Episode 26 - QxMD, Mobile Solutions That Drive Evidence-Based Medicine with Dr. Daniel Schwartz
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Episode Summary
Because medicine is in a perpetual state of evolution, it is incumbent upon medical practitioners to be lifelong learners, always sharpening their intellect and skill set. In recent years, much of this continuing education has become reliant on technology. While clinicians have access to scientific journals, magazines, blogs, podcasts, and other digital sources at their fingertips, quickly accessing full research articles continues to be a hindrance. Enter QxMD, a company designing apps to help clinicians keep up with the latest research and integrate decision support tools into their practices.
On today’s episode of Back Talk Doc, Dr. Lakhia welcomes the co-founder of Back Talk doc’s new sponsor, QxMD, Dr. Daniel Schwartz. Dr. Schwartz is a practicing kidney doctor, nephrologist, clinical educator, and vice president of WebMD. Additionally, he’s the medical director of a regional home dialysis program and a clinical assistant professor of medicine at the University of British Columbia.
Dr. Schwartz shares his experience building QxMD. From starting with a product with no commercial strategy to an eventual partnership with WebMD, Dr. Schwartz reveals how solving his own problem led him to designing a service focused on making it easier for doctors and other healthcare providers to access relevant medical literature. Dr. Schwartz also walks us through three of QxMD’s innovative products: Calculate, Read, and Learn.
Highlights from the episode:
For more information about QxMD visit qxmd.com, or email [email protected]. To try QxMD’s apps, download them on your device’s app store or follow these links:
Calculate by QxMD, Read by QxMD, Learn by QxMD.
For more information on Dr. Sanjiv Lakhia’s practice, visit BackTalkDoc.com
Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.
Because medicine is in a perpetual state of evolution, it is incumbent upon medical practitioners to be lifelong learners, always sharpening their intellect and skill set. In recent years, much of this continuing education has become reliant on technology. While clinicians have access to scientific journals, magazines, blogs, podcasts, and other digital sources at their fingertips, quickly accessing full research articles continues to be a hindrance. Enter QxMD, a company designing apps to help clinicians keep up with the latest research and integrate decision support tools into their practices.
On today’s episode of Back Talk Doc, Dr. Lakhia welcomes the co-founder of Back Talk doc’s new sponsor, QxMD, Dr. Daniel Schwartz. Dr. Schwartz is a practicing kidney doctor, nephrologist, clinical educator, and vice president of WebMD. Additionally, he’s the medical director of a regional home dialysis program and a clinical assistant professor of medicine at the University of British Columbia.
Dr. Schwartz shares his experience building QxMD. From starting with a product with no commercial strategy to an eventual partnership with WebMD, Dr. Schwartz reveals how solving his own problem led him to designing a service focused on making it easier for doctors and other healthcare providers to access relevant medical literature. Dr. Schwartz also walks us through three of QxMD’s innovative products: Calculate, Read, and Learn.
Highlights from the episode:
- Dr. Schwartz’s path from clinician to entrepreneur (03:37)
- On building a useful product and then finding a pathway to profit (06:52)
- What is QxMD? (09:39)
- Overcoming access to information obstacles (13:45)
- The birth of QxMD (17:13)
- The relationship between QxMD and WebMD. (22:43)
- What’s on the horizon for QxMD (28:01)
- Health hacks from Dr. Daniel Schwartz (30:13)
For more information about QxMD visit qxmd.com, or email [email protected]. To try QxMD’s apps, download them on your device’s app store or follow these links:
Calculate by QxMD, Read by QxMD, Learn by QxMD.
For more information on Dr. Sanjiv Lakhia’s practice, visit BackTalkDoc.com
Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.
Sponsor: 00:00
This podcast is sponsored by our partner, QxMD. QxMD builds mobile solutions that drive evidence-based medicine in clinical practice. Check out, Read for easy access to research, personalized for you and Calculate for over 500 easy to use decision support tools. Try them today at qxmd.com/apps. Again, that is qxmd.com/apps. This podcast is sponsored by our partner QxMD. QxMD builds mobile solutions that drive evidence-based medicine in clinical practice. Check out, Read for easy access to research, personalized for you and Calculate for over 500 easy to use decision support tools. Try them today at qxmd.com/apps. Again, that is qxmd.com/apps.
Intro: 00:59
Welcome. You're listening to Back Talk Doc, where you'll find answers to some of the most common questions about back pain and spine health brought to you by Carolina Neurosurgery & Spine Associates, where providing personalized, highly skilled and compassionate spine care has been our specialty for over 75 years. And now it's time to understand the cause of back pain and learn about options to get you back on track. Here's your Back Talk Doc, Dr. Sanjiv Lakhia.
Sanjiv Lakhia: 01:35
Thank you to everyone for tuning in today to this episode of Back Talk Doc. For those of you that have been following me, you may have noticed the last few episodes. We have a bit of a new lead in intro with our sponsor, our new sponsor QxMD. And today I have the pleasure of bringing to you an interview with Dr. Daniel Schwartz, who is really a co-founder of QxMD and an integral part of their company, and building a relationship with us here at Back Talk Doc and Carolina Neurosurgery & Spine Associates. So Dan, welcome to the show today.
Daniel Schwartz: 02:09
Thank you for having me.
Sanjiv Lakhia: 02:11
All right. I want to introduce you to the listeners here. Thanks for forwarding me a little bit about your background. So Dan is a ... He's a practicing kidney doctor, nephrologist. He's a clinical educator and vice president at WebMD and co-founder of QxMD. He's a medical director of a regional home dialysis program and a clinical assistant professor of medicine at the University of British Columbia. He has a keen interest in knowledge translation at the point of care and the intersection of information tech with clinical medicine. As a co-founder of QxMD, he's built digital solutions that help practicing healthcare professionals like myself, provide evidence-based care, stay at cutting edge of the clinical research and really gain new knowledge via digital eLearning, which is the new way to learn and through a network of apps for the web iOS and Android devices, he's helped QxMD support a community of over three million healthcare providers.
Sanjiv Lakhia: 03:08
Currently he's focusing on implementing digital tools that allow hospitals, researchers, government, commercial partners, and nonprofits to enhance quality of care and adherence to evidence-based guidelines. And his personal clinical interests include peritoneal dialysis, interventional nephrology, and management of late stage chronic kidney disease. So Dan, that is a lot, you've got a lot going on my friend.
Daniel Schwartz: 03:33
Yeah, I do. I like to keep it busy and mix things up.
Sanjiv Lakhia: 03:37
All right. So I'm curious to know, give us a little insight about your pathway from clinician to kind of clinician entrepreneur, businessman.
Daniel Schwartz: 03:48
That's a great question. And it certainly has been a journey. It really all started, I think, with a recognition. Looking around in my role as a clinician educator at the University of Toronto, where I started out, that although so many healthcare providers aspire to stick to evidence-based medicine. In practice, it's just really, really hard. And so, so much of my career has really focused on how do we make it easier for doctors and other healthcare providers to become aware of the medical literature, make it usable and keep up in general, because I think this is something that we all struggle with. And so over that journey, I've certainly had more failures than successes. The things that you see out there today are the ones that have worked, but I've also built lots of stuff, which really maybe they were building blocks or things I learned from. But that journey I think has helped me figure out what resonates with the healthcare community and really build upon them so that they grow and grow.
