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0:00 Speaker 1: Welcome to the Healthy, wealthy and Wise podcast with Dr William Choctaw, MD. JD. In this episode, Dr. Choctaw will continue his Leadership Masterclass series by covering how AI chatbots improve healthcare. One of the many ways AI has manifested in healthcare is through chatbots, which are computer programs designed to engage with human users in natural language conversations. Dr Choctaw will dive into this aspect, as well as share AI chatbots' ability to directly assist the medical community in various ways. Dr Choctaw will also take a look at some of the tech companies that are major players in this space , with large investments and chatbots of their own. Dr Choctaw will address the cheers and the fears regarding this transformative technology Question. Do you know what a DaVinci robot is or what it does ? Well, these and other questions will be answered and addressed in this podcast episode. So let's get started.

1:09 Here's Dr William Choctaw, md JD . Speaker 2: We're going to talk about how artificial, intelligent chatbots improve healthcare. So buckle up, stay with me and here we go. I believe the life is about being of service to others. I believe knowledge is power. I believe leaders can change the world. As always, when we do the masterclass, we talk about medicine specifically and then, on top of that, we'll talk about law or legal issues. Today, we're going to talk about medicine as it interacts with artificial intelligence and finances, and we'll delineate that more as we go along. So stay with us. As always, i like to include an outline. The purpose of the outline is to let you know what I'm going to talk about. I'm going to talk about artificial intelligence specifically. We're going to define it. We believe in definitions. We're going to define what a chatbot is. We're going to define some of the different iterations of AI and the chatbot. We're going to define reasons for issues. We're going to talk about some of the problems and fears with chatbots that individuals are going through presently, and we're going to talk about robots and surgery. Yes, there are robots in surgery, don't worry.

2:43 We'll explain it when we get there. I don't want to scare you . Don't scare you, but they are there. But that's a good thing. That's a good thing. Okay, so what is artificial intelligence? I know you've heard the term for many, many years and I know that you have an idea about what artificial intelligence is. But what do we mean when we say artificial intelligence? Let me give you a definition The simulation or approximation of human intelligence in machines. Let me give you my definition Teaching machines to think. Artificial intelligence is teaching machines to think. Now you can either be excited about that or that could scare you, and I submit that it's probably a little of both. You know that one goes through. I know it's probably a little of both that I go through, but this is what artificial intelligence is, and I can tell you that if you're finding out or listening now about artificial intelligence, it's already probably at least the last five or 10 years. So this is Dr Chalk-Tom brain surgeon, heart surgeon, that are both exciting and a little traumatizing at the same time.

4:10 What is the goal of artificial intelligence? Well, the goal is computer enhanced learning, reasoning and perception. Think about that Computer enhanced learning, reasoning and perception. Think about a computer that can reason. Think about a computer that has perception. Okay, and I remember we always say perception is a reality. You know, certainly in politics that's true. Whatever people perceive you are politically and in terms of how they're going to vote, is probably how you really are from their perspective. But think about that. There are types of artificial intelligence. I'm just going to give you the two broad categories. That's basic pattern recognition. Now, basic pattern recognition is where you give a computer or machine a certain set of data and you keep giving it the same amount over and over and over again, and it learns by repetition. It keeps repeating it and repeating it and repeating it until it has it memorized. And then there's the other part of artificial intelligence, or thinking machines, if you will, complex human emotion. And I submit that this is where we get into the discomfort that we humans have, and I would argue that we should have, and we'll talk about this a little bit later in the presentation. What is an emotional machine? Is that an oxymoron? What does that mean? A

5:44 machine with emotion? Think about that. Just let that marinate for a bit. One of the ways that scientists who do this work, computer scientists who do this work, are able to get machines to do what they do is they use something called algorithms. Those of you in math and those of you in engineering and data management, you're very familiar with algorithms, but basically algorithms are rules that data is given to make it, in my estimation, in my opinion, form a particular pattern to get something done. So this is all developed ahead of time. But so the broad umbrella of what we're talking about when we talk about AI, chat box AI stands for artificial intelligence, chat box is the broad umbrella is artificial intelligence. My definition thinking machines or teaching machines how to think. Well, what in the world is a chat box? CHATBOT? Well, obviously it's made up word that chat means to talk or to speak, and bot like robot. Okay, so think of a talking robot as a chat bot. Okay, the official definition is a chat bot is a program that communicates with you, most commonly using the texts interface and artificial

