Crowding, boarding, repeat visits, difficult discharges; many challenges emergency physicians face begin long before a patient reaches the ED. Dr. Italo Brown, a nationally recognized leader in social emergency medicine and health equity, joins host Dr. Matthew Strehlow to explore what can be learned by looking upstream and listening to communities. Drawing on his community-based work, Brown discusses how trust, access, and local knowledge can lead to better solutions—and inform advocacy, health policy, and the growing use of AI in healthcare.
Crowding, boarding, repeat visits, difficult discharges; many challenges emergency physicians face begin long before a patient reaches the ED. Dr. Italo Brown, a nationally recognized leader in social emergency medicine and health equity, joins host Dr. Matthew Strehlow to explore what can be learned by looking upstream and listening to communities. Drawing on his community-based work, Brown discusses how trust, access, and local knowledge can lead to better solutions—and inform advocacy, health policy, and the growing use of AI in healthcare.
Italo Brown, MD, MPH, is a nationally recognized leader in social emergency medicine and health equity and a clinical assistant professor of emergency medicine at Stanford. His work spans community-based health initiatives, advocacy, and medical education, with a focus on improving health and access for underserved communities.
Dr. Matthew Strehlow is a Professor of Emergency Medicine at Stanford and serves as Vice Chair for Innovation and Clinical Improvement. His work focuses on improving patient care through system redesign, global health initiatives, and advancing emergency medicine education.
(Transcript lightly edited for clarity.)
Dr. Matthew Strehlow: Innovation in healthcare isn't always about the latest technology. Sometimes the greatest opportunities come from rethinking how we educate future physicians, engage communities, build trust, and expand the reach of medicine beyond the traditional healthcare setting.
Hello, everyone, and welcome back to the Stanford Emergency Medicine podcast. I'm your host, Dr. Matthew Strehlow, vice chair of the Department of Emergency Medicine at Stanford. Dr. Italo Brown is an emergency physician here at Stanford, our health equity and social justice curriculum thread lead, and the chief impact officer of TRAP Medicine, a barbershop-based wellness initiative reaching Black men and boys.
He's also the creator of Health Equity Rounds and the SPACE Model now used in clerkships across the country, and he was selected for the White House's Health Equity Leaders Roundtable. Today, we'll dig into the experiences that shaped his path, the work that he's currently focusing on in community engagement, and where he sees AI and data fitting into that work.
Dr. Brown, Italo, welcome.
Dr. Italo Brown: And it's an honor to be here
Dr. Matthew Strehlow: Italo, let's start at the beginning. What first drew you to emergency medicine, and what experiences shaped the physician and the innovator that you've become?
Dr. Italo Brown: You know, it's, it's interesting. I think of emergency medicine as this space full of diagnosticians, and I was attracted to that.
I remember being on rotations and saying, "It seems like they're figuring out solutions to problems." But I think what really kept me was realizing that the problems weren't always medical, and that they were so broad and had so much opportunity to solve them. And, and it's just natural for me to gravitate towards where the work is actually happening, so emergency medicine fit right in.
And I have to, like, shout out my father and my mother. My father was a firefighter, my mother was an educator. So if you, like, throw them together, you kind of end up with an ER doc.
Dr. Matthew Strehlow: Wow. So you were brought up in this service environment where you saw teaching and your father was serving.
And were you somebody in your community and in your space where you were solving problems and, and you saw people, experiencing challenges, and you were drawn into that?
Dr. Italo Brown: Yeah. I think that every single city that I've lived in, I was around individuals who would be considered medically vulnerable.
And having that exposure and seeing what the day-to-day is like, you know, when you can't afford groceries, when you cross the street and there's a person there that's asking for some kind of help or some kind of aid, it puts a specific lens on the way that you view the world. So, I immediately felt like this is where I belong in terms of serving populations that don't always have answers and don't always have access, and being the conduit for them.
Because I've always been able to follow where the trend is, where the education is, where the problem-solvers, the thinkers and doers are and just make it naturally flow down the gradient to people who don't have the same access.
Dr. Matthew Strehlow: Well, I think a lot of people, they know you for your work with TRAP, for that SPACE Model.