Daniel Schwartz: 04:57
And a very core part of that, I think has also been the practical aspects of commercialization. Although some of my colleagues, I respect very much, really focus on finding research question, getting grant support and pursuing from that avenue. What I found very liberating early on with the ability to find commercial partnerships, which essentially would fund the work we wanted to do. And that to me was a real pathway to pursuing the projects we like, and then get a bit creative about how do we commercialize in a way which is useful still to clinicians, but gives the funding we need to keep growing and building.
Sanjiv Lakhia: 05:39
Yeah. Hearing you say that makes me reflect back on my days in internship many a day ago, where our internship director would drill into our heads that we must read an hour a day. If we're not reading journals and medical literature an hour a day, then we are getting lost. And now that I'm about 15 years into my clinical practice, I look back on that and I know how insufficient an hour a day of learning really is in the medical field. But what you really have to do as a clinician is fit maybe two or three hours a day of reading into 30 minutes and that's where these evolving tools have been so helpful. And one of the reasons that I felt good about, when you guys reached out to us at the show about collaborating a little bit was, your vision really seems to be genuine and putting out great information in a digestible manner and accessible manner. And that's really what I've tried to do with this podcast in terms of the world of spine care and neurosurgery and physiatry is just put out really good actual information that's based upon evidence that's cutting edge and out in front that people can digest.
Sanjiv Lakhia: 06:52
So it's a really interesting path that you just described. Tell me a little bit about the collaboration piece that you mentioned, where you take an idea and you collaborate commercially, and then you produce a product. How does that work?
Daniel Schwartz: 07:07
Yeah, so at the very beginning, we set out really to build what we wanted to build first, not be influenced by commercial realities and then look backwards and say, "Okay, how do we construct those?" I think most businesses and this is where, you referred to me as a businessman. And I think that's probably not how I view myself. What I really do is build what I believe and when build what I love, keep growing the things that garner attention and support from the medical community, and then figure out how might we commercialize these things. So we've taken many different stabs of this. At the very earliest stages, and this is going back quite a bit. When I was at the University of Toronto, I had to give up my PalmPilot, and trade it in for a Blackberry and in doing so, I lost all my software, all the stuff I accumulated on my PalmPilot device. So I'm aging myself here.
Daniel Schwartz: 07:59
But we decided we would build the first version of what later became Calculate, our clinical decision support tool and build it out for the Blackberry device. And at the time we had zero commercialization intent nor really an idea how to do that and that only came many years later. And so since we didn't really have a commercialization intent but we did know how to build software. We built an educational tool for ECG interpretation and another tool for pediatric critical care. And we just sold. We sold those for, I think it was a dollar or five dollars or somewhere in that range. And those revenues funded our free products and actually funded all the development of our free software. Our goal has always been to never let payment be a barrier to utilization. And even though say, five dollars doesn't sound like a lot of money, we know that practically speaking.
Daniel Schwartz: 08:53
So I've always looked for the models that might allow us to get the funding we need, but still preserve access. And when we think about access, I really think about it at a global level. We want our tools to be usable, not just in North America, where we practice, but really all over the world. And I'm pleased to say that because of that strategy, we've had quite a bit of success. We've seen amazing dissemination across Europe, striking engagement in Latin America and South America, India, many other parts of the world. And our free software model, I think has really supported that. But again, I think that the goal we've always had is build what we love, build what we believe in and figure out how to commercialize it later.
Sanjiv Lakhia: 09:39
Well, before we get too far down the rabbit hole, I want to make sure that those who are listening right now, have an understanding about what actually QxMD is. So can you just share briefly about products and what you're offering there?
Daniel Schwartz: 09:55
Yeah, absolutely. So we have really three products. One is called Calculate by QxMD. One is called Read by QxMD. One is called Learn by QxMD. Calculate was our first product and basically we would go out to the medical literature, find clinical decision support tools, and digitize them. I'm a nephrologist by training and I remember a nephrologist, a guy named Dr. Dan Katrin. For those of you in the nephrology world, that was a significant leader in glomerulonephritis. And he developed this really cool model, a mathematical predictive model to determine which patients with membranous nephropathy would progress and get worse. Because for those of you who don't deal with nephrology, membranous is a tricky disease and that some people just get better on their own. Some people stay the same and about a third, get quite a bit worse and get the chemotherapy. Especially at the time, the sort of treatment at the time was chemotherapy with cyclophosphamide, it's changed a bit since then.
Daniel Schwartz: 10:52
But obviously you didn't want to hit someone with big toxic therapy who was going to get better on their own and not get worse, but you also didn't want to miss treating a patient who was at high risk of progression. And so when I asked him about his tool, he was like, "Yeah, it's great, but I don't really use it because it needs like a scientific calculator. I never have one." We went out and we built that. It actually is one of our very first tools. So Calculate really has run from there, where we take the existing medical literature, whether it's a prognostic tool, a clinical decision support tool or even a guideline. And we try to rip it apart and put it back together again. So it's just really easy to use and you can apply it at the point of care. So we don't invent the research, we just make the user interface a little bit easier, a little more accessible.
Daniel Schwartz: 11:35
We also built a product called Read by QxMD. It's probably my favorite one, of the things we've built. I remember many years ago when I was a chemistry student, I always wished somebody would go to the library for me and rip out all the pages of the journals that I needed, staple them together and mailed the to me. That obviously was very feasible but then the day the iPad came out, I'm like, "Oh my goodness, we're here." What if we could create a digital, personalized medical journal? And so that's what we set out to do. And it's had many iterations over time, but really its core functionality is, we learn about you in a mathematical kind of way and we would create a profile of you. And we try our best to make really good recommendations for what we think you want to read.
Daniel Schwartz: 12:19
So we take the 15,000 articles published each week and distill it down to just a few, that we think are relevant. And then with the added step of making access to full texts, super easy. There's lots of content, it's open access, but hard to find. There's lots of content that your institution, for example, I'm affiliated with the University of British Columbia in Canada. And although they pay a lot of money for site licenses, it's kind of awkward and challenging to actually get access to full text. And so we wanted to solve both those problems. How do we make recommendations for content, but also, do all of the backend communication and credentialing so that I can access full text content super fast? And really that's what the product does. Give us five minutes a day and what will keep you up to date with the medical literature. And if you do have access through an institutional license, or if you don't and just want to get open access sources, we make that pretty seamless.
Daniel Schwartz: 13:11
Our last product is Learn. Learn is sort of our take on online digital education. And this was born out of the recognition from our own data analysis of our users, that people don't want to spend an hour in front of their computer learning. Even before Twitter shortened all of our attention spans, we were noticing that people were only spending about six to eight minutes doing educational tasks. And so we thought, "Well, could we build an educational platform, where we taught people something in about six to eight minutes?" And that's really all that it is. It's a very simple platform that allows for micro-learning. Those are our products and that's what we give away.