7:14 intelligence, when you get in your car and you use your GPS. Your GPS is not human. I don't mean a virtual bubble. That GPS is not a human. It is a chat bot of type. You know it actually is a very early, rudimentary chat bot. You know, it's not even at the higher levels that we're going to talk about today, but that's what a chat bot is. So how does that work in terms of where we are today? I would suggest you this is this information is in the public domain in the last six months.

8:00 So this is not stuff that the public has found out about recent, you know, five or 10 years ago, even though it's been around. But we're learning about it in the last six months or so and we're go with that. Remember when I talked about your academic hand computer. I eat your cell phone. It's also a computer and we already talked about this. But let me sort of use that as an example to talk about the chat bot. Okay, first a bit of history. The first company to come out with a chat bot is Microsoft. Now, obviously , many of you are familiar with Microsoft If you have a computer and you may be using Microsoft software in your computer. I do, i'm old school. As a matter of fact, these presentations are done with a product of Microsoft called PowerPoint. I've used PowerPoint for those 30 plus years. Microsoft is a very big, world-wide computer operating system. Microsoft basically heard about a company called OpenAI. Microsoft then decided and we'll get into this later to work with this company. The very earliest form of a chat bot

9:30 is something that's called ChatGPT. This is from Microsoft. I'm just going to deal with the big players with computers, or talking computers, if you will. Let me just go over the list. Microsoft is the first, google is second, meta or Facebook is third and Baidu, which is the Microsoft, if you will, of China . It's the last one, but Microsoft's product is called ChatGPT. Gpt just stands for some computer iterated language.

10:11 It doesn't really mean anything other than that, but this is their first product. This product rolled out to the public 2022 last year. We're not talking about a long time, but free. Basically, it's free. It's called ChatGPT. Indeed, if you have a Microsoft computer, it's already on your computer. It's already there. If you don't know where to look, go to your browser. Go to where you search and type in ChatGPT, and then it'll pop up. Don't be scared, it'll pop up on your computer. The very basic type of a Chatbot named ChatGPT. Chatgpt is the name of the Chatbot that Microsoft owns. This is called Chatbot or GPT 3.0. Now Microsoft has already, within months, come out with an advanced version of that called GPT4. Gpt4 you have to pay for. Gpt3 is free. Gpt4 you have to pay for I think it's like $40 a month or something like that.

11:30 But if you have Bing, this is another operating system with Microsoft. If you have Bing on your computer, you already have GPT4 for free. Let me go over that again. Gpt3 is the early example of the Chatbot that was made by Microsoft, which is the leading country because it's out with this technology First for the public. The advanced is GPT4 , but you already have GPT4 on your computer for free. Google has a product called Bart with Palm 2. They're already coming out with their product, but they're a little behind Microsoft. Then Facebook Meta has a product called Blenderblot , and Baidu, the Chinese operating system, has one called Ernie, which I found interesting. I'm sure there's a message there, but I just don't understand it. Now just make sure that you understand what I mean by Microsoft. You are familiar with Microsoft products . You'll either use Word when you type the letter, you type the paper. You may use Excel for numbers If you do any type of number accumulation or accounting. As I mentioned about PowerPoint, these are the products of Microsoft. They call Microsoft Office. The company that started the Chat GPT is