But right now I know that you're working on something called Know Your Numbers, and this is a real focus of your community-engaged work. Can you tell us a little bit about that, how that runs, and how that grew out of the social EM lens that I've heard you speak about before? This idea that these problems that we see in the ED really come from these upstream areas where we could, uh, we could impact them.
Dr. Italo Brown: Exactly. I think you kind of characterized social EM perfectly. You're looking at upstream causes and trying to attack key points and making sure that the downstream is better health outcomes for everyone. And so, when you mix community environments, you're naturally going to have your fingers on the pulse of these issues a little bit better.
I learned that through working in barbershops. I naturally love being in spaces where there's community, but also understanding that they will talk to you about things that they normally don't talk to their doctors in a clinical brick-and-mortar space because of that comfort level. And so, the Know Your Numbers campaign is really an extension of that.
It's going to people where they're at. I love the fact that we have really amazing hospitals, but a lot of hospitals are not made with community members in mind, and we have to step beyond the walls in order to understand their needs.
So the Know Your Numbers campaign centers on different needs of community members, talking about cardiovascular health, preventative measures, making sure they have access to certain screening tools right there in community, and then looping them to care because, again, it's always about having this boomerang effect back to an institution, back to a system that has more robust features to manage the complexity of each person.
Dr. Matthew Strehlow: So, give us an example then of where Know Your Numbers is working. What kind of community event or community setting are you targeting?
Dr. Italo Brown: Sure. So, in Oakland, I'm sure, you know, one of the major waves right now is the development of a cancer center. And so, part of it was creating a natural bridge between the community and Stanford's brand.
This has not always been a natural alignment. There's multiple systems in the Bay Area, and in Oakland, this is a community that is extremely well-resourced in terms of its cultural capital but often is left without having real investment. And so, the Know Your Numbers campaign was not just a visual stance, but we went to multiple things from community service events, parades…
We had multiple interactions at faith-based organizations, and then did these same installations or activations. So, blood pressure and blood sugar checks, talking about mental health and wellness, doing screens, seeing who has medication reconciliation opportunities all in one space, and that now creates a natural bridge for them to be looped into care at Stanford.
So again, it's always about trying to figure out what their needs are, what we have that is available to them, and then bridging that gap.
Dr. Matthew Strehlow: I grew up in a family where you did not talk about mental health and wellness. That was not the norm at all, and I feel like there's a lot of cultures and communities where that's been, been stigmatized or something you would avoid. Do you find that when you go to these events that it, it is really opening up people in a way that they are not able to do in the healthcare environment?
Dr. Italo Brown: Yeah, honestly that seems to happen more commonly than I anticipated. They'll look at me, they'll see someone who looks like their cousin, their friend, and start to share details, like deep-seated details in a two, three-minute interaction because they now feel like they are safe, and I've established that community presence.
Often what you'll hear are questions around different substances, whether or not it's safe to take medications that are prescribed to them, their thoughts around the medical ecosystem, clinical trials…
All these different concepts that they've been exposed to and saying, "I just don't know if I should trust it." And being able to go through those questions and then finally pulling out that they're dealing with anxiety or they're dealing with depression, and that they have family members who are struggling, and they don't know how to deal with those stressors.
So, I normalize for them that these feelings are real, and that we have a lot of different providers that are capable of managing that, and if they're in acute crisis, I know where to send them because I work around great colleagues every day.
Dr. Matthew Strehlow: Trust strikes me as something we have a... I think I would use the term crisis right now with facts between the community, if we think about our global community or the national community and the healthcare. And we see the, some of the impacts of that trust around vaccination rates and other things.
You've been able to reach out to people in areas where they might have higher rates of trust or in ways where they might trust you more. Tell us a little bit about how that has changed the way you think about care delivery overall.
Dr. Italo Brown: Trust is a currency that is immutable, that, when it’s exchanged is very palpable. People feel it, and I think that that's different than anything else that we've seen in healthcare, right? When you lose it, it's so hard to get it back.
These communities almost move through the world with that natural currency. Like, they decide where they're going to get food based upon a recommendation. They move places where they know other people have lived there. All of this is like a version of trust. And so, understanding that dynamic as a physician is critical.