Sanjiv Lakhia: 13:45
If you're listening and you're a healthcare provider and you don't have these, you could easily go and download them for free from the iTunes store or Android. So we'll put links to that in the show notes as well. I went in myself and I've downloaded the Read app and now I get routine and a curated content on spine care, back pain. I have a search in there for acupuncture and it's great. I can just flip through it and look at what I want. I want to touch on real quick, what you said there, the idea of getting access to full articles and making that easy is a bit of a game changer. Because I think as a clinician, it can be very, very frustrating when you've got a patient case in front of you and you're going to PubMed or wherever it is. And you see an article with an abstract or title that looks like it can be very helpful. And then you got to pay 30 bucks for a 24 hour rental or whatever have you.
Sanjiv Lakhia: 14:39
We could talk about this another time, but I think that whole industry, that whole concept of having to put in that money, I don't think patients even have any idea that, that's a hurdle that a lot of us clinicians struggle with.
Daniel Schwartz: 14:51
I agree. I think that the whole publishing industry is super challenging. I also think that the biggest shame is that so many people actually have access through a site license that their organization has paid handsomely for. And yet getting to that full text in a timeframe that works for busy clinicians, it's just too cumbersome. And that's really where we wanted to solve some of those problems. I think the bigger challenge is, will we ever get to a Netflix model of medical literature where you pay one reasonable monthly fee and you can access whatever you need. I think that's still very far off, but at the very least we wanted to connect really anyone with open access science, which is actually more and more available, but also really be sure that if your institution is spending tens of millions of dollars a year on site licenses, at the very least, you should be able to access it without any impediment.
Sanjiv Lakhia: 15:49
Yeah, that's great. Our group is a private group, but we're certainly affiliated with major hospital systems in the Charlotte area. And the way I do it now is, or before this, was I would basically email the librarian with an abstract. So I'd have to go in search, copy, paste, email, and then she would have to search, pull it and I'd get a PDF back within a day or two, which certainly I appreciate, but this is just a lightning speed. And then I get content that I didn't even know that I needed, that is fantastic. Coming in, in a summarized manner. So it's really great.
Daniel Schwartz: 16:25
Yeah. And I think that's also interesting about not knowing you need it. There was a very interesting study done by a guy named Amit Garg, who is also another Canadian. And he found certainly in the field of nephrology, that more than 50% of landmark clinical trials were not even published within the core nephrology literature. And I presume this likely extends to other specialties. So that even if you were super diligent, and even if you kept up with all the key journals in your field every week, you could still miss more than 50% of the landmark clinical trials, which should be impacting your practice. And so the only way to really do it at scale is either through human curation, by people are willing to put in the time or some sort of algorithmic curation. And so we have really focused on the latter.
Sanjiv Lakhia: 17:13
There are other tools out there that curate content for clinicians, but I think this is what really separates QxMD and Read from some of the others. When you started this with QxMD and in particularly the Read app, what was kind of like your initial vision. And then when I read stuff like you've got a million or two million or three million health care providers, how did that happen?
Daniel Schwartz: 17:37
Yeah, it's a good question. So I think you asked me the question, our initial vision, my initial vision was very selfish. I just wanted software for my Blackberry device. And so I thought, "Well, if I get it, that's great." And I had taken one computer science class in my undergrad. I worked for a volunteer organization and I sort of volunteered to build their website, not knowing how to build a website but at the time you kind of had to hand code, the website in WordPad. And so I built this website and then I didn't really do any computer science, but then I ended up going to the bookstore and buying a book on PHP and HTML, and I threw up a quick website. Well, it wasn't quick. It took me a while to build it and I uploaded ... This was before the app stores. I uploaded these Blackberry files, these Blackberry apps that we were building.
Daniel Schwartz: 18:24
And I thought maybe like 10 of my colleagues would download the app. And then we had 10,000 people download them. And then 20,000, then a 100,000. And then I thought, "Oh, I guess I'm not the only one who wants these things." And so really we took the feedback from the community as to what they wanted. Initially being a nephrologist, a lot of my content that we built was nephrology focused. Then a friend of mine who was a hematologist, said we should do this for hematology and then it happened in cardiology and gastroenterology. And then we kind of realized this was a uniform need. So we just kept building and building and building.
Daniel Schwartz: 18:59
In terms of user acquisition, we've never had, for example, a budget to go out and do paid advertising to bring in users. So for the most part, we really focused on word of mouth. But as time went on, we focused a lot on partnership. Just kind of like the one we have with you. Finding people who have mutual interests, who we can help or you can help us and we build relationships. One of the first set of relationships we built was with researchers. So I think back, way back, maybe 2011, I'm thinking. There's a doctor Nav Tangri, who is pretty much now considered a world leader in clinical epidemiology and nephrology. At the time he was just developing, what's called the Kidney Failure Risk Equation, which is a really important model, which helps predict which patients with chronic kidney disease will progress. So you can have real conversations with them based on data, not conjecture, but he wanted to disseminate this tool. And so what did we do? Well, we said, "All right, you're presenting at the International Society of Nephrology meeting at 10:00 AM on Tuesday, we will make our app automatically go live with your content at the exact same moment that you present on the podium. And that JAMA presents the paper and its journal."
Daniel Schwartz: 20:10
And so those kinds of research partnerships turn out to be very valuable. So somebody would work with us, they get on the podium to present their work. And we get 10,000 downloads that week. Based on them talking about our collaboration or eventually we'd get our links put into medical journals. So when someone publishes our work, you can be on and you're on your computer. You click on the link and you can actually use the tool the minute you read about it. We also would Read, have thousands and thousands of institutions around the world that we offer integration with. It's a free integration. We do have a paid service, which is probably how we commercialize, but really any hospital university that has a digital medical library, we will integrate with them at no cost if they don't have budget.
Daniel Schwartz: 20:51
And so what happens is when they do integrate, they tell all their patrons, that you should use Read. So like for example, Harvard, if you go to one of their conferences, they're probably not going to give you a course pack. They're probably going to say, "Hey, we created the course pack on read, install the app and you can get our course pack there." So really we have focused on academic and collaborative partnerships to really spread the word and it's worked. It's really worked.
Sanjiv Lakhia: 21:15
Yeah, and I'm just thinking from our space, which is spine care, neurosurgery, physiatry. Just looking at some of the tools that can be created. I can see in the future, where we're developing risk stratification tools for regenerative medicine. Trying to determine is a patient a good candidate for an intradiscal STEM cells or PRP. I know there's already tools created to help stratify for lumbar fusions. Certainly opioid and chronic pain management, looking at tools in that regard. So I think the opportunities can be totally endless here.
Daniel Schwartz: 21:50
And where we come in is that there's lots of amazing researchers building just those kind of decision support tools, those predictive models. The real upsetting part is they do the work, they get it published, and then we faced the whole fundamental problem with knowledge and translation. That nobody reads their work or no one applies their work. So I'm not a researcher per se, I've dabbled in past. But what I really believe in is taking other people's great work and getting the word out and making it easy for people to discover that research and then apply it at the point of care. And so for me, that's I think the contribution that I like to make, and that our team at QxMD really believes in. Taking people who aspire to be better and making it really easy for them to either find that research and dive in, or maybe not know too much about it, except that it's useful and be able to apply it literally the day it's published.