13:07 called OpenAI. That's at the top . This is the small company I think. Right now I think it's main office in San Francisco, california small company. It's the one that started Chat GPT. Now, i think you'll be interested in the history of how this came about. Openai is the name of the company that started Chat GPT. It was founded in 2015,. Not too long ago. Microsoft, being the gentle giant that it is in the tech industry, is always looking, obviously worldwide, for new technology and obviously potential competition. Microsoft approached OpenAI, the company founded in 2015 in San Francisco , and said we like your product, we want to invest in your product. We're going to invest one billion, with the B dollars, into your company. Of course, your small startup tech company and Microsoft comes in and says they want to invest a billion dollars. What do you do? You said sure, bring it, i'll take it, stay with me. Now, four years later, 2023, this year,

14:37 microsoft says we're even more impressed with your company, openai, and your product, chat GPT. We want to increase our investment to an additional 10 billion. Stay with me now. This is 11 billion dollars from Microsoft to a little company in San Francisco. You may say well , why in the world is Microsoft doing that? Well, obviously, if you're a worldwide company and you've got information throughout the world and there was something Microsoft saw that it liked, and that's that bullet point. The next bullet point that in December alone of last year, a million people signed up with Chat, gpt. A million people in one month. Okay, you think that was something. In January, the next month, over a hundred million people signed up for the same product. So what do you think Microsoft is thinking now? We got a good one here, okay. So what's my point? My point is to show you the speed of this stuff . This is not stuff that happens in six months and then another three months. This is happening daily, weekly, monthly. The speed which goes along with computers. What is unique about computers compared to humans? One of the things is speed. Okay , that a computer can do what I can do. The computer can do it in a second. A second is when you say one, one thousand,

16:10 that's a second, that's one second. One, one thousand, two, one thousand, three, one thousand four, one thousand five , one thousand Five seconds just went by. The computer is already done then. So this is the area that we're in Now. Let me put this in context. I'm a baby boomer, i'm 75 years old. I still remember rotary telephones. I remember There were no cell phones in my neighborhood. So I'm being transported now to a whole new area And, to be honest with you, i find that exciting. I said cool, bring it, bring it, okay.

16:51 So let's go into detail a little more about chatbots, and particularly as it has to do with healthcare, and I'll just go through this relatively quickly. Well, how? does this talking computer process, thinking machine, help in a hospital, whatever, whatever. Well, ironically it helps in a number of ways And I will submit to you if you are, if you get your healthcare in a large healthcare delivery system And I'm talking about a large university related healthcare delivery system or Kaiser or something like that You are already interacting with these bots and you just don't know it. You think you're dealing with humans, you're not, and, believe it or not, some of that is a good thing, because the robot just keeps doing what it does, it doesn't get tired, it doesn't get frustrated And it just keep doing it and doing it, and doing it. But so five ways that it works in healthcare is providing informational support. Clearly, one of the most frustrating things is about being a patient, having a family member who's a patient is getting information. What's going on, why are you doing this , why are you doing that, what does this mean, What did that show? Et cetera, et cetera, et cetera. Second, scheduling appointments. Now, when I want to see my doctor or whatever, i go to my computer, i pull down the website of my healthcare delivery system I happen to have Kaiser And I just dial in. I want to see blah, blah, blah for

18:23 X And I do it all online is my point. I never really talked to a human And I sort of like that quite honestly. It collecting patient information. Obviously, when you sign into the hospital or you go into a clinic, they have you fill out a lot of stuff And all that stuff goes into a computer And that computer then becomes more knowledgeable about you Providing medical assistance. When the physician wants to know more and more information, he goes to that data bank and can get it And assist in refilling. When you, if you take a lot of medication and you need to refill your medication many times, you can do that online And that process is facilitated by an artificial intelligent machine, by an artificial intelligent machine.