So, when I walk into a room or walk into a space, my hope is to establish trust very early and then to continue to layer on trust so that they don't feel at any point that, A, I've deceived them, that our institution or the brand of the institution is selling them a false bill of goods. And then finally, that they can ask questions and those questions be honored, not just because it's a good question or a bad question, but because that trust dynamic is established and we're both hoping to move and grow with this particular conversation.
One of the ways that I've found that trust is, again, useful in my practical environment, I could walk into a room, I could tell that somebody feels a little on edge, and then I just cut right on through it and let them know from the beginning, like, "Hey, you can talk to me like I'm your friend, your family member, like I'm your cousin. I understand exactly what you go through. I don't know what you're feeling right now, and I'd like to learn that." And so, it kind of disarms them and helps to create this foundation of trust, and then we just start adding in the medical stuff.
Dr. Matthew Strehlow: You know, I use the fact that I'm a parent, I think, a lot.
I love working in the pediatric ED and I use the fact that I'm a parent a lot to connect with the parent when they're feeling that sense of anxiety, and I think it really eases things. And I think there was a lot that I didn't necessarily appreciate before I was a parent that that parent is going through.
And I think that there's gaps, right? Where we're…our backgrounds and our patients' backgrounds…and finding ways that you're teaching us, and others, finding ways for us to bridge that in our individual patient interactions is really important.
I'd like to zoom out a little bit though, and, and talk about that Know Your Numbers and what you've learned about that as far as how to engage a community. How can healthcare systems be more community-engaged and less just, "Hey, we're delivering care in this area"?
Dr. Italo Brown: It takes a lot of listening, right? Like, really stepping back and saying, "All right, they are the experts on what's affecting them." We can't step to the plate and 100% of the time just assume we know what's occurring and what their health struggles are.
So, starting by listening and trying to take an honest inventory of all the different microstressors, all the different challenges that they face, both social and medical. And then you realize that systems that we built are built for a reason. How do you make that system in a way that keeps them in mind, and so they feel like they are naturally a part of the solution, and then scale that.
And so some of the, the different innovations that we have are naturally useful in communities that are dying for this type of information or dying for these types of resources. We just haven't taken the time to hear them out. We haven't taken the time to look through all of that cache of resources and figure out what the specific solve is, let them try it on, and then find out what works and scale it.
Dr. Matthew Strehlow: You know, I think a lot of healthcare systems have heard this a littlebit, right? And they've started to form community advisory panels and groups like that, and, and even for emergency departments specifically, Do you think those are working? Tell me your thoughts.
Dr. Italo Brown: That's a great question. I think they, in theory, have this kind of broad swath approach where you're getting good information all the time, and then you end up taking the best ideas from that and trying to make those work.
Inevitably, I think you run into a financial concern there. Like, how practical are these ideas or are these, potential solves? And then it's almost like trying to hit a moving target all the time, right? So, when you solve this one problem, there's a bigger problem that's downfield.
And so, I think that it's not always the best solution. What I find has worked is constantly engaging them, but in a way that's not, monthly, quarterly. But having them filter throughout the ED and having other providers who are working on the smaller problems more longitudinally. And then making sure that they are constantly reporting what those micro results are.
And I wanna give, a good example of that, but I don't know how much time we have.
Dr. Matthew Strehlow: As much time as you need. I would love to hear this example.
Dr. Italo Brown: Yeah. All right. So for example, there's a couple of studies that talk about the ease of getting certain medications, right? And if I'm constantly telling you, you know, "We want you to be taking this medication," and you realize that the solve is making them, making blister packs when you leave the emergency department or having some type of pharmacy system, that may not be practical for everyone.
Like, we certainly can't do that…the cost. But if you have individuals who work in your department that live in those communities, and they understand which pharmacies stay open late, they're able to engage them on a micro basis and say, "Hey, I write for these medications.” Pharmacies will be a little bit more amenable to that.
And then talking with them, like, "How do I get a community member to get their medications at 9:00 PM? Do you all have a process around that?"
So that's a micro solution that can be then scaled. The blister pack is the solve, right? They leave the ED, they have the medication in hand, you know they can potentially take it.
But that's not practical. So, what are the communities, what do the pharmacies around that community member do? What are the pharmacies around each individual provider doing, and how do you blend those ideas? And so, I always, I just constantly think about leveraging personnel who know the problem and trying to give them upstream channels to, like, report that feedback.