Sanjiv Lakhia: 22:43
Talk to us a little bit about the evolution of a relationship between QxMD and a WebMD.
Daniel Schwartz: 22:50
Yeah. So that's a really nice story. Our whole team at QxMD has been very collaborative by nature and that relationship really started through like many things, a conversation. I don't remember who reached out to who first, it was quite awhile ago. But we started conversations about how we might find a way to work together. And over time, as we learned more about each other, I think the WebMD team recognized there was a lot that we did, which would provide value to them and their clinical audience. And we also discovered that the resources that WebMD brought would provide a ton of value for us, our team and the audience we serve. And so over time, and it was at least a couple year process. We found more and more synergies until we reached the point that it sort of just made sense to become one entity.
Daniel Schwartz: 23:43
And so as of basically two summers ago, now. We've been part of the WebMD family. And as some of you may have heard, there's lots of great companies joining WebMD. We've certainly seen that we are much stronger through collaboration within one organization. And I can say certainly for us, as a small organization, we've been able to give up some of the work, which we didn't really love. Things like human resources or legal or accounting or finance or all of those things, which really weren't core to our mission or what we're good at. Certainly they were not my areas of expertise, and they often fell to me as being the leader of a smaller organization. And so now our days are certainly filled with doing more of the work we really care about, enhancing our products, increasing our offering, but we've also been able to give back to the WebMD family.
Daniel Schwartz: 24:34
So the Medscape application, which I'm sure many listeners on this podcast used, we now power the decision support portion of that app. There's many affiliates who we're doing partnerships with, there's relationships that Medscape has around literature dissemination and scientific dissemination that we're assisting with. So it's really allowed us to take some of our core technologies, which we've put a lot of love into and a lot of work into and actually see them get even more utilization and even more reach.
Sanjiv Lakhia: 25:04
When I heard that QxMD was a partner with WebMD, my first thought was, wasn't really sure how that works simply because my understanding of WebMD has always been from a patient side. It's like where patients go there to get information. And then QxMD is curating content for health care professionals. So how have you blended those two things together?
Daniel Schwartz: 25:27
Yeah. So it's a good question. So Medscape, which you may or may not know is actually a part WebMD. And so we work almost exclusively with the Medscape team, but also some of the companies which are now affiliates of Medscape, we also partner with them. We really have not yet even scratched the surface of providing services to regular people, patients, consumers. It's something I've always wanted to do and something I would still love to do in the future. For example, many of these clinical decision support tools that we build, we build them from the medical literature, but the language is still medically, it's not really English. It's really hard for anyone without a medical background to understand these tools and how to use them.
Daniel Schwartz: 26:13
One of the things we did is, we translate our app into English and French, Spanish, and German and so on and so forth. One thing that I've always thought would be great is, imagine if we translate it into standard English, so just normal people could use it and we could empower just everyday people to actually utilize the same tool that our doctors are using, but actually understand what they're talking about. Similarly, with the medical literature, I look at journals like JAMA, which has like JAMA patient pages. And I love that content because the literature, which even for many doctors is kind of obtuse, and hard to dig through. But they write it at a level that the average person could read it and say, "Oh, I understand what that research does."
Daniel Schwartz: 26:55
And I would love at some point, if we could find a way to make Read, do just that. Take what's cutting edge publication, but make it accessible to everyday people. So for now, we're not really doing much of that. We're really focusing on our work with Medscape and the other affiliates in that organization. But the future I think is very bright, I think there's a lot of opportunity.
Sanjiv Lakhia: 27:17
Yeah, it's interesting you would say that because that's exactly what I'm trying to accomplish on this podcast. And when I started Back Talk Doc, my original audience was for patients and lay people who are just trying to up-level their information as they make decisions with their providers. But what I found was a lot of feedback from primary care docs and other clinicians who say to me, "I really love it because you're speaking in a way I can actually understand what you guys are talking about from a spine and surgical side." So I think there's always going to be a demand for communication that's easy to understand, no matter what your level of training or background is. And I think if you guys get to that goal, that would be absolutely phenomenal. So where do you think the vision here moving forward is for QxMD? What are we looking to accomplish in the next three to five years?
Daniel Schwartz: 28:08
Yes. So a big part of our vision is really around collaboration. I think that when we first started out, even as recently as the last couple of years. Our thing was, let's build the best application platform we can, so that if anybody needs our services, we're the ones they're going to come to. And what we've realized is, that maybe a little bit shortsighted. In that if someone is used to going to perhaps your podcast or some blog, or there's a website that you use, or they rely on UpToDate or wherever it is they want to go. We want to make sure that if we have amazing resources, which I think we do, that we make them accessible wherever the user finds themself, wherever the listener or the person who's engaging, finds themselves. To ask that you have to use this app on this platform, with this device is a bit more company centric then I think the vision should be.
Daniel Schwartz: 29:03
So we're really right now looking for folks like you, people running great podcasts or people that have great blogs or medical websites who can leverage the technology and the offerings that we provide. So we're now reaching out to really anyone who's needing help with recommending curated medical literature, or who has references to the medical literature, but is also struggling with how do I get my users full text fast. Or they want to embed a clinical decision support tool on their platform, but they don't really want to build it themselves. So whether that's in EHR, some folks we're talking to or other digital media, anyone who thinks they can leverage our core technologies, we're really looking to partner. Because our new reality or our new perspective is, we can achieve more by partnering with anyone and everyone then we can just by building a single platform on our own.
Daniel Schwartz: 30:01
So if anyone's listening, certainly feel free to reach out to us. You can write to us [email protected] and we're certainly happy to field your requests and see if we can help.
Sanjiv Lakhia: 30:13
Well, I really appreciate you taking the time today to give our listeners some information about QxMD and your vision. It's a real exciting relationship for us. I'd like to close as those who listen know, I'm kind of a wellness nut. I always like to pick the brains of the people I interview about their own health habits, whether they're great or not. It keeps the show real. And I think people can relate. So as a very busy nephrologist, who's basically running a company and creating this broad vision to help millions of people, what are some of your, I guess, health hacks that allow you to stay healthy and productive?
Daniel Schwartz: 30:49
So my new favorite health hack and there's no sponsorship involved here, is the Peloton device. I must say, I love it. COVID took away my spin classes that I used to go to, but I have to say the Peloton, like I say, I have no stake in that company, but I do find it's an amazing way to do really great activities. Even if we are in lockdown and even if the weather is miserable outside. I also think that the other big health hack is blocking time for yourself without any apology. I think so often, certainly in clinical medicine, we put ourselves last, but it's okay, once in awhile to put yourself first. If you need a day, take a day, you need to block an afternoon, block and afternoon. And so my colleagues will often look up at my shared calendar and see there's six hours where I'm unavailable, no meetings, no nothing and I'm not working. I'm just taking time to myself. And I have to say that the more time might take away from work, the better I perform at work.
