Superhero radiologist David Gruen speaks to AIMed about his journey through medicine and artificial intelligence, the future of radiology, and the importance of retaining focus on the patient.
What initially sparked your interest in medicine?
When I was a very young kid, I had my heart set on being Batman when I grew up—or, at the very least, Robin. By age eight or nine, as it became increasingly clear that I lacked the speed, strength, and comfort with heights to be a superhero, I figured I’d settle for the next best thing: practicing medicine. After all, my uncle was a brilliant surgeon, whose stories about saving lives (in a mask, no less!) were almost as exciting as the ones I read about in comic books. And my own experience in the field—as the “Doctor” in the board game “Game of Life” —had always worked out pretty well for me, seeing as I won far more often than my sister and cousin, who always picked the superstar and salesperson respectively.
When did you become involved in medical AI?
Like many radiologists, my first foray into the world of AI was through mammography. I remember back in 2002, being told that a machine was able to recognize patterns that us doctors might otherwise overlook—subtle calcifications that could go undetected until it was too late. While plenty of colleagues were nervous that this would make radiologists irrelevant, I knew even then the incredible potential of this kind of technology. And yet, even I underestimated just how much AI would change the field of medicine for the better. Today, we radiologists rely on AI for everything from clinical decision reports, to data driven insights, to advanced pattern recognition—all courtesy of machines that don’t experience exhaustion like we do, or fall victim to human error like we do. Far from making us worse doctors, technology enhances the skills we’ve had all along, making us more informed, more engaged clinicians.
What are the main challenges you face in your clinical practice, and to what extent do you see artificial intelligence helping to solve these?
Even before the pandemic accelerated doctors’ exodus from the medical field, radiology experienced a significant shortage of clinicians, a result of the brutal combination of more and more patients due to an aging population, increasing retirements, and decreasing numbers of medical students going into the field. I can’t say I blame that last category—for too long, radiology has been a churn and burn field.
Technology has been vital to helping doctors keep up with the volume of patients, and keep up our spirits, with better tools giving us more data and greater accuracy than ever before, at a faster speed than ever before. In other words, by offering the insights we’d otherwise have to spend hours finding and prioritizing, AI allows us doctors to get back to what we’re best at: treating patients with compassion.
Operationalizing and scaling of innovation is a universal challenge in healthcare. How does your organization approach this?
There’s never a shortage of opportunities to invest in—but, somewhat ironically, a shortage of data needed to decide which investments are best for each practice. Not to mention, each decision must account for a wide array of stakeholders—from frontline doctors to the finance department, billers to machine operators. For me, the best way to approach this is by, quite literally, sitting down with the many members of this ecosystem to create a strategy together: whether we invest in X or Y, focus on A or B. It’s my job to make sure that everyone who needs a seat at the table, gets one—and that once there, peoples’ voices are being heard.
Who’s been the biggest influence on your career?
I’ll give you three. The first is my Uncle Stephen. The only doctor in the family until I came along, he impressed upon me the notion that taking care of people was a privilege—and that our number one duty was to do right by them. The second person was my grandmother. Because of the world crises of the 1920s, she never graduated from college, but was the most intellectually curious person I’ve ever known (she spoke a half dozen languages—averaging a new language every 16 years). She’s the reason why I pursued my MBA to learn the business of medicine, why I pivoted careers to join IBM, and why I continue to learn about health technology as much as I do healthcare itself. And the third person was my fellowship director, who helped me understand what radiologists really do: provide answers to patients and referring clinicians, to help decide their course of treatment.
What’s the best piece of advice you’ve ever received?
As Uncle Steve told me time and time again, “Focus on the patient. Not the insurance companies, not the hospital lawyers, not the drug reps and technology reps and financial reps—your job as a doctor is to care for your patient.”
What advice would you give someone starting their career in medicine or medical AI?
Stay curious: yes, about the tools you work with and diseases you treat for, but mostly, about the patients you look after. People come to doctors at their most vulnerable—the best doctors are the ones who truly seek to build a relationship, rather than tick a box.
If you could return to the past, what would you change or do differently?
As doctors, it’s easy to dwell in “shoulda coulda woulda land”—so, I don’t let myself. Because at the end of the day, if I were to do it again, I’d still become a doctor. I’d still choose radiology. I’d still want to build a career at the intersection of medicine and technology. Because I know doing so has saved lives and will continue to save lives long into the future.
Where do you see the radiology profession in 5-10 years?
I think the future is exceptionally bright for radiology. We’ve seen exponential progress when it comes to more detailed pictures, more granular imaging, more incisive metabolic physiologic assessments of what causes the world’s greatest health mysteries. And I know AI is only going to continue to transform diagnostic healthcare. I hope the same can be said for the future of radiologists. There are still far too many of us who believe doctors and technology are mutually exclusive, when in reality, they’re mutually reinforcing.
Dr David Gruen is the Watson Health Imaging Deputy Chief Medical Officer and a practicing radiologist. After completing his fellowship at Memorial Sloan-Kettering Cancer Center, Dr Gruen went on to specialize in women’s imaging and breast cancer. Dr Gruen inspects breast programs nationwide for the American College of Radiology and continues to serve on several national committees. Dr Gruen is also on the board of the Breast Cancer Alliance and previously served on the board of Susan G Komen, New England.
Dr Gruen will be speaking at AIMed’s Global Summit in Laguna Beach, CA, from 18 to 20 January 2022. Find more information and book your place here.