It works in LA pretty well. Okay. But they live in community. So-
Dr. Matthew Strehlow: And these are healthcare workers?
Dr. Italo Brown: There are healthcare workers who will live in a community. And they know all the pharmacies that are in that area that they prescribe to.
So if you are able to have a conversation with the pharmacies, tell them that, "Okay, I prescribe medications. Your hours don't work," it now serves as a different voice telling them that as opposed to the people who are buying the medications. And it gives a different lever, and then you can lean into the institution.
And so, this has worked at community, federally qualified health centers having them have pharmacies stay open longer to solve this problem, and it was brought up because of physicians who were either working in community or working at both sites, like the institution and the federally qualified health center.
All I'm saying is you have to create more than just hearing the community and then taking that information and then deciding from that list what you can act on.
It really requires having other agents along the way, and I usually say that the providers are the best because they bring social capital to every situation.
I walk into a pharmacy and I tell them, "You're not taking my prescription," someone from the back is gonna come out and say, "Let me try to help you." They're gonna bring out the pharmacist or the head's gonna come out and speak to you. Someone's gonna speak to me, and that's not gonna happen for the patient.
Dr. Matthew Strehlow: That's right. Let’s go back to the community advisory panel. Who can sit on it? Who has the time to have an unpaid extra job? And I think we have a lot of burnout in medicine as well, right? It's another job. In emergency medicine. Where people are like, "Oh, another job."
But I do view this a little bit differently. I think that some of what makes us struggle and have so much stress in our role is all of these challenges that aren't getting fixed, these upstream issues, right? And it's not the fact that, that taking care of that patient is challenging.
It's actually the system beating down on you, on the patient, on our mission, our shared mission of taking, of, of providing great care. This is different kind of work. And I don't know if it's the kind of work that actually draws from you or restores you.
I would say this is the kind of work that restores you. And maybe we don't have a system right now that pays for that work, but maybe it's the thing that actually helps you appreciate your work and enjoy your work and have passion, and that's time well spent.
Dr. Italo Brown: I agree with that. You, you named a couple of really good points here. The first is, it is another unpaid job. A lot of this is thankless. Sometimes the patients won't thank you. Sometimes the institution won't be aware of the, the hours that are spent, and you can't quantify it, and you definitely can't bill for it. You know?
So that is one thing that I think about. But the other part is realizing that if you're taking the vulnerable populations and realizing that they might be among high utilizers for example, of the emergency department, or any type of institutional-based services, and you are consistently whittling away at that problem, what you add back to the system is magnified.
So now maybe I'm tired, but my colleague's shift is a little better because of the work that I put in outside of the hospital or outside of that system. And that patient, or the third patient who's just like that person because they live in the same community, their pathway is a little bit easier, or they don't have to come back to the hospital as many times.
And so, what we hope is that as more people take on this mantle, you start to have a distributed effect, one that now everybody experiences less burnout, less poor interactions with hospital staff members, less opportunities for us to see a patient fall through the cracks because we're now collectively taking on this problem
Dr. Matthew Strehlow: Yeah, I see that, you know, it can really fall on a few people as well. And I think the idea that you're reaching out bringing others into the fold to work in this space and to help solve those problems are where you get to that many hands make light work approach. And that's really what I think we need so that it doesn't just disproportionately land on a few.
You're right. Let's zoom out again then and talk about partnership. And tell us about how you have learned through the partnerships that you've led and contributed to how to build lasting change instead of something that's more one-off or onceItalo is no longer there, it is no longer there.
Dr. Italo Brown: I like that. I…one of the things that's helped a lot is making sure that you have good clarity around what the partnership entails, like what are the actual asks. I find that if there are no monetary asks, partnerships run very smoothly for some reason. It's like if I don't have to…so if nobody's getting paid everything's fine.
Honestly, it's about presenting mutual value and looking for some sort of return on investment and articulating that very clearly to them. Sometimes it's even optics and scope. Like, how can I make this particular opportunity larger than life and show that because you bought into it, you are forward-thinking, and you're on the cutting edge of this type of particular development.
