

Yeah, there's plenty of problems in healthcare for sure.

AR:

Intelligent access, I think, is a big part of it, right? Access is one of the, I think, biggest sort of issues in the healthcare world. It's not just sort of opening up capacity, but also making sure you're going to the right place. No ophthalmologist wants to see the patient with pink eye, right? There's a lot of just low-acuity stuff that I think can unfortunately get routed to the wrong place. So being able to more intelligently navigate and route the patient is one component of it. I think the other component here is moving to a more proactive and longitudinal care delivery system. Today, a lot of our care is still feels disjoint and episodic, and we think that there's an aspect here where technology can help bring a lot of that into a more connected ecosystem, which we don't think exists in just a virtual-only capacity. We think that it needs to be a hybrid system that allows you to have virtual and in-person care connected, and we think that in-person care needs to be delivered at the local system.

And so being able to also just connect the supply side and the demand side of care. I think that's one of the reasons why we got into the employer and payer side of things, is every employer and payer want to divert their patients to the most appropriate site of care, make sure that it's a high-quality, low-cost site of care. If it's virtual, that's great. If it needs to go to in-person, you want to send that patient to high quality, low cost side of care. Today, that orchestration doesn't really exist because there's different systems that are being used across the supply side and the demand side of care, and so I think that's another big opportunity that we think is unsolved. And as we're sort of starting to build up more critical mass on both sides, we think there's an opportunity to be one of the solutions in that world.

GW:

I'm always thinking about who to blame. I guess the better way to say this is, "Who's responsible?" But when you mentioned continuous care or moving away from episodic care, one of the challenges seems to be that, well, those doctors aren't going to get paid for ongoing care. The system in most places in the United States, and probably the world, the system pays when you make an appointment, and in fact, the system often doesn't pay if you send an email. I think a lot of patients think they are helping or making it easier for their doctor because, "Oh, it's just a quick question. I'm just going to shoot them an email."

Well, if that doctor has paid $0 and has 50 emails to respond to, where does that time and value go? What often happens is they give a short message reply that either says make an appointment or they're doing it in their free time and they're not paid for that, but they're only paid for the episodes of an appointment or a telephone visit or even if it's a video visit, it's still like that is allotted, that that is value. And the other ways that the patients actually want to get care, the health system, the employer, insurer, whoever it is says, "Well, yeah, that's work you do for free." I think that's the other challenge is the structure creates the problem too.

Rethinking Payment Models with Asynchronous Care

AR:

Part of this is addressing the uncompensated care that you're doing through an in-basket or an email. We've built software around asynchronous telemedicine that allows a patient to go through an asynchronous intake but then send you a fully drafted encounter summary that allows the provider to select an assessment and pick meds off a formula you prescribe and really get the patient meds in a treatment plan and also get paid for it rather than having to do that all through a more clumsy modality, just back and forth messaging. Additionally, we're helping unlock new payment models across our customer basis. So, for example, some of the health systems we're working with, it's actually turning that sort of episodic interaction into more of a subscription experience for a patient or employer. I think patients are actually subscribing to stuff all the time in healthcare, right?

GW:

I was just going to say it feels like everything in society is becoming a subscription. It's fascinating.

AR:

I think the concierge models, right? You can spend as much as you want on a concierge doctor across the country.

GW:

You sure can.

AR:

I'm sure there's some people that are charging even more, hundreds of thousands or millions. There's that, and then there's really the more democratized, the tech and retail disruptors that are out there charging 10, 20 bucks a month for some sort of subscription care. I think a lot of health systems are thinking about ways of, at least the forward thinking ones, they're thinking about ways of actually being able to meet that consumer need or want of like, "Hey, I just want to have a way to get access to care on my own terms when I need it and have it be connected to my labs and specialists and being able to have that one medical-like experience, but not have to go to Amazon necessarily to go get that, and have it be integrated with my broader care delivery system." And obviously, employers and health plans. They've been historically paying on PMPMs and PEPMs looking at more of a subscription modality, and so I do think that we can help enable that with our technology.

GW:

The subscription model is interesting. Typically, if you buy a subscription, often you get unlimited to access to all of Netflix catalog, and maybe that means that you're watching more Netflix and, I mean, you're not renting from Blockbuster anymore. At the time you had to rent a movie from Blockbuster or you can get all-you-can-eat from Netflix. I mean, I think one of the things that doesn't feel great about medicine is that patients have way more questions than we doctors, nurses, the universe has experts available to answer them. I would love to be able to answer every single question that comes up.