Daniel Schwartz: 31:52
So I think it's not just about staying healthy. It's not just about being protective of yourself, it actually improves your productivity. So we're in this for the long haul. One of my colleagues once referred to it, this is a marathon, not a sprint. And I think it's very true. We have to be in this for the long haul. So taking the time you need is super important, no matter how hard it seems to do it, I promise you if you're not available, the world will not stop.
Sanjiv Lakhia: 32:18
That really resonates with me. I think two things, the Peloton bike, I don't have one, but there are bikes. Bikes have been around forever. But I think what they've done is, they've made that fun and for the people who use it. I think it's a key element, if you're trying to improve your health. Get into something you enjoy and you look forward to, and it's an investment, it's not spending money, it's investing in money. And if you use it, you'll get limitless return. And then in terms of what you said there about taking your time. Most of us, particularly health care providers or those that work in the business world, or what have you. We're all familiar with the idea of putting down 10 to 20% of your income right off the top into a 401k. So you quote, unquote, "Pay yourself first." And I think you can extend that concept to paying yourself first with time, because as we go on in life, really time is our biggest asset. I would say energy is our second biggest asset. And then I would say financially, I don't know, that would be maybe a distant third.
Sanjiv Lakhia: 33:17
So it's great to hear that you're doing that. And that tells me you're going to be primed to deliver on more great things as we move ahead. Listen, thanks for your time. I really enjoyed getting to talk to you and learn a little bit more about you and what you're offering. And I look forward to collaborating in the future.
Daniel Schwartz: 33:33
This was wonderful. Yes, I look forward to our future collaboration.
Outro: 33:36
Thank you for listening to this episode of Back Talk Doc, brought to you by Carolina Neurosurgery and Spine Associates with offices in North and South Carolina. If you'd like to learn more about Dr. Lakhia and treatment options for back issues, go to backtalkdoc.com. We look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at carolinaneurosurgery.com.
This podcast is sponsored by our partner, QxMD. QxMD builds mobile solutions that drive evidence-based medicine in clinical practice. Check out, Read for easy access to research, personalized for you and Calculate for over 500 easy to use decision support tools. Try them today at qxmd.com/apps. Again, that is qxmd.com/apps. This podcast is sponsored by our partner QxMD. QxMD builds mobile solutions that drive evidence-based medicine in clinical practice. Check out, Read for easy access to research, personalized for you and Calculate for over 500 easy to use decision support tools. Try them today at qxmd.com/apps. Again, that is qxmd.com/apps.
Intro: 00:59
Welcome. You're listening to Back Talk Doc, where you'll find answers to some of the most common questions about back pain and spine health brought to you by Carolina Neurosurgery & Spine Associates, where providing personalized, highly skilled and compassionate spine care has been our specialty for over 75 years. And now it's time to understand the cause of back pain and learn about options to get you back on track. Here's your Back Talk Doc, Dr. Sanjiv Lakhia.
Sanjiv Lakhia: 01:35
Thank you to everyone for tuning in today to this episode of Back Talk Doc. For those of you that have been following me, you may have noticed the last few episodes. We have a bit of a new lead in intro with our sponsor, our new sponsor QxMD. And today I have the pleasure of bringing to you an interview with Dr. Daniel Schwartz, who is really a co-founder of QxMD and an integral part of their company, and building a relationship with us here at Back Talk Doc and Carolina Neurosurgery & Spine Associates. So Dan, welcome to the show today.
Daniel Schwartz: 02:09
Thank you for having me.
Sanjiv Lakhia: 02:11
All right. I want to introduce you to the listeners here. Thanks for forwarding me a little bit about your background. So Dan is a ... He's a practicing kidney doctor, nephrologist. He's a clinical educator and vice president at WebMD and co-founder of QxMD. He's a medical director of a regional home dialysis program and a clinical assistant professor of medicine at the University of British Columbia. He has a keen interest in knowledge translation at the point of care and the intersection of information tech with clinical medicine. As a co-founder of QxMD, he's built digital solutions that help practicing healthcare professionals like myself, provide evidence-based care, stay at cutting edge of the clinical research and really gain new knowledge via digital eLearning, which is the new way to learn and through a network of apps for the web iOS and Android devices, he's helped QxMD support a community of over three million healthcare providers.
Sanjiv Lakhia: 03:08
Currently he's focusing on implementing digital tools that allow hospitals, researchers, government, commercial partners, and nonprofits to enhance quality of care and adherence to evidence-based guidelines. And his personal clinical interests include peritoneal dialysis, interventional nephrology, and management of late stage chronic kidney disease. So Dan, that is a lot, you've got a lot going on my friend.
Daniel Schwartz: 03:33
Yeah, I do. I like to keep it busy and mix things up.
Sanjiv Lakhia: 03:37
All right. So I'm curious to know, give us a little insight about your pathway from clinician to kind of clinician entrepreneur, businessman.
Daniel Schwartz: 03:48
That's a great question. And it certainly has been a journey. It really all started, I think, with a recognition. Looking around in my role as a clinician educator at the University of Toronto, where I started out, that although so many healthcare providers aspire to stick to evidence-based medicine. In practice, it's just really, really hard. And so, so much of my career has really focused on how do we make it easier for doctors and other healthcare providers to become aware of the medical literature, make it usable and keep up in general, because I think this is something that we all struggle with. And so over that journey, I've certainly had more failures than successes. The things that you see out there today are the ones that have worked, but I've also built lots of stuff, which really maybe they were building blocks or things I learned from. But that journey I think has helped me figure out what resonates with the healthcare community and really build upon them so that they grow and grow.
Daniel Schwartz: 04:57
And a very core part of that, I think has also been the practical aspects of commercialization. Although some of my colleagues, I respect very much, really focus on finding research question, getting grant support and pursuing from that avenue. What I found very liberating early on with the ability to find commercial partnerships, which essentially would fund the work we wanted to do. And that to me was a real pathway to pursuing the projects we like, and then get a bit creative about how do we commercialize in a way which is useful still to clinicians, but gives the funding we need to keep growing and building.
Sanjiv Lakhia: 05:39
Yeah. Hearing you say that makes me reflect back on my days in internship many a day ago, where our internship director would drill into our heads that we must read an hour a day. If we're not reading journals and medical literature an hour a day, then we are getting lost. And now that I'm about 15 years into my clinical practice, I look back on that and I know how insufficient an hour a day of learning really is in the medical field. But what you really have to do as a clinician is fit maybe two or three hours a day of reading into 30 minutes and that's where these evolving tools have been so helpful. And one of the reasons that I felt good about, when you guys reached out to us at the show about collaborating a little bit was, your vision really seems to be genuine and putting out great information in a digestible manner and accessible manner. And that's really what I've tried to do with this podcast in terms of the world of spine care and neurosurgery and physiatry is just put out really good actual information that's based upon evidence that's cutting edge and out in front that people can digest.
Sanjiv Lakhia: 06:52
So it's a really interesting path that you just described. Tell me a little bit about the collaboration piece that you mentioned, where you take an idea and you collaborate commercially, and then you produce a product. How does that work?