Sometimes it's showing people like, "Hey, this has such a significant effect and impact, and you could be a part of something incredible.” Outside of that, I find that what makes it sustainable is weaving in or grandfathering in positions. So, who owns this task? Who is a part of the decision-making group, and how can we leverage that?
So, if I'm including, for example, faculty members, it's like, all right, well, what is this role? How can this role help not only advance the aims and the missions of the partnership but help boost the career of the individual in a way that is meaningful? If I'm working with residents or med students, it's all right, so what kinds of downstream products can we get from this at the same time centering that this is a community that's changing simply because you are a part of this project or this particular partnership.
If I'm partnering with an organization or a company, what I'm constantly coming to the table is, “You say that you're about X. This is what your mission statement says, or this is what your company says it stands on. These people use your product. These people are invested in what you do. What are you doing for them? How have they changed because you're in their households or you're in their lives? If you really believe that, stand on business, be a part of this.”
And then I will constantly make sure that, one, you have coverage, that two, you are amplified, and three, that you build a relationship with them that's not just in this generation, but multi-generational.
Those types of pitches are very easy for people to get on board with.
Dr. Matthew Strehlow: You have obviously done a lot of advocacy work. And you can feel the passion, when you speak. Where do you think our specialty really needs to be advocating and focusing right now?
Dr. Italo Brown: Well, I first think we need to acknowledge that, and I'm a little biased here, but emergency physicians are, to me, the perfect advocates.
We argue with consultant- or we debate with consultants… we have very educational conversation around why a patient should be admitted. We have to present data and, and facts to support our points constantly. We have to adapt. We have to adjust for real-time change.
This is literally the whole, in my opinion, the crux of advocacy, being able to tell somebody what a particular body of individuals are experiencing, sharing what policy could potentially help that, evaluating that policy, and then changing it or making it better, refining it. We just are naturally gifted in that ability.
Now, what I hope we are starting to understand is that you can't have great outcomes in healthcare without health policy, without actively addressing the advocacy arm. Patients require so many different things, and it's more than just whether we have vancomycin or whether we have a Belmont or whether or not we have beds.
Sometimes it's multifaceted I have experienced some of the most incredible victories standing alongsideother healthcare providers on things that you would expect to be very basic, like not wanting to be punched in the face. You know? Not wanting your colleague to deal with feelings of depression or be worried about going to work and getting shot by someone who was disgruntled.
These are real healthcare victories, and they're driven by providers. Emergency physicians are uniquely tooled to lead in advocacy, and we just have to continue to stay on top of issues, and those issues that we don't see or we have blind spots on, gotta be sensitive enough to have others kind of pour into us.
Dr. Matthew Strehlow: You talked about violence against healthcare workers. You've talked about boarding crisis. You've also talked about policy and how poor policy or poorly designed policy despite the good intentions behind it, disproportionately impacts those that are most vulnerable.
What's onespecific policy that you'd like to implement or see changed?
Dr. Italo Brown: Right now, I feel that there are two wars that are being fought in terms of the healthcare ecosystem. One is realizing that our sickest patients will end up in hallways, will end up boarding for hours, and they're going to die.
Our most vulnerable patients are gonna be less likely to have access to our EDs, might get sent to another place because of insurance issues. And when I look at how to really address this, a lot of it comes down to whether or not we have policy that's supporting our hospitals to eliminate crowding, eliminate boarding, or to make it as less of a burden as possible.
We are fortunate to work in a place where we have, uh, I would say, a mixture of communities. We get some inner city, we get a little bit of suburban, we get a little bit of rural. Butimagine being that rural hospital where you have no beds and the patients have nowhere else to go except to be transferred out, and that creates more backflow, more red tape issues.
And while those patients are waiting to get this solved, they're just getting worse, declining. And so, I think about how that can be solved through policy. The second fight that I said was around, I don't like to hear our colleagues getting hurt. You know? I don't like hearing stories about, uh, nurses being assaulted verbally and physically.
I hate the idea that a physician can walk into a room and really fear for their lives, not because they are inherently at danger, but because there may be a patient that's not getting addressed in terms of their mental health issues, or there may be frustration built up from even that boarding crisis.
But to not have protection, basic protection as a provider makes you potentially vulnerable, and it could end in a situation where you're not going back home the same way, and you're definitely not coming back to work the same way.