19:19 Well, how do these chat about things help doctors? How does these computers help doctors? And let me just add here if you remember back to some of the previous masterclass lectures, we talked about the Affordable Care Act, obamacare that was passed in 2010, 13 years ago, and we mentioned that one of the main factors of Obamacare was it forced healthcare to go from to computers. This is a part of that process that started 13 years ago. So how do we physicians use the chatbot? Well , it helps us with clinical decision support. What does that mean? That means is, let's say, i admit my patient to hospital A and patients very sick, and it's a condition that you don't see very often, let's put it in that category. And so I think that I wanna do treatment A. And so I type treatment A into the computer And the computer gives me a red X or something, and I said whoa, what's that? And the computer says that it will not accept my treatment recommendation. And then I asked why? And the computer says I need to talk to X or Y or Z. My point is it is helping me with my decision regarding the treatment for that patient. That's a good thing. Medicine

20:50 changes every single day And it is impossible for anybody I don't care how smart you are or what school you went to to stay up with everything that's current. On and on and on. Think about an artificial intelligent chatbot computer and think about it in terms of a library, a world library. Think about a library, but it's a world library. And think about this world library that has every single book in the world in its library, and think about all the data and information in that world library that you can download to one computer system. And that's what we're talking about when we're talking about an artificial intelligent chatbox. So the computer just goes to this database and says, no, you need to do A, b and C.

21:39 The same thing is with literature search procedure review. One of the very interesting areas that hospitals particularly like and doctors also, is that you can get a lot of good feedback from patients. Speaker 4: Dr Choctaw Speaker 2: Quickly, let's drill down a little bit more about this artificial intelligence stuff, and particularly as it has to do with machine learning. Now on the left side you see machine learning and deep learning Again. Machine learning here is that repetition type of learning. More superficial Deep learning is where you get into perceptions and reasoning and that sort of thing. Go down to the lower level, you get natural language processing. This is how multiple languages around the world that has to be processed. So it means the same thing for everybody Predictive analytics. Ceos of companies love predictive analytics. Why? Let's say you're the CEO of hospital A. Hospital A has 500 beds. You have 2,000 employees in hospital A. You treat, let's say, 5,000 people in six months in hospital A, but it is problematic in terms of knowing how many staff you need on a Friday or a Sunday, how many nurses you need, how many doctors are gonna be on call, how many emergencies are you gonna get. So you have to bring

23:10 in more of this and that You have to guess. You have to guess And most of the times we guess wrong. I mean, because we're human. The computer, the chatbot , can do that for you And it does that for you with what it calls predictive analytics. Go back to that world library that's been downloaded to the chat box with all the world's data. It can tell you in hospital A, looking at your data for the last year, what's your staffing is gonna be like on a Friday night in December. It can tell you that It can deduce it from the data that you've given.

23:50 That's just extraordinary. So a CEO and executive team that has that much information. Again, as an executive, your job is to predict the future, right, because you have to guess Do I add this many people, or do I get this much money? Do I take a loan? blah, blah, blah. The computer can take all that away from you. Look at that third box Sentiment analytics. Sentiment analytics Well, guess what that's talking about? Sentiment analytics means that it can do a better job of getting patient feedback that it can give to the organization ie hospital, physician, et cetera in terms of what patients think, and I think that's a good thing. I think that's a good thing. I think that's a good thing that doesn't rely on how much time I have or how relaxed I am or available I am, if you can put your thoughts and feelings and belief into a computerized system that goes directly to the people in charge. That's a good thing. Well, i admit, this is a cell phone with a I don't know a toy chat bot. I hesitate about putting this picture in here because I didn't want to scare anybody, but I decided to put it in anyway. All right. Now the chat bot doesn't necessarily look like this. This is just, no doubt, a computer rendition of

25:24 what it is, but the point is, the chat bot is there to help you. There's no question that there are issues and concerns, and we'll talk about that a bit later But it can be of help to you And I would encourage you to look at how it can help you Very, very quickly. And we'll just go this real fast Again hospital administration like chat bots, because some protocols and HR stuff and all the regulatory stuff that most of times is very difficult to deal with. One of the places that chat bots have been found to be helpful is with hospice. The many times individuals who are in hospice are able to communicate. Think about texting a friend. Think about texting a friend who has unlimited time, limited capability and can listen to you 24 seven. Think about how therapeutic that might be if you or your loved one or your family member and or loved one happen to be in a hospice situation. You want to know this guy, this guy, his first name is Sam. So what is Sam doing here? Sam is actually testifying in Congress. He started this.

