Jeff Bauer, Healthcare Futurist, in conversation with Futurist Ian Khan
In this episode, i speak with globally recognized Futurist Jeff Bauer, also a co-contributor to the recent book “After Shock”.
Bio
Jeff Bauer has built a distinguished career by applying principles of creativity to health care and art. Recipient of many national awards, he is widely recognized as a teacher, researcher, writer, and speaker on ways to improve the medical marketplace.
He is now focused on speaking about strategies for real health reform and producing conceptual paintings that transform purposeful phrases into colorful kaleidoscopic images—making the verbal visual. The common denominator of his provocative work in both areas is words.
Learn more about Jeff at https://jeffbauerwords.com/
About After Shock
The world’s foremost futurists reflect on 50 years of Future Shock—and look ahead to the next 50
Contributors include:
Alan Kay
Aaron Frank
Adrienne Mayor
Alexander Mankowsky
Alexandra Ivanovitch
Alisha Bhagat
Amy Zalman
Anders Sorman-Nilsson
Andra Keay
Andrew Curry
Andy Hines
Anita Sengupta
Anne Lise Kjaer
Aris Persidis
Aubrey de Grey
Barry O’Reilly
Barry Vacker
Bill Davidow
Bill Diamond
Bryan Alexander
Byron Reese
Carlos Osorio
Carver Mead
Cat Tully
Cindy Frewen
Clem Bezold
Daniel Burrus
Daniel Levine
David Brin
David Guston
David Krakauer
David J. Staley
David Weinberger
Deb Westphal
Diane M. Francis
Donna Dupont
Eleanor “Nell” Watson
Eric Daimler
Erica Bol
Erik Qualman
Fotis Sotiropoulos
George Gilder
Grady Booch
Gray Scott
Hannes Sjoblad
Harish Natarajan
Hazel Henderson
Helen Messier
Ian Khan
Ignacio Pena
Jack Uldrich
James Canton
Jane McGonigal
Jason Jackson
Jason Schenker
Jay Gambetta
Jeff Eisenach
Jeffrey C. Bauer
Jerome Glenn
Jerry Fishenden
Joe Dispenza
Joe Tankersley
Joel Garreau
John L. Petersen
John M. Smart
John Sack
John Sanei
John Schroeter
Jonathan Venn
José Morey
Kaitlyn Sadtler
Kirk Borne
Klee Irwin
Kris Østergaard
Lisa Bodell
Maciej Kranz
Martin Guigui
Martin Rees
Maggie Greyson
Michael Tomczyk
Michel Laberge
Mick Ebeling
Moon Ribas
Naveen Jain
Neil Jacobstein
Newt Gingrich
Patricia Lustig & Gill Ringland
Paul Saffo
Paul Stimers
Po Bronson & Arvind Gupta
Ray Kurzweil
Rebecca Costa
Richard Browning
Richard Slaughter
Richard Watson
Richard Yonck
Rodrigo Nieto Gómez
Rohit Bhargava
Ross Dawson
Ruth Miller
Sanjiv Chopra & Pankaj K Vij
Sohail Inayatullah
Sridhar Mahadevan
Stan Rosen
Stephanie Mehta
Steve Waite
Tanya Accone
Terrence (Terry) Sejnowski
Teun Koetsier
Theodore Jay Gordon
Thomas Frey
Timothy Chou
Vikram Mansharamani
Wolfgang Fengler
Zoltan Istvan
Full Transcript : Hi friends this is Ian Khan and you’re listening to the Ian Khan show today is a special aftershock episode, which means I’m speaking with a co contributor to the recent book aftershot. Today I’m speaking with Jeff Bower PhD, who’s an internationally recognized health futurist and medical economist. He’s the author of nearly 300 publications on the medical marketplace. Dr. Bauer is a frequent keynote speaker all across the world, and he’s really well known around the world. Dr. Barr was a Ford Foundation, independent scholar, Fulbright scholar and Kellogg Foundation national fellow, and he’s based out of the US Let’s speak with Jeff. Welcome to the Ian Khan show. This is your host Ian Khan. And today I have an aftershock special episode with me is renowned futurist and a legend Jeff bower. Now, Jeff Bauer is a PhD, he’s a healthcare futurist. He’s been telling us about the future for almost five decades plus, so I’ve been looking forward to this conversation for many, many weeks. Jeff, welcome to the show.