Daniel Schwartz: 07:07
Yeah, so at the very beginning, we set out really to build what we wanted to build first, not be influenced by commercial realities and then look backwards and say, "Okay, how do we construct those?" I think most businesses and this is where, you referred to me as a businessman. And I think that's probably not how I view myself. What I really do is build what I believe and when build what I love, keep growing the things that garner attention and support from the medical community, and then figure out how might we commercialize these things. So we've taken many different stabs of this. At the very earliest stages, and this is going back quite a bit. When I was at the University of Toronto, I had to give up my PalmPilot, and trade it in for a Blackberry and in doing so, I lost all my software, all the stuff I accumulated on my PalmPilot device. So I'm aging myself here.
Daniel Schwartz: 07:59
But we decided we would build the first version of what later became Calculate, our clinical decision support tool and build it out for the Blackberry device. And at the time we had zero commercialization intent nor really an idea how to do that and that only came many years later. And so since we didn't really have a commercialization intent but we did know how to build software. We built an educational tool for ECG interpretation and another tool for pediatric critical care. And we just sold. We sold those for, I think it was a dollar or five dollars or somewhere in that range. And those revenues funded our free products and actually funded all the development of our free software. Our goal has always been to never let payment be a barrier to utilization. And even though say, five dollars doesn't sound like a lot of money, we know that practically speaking.
Daniel Schwartz: 08:53
So I've always looked for the models that might allow us to get the funding we need, but still preserve access. And when we think about access, I really think about it at a global level. We want our tools to be usable, not just in North America, where we practice, but really all over the world. And I'm pleased to say that because of that strategy, we've had quite a bit of success. We've seen amazing dissemination across Europe, striking engagement in Latin America and South America, India, many other parts of the world. And our free software model, I think has really supported that. But again, I think that the goal we've always had is build what we love, build what we believe in and figure out how to commercialize it later.
Sanjiv Lakhia: 09:39
Well, before we get too far down the rabbit hole, I want to make sure that those who are listening right now, have an understanding about what actually QxMD is. So can you just share briefly about products and what you're offering there?
Daniel Schwartz: 09:55
Yeah, absolutely. So we have really three products. One is called Calculate by QxMD. One is called Read by QxMD. One is called Learn by QxMD. Calculate was our first product and basically we would go out to the medical literature, find clinical decision support tools, and digitize them. I'm a nephrologist by training and I remember a nephrologist, a guy named Dr. Dan Katrin. For those of you in the nephrology world, that was a significant leader in glomerulonephritis. And he developed this really cool model, a mathematical predictive model to determine which patients with membranous nephropathy would progress and get worse. Because for those of you who don't deal with nephrology, membranous is a tricky disease and that some people just get better on their own. Some people stay the same and about a third, get quite a bit worse and get the chemotherapy. Especially at the time, the sort of treatment at the time was chemotherapy with cyclophosphamide, it's changed a bit since then.
Daniel Schwartz: 10:52
But obviously you didn't want to hit someone with big toxic therapy who was going to get better on their own and not get worse, but you also didn't want to miss treating a patient who was at high risk of progression. And so when I asked him about his tool, he was like, "Yeah, it's great, but I don't really use it because it needs like a scientific calculator. I never have one." We went out and we built that. It actually is one of our very first tools. So Calculate really has run from there, where we take the existing medical literature, whether it's a prognostic tool, a clinical decision support tool or even a guideline. And we try to rip it apart and put it back together again. So it's just really easy to use and you can apply it at the point of care. So we don't invent the research, we just make the user interface a little bit easier, a little more accessible.
Daniel Schwartz: 11:35
We also built a product called Read by QxMD. It's probably my favorite one, of the things we've built. I remember many years ago when I was a chemistry student, I always wished somebody would go to the library for me and rip out all the pages of the journals that I needed, staple them together and mailed the to me. That obviously was very feasible but then the day the iPad came out, I'm like, "Oh my goodness, we're here." What if we could create a digital, personalized medical journal? And so that's what we set out to do. And it's had many iterations over time, but really its core functionality is, we learn about you in a mathematical kind of way and we would create a profile of you. And we try our best to make really good recommendations for what we think you want to read.
Daniel Schwartz: 12:19
So we take the 15,000 articles published each week and distill it down to just a few, that we think are relevant. And then with the added step of making access to full texts, super easy. There's lots of content, it's open access, but hard to find. There's lots of content that your institution, for example, I'm affiliated with the University of British Columbia in Canada. And although they pay a lot of money for site licenses, it's kind of awkward and challenging to actually get access to full text. And so we wanted to solve both those problems. How do we make recommendations for content, but also, do all of the backend communication and credentialing so that I can access full text content super fast? And really that's what the product does. Give us five minutes a day and what will keep you up to date with the medical literature. And if you do have access through an institutional license, or if you don't and just want to get open access sources, we make that pretty seamless.
Daniel Schwartz: 13:11
Our last product is Learn. Learn is sort of our take on online digital education. And this was born out of the recognition from our own data analysis of our users, that people don't want to spend an hour in front of their computer learning. Even before Twitter shortened all of our attention spans, we were noticing that people were only spending about six to eight minutes doing educational tasks. And so we thought, "Well, could we build an educational platform, where we taught people something in about six to eight minutes?" And that's really all that it is. It's a very simple platform that allows for micro-learning. Those are our products and that's what we give away.
Sanjiv Lakhia: 13:45
If you're listening and you're a healthcare provider and you don't have these, you could easily go and download them for free from the iTunes store or Android. So we'll put links to that in the show notes as well. I went in myself and I've downloaded the Read app and now I get routine and a curated content on spine care, back pain. I have a search in there for acupuncture and it's great. I can just flip through it and look at what I want. I want to touch on real quick, what you said there, the idea of getting access to full articles and making that easy is a bit of a game changer. Because I think as a clinician, it can be very, very frustrating when you've got a patient case in front of you and you're going to PubMed or wherever it is. And you see an article with an abstract or title that looks like it can be very helpful. And then you got to pay 30 bucks for a 24 hour rental or whatever have you.
Sanjiv Lakhia: 14:39
We could talk about this another time, but I think that whole industry, that whole concept of having to put in that money, I don't think patients even have any idea that, that's a hurdle that a lot of us clinicians struggle with.
Daniel Schwartz: 14:51
I agree. I think that the whole publishing industry is super challenging. I also think that the biggest shame is that so many people actually have access through a site license that their organization has paid handsomely for. And yet getting to that full text in a timeframe that works for busy clinicians, it's just too cumbersome. And that's really where we wanted to solve some of those problems. I think the bigger challenge is, will we ever get to a Netflix model of medical literature where you pay one reasonable monthly fee and you can access whatever you need. I think that's still very far off, but at the very least we wanted to connect really anyone with open access science, which is actually more and more available, but also really be sure that if your institution is spending tens of millions of dollars a year on site licenses, at the very least, you should be able to access it without any impediment.
Sanjiv Lakhia: 15:49
Yeah, that's great. Our group is a private group, but we're certainly affiliated with major hospital systems in the Charlotte area. And the way I do it now is, or before this, was I would basically email the librarian with an abstract. So I'd have to go in search, copy, paste, email, and then she would have to search, pull it and I'd get a PDF back within a day or two, which certainly I appreciate, but this is just a lightning speed. And then I get content that I didn't even know that I needed, that is fantastic. Coming in, in a summarized manner. So it's really great.