26:40 He and his people started, discovered it. Microsoft bought it out. It spread worldwide. But Sam look at his face, sam's a little worried. And so what he's doing, which is smart, he's trying to be proactive or preemptive. And he went to Congress and said I need to come and talk to you guys in government because I've created something here that you need to be aware of and you need to start providing some regulation with it. You need to start providing some regulation with it. Right, it's not 100% accurate. So my point is that if you do a query in the chat button, it gives you certain number of answers. Double check those answers another way if possible, and I would argue nothing is really 100%. Quite honestly, skepticism is never a bad thing. Never a bad thing. So he says that sometimes he's worried about people using the chat bot, putting it into a political forum and then using that to spread disinformation. He's worried, legitimately, about people losing jobs, and that's obvious, right? I can remember when the main mechanical robots came out, they said well, they're going to get rid of blue collar jobs. Well, the chat bot, the AI chat bot is going to get rid of white

28:11 collar jobs writers, artists, lawyers, individuals who think for living. It can even replace artists. These chat bots can draw art, they can create, they can do everything. So just think about that on the world stage. And if you happen to be a writer for a Harper's company and the chat bot comes out and says I can write that 300-page book in 44 hours, right, think about time and money. And then you understand the financial implications. And think about it . Microsoft is not stupid. They didn't put $11 billion in this company because they thought that they were going to lose money. But my point is, even people who are creating the product are concerned, and Sam is an example. This is another guy. His name is Blake Lamone.

29:14 He's a senior engineer or was a senior engineer for Google. So remember, they're all doing it. It's not just Microsoft, all of them are doing it. And his claim get this that the chat bot, the machine, the robot, the computer had gained sentience. Now I must admit to you, i didn't know what sentience was. I don't remember hearing that word. So I looked it up And sentience means the ability to experience feelings and sensations. Think about that with your computer. Do you want a computer that has feelings and sensations? right, and Blake says that his job was to probe the chat bot. Ask it questions 24-7. What do you think about this? What would you do with that? How would you handle this scenario? How did you handle that scenario? And what Blake has said is what he's learned disturbed him. It disturbed him And when he tried to talk to the bosses, obviously at Google they didn't want him talking about stuff like that And they certainly didn't want him talking about it to the public. But what got Blake fired was he gave documents to the Washington Post newspaper to prove his fault and Google fired him. But you know he proved his point. So my point is that even people who are on the inside are sounding an alarm bell. They're saying be wary of this stuff.

30:47 Maybe we can't stop it, but you just need to be careful with it. And thirdly, this is Jeffrey Hinton. Jeffrey Hinton is an older guy who's called the father of Artificial Intelligence. Think about that, if the father of artificial intelligence is saying I'm worried about chat GPT and computers with feelings, because I think these computers are going to become more intelligent than us. Think about it Now. I would admit that I'm a movie buff and I know I'm dating a lot of you, but I can remember a movie called War Games with Matthew Rodrick and the whole thing was Matthew the teenager and his girlfriend were playing around with the computer, and he was trying to show off to her. So he broke into the national security computer system and started talking to one of the computers in the big computer system government computer system. And he went into the computer and the computer said would you like to play a game? And so the teenager's girlfriend and giggling and playing around and they said sure, and so the computer gave them a list of games. You can play chess, you can play blah, blah, blah. And the teenager of course wanted to impress his girlfriend and said I want to play Thermonuclea Warfare. And the computer said OK, and the computer's name was

32:22 Joshua. I remember the name. I love that movie, i watched it at least 100 times And the problem was the computer started playing the game for real And the kid couldn't stop it and the adults were going crazy. But everything ended up all right. But my point is that computers are computers. The other thing that Hinton says is this process scares him. You know I didn't write down everything He said. That was one of his quotes. He said this scares me. Think about the father. This is the father saying you know, one of my kids scared me, or something to that event, and his concern is, you know, he's not going to be able to play the game, that we need to have some way to control it.