How are you? I am fine in spite of the bigger picture circumstances and delighted to be here. It’s future view and my crystal ball is a delight. But being able to discuss it is and I really appreciate you pulling me into your community have a chance to look ahead. So thank you, first of all, Jeff for being part of Aftershock. This is the glue that binds us together and I’m so grateful to john Schroeder for going out there reaching out to all these amazing people putting them all together and talking about Toffler, someone, Alvin Toffler wrote Future Shock 50 years ago. And for those of my viewers and our audiences are listening on the podcast as well. You’ve been telling us over 50 years what’s going to happen and you’ve been in industry and what you’ve been in you were there at tougher his time. In fact, Toffler wrote the book after you joined the industry, isn’t that right? Yes, that is correct. And not only that, at the time, I joined the industry and started doing graduate studies in the economics of health care. My mentor was a close friend of Alvin Toffler is a very, very well known economist and peace activist named Kenneth boulding. So I had a bit of an inside scoop, you go through all of Future Shock as I did, to write my chapter, which is a delight. In retrospect, I saw many references to Kenneth moldings work. And I remember Kenneth with whom I spent a lot of time when I was in graduate school, talking about his association with Dennis and his wife. So yeah, I was there. But not only is the casual observer felt that that was a fly on the wall and able to figure out because the the mindset, Jeff, you’ve been an influence and a contributor to industry for five decades, and the amount of work you’ve put out there to your thought leadership through your initiative is mind boggling. Today, I think we just want to scratch the surface, because it’s going to take us a lot of time otherwise, starting right from aftershot. your essay with an aftershock. And you Let’s dive deep into it. Sure. In your article, you mentioned that Toffler didn’t get things right. And we’re not here talking just about Topher, we’ll start off with that, but talk about what’s happening in the world right now as well. So you mentioned that Telford didn’t get it right. He had many things that he had predicted, for example, we would be growing the organs in the lab in the mid 80s. So there’s many things that he tried to predict, but they didn’t go right. But tell us about that era, the early 80s, the late 70s, that what was the world like, at that time? Well, my era was really starting in the late 60s, when I took my first job in healthcare, I became a clinical photographer in a 300 bed Cancer Hospital in the late 60s. So there was General excitement about science. In fact, as a high school student in the early 60s, I was able to receive a National Science Foundation study grant, because the American government was so concerned about the Cold War and being able to beat the Russians to the moon and win the very scientific thing. So the 60s is really the era when I grew up. So the answer to your question is was a real excitement about what we could do with science, science fairs, getting jobs in engineering suddenly really rose to the top. So there was a field that science could solve a lot of problems, the field that I ultimately adopted coming to it from research, meteorology, atmospheric physics, namely economics was in a transformation from pretty much the economists being a good thinker who followed logic to the economists being a numbers based guy or gal that did heavy quantitative work. So why would stress i think is my best summary of that 70s period coming out of the 60s is a real focus on quantitative analysis. Not that I agree with it. I think I’ve made it clear my chapter I think the balance is important. In fact, I love about the work you’re doing when I read up on you is looking at the ways to merge all this and the book and the other contributors. I think, in large part do that too. But in order lesson sorry for being wordy. It was real belief that we could add objective analysis numerical quantitative stuff to our good thought processes and begin to design policies that can make a difference. Thank you Now since those days since the 70s, and I was quite young ladies, as you can probably guess, we had no technology as we have today. We didn’t have cell phones, we didn’t have personal computers, like, really, we were literally in an age of fax machines, telex machines, I would say color televisions were a great thing to have, it would probably have been a big thing, at least where I was growing up and coming out what was it to be able to do foresight work to look into the future of the world. And when Toffler as an example, started predicting things, and he came up with a third wave, Future Shock a bunch of what what was surrounding you thinkers like Toffler, what was it that you guys are feeding off to help shape conversations about tomorrow? Well, one big difference between the the 70s when I did my graduate work, and today was I think, the openness of the intellectual community, intellectuals have not divided into conservatives or liberals, there was a real, a real excitement about just being able to share ideas. So symposia were very, very common, the idea of just bringing together collective people to think with no expectation that there would necessarily be a common denominator wasn’t like a