Daniel Schwartz: 16:25
Yeah. And I think that's also interesting about not knowing you need it. There was a very interesting study done by a guy named Amit Garg, who is also another Canadian. And he found certainly in the field of nephrology, that more than 50% of landmark clinical trials were not even published within the core nephrology literature. And I presume this likely extends to other specialties. So that even if you were super diligent, and even if you kept up with all the key journals in your field every week, you could still miss more than 50% of the landmark clinical trials, which should be impacting your practice. And so the only way to really do it at scale is either through human curation, by people are willing to put in the time or some sort of algorithmic curation. And so we have really focused on the latter.
Sanjiv Lakhia: 17:13
There are other tools out there that curate content for clinicians, but I think this is what really separates QxMD and Read from some of the others. When you started this with QxMD and in particularly the Read app, what was kind of like your initial vision. And then when I read stuff like you've got a million or two million or three million health care providers, how did that happen?
Daniel Schwartz: 17:37
Yeah, it's a good question. So I think you asked me the question, our initial vision, my initial vision was very selfish. I just wanted software for my Blackberry device. And so I thought, "Well, if I get it, that's great." And I had taken one computer science class in my undergrad. I worked for a volunteer organization and I sort of volunteered to build their website, not knowing how to build a website but at the time you kind of had to hand code, the website in WordPad. And so I built this website and then I didn't really do any computer science, but then I ended up going to the bookstore and buying a book on PHP and HTML, and I threw up a quick website. Well, it wasn't quick. It took me a while to build it and I uploaded ... This was before the app stores. I uploaded these Blackberry files, these Blackberry apps that we were building.
Daniel Schwartz: 18:24
And I thought maybe like 10 of my colleagues would download the app. And then we had 10,000 people download them. And then 20,000, then a 100,000. And then I thought, "Oh, I guess I'm not the only one who wants these things." And so really we took the feedback from the community as to what they wanted. Initially being a nephrologist, a lot of my content that we built was nephrology focused. Then a friend of mine who was a hematologist, said we should do this for hematology and then it happened in cardiology and gastroenterology. And then we kind of realized this was a uniform need. So we just kept building and building and building.
Daniel Schwartz: 18:59
In terms of user acquisition, we've never had, for example, a budget to go out and do paid advertising to bring in users. So for the most part, we really focused on word of mouth. But as time went on, we focused a lot on partnership. Just kind of like the one we have with you. Finding people who have mutual interests, who we can help or you can help us and we build relationships. One of the first set of relationships we built was with researchers. So I think back, way back, maybe 2011, I'm thinking. There's a doctor Nav Tangri, who is pretty much now considered a world leader in clinical epidemiology and nephrology. At the time he was just developing, what's called the Kidney Failure Risk Equation, which is a really important model, which helps predict which patients with chronic kidney disease will progress. So you can have real conversations with them based on data, not conjecture, but he wanted to disseminate this tool. And so what did we do? Well, we said, "All right, you're presenting at the International Society of Nephrology meeting at 10:00 AM on Tuesday, we will make our app automatically go live with your content at the exact same moment that you present on the podium. And that JAMA presents the paper and its journal."
Daniel Schwartz: 20:10
And so those kinds of research partnerships turn out to be very valuable. So somebody would work with us, they get on the podium to present their work. And we get 10,000 downloads that week. Based on them talking about our collaboration or eventually we'd get our links put into medical journals. So when someone publishes our work, you can be on and you're on your computer. You click on the link and you can actually use the tool the minute you read about it. We also would Read, have thousands and thousands of institutions around the world that we offer integration with. It's a free integration. We do have a paid service, which is probably how we commercialize, but really any hospital university that has a digital medical library, we will integrate with them at no cost if they don't have budget.
Daniel Schwartz: 20:51
And so what happens is when they do integrate, they tell all their patrons, that you should use Read. So like for example, Harvard, if you go to one of their conferences, they're probably not going to give you a course pack. They're probably going to say, "Hey, we created the course pack on read, install the app and you can get our course pack there." So really we have focused on academic and collaborative partnerships to really spread the word and it's worked. It's really worked.
Sanjiv Lakhia: 21:15
Yeah, and I'm just thinking from our space, which is spine care, neurosurgery, physiatry. Just looking at some of the tools that can be created. I can see in the future, where we're developing risk stratification tools for regenerative medicine. Trying to determine is a patient a good candidate for an intradiscal STEM cells or PRP. I know there's already tools created to help stratify for lumbar fusions. Certainly opioid and chronic pain management, looking at tools in that regard. So I think the opportunities can be totally endless here.
Daniel Schwartz: 21:50
And where we come in is that there's lots of amazing researchers building just those kind of decision support tools, those predictive models. The real upsetting part is they do the work, they get it published, and then we faced the whole fundamental problem with knowledge and translation. That nobody reads their work or no one applies their work. So I'm not a researcher per se, I've dabbled in past. But what I really believe in is taking other people's great work and getting the word out and making it easy for people to discover that research and then apply it at the point of care. And so for me, that's I think the contribution that I like to make, and that our team at QxMD really believes in. Taking people who aspire to be better and making it really easy for them to either find that research and dive in, or maybe not know too much about it, except that it's useful and be able to apply it literally the day it's published.
Sanjiv Lakhia: 22:43
Talk to us a little bit about the evolution of a relationship between QxMD and a WebMD.
Daniel Schwartz: 22:50
Yeah. So that's a really nice story. Our whole team at QxMD has been very collaborative by nature and that relationship really started through like many things, a conversation. I don't remember who reached out to who first, it was quite awhile ago. But we started conversations about how we might find a way to work together. And over time, as we learned more about each other, I think the WebMD team recognized there was a lot that we did, which would provide value to them and their clinical audience. And we also discovered that the resources that WebMD brought would provide a ton of value for us, our team and the audience we serve. And so over time, and it was at least a couple year process. We found more and more synergies until we reached the point that it sort of just made sense to become one entity.
Daniel Schwartz: 23:43
And so as of basically two summers ago, now. We've been part of the WebMD family. And as some of you may have heard, there's lots of great companies joining WebMD. We've certainly seen that we are much stronger through collaboration within one organization. And I can say certainly for us, as a small organization, we've been able to give up some of the work, which we didn't really love. Things like human resources or legal or accounting or finance or all of those things, which really weren't core to our mission or what we're good at. Certainly they were not my areas of expertise, and they often fell to me as being the leader of a smaller organization. And so now our days are certainly filled with doing more of the work we really care about, enhancing our products, increasing our offering, but we've also been able to give back to the WebMD family.
Daniel Schwartz: 24:34
So the Medscape application, which I'm sure many listeners on this podcast used, we now power the decision support portion of that app. There's many affiliates who we're doing partnerships with, there's relationships that Medscape has around literature dissemination and scientific dissemination that we're assisting with. So it's really allowed us to take some of our core technologies, which we've put a lot of love into and a lot of work into and actually see them get even more utilization and even more reach.