So, I just think about fighting those two things through policy, protecting our workforce, uh, because we value them and we wanna empower them to do the best work possible, so they should feel safe where they're at, because often we're spending more time here than we are with our loved ones.
And then trying to solve systemic issues, making funding available to help the boarding crisis, trying to create restrictions or sanctions on hospitals that don't do this effectively and don't prioritize this. I think that all of these policy elements need to be addressed, and again, emergency physicians are leading from the front
Dr. Matthew Strehlow: Well, I know you were leading from the front. You were recently in DC, I saw in a photo. And tell us a little bit about how your message was received there... whether you think there's a possibility for change.
Dr. Italo Brown: Sure. I think the cool thing is, here in California, it doesn't take a whole lot for our legislators to understand the points that we're making.
Because on one end, I just think that they are actively experiencing the same thing. Like, they have family members who have to go to the hospital, and they see that there's a six-hour wait, and they're like, "This is ridiculous." Mm-hmm. I'm like, "You're right. It is, and there's a way that we can work around that."
But then there are other states that aren't experiencing things the same way. And so, what I noticed and what I witnessed was, I went through all of my meetings with a smile on my face. I came out with a smile on my face. But then I talked to colleagues who were in Mississippi, who were in Tennessee, who were in Arkansas, who might be in, in Ohio, that were having their meetings, and they were like, "Ah, that was a little rough."
And, and the question to me was, why was it so rough? You know, everybody is gonna be sick at some point. Everyone's gonna need a hospital at some point. Everybody ends up in the ED eventually, is the way I look at it. I was like, why was it so rough? I understand that we wanna improve wait times, we wanna make patients safe, we think that some styles of hospitals are more dangerous than others, and that we want to come home after a shift and not have bruises on our bodies.
This to me is not complicated. It did seem like it was simple math to me. But the experience was one that I recommend every physician go through, to sit in a room and pare your message down to 30 seconds, to get asked real critical questions, because staffers and legislators are really keen people. You know, their time is very valuable, and they know a little bit about almost every topic under the sun. And so, you have to be sharp with how you come across, and you have to actually know something about the person to get through and for it to resonate.
Dr. Matthew Strehlow: Well, you know, you brought up this idea that we are all experts in advocating. And I think that's right, and we don't often take that skill set then and say, "Hey, you know who can break something down to 30 seconds and understand that's what I'm saying ... a complicated message. That would be me on the phone. It would be you every five minutes while working. It would be you when they said, "Tell me about this patient."
So that's a good point, and it hopefully encourages us to get out there and do that. One of the other big things that is coming down, hopefully not upon us, but that is changing healthcare, is AI and data science.
And I think that we're at the center of that here. You've been a real person engaging on this thought process of how is this gonna impact healthcare workers? How is this gonna impact our communities? How is this gonna impact our marginalized? So, talk to us a little bit about that.What are your biggest worries as AI integrates into healthcare, and where are the biggest opportunities?
Dr. Italo Brown: I really love the fact that I get to go to work every day with people who are actively working on this. It makes me feel like I'm on the cutting edge. And it also makes me feel like there's so much runway to ask these types of questions and to actually tinker at things to get real-time feedback.
So, the biggest concern for me has always been the communities that get forgotten, the communities that fall through the cracks. How do we use AI to not only identify those cracks in those areas that are less likely to be explored, and then elevate it, and then try to solve it at a faster rate than what we were doing previously?
The problem here is that a lot of the data that we get, the models that are using the data, these sets have inherent bias, right? There's bias woven into it, and it's not just algorithmic bias. There's, like, eight or nine different types of bias that are present within data sets, and it can lead to things like missing a person who should be flagged for sepsis simply because it's going off of poor data.
And so, what is the process of, looking at that data quality and how does it effectively happen on a longitudinal ongoing basis so that those populations don't get left out? The other thing is realizing that, all right, we have a wealth of solutions. Do they penetrate to the most vulnerable populations?
I can build an app 1,000 times. It doesn't matter if the people who need to use it aren't using it. I can tell that this one algorithm will hyper-identify this patient, but if they're not coming in the first place or they're sicker before they get here, that's problematic. And so I just really think that that's some opportunities in the social EM and the health equity AI space for us to kind of tackle.