liberal think tank and a conservative think tank, it was a think tank, and people were really excited about trying to envision things together. And I think that’s one of the biggest differences. Also, you mentioned, the technologies were absent, you bet I did most of the work for my PhD dissertation and study of how doctors set their fees with a slide rule. The University of Colorado where I did the work, I had a computer center with graduate students, if they wanted to use that had to do their own punch cards, haul them into the computer center between roughly midnight and six in the morning when none of the PhD scientists wanted to be there. So it was not a technology absent era. But we had a different technology, I and most of the other people doing quantitative work at that time knew how to use a spreadsheet, we did an awful lot with calculators where he just punched in, I remember my in graduate school buying my first Hewlett Packard electronic calculator, it would do nothing but add, multiply, divide and subtract. It costs $300, which was probably a semesters tuition, and all it would do is add multiply, so I didn’t have to divide and subtract. So it’s funny, I’ve never quite had someone posed the question in that way. But we didn’t have the technologies. We really had exciting intellectual discussions, I fear that we’ve gotten to the point now where we have the technologies and don’t spend much time thinking so somewhere between technology rise and the thinking we had to do, we’ve lost something, even though we’ve gained incredible powers. Several of the other authors and aftershock show artificial intelligence, not just in healthcare in a variety of fields, you show that in your own work to allows us to do a lot of different things. But I think what I really lament is the lack of shared intellectual discourse with an open mind and completely understand that when I was growing up, having a scientific calculator was amazing. It was just amazing. And it would do so many different things. I remember when I was in my, I think my sixth grade or my fifth grade, that was my first exposure to the computer. And it was a BBC Micro in our computer lab. And it had that small black and white monitor. And what we do on it is play Pac Man to start off with that was it that was Pac Man was my introduction to computers with the big floppy disks, of course, yeah. So when I look at, and I reflect upon, you know, the current era and how you compare it, because majority of us think about our past all the time, right? I’m one of those people 50% of my thinking is about Okay, how are things before so when I start thinking about the past, and then I look at all the things we have access to today, I’m just so grateful for the world and technology and what has culminated until now, because now we can reach millions of people in one second and talking about COVID-19. Look at the amount of information. You could do a PhD in COVID-19 sitting at home if I just sat there and studied everything. So just to make a point. I think we’ve I have seen this in the last 2030 years. And it’s so amazing and humbling to be living in an era where we have access to creating an impact. I want to ask you about COVID-19. We’re living through the era of COVID-19. You’re a healthcare futurist. Let’s talk about where we are today. Like Did you think this was a possibility a few years ago or decades ago? What were your kind of thoughts about something like this happening? Well, I’ve always believed that we were not taking epidemic science seriously enough. It’s interesting. I joined the faculty of the University of Colorado medical school in 1973. Under a federal grant, this was the first time the government was making money available to medical schools to hire economists. And very quickly I discovered the dean and other significant people who control the curriculum at the medical school didn’t want economists thought so inculcated into physicians minds. physicians were supposed to think about disease, not about the dollars and cents of treatment. So I was very quickly diverted to teaching epidemiology and all I had almost no training in epidemiology. I was qualified quantitative scientists, I started teaching the science of transmission of disease. That’s incredible epidemics were very significant. And I’ve taught the classes I feel somewhat conversant in the basic vocabulary. But I have felt for years, we were underprepared for an epidemic, I could not have predicted that it would be COVID-19. One of the real exciting and negative scary way of epidemiologic science is how much just comes from genetic permutation. But I’ve been telling people, even in my writings, as recently as the last month or two, before the month or two before COVID-19 became very clear, to expect a surprise, I had no idea what it would be between expect a big surprise, something was lurking on the horizon. And I really believe that the biggest one in the five to 10 year horizon is global climate change. But to have an epidemic come up like this should not surprise us in the slightest. That’s why I’m so dismayed at our lack of preparation, we should have been ready for this. Because quite frankly, I think anyone who understands epidemiological science and the history of disease for 1000s of years about which there’s an extended record should not be surprised by COVID-19. It is no surprise at all, what’s disgusting factors, we are prepared. One of the interesting