If I saw a patient three days ago and they wake up at three in the morning, they have a question, I would love to be available to have a version of me that's just twiddling my thumbs, waiting to answer their every question, because I want to be able to help them. I mean, I genuinely do, but the challenge is I would like to sleep and I have other patients that need my help too. I think that subscription model, if we could offer unlimited questions, unlimited answers that are accurate and high quality, that would be a nice thing to have.

AR:

Yeah, I mean, I would probably subscribe to the Graham Walker avatar. There's a lot use actually for AI that are already out there and in the wild. There's care delivery use cases around triage, scheduling, finding care gaps, outreach, managing referrals, scheduling follow-up care. And so I think some of that I think can help turn the system from being this kind of reactive, find me when you need me system to being this more proactive system that... I think just taking canonical, like primary care use case, right? Like, what does a patient doing the other 364 days a year? Can we turn that into something that where we're reaching out on a monthly, weekly, daily basis even, to help manage that chronic condition?

I think one of the issues today with, at least a lot of the digital infrastructure, is it feels like there's a different system for virtual urgent care, virtual primary care, chronic condition management, behavioral health. It almost feels like three or four disjoint systems, and I think being able to bring that all together can actually help get to the root cause of some of these problems. And again, I think subscription may not be the right sort of framing, but I think it needs to be a proactive, always on system, and maybe subscription is the right payment model for some people.

GW:

Let's role play here. You are you, you're a technologist and CEO, let's say I'm a more AI hesitant physician, ER doctor, PCP, whatever it is. Obviously, the real Graham Walker, I think, is a cautious optimist about AI. But when I hear physicians who are skeptical or concerned, I think of a couple different things. And maybe just as a technologist, I'm curious to hear your response to some of these concerns. Probably the biggest one that I hear the most is, "AI is just going to replace me." "AI is just going to take my job." "What am I supposed to do when AI replaces me?"

AI in Medicine: Superpowers, Not Substitutes

AR:

There's a lot of busy work that I think will just be automated over time. I think over time most of documentation will probably be automated. I'd probably share your disposition around this. I'm cautiously optimistic. I think we've taken a very conservative approach to a lot of the models that we've built because we have more of these deterministic decision trees that we've built initially to drive our virtual urgent care protocols, and we're seeing pretty huge efficiency gains. Across almost 7 million visits we've done on our platform our average provider work time is only a minute and a half to do the full triage evaluation, diagnosis, and treatment.

Because so much of it can just be a patient going through a decision tree and then that, again, can take that encounter and give the patient honestly that time back, give the provider that time back. But I also think that the promise of AI is to really hopefully give every doctor, specialist superpowers over time. I think it's the Iron Man suit. I'm waiting for that to sort of be realized where... It actually kind of harkens back to that a hundred years that you were talking about, right? At one point, every doctor was expected to be this sort of generalist and we've super specialized now, and so what if we can be generalists that have super specialist capabilities?

GW:

What do you think the benefit in the longer term, say five, 10 years is for physicians? We're around AI. I mean, I feel like if we think of AI as kind of just another tool, which I think is an okay framework to think about it in medicine, I know what a CT scan gets me or an MRI or a lab test or an EKG. I have a sense for what this tool is helping me accomplish or what question it's answering in my head or what question needs to be answered for the patient. What do you think that answer is for AI? And maybe we can say generative AI because AI is becoming a garbage term of marketing jargon at this point.

AR:

Just the amount of data exhaust that each of us creates is, I mean, it's hard to sort of always know what's useful and what's not useful. I track my sleep every night for probably over a decade at this point. I have been wearing an Apple Watch or Fitbit or whatever for a long time. I've been to a bunch of different doctors, gotten tons of different lab tests and imaging. And being able to track disease progression, being able to track just behavior changes, understanding also the context of you could probably adjust my calendar and know when I'm having a stressful day or stressful week or when I'm traversing time zones. I think that AI should help unlock a lot of that.