Sanjiv Lakhia: 25:04
When I heard that QxMD was a partner with WebMD, my first thought was, wasn't really sure how that works simply because my understanding of WebMD has always been from a patient side. It's like where patients go there to get information. And then QxMD is curating content for health care professionals. So how have you blended those two things together?
Daniel Schwartz: 25:27
Yeah. So it's a good question. So Medscape, which you may or may not know is actually a part WebMD. And so we work almost exclusively with the Medscape team, but also some of the companies which are now affiliates of Medscape, we also partner with them. We really have not yet even scratched the surface of providing services to regular people, patients, consumers. It's something I've always wanted to do and something I would still love to do in the future. For example, many of these clinical decision support tools that we build, we build them from the medical literature, but the language is still medically, it's not really English. It's really hard for anyone without a medical background to understand these tools and how to use them.
Daniel Schwartz: 26:13
One of the things we did is, we translate our app into English and French, Spanish, and German and so on and so forth. One thing that I've always thought would be great is, imagine if we translate it into standard English, so just normal people could use it and we could empower just everyday people to actually utilize the same tool that our doctors are using, but actually understand what they're talking about. Similarly, with the medical literature, I look at journals like JAMA, which has like JAMA patient pages. And I love that content because the literature, which even for many doctors is kind of obtuse, and hard to dig through. But they write it at a level that the average person could read it and say, "Oh, I understand what that research does."
Daniel Schwartz: 26:55
And I would love at some point, if we could find a way to make Read, do just that. Take what's cutting edge publication, but make it accessible to everyday people. So for now, we're not really doing much of that. We're really focusing on our work with Medscape and the other affiliates in that organization. But the future I think is very bright, I think there's a lot of opportunity.
Sanjiv Lakhia: 27:17
Yeah, it's interesting you would say that because that's exactly what I'm trying to accomplish on this podcast. And when I started Back Talk Doc, my original audience was for patients and lay people who are just trying to up-level their information as they make decisions with their providers. But what I found was a lot of feedback from primary care docs and other clinicians who say to me, "I really love it because you're speaking in a way I can actually understand what you guys are talking about from a spine and surgical side." So I think there's always going to be a demand for communication that's easy to understand, no matter what your level of training or background is. And I think if you guys get to that goal, that would be absolutely phenomenal. So where do you think the vision here moving forward is for QxMD? What are we looking to accomplish in the next three to five years?
Daniel Schwartz: 28:08
Yes. So a big part of our vision is really around collaboration. I think that when we first started out, even as recently as the last couple of years. Our thing was, let's build the best application platform we can, so that if anybody needs our services, we're the ones they're going to come to. And what we've realized is, that maybe a little bit shortsighted. In that if someone is used to going to perhaps your podcast or some blog, or there's a website that you use, or they rely on UpToDate or wherever it is they want to go. We want to make sure that if we have amazing resources, which I think we do, that we make them accessible wherever the user finds themself, wherever the listener or the person who's engaging, finds themselves. To ask that you have to use this app on this platform, with this device is a bit more company centric then I think the vision should be.
Daniel Schwartz: 29:03
So we're really right now looking for folks like you, people running great podcasts or people that have great blogs or medical websites who can leverage the technology and the offerings that we provide. So we're now reaching out to really anyone who's needing help with recommending curated medical literature, or who has references to the medical literature, but is also struggling with how do I get my users full text fast. Or they want to embed a clinical decision support tool on their platform, but they don't really want to build it themselves. So whether that's in EHR, some folks we're talking to or other digital media, anyone who thinks they can leverage our core technologies, we're really looking to partner. Because our new reality or our new perspective is, we can achieve more by partnering with anyone and everyone then we can just by building a single platform on our own.
Daniel Schwartz: 30:01
So if anyone's listening, certainly feel free to reach out to us. You can write to us [email protected] and we're certainly happy to field your requests and see if we can help.
Sanjiv Lakhia: 30:13
Well, I really appreciate you taking the time today to give our listeners some information about QxMD and your vision. It's a real exciting relationship for us. I'd like to close as those who listen know, I'm kind of a wellness nut. I always like to pick the brains of the people I interview about their own health habits, whether they're great or not. It keeps the show real. And I think people can relate. So as a very busy nephrologist, who's basically running a company and creating this broad vision to help millions of people, what are some of your, I guess, health hacks that allow you to stay healthy and productive?
Daniel Schwartz: 30:49
So my new favorite health hack and there's no sponsorship involved here, is the Peloton device. I must say, I love it. COVID took away my spin classes that I used to go to, but I have to say the Peloton, like I say, I have no stake in that company, but I do find it's an amazing way to do really great activities. Even if we are in lockdown and even if the weather is miserable outside. I also think that the other big health hack is blocking time for yourself without any apology. I think so often, certainly in clinical medicine, we put ourselves last, but it's okay, once in awhile to put yourself first. If you need a day, take a day, you need to block an afternoon, block and afternoon. And so my colleagues will often look up at my shared calendar and see there's six hours where I'm unavailable, no meetings, no nothing and I'm not working. I'm just taking time to myself. And I have to say that the more time might take away from work, the better I perform at work.
Daniel Schwartz: 31:52
So I think it's not just about staying healthy. It's not just about being protective of yourself, it actually improves your productivity. So we're in this for the long haul. One of my colleagues once referred to it, this is a marathon, not a sprint. And I think it's very true. We have to be in this for the long haul. So taking the time you need is super important, no matter how hard it seems to do it, I promise you if you're not available, the world will not stop.
Sanjiv Lakhia: 32:18
That really resonates with me. I think two things, the Peloton bike, I don't have one, but there are bikes. Bikes have been around forever. But I think what they've done is, they've made that fun and for the people who use it. I think it's a key element, if you're trying to improve your health. Get into something you enjoy and you look forward to, and it's an investment, it's not spending money, it's investing in money. And if you use it, you'll get limitless return. And then in terms of what you said there about taking your time. Most of us, particularly health care providers or those that work in the business world, or what have you. We're all familiar with the idea of putting down 10 to 20% of your income right off the top into a 401k. So you quote, unquote, "Pay yourself first." And I think you can extend that concept to paying yourself first with time, because as we go on in life, really time is our biggest asset. I would say energy is our second biggest asset. And then I would say financially, I don't know, that would be maybe a distant third.
Sanjiv Lakhia: 33:17
So it's great to hear that you're doing that. And that tells me you're going to be primed to deliver on more great things as we move ahead. Listen, thanks for your time. I really enjoyed getting to talk to you and learn a little bit more about you and what you're offering. And I look forward to collaborating in the future.
Daniel Schwartz: 33:33
This was wonderful. Yes, I look forward to our future collaboration.
Outro: 33:36
Thank you for listening to this episode of Back Talk Doc, brought to you by Carolina Neurosurgery and Spine Associates with offices in North and South Carolina. If you'd like to learn more about Dr. Lakhia and treatment options for back issues, go to backtalkdoc.com. We look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at carolinaneurosurgery.com.