things, Jeff, and you are so much more well learned than I am. And I’m just going to try and share my perspective here as speaking with people from Europe over the last few weeks, somebody from Sweden, somebody from Copenhagen, and different people are dealing with COVID-19 in a different way different governments are dealing with it a different way. I don’t know what your views are on whether the lack of preparedness is more political reasons. Because of you know, who’s in power? What are they doing? Or is it because the intellectual class the people who drive the thinkers, they’ve stopped thinking, right? I mean, I refuse to see that it’s only just the government that’s not doing enough. I mean, we’re supposed to do a lot more we’re supposed to have these conversations and in within think tanks and talk about what we can do. So in Europe as an example, the government’s response is completely different. Government has stepped back, politicians have stepped back and they’ve put domain experts up front, and they’re dictating the terms and conditions of how lockdowns will happen. What will happen, what are we doing different? or What should we do different to avoid something like this impacting us so much in the future? Well, I personally believe that the tragedy is the anti scientific bias that’s developed in the United States. I’m very familiar with France, I’ve lived there for several years and and stay in close touch with France watch French news on TV and alike. So I can compare the US and France and France has never had anything close to the level that we’ve had. It is anti scientific thing. And that’s been a real political problem in the United States, the anti vaxxers people that want the freedom to decide whether they can have large meetings, face to face when it’s clearly not wise, not recommended by the medical community. So I agree 100%, clapping silently when you made your comment about we should be having these think tanks in these discussions. And I’ve attended many of those over the years in my role as a health data scientist, but they were largely funded by the federal government. In fact, the CDC, if I went back and thought of that, several meetings where I was that sort of statistician and resident in the 90s, or even into the first year or two of the george bush administration, when this began to turn around, they were government funded, but because the government funding was seen as a challenge to certain religious beliefs, or people would believe the cockamamie stories about mercury poisoning and vaccines that are being given to kids, we say beginning with Bush, and I was actually interviewed by the Bush administration to be a fairly significant person in Health and Human Services at the time. But when when I pointed out that I absolutely had no truck for these anti science people. They told me, sorry, your your interview is done, we’re not going to use you. We have to listen to the non scientists look where we are today. So I guess I’m my answer to your question is that, yes, I really lament the lack of these. But I think that the best source of the discussions in the past has been the government. I’m not a regulator type at all. I think that the government needs to be supporting that. And one of the reasons we’re so unprepared in the United States today is the people that the positions would be responsible for having had these debates and turning into policy recommendations at the White House are empty. We simply have the powers that be in the Trump administration, making sure that those people weren’t there to do that structure set up. It’s simply the cave into political forces in this country is causing us to pay a tragic price. I’m thinking just thinking out loud. You know, perhaps one of the answers to this could be just a lot of transparency, I mean, transparency of data, so a lot of data and regenerating so much knowledge and data right now, which is really factual that, hey, here’s all the data. This is what this means. And this is what it can do. Not a politician, I’m just presenting data. And you know, when we have transparency, go to different groups of people, maybe that’s a way to influence them. And to help them make a better decision on it right is that way to perhaps go further, I couldn’t disagree. That’d be a hypocrite if I did anything other than talk about data. But funny, I’m sort of a renegade within the data science field, because I’m one of the few people that’s authored medical school statistics books, for example, talking about the quality of data. And then I’ve taken on editors of major medical journals for walk overly overseeing these remarkably solid scientific studies. But the numbers weren’t accurate measurements of what they thought they were looking at. So I couldn’t be a stronger supporter of the database approaches that you’re talking about. But the accuracy of the data is terribly important. And we have almost no accurate data about COVID-19. Right now, as you pointed out, in your eloquent question, a moment ago, it caught us by surprise, the people would have been responsible for quickly ramping up the test. I didn’t do it for developing the databases. Nobody was in that office because it was empty for political reasons. And so we’re paying an enormous price. But I want good data. But I won’t be able to answer questions about what to do about COVID. Till we know how many different variations of it there are the interaction