33:08 Now, who's gonna do that? Because the whole premise is we have a robot that has the world's library data inside of it so that it can think faster and smarter and quicker. It's like our Frankenstein to some extent Another one of my favorite movies, by the way And we built it. But then can we control it? So I don't want to scare you, but I think it is important that I give you both sides of the argument, the way I look at it. And again, if you've been with us for the last six months or so, you're familiar with one of my favorite parts of the brain called the amygdala. Remember the amygdala?

33:52 The amygdala is the machine control center of the brain And I see the way I analyze this is computers don't have amygdalas yet yet. Yet Now I don't even know what an amygdala would look like in a computer or whatever. But my point is the difference, what I've always thought the difference between me and them is that I have emotions and they don't. They may be smarter than me, but I can love and they cannot because they don't have emotions. Well, whatever computer learns what love is because then if you learn what love is, you may learn what hate is okay Then that's a whole slippery slope that you want to be careful of. So let's switch here and look specifically at healthcare. Okay, what are the areas that the chatbots are helpful in hospitals and healthcare delivery that hospitals like, and why do hospitals like them? Well, one of the reasons is, and as I mentioned before at the beginning, the use of the chatbot or the super-duper advanced thinking computer saves money for the hospital. That does that directly and indirectly. It provides

35:23 cybersecurity, it helps with clinical trials, it helps with work assistance, it helps with nursing assistance. One of the ways that hospitals love using the robot is in surgery. In surgery Now I should share with you. As I said, i've been a surgeon for 50 years. As I mentioned before, my medical school is celebrating our 50-year anniversary, because I graduated in 1983 from Yale Medical School. The robot can generate a total close to $100, over $100 billion, just by using the robot alone. Okay, this is what one of the robots looks like that's used in surgery And it's used in most types of surgery. Some are more beneficial than others. These are the ones that are very beneficial with the robot Prostate surgery, general surgery, gynecological surgery, heart surgery. This is an example of the robot being used in, say, heart surgery case. So what do you notice immediately about this picture? You're right , the surgeon is not standing at the table, he's sitting off to the left side. You say wait a second. Aren't you supposed to be up there at the patient?

36:48 That's the way it is on TV. Well , guess what? This is a new process And, as I said, this has been around for about 15 years This is not last year, or last November, or 21 or 20 or 1918. And it is growing in usage. I know this because for the last four years, before I retired, sent and retired, i was running around the country doing accreditation work for the joint commission and helping to accredited hospitals and making sure that they were following the rules, and the majority of them are doing robotic surgery in increasing numbers, increasing numbers. Another example of robotic surgery Here we have two surgeries Because a lot of times when we as a general surgeon I would be doing a case and I would maybe call it in a urologist because my the area that I'm gonna be working in is gonna be very close to the ureters or the kidney And I want a urologist in there, or a gynecologist would call me in, obstetrician would call me in because of possible bowel injury . So it's not uncommon to have two physicians working. So the patient's on the table, the robot is over the patient, the nurse is standing by the table but the surgeons are at the monitors like a computer screen, computer mod. This is what the

38:19 robot looks like. From a different perspective. This is probably the most famous robot is called the DaVinci XI. Surgeons love the robot. This is how it looks like in another type of surgery. We see all the plastic over it to keep the area sterile. But robotic surgery is increasing in scope and speed in surgery. It's beneficial in surgery. One of the reasons beneficial in surgery is there's a smaller scar for the patient. Smaller scar means less postoperative pain. The surgery is more accurate because remember, this is super-duper intelligent assistant that the surgeon has and can keep the surgeon out of danger more efficiently, more effective, it helps to provide better patient care. In summary, the AI future is now. The artificial intelligence future is now.