Dr. Matthew Strehlow: Well, it's exciting to see that All of Us initiative has really continued. You know, I think I had a lot of fears that that very important initiative to try to create a data set that's more representative but still has richness…that larger initiative. But it's one initiative. And it really needs to be put on steroids and built exponentially from where it's at. And I hope that those conversations will continue as we go forward. But it is a risk that if we farm out more and more of this AI and health to for-profit companies, the focus is going to be on where the profit comes from.
Dr. Italo Brown: For sure. For sure. I think we have some solves that are, that are easily deployable. Governance. Like, why is there not a person who is health equity trained or who has a social EM or social medicine background involved in every governance committee?
That should be a standing thing because they're going to flag when that data is not representative or when that model is not performing well. And they can help develop these types of systems that early detection of this and can start to incorporate it into the next model so that you start to get more adaptive behavior.
But again, this is stuff that's usually unfunded, it's not sexy or cool. And it really requires dedication to it. But my point is, it's at the ground level. Like, this stuff is so new, and it's developing in real time. It gives us an opportunity to have such a lasting effect
Dr. Matthew Strehlow: Well, if I could make you the second trillionaire in the world what would you do with these unlimited resources? What one thing would you absolutely put those resources to, to change?
Dr. Italo Brown: Round Table Pizza for everybody. Round Table Pizza. I mean, it's one of my favorite types of pizza, and you say trillionaire…I was like, "Everyone should taste this." You got it.
But, no, if I had that type of money or those resources, I think the first thing that I would do is create incubators for companies the same way that you do with these Y Combinators. Create that specifically for health equityand AI problems.
And the reason is because the constant question is like, "Is this stuff valuable, and where's the money coming from?" A lot of people just need to be empowered to do stuff that they care about. And so, I would start to create re- reservoirs of money to fund these types of ideas.
And the cool part is you'll never run out of populations, right? There's so many different subgroups that are, are fighting to be like, "Hey, we're sick. We need resources," or, "We noticed this trend. We don't know what to do about it." Well, AI is so expansive that it actually can factor in all of these. And if you train models specifically for them, you now have data that's useful.
And so I think I would just deploy these micro grants in very large sums, and then build governance boards within hospital systems, and then make these small groups that are being successful directly integrate with them so that you now start to have, you, you now have, like, this network of people who are problem-solving [and giving you real-time feedback, and then you can directly employ it and constantly check to see how valuable it is or where the safety issues are.
Dr. Matthew Strehlow: Well, I know why you work in the community so much. Because your answer's right back there into the community. You're circling right back to how do you integrate.
Dr. Italo Brown: I am, for lack of a better word, I am the Robin Hood of this. I believe that the goal is to always take resources, magnify them, and then disseminate them as best as possible to people who don't have the same access.
Dr. Matthew Strehlow: Yeah. Well, I love being part of emergency medicine because of our commitment to access, and I appreciate all the work you do. Absolutely. Before we close, what's one thing you're really looking forward to that's going on right now? What are you thinking about?
Dr. Italo Brown: Oh, that's a great question. I mean…I'm always looking forward to the oncoming seasons, NFL, NBA. It's LeBron's possible last year, and I've appreciated him more because as a 41-year-old man to still dominate, to have built his body in a certain way, and to start to now be developing other abilities, and likes, and passions, and interests is just very inspiring to me, or inspirational. And so that's one thing I'm looking forward to is his final year of basketball.
Dr. Matthew Strehlow: Yeah, that's a great answer. I appreciate someone who's really thoughtful about the pivot, and I feel like he really is.
Dr. Italo Brown: He is doing this in a way that... I mean, he's already been a leader in so many different ways, but just watching him take this back nine, and then start to find new things, and still look amazing, and still dominate on the court is just, it's really impressive.
Dr. Matthew Strehlow: Well, that's a wrap for today's episode. Huge thanks to Dr. Brown for sharing his insight and experience. Check the show notes for links to his latest work, including Know Your Numbers. If you liked today's episode, don't forget to subscribe, leave a review, and share it with a colleague.
And as always, we want to hear from you. Send us your questions, ideas, or feedback at the link in the description. Thanks for tuning in. We'll see you next time.
Until then, keep taking care of anyone, anything at any time.