between, say one or two variations of the virus with our own individual health statuses with our own genetics. One of the other authors in aftershock has a great article about the need for it of data approaches. And we need to make sure that we’ve got good data and we don’t right now. So even if I Well, I guess one of the reasons I’ve chosen not to become a COVID expert right now, because I’m sure I could, you know, book, lots of interviews would be that I don’t have good numbers to stand on. And we need that desperately. Absolutely. Jeff, I know, we don’t have a lot of time with you today. But I really do want to appreciate all the time you’re spending with us. I want to ask you about the future. I want to ask you about the future, not just healthcare but of human being. Get my crystal ball here, okay, us as people, there you go. You got to get the ball up. Are we headed when it comes to health care when it comes to living a longer life? Many people predict that in the next 15 to 20 years, maybe we’ll have these nanobots and humanity will read an escape velocity. And we can extend our lifetimes by 20 3050 100 years help us understand where we’re headed in the next 10 to 15 years. I think I answered that question today differently than I would have answered it three months ago, given the COVID virus we are going to be so drapped put together resources for carrying on with medical research that I would have given you a fairly optimistic view about the roles of technologies. Right now. I’m worried about the survival of enough physicians and advanced practice nurses and clinical pharmacists and other people to deliver health care. I’m worried about the survival of research communities, not just the scientists themselves, some will die from COVID. But but they won’t have the money and will have terrible political fights. So three months ago, I would have told you Yeah, I’m pretty optimistic that the genetic revolution will prevail. I’m absolutely And sadly, there’s no excitement. As I say, when I look at my crystal ball, I see chaos. I have an article circulating right now hopefully to get on the editorial pages of one of the big newspapers. But it really sadly points to a rather chaotic situation. And that means I would be violating my own principles. If I were to tell you what happened, because I don’t have a slightest idea. Chaos means that which is operating with no overall direction, no preordained plan. And so there’s a cynicism, there’s no delight in telling you that. But if I were to tell you, here’s what I think is going to happen 10 to 15 years from now, I would be making something up as opposed to giving you a viable analysis, based on good data of real trends. I’m very excited about our new medical sciences, if capabilities we’ve never had before, but we’re being set back so tragically by what’s going on right now. And with respect to hopefully on the positive side, let’s say we overcome this challenge. And somehow in the next two to five years, I really believe COVID-19 is going to have a long term impact. It’s not going to go away when the vaccine is out, you know, I would say maybe even five years until we put it in our distant memory to say, okay, that happened one day, let’s say post five years timeframe and we’re back to being amazing and fundings are there. Everything’s people are back on research. What are some of the things that you would want to see to really take shape? Is it drug discovery? Is it the cure for cancer? Is it you know, a cure for pandemics? What are some of your favorite things that you would want acceleration to happen in? Well, I think one of the biggest impediments for the kind of desirable future You and I both would love to see is the way we organize the personnel in our healthcare delivery system. It is so 20th century to assume that medical care is provided when a patient is in office with the door closed seeing a doctor first of all, my passion for the last several years has been studying the role of the advanced practitioners, the nurse practitioners, certified nurse midwives, clinical pharmacist, PhD. level or doctoral level physical therapist, these people are at least as good I just published a book called not what the doctor ordered the third edition of it. I’ve got over 300 peer reviewed journal articles in there showing that the quality of the non physician has risen to be as good as the physician. So I’m not anti physician, I’d spent 18 years of my life proudly as a professor to medical schools and I’m very proud of one of my kids. It’s a physician, I love American medicine, but to argue that we should return to a system that’s controlled by doctors I simply can’t do so an answer to your question. I would love to see us respect all of the people who are qualified to see patients directly and start building teams that respect those skills. Also telemedicine. It’s funny I and very dear friend and colleague named Mark ringel, and a few other people have been pushing telemedicine for well over 20 years, and all of a sudden, people are discovering it work well. Our colleagues in the military and academic centers with people that have dealt in rural health have known for 20 years of telemedicine works but the powers that be haven’t wanted to do it because it got in their way. So I think we need to come back with just as much an acceptance of telemedicine the virtual relationship. In other words, you and I, instead of talking about future can