39:25 Chatbots are working right now. Today, artificial intelligence is non-human learning. The more advanced chatbox today is the ChatGPT-4 made by Microsoft. If you have Bing operating system on your Microsoft computer, you already have it for free. Chatbot is an advanced search engine that communicates verbally with the patient and with the physician. Robots have been using surgery for 15 years, as I've said, but the other side of that, though, is one needs to be cautious with the whole artificial intelligence area. If you will, and don't hesitate to think and re-evaluate and make sure that you have the most appropriate use Presently. The most advanced Chatbot today is the Bing, and this is the logo that you'll see on your computer screen. My basic principles is I like to always end God is in charge. As I've mentioned each and every time, god is the leader of my world. I am a physician of faith , and because of that, he has sustained me and allowed me to do what I have been blessed to do. I have no bad days. I discovered many years ago that whether the day was good or bad, it was up to me, and so I decided that I had had enough

40:56 bad days and I didn't want it anymore. So I now only have good days, so I have great days. Don't sweat the small stuff, and most stuff is small. I have learned that whenever something bothers me or appears to aggravate me, it's usually not that big a deal. So I've learned to go slow, take a step back and just not worry about stuff. Forgiveness is therapy. People will do or say things to you that may very well aggravate you or bother you or hurt you or give them. Doesn't matter who's right or wrong. Just forgive them and you will be amazed that not only is that the right thing to do, it is also therapeutic for you. And the fifth thing is everything is a relationship. Most relationships are built on three things mutual respect, mutual trust, good communication. If you have those three things, you have a good relationship. If you do not have those three things, then you have some work to do to build that relationship up to where it should be. Are there any questions?

42:03 Speaker 5: What if you were talking about the benefits of AI in the hospitals in relation to patient satisfaction? Speaker 2: Yes. Speaker 5: Is that because of the pain that the computer will communicate with the patients before they leave, or how is that beneficial or faster? Speaker 2: Okay, let me repeat the question. The question is that on one of my slides I had some information about how the chatbot is a beneficial in terms of patient satisfaction, and is that when the patient is still in the hospital or when the patient goes home? This is mainly used for survey of patients, and so it's mostly when the patient goes home in terms of patient satisfaction where the patient can give accurate and quick feedback about their experience, and that's one of the ways that it helps with patient sentiment and patient experience. Also, there could be surveys that patients would take even while they're in hospital And some hospitals do that also but they can do it very quickly with the chatbot and not have to have a person or a nurse to do that, and they can get that information faster back to the hospital. Thank you.

43:26 The question on one Yes, go ahead. Speaker 4: I have a question. Speaker 2: Yeah, go ahead. Speaker 4: Okay, actually I have two questions. Yeah, in that illustration with the DaVinci robot, you had the two surgeons. Like you said, this is technology that's a few years old. Has there been any growth, with those two surgeons not being in the room, perhaps being in another city and conducting surgeries? Speaker 2: No, no One, because I think it would not be acceptable to do that. And two, i think you would then get into situations of error and litigation and that sort of thing. So it hasn't quite gotten to that level where you could be absolutely absent. Now that may happen in the future, but presently that's not the case.

44:22 Speaker 4: Okay, Thank you. And my second question is do you see a day coming when those two surgeons would be completely replaced by another DaVinci robot? Speaker 2: Maybe What answer? It is possible Because I've gotten to the point now where almost anything is possible. But, to answer your question, it is possible because things are moving in the direction of the robotics doing more and more and more. So that's not inconceivable, to be honest with you. Speaker 4: All right, thank you. Speaker 1: The tools that you're using. Are they the? same that they would be in your hand.

45:08 Speaker 2: They're similar, as they would be in my hand, For instance. They have extensions and by sitting at the monitor I'm able to move their hand because they're an extension of me. So they're sort of similar but modified for the robot. So it's basically similar but it may be a little longer, It may have a little dissonant And remember, the robot doesn't get tired. I remember we used to talk about five, six hours surgeries and what it would be. The robot didn't get tired And remember, the surgeons are sitting. So that's another advantage too. But there's maybe a slight modification of the instruments with the robot. Any other questions.