Maybe some of that benefits the patient outside of the patient-doctor context. I think also on the physician side, today, it feels like you have to read through a ton of notes and read through a ton of, really kind of piece together a history because you really only need to spend a few minutes in an emergency room shadowing a patient doctor in a rush to know that patient stories change very, very quickly.

GW:

You heard it here first from a non-health care worker. The stories do change. Yes.

AR:

Yeah. And you're like, "Oh, I forgot I'm on that medicine," and sometimes the pills are sort of denominated by the color they are or the shape they are. Being able to collect all that information and then look at it on a more continuous basis, I feel like we don't have the systems in place or the integration or the interoperability in place to really enable that, but I would hope that in the next five to 10 years we were able to actually go do something really useful with that and use that to condition behavior changes and help people stay healthier longer.

GW:

What's your biggest bet on the future of care?

AR:

The intelligent access piece, like being able to divert costs and navigate patients more efficiently. I think the proactive care component as well, like, can we use AI to help check in with patients again on a monthly, weekly, daily basis and maybe take in some of that, the wearables and the connected devices and all the various sort of digital touch points? And then being able to integrate across specialties. Again, in the digital context, it's like urgent care, primary care, chronic care management, and behavioral health, I think being able to put that into one more accessible place. And then thinking about new care enablement models and payment models around it. When we think about our biggest bets, those are the three buckets that we think about the most.

GW:

You think you're going to get health plans and health systems to work together?

AR:

We're seeing that already in, some of our health systems that we work with actually own health plans as well.

GW:

Their own health plans.

AR:

Yeah. And so being able to just have the right hand talk to the left. But then we're also seeing some of the health plans that we work with that have more regional plans that have maybe a couple of health systems that they do a lot with are looking actually for ways to have a tighter integration. I can't speak to the way that they go back and forth on claims and denials and adjudication, but yeah.

GW:

At least some parts of the systems want to work better together. Yeah.

AR:

Yeah, exactly. I'll wear the rose colored glasses on the podcast.

GW:

Yeah.

AR:

Yeah.

GW:

And then Aniq, let's say it's 2035, we're doing the thousandth episode or 5000th episode of How I Doctor here again, what do you think from the healthcare experience feels completely different, like we look back and we're like, "I can't believe we did it that way."

What the Future of Care Could Look Like

AR:

What we're talking about earlier on that hybrid care infrastructure, being able to orchestrate across modalities and honestly create one omni-channel journey. You look at the world of commerce and you can buy things online and then return them in the store and vice versa, and I think there's nothing that feels quite that seamless right now in the healthcare world around enabling seamless triage, scheduling, follow-up care across all settings, and I think that that orchestration piece is something that we're excited to continue to build that we think AI is going to be a huge enabler for. Again, it's going to be challenging for systemic reasons, for technology reasons, but we think that the world is kind of heading in that direction.

GW:

I'll see patients in the ER that maybe were seen by another doctor at another health system or they had a video visit or something, and it is interesting the areas where I will agree with the other clinician that they were seeing, and then the areas where I'm like, "I don't know what they were doing." That's the other challenge. Sometimes you get a very different understanding for what's going on with the patient just by seeing them in person. That's the other particular challenge of healthcare is, "Do I have the right diagnosis? Do I have the right treatment?" And then if the treatment's not working, is it that the diagnosis is actually wrong or they have a more severe form of the correct diagnosis, and so I have to give them more treatment essentially as well.

AR:

To your point, right, you've got discrepancies maybe around how you view a correct treatment.

GW:

The management of X. Yeah, yeah, yeah.

AR:

Yeah. Like, could we use technology to come to more objective POVs and sort of consider outlier use cases or outlier treatment plans?

GW:

Well, Aniq, it's been really a pleasure to have you. It's always fascinating to talk to somebody as successful as you and then someone that has such a different and actually similar perspective on fixing healthcare as well.

AR:

No, thank you so much for having me, and it's really a pleasure to be here. I mean, I think what you're doing as a physician, as an innovator, as an entrepreneur is really inspiring, so hopefully we can continue the conversation.

GW:

Thanks for joining me today. For interviews with physicians creating meaningful change, check out offcall.com/podcast. Make an account on Offcall to confidentially share your details about your work and sign up for our newsletter where you can hear more about the latest trends we're seeing in physician pay. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly. This has been and continues to be Dr. Graham Walker. Stay well, stay inspired, and practice with purpose.