be talking about my heart condition, just no need for us to be having this face to face. And it doesn’t need to be between just a doctor and a patient. I also think we need to change the healthcare delivery system. I I think that health insurance is a terrible way to build on the future of healthcare, because health insurance is controlled by the people that have financial interest. So I’m taking a big position as a real gadfly, trying to get the insurance companies think about quitting this waste of all the resources we put into processing payment and start default delivering care directly. So instead of figuring out ways to make insurance more affordable, I’d like to start society’s thinking about ways to make healthcare more, more affordable, so that we take the most common diseases, the diabetes, the mental health conditions, and and start providing those in the community rather than giving you insurance to people that may not be capable of doing it in a good way. And it’s fascinating. I know that you’re in Canada, and I’m not the first person to come up with that idea. Their current prime minister Home Health and Social Welfare guy, a guy named Mark Lalanne, back in the 70s started thinking, you know, Canada’s very progressive country. My grandpa was kidding. I love Canada, but Lalanne came up with the idea. Why don’t we just start, you know, let’s not talk about universal health insurance. Let’s talk about universal access. So let’s find the diseases the top five diseases that most Canadians or us Americans are dying from and provide care directly to them. And so I can ramble. I’ve got several more ideas, but I’ll put his let’s get creative and reinvent the healthcare delivery system. It’s sort of like the dilemma my Parisian friends are facing right now in notre DOM, you want to rebuild notre Dom to look like it didn’t 1300 or to meet the needs of a religious and cultural community for the 21st century. I’m clearly in the latter camp. And so rather than figure out how to rebuild what we had, let’s admit it had lots of flaws. And Notre Dame did burn to the ground, which is, after all, pretty big flaw and redesign. So not not restore, but redesign. And so I get real excited. And you notice my first couple of answers to your question, and a lot hats off to people like you and other contributors to aftershock who are doing the same thing. But I’d love to use this as an opportunity to think of doing things differently and better with the new tools that you so rightly posited as the questions foundation. Amazing, Jeff, thank you. I can’t thank you enough for your time. One final thing, tell our listeners and viewers where can they find more information about you follow your work, tell us about your book, just point us in the right direction. Couple of them the latest one is not what the doctor ordered. The one before that is upgrading leadership’s crystal ball, which is a lot about the things that you and I talked about. My website is a good place to start. And it’s Jeff Bower words je FF ba Yu er WORDS calm. It’s in beta. Right now I’m just revising my professional stances, I also pursue a dream to become a struggling artist. And so what I’m really trying to do as a futurist, by the way, is to merge my quantitative and scientific backgrounds with my artistic background, and actually had a Foundation grant from the Kellogg Foundation about 30 years ago, to learn to be an artist, and they gave me that as an assistant chancellor at an academic health center. So I’m trying to merge the worlds of art and that and Jeff, our words, calm is a good place to get started. And I love dialogue. I can learn a lot from people just, you know, engaging in discussions. It’s wonderful, you are doing this and again, I appreciate the other contributors to aftershock but Jeff power words calm, I’ll show you my new mission to create or to merge artistic thinking with scientific thinking and imagine new possibilities. And anyone that looks will see the title of my blog. In my my latest blog post on the website is called in search of green swans. We’re always looking for the rare event. The Black Swans, at least Black Swans exist. My new passion is to create green swans and then three to five years from now as you and I both believe I agree with you, by the way. Hopefully things are back to a semblance of normality that allows us to think constructively about the future. Let’s do some green swans. Amazing Jeff, thank you so much. Please, folks, check out Jeff’s work, not what the doctor ordered third edition updating leadership’s crystal ball to many amazing works by Jeff also His website def Bower words.com. Jeff, thank you so much. We wish you a safe time and safe passage to win 19 and this era that surrounded us right now, but please keep writing keep inspiring us. Tell us about what’s happening because people are listening. We’re listening to you, and hopefully we’re going to catch up real to him. Thank you so much. I look forward to coming up to Toronto and doing that face to face when it’s safe. You stay. Absolutely, it’d be my pleasure. Thank you so much. Thank you. Hey, friend, this is Ian Khan. If you like what you saw on my video, then please subscribe to my YouTube channel and be inspired every single day with innovative content that keeps you fresh, updated and ready for the future. For more information. Also, visit my website at Ian khan.com
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