45:51 Speaker 4: One last question. Back to the chatbot, the AI chatbot. there are some concerns about accuracy of the information that's coming back, and you talked about that. Where do you think that's going And how is that going to be addressed? I mean, obviously you can't do it with legislation, but what's the tech industry doing about the accuracy of the information that's coming back from all the searches that they're doing? That's an excellent question. Speaker 2: I don't think the tech industry is doing as much as it could And I think that's why a lot of them are going to Congress and say you guys need to do something. And obviously, you know, a 65 year old man in the Senate knows less about the tech stuff than I do, so they can't do anything. I do believe that they are legitimately worried, as they should be, but I think but to answer your question specifically, i think it's a matter of buyers. Beware Those of us like me and you and others, who are end users. We have to have a certain degree of organization, and health is suspicion about everything. For instance, i've started using the chatbot And I've even prepared in this presentation. I use the chatbot And I was very impressed because it's so fast, you know, and literally when I put something into the, the request or the search, it starts in a

47:24 second telling me what I need to know. But I would then also go out and maybe do a different search to validate that. So I think we're going to have to do more of that sort of thing, but I think it's going to take a combination of all those things, but I think we're going to have to do our part and not just rely 100% on this accuracy. And they have actually said that the areas that is weakest is opinion. Of course, if you ask it who's better Republican or Democrat, you know now, it may give you what it thinks, but it may not be accurate, and those types of questions are the ones that you have to sort of take with a grain of salt.

48:05 Speaker 4: Thank you. Speaker 2: Yes. Speaker 3: Thank you so much for your presentation. I really liked the end of it where, after you've given us all this news, you talk about my basic principles And you know you can feel free to use that in all of your presentations, because sometimes we need that reminder, because there's so many things going on in the world today That causes us to fear And you know, the word of God tells us not to fear And when fear comes it's not from God. Speaker 2: Yeah, i think I got most of what you said, but, to be honest with you, i decided to do exactly what you suggest. I do use my basic principles in every single presentation for the reason that you mentioned, because I think it's important that I not only do I give you didactic, healthcare, legal and financial information. I think it's important that there be a second message there, and that is about me personally and about what I've learned and what's worked for me, and certainly my faith is a part of that. So, thank you for your suggestion And I completely agree with you and I've already decided to do that. Thank you.

49:22 Speaker 3: Any other questions, i just want to. I just want to ask one more thing. With the AI intelligence, i think the concern is probably, when you consider Bible prophecy, how we are headed towards one world government. I mean, you talk about the move is there for one world religion, there's one world money then to have no borders. I'm interesting to hear your take on how you see AI bringing all these one world, this and that together, and how it's going to just affect the world.

50:03 Speaker 2: Well, you know, to be honest, i don't have a clue how that's going to work out. I I I'm not familiar with the one world concept, but I think what one of the things that's interesting and fearful at the same time is no one knows, 12 months from now, 24 months from now, 36 months from now, not what the impact is going to be with AI in multiple areas religion, healthcare, law, medicine, finance, etc. Etc. I honestly don't know. But I think if we have all about, if each of us has our basic principles intact, it does not matter. But the world does We stand for what we believe and become leaders?

50:44 you know, it is not accidental that this is called a leadership masterclass, because I believe, as I said in my basic principles when I start out leaders, leaders can change the world. So it's up for us to stand and be leaders in all of that chaos, if you will, and stand for what we believe is right, thank you. So, finally, thank you all so much, and I, i, i like this slide. I came across this slide and I like it because we always talk about change and we talk about leadership. I like the idea of us looking at the person in the mirror and saying What, what am I doing to change the world?

51:26 What am I doing to make people love each other better? What am I doing to make people happier, etc. So I like to say leave this with you be the change that you want to see in the world. Let me also say that these lectures are also on a new podcast that you will be hearing about, and so if you have, if you listen to podcasts and you have a platform that you download your podcast, look us up on your platform and you'll be able to hear some of the same material. Thank you and have a wonderful day.

52:28 Speaker 1: And then share it with your family, friends and or your coworkers. They'll be glad you did So. until the next time , live your best possible life the best possible way.