#441: Why Are So Many NHS Doctors Leaving for Healthtech?

0:02When I was 15, you'd have career talks at school where they would compare different careers and medicine would always be the best career if you wanted job stability. I don't think that's true anymore. Previously, if I would speak to my colleagues about what technology they're seeing or being deployed, they wouldn't be able to name so many. But now everyone is talking about this is what technology can do for you. This is how exciting this space is. And why don't you come and work in this space?

0:32hey everybody uh i've got yath with me today um works at flow does a load of content uh talks a lot about helping clinicians into health tech um loads of stuff for us to talk about man but um yeah i realized we never really sat down and had a long conversation before so this can be fun um how you doing yeah not too bad yeah thank you for having me and yeah i realized that we we haven't had this conversation and i've been a long-time listener of this podcast so it's really great to finally be on. Oh I appreciate you man. Well I guess let's just start with with your journey. I'm noticing on I was gonna say LinkedIn I mean yes LinkedIn but also Instagram, TikTok like all the channels like you're creating a lot of content on your journey helping other people with their journey talking about the moves into health tech and I know that I've done you know Keith's done a series on here about how to get into health tech and interview a load of people so it's such a hot topic and you're working in clinical product at flow the women's health company and and you know very uh qualified to explain how to how to get in into a sort of a dream role i guess but talk us through it man like yeah where does it all start for you and uh yeah how did you get here yeah sure um i think it all starts from really my personal journey and how how i had to navigate my own uh path into health tech so if i can give just give a very brief background obviously i'm an nhs doctor by background, or maybe I should say ex-NHS now because I don't actually do any clinical shifts at the moment.

2:00So I'm an ex-NHS doctor. And when I first decided that I might want to pivot into health tech, I had to do a lot of this work myself, like reading on what even is health tech. And there's other terms, right? There's med tech, there's digital health. What are the differences? Even to this day, sometimes I don't really know what the difference is between some of them and every time it's used interchangeably. So I was doing a lot of this myself, trying to figure it out, and I found it really difficult. I had a lot of coffee chats, a lot of people that I found on LinkedIn tried to reach out and often met with no response.

2:38And eventually when one or two people did reach out, they were super, super helpful. So it helped me pivot into into this health tech career that I'm pursuing now. I initially started off at Dockler in a operations role, which was very much a generalist role that I would say. And that really helped me to really understand the inner workings of a health tech company and see what I enjoyed, what I didn't enjoy and use that as like a, almost like a training ground to see where I wanted to land eventually within health tech, because it's such a vast term and vast field. You can do so many different things.

3:14And when I eventually got into the clinical product space, which is where I'm now, and we can talk about that as well, I realized that I have something to give back here, a real good opportunity to share my personal journey, how I did it, what I did do that worked really well, what didn't work really well, and give back a piece of my journey to others also trying to jump on this. I wouldn't call it a trend, but like a change in career, which is increasingly becoming very, very popular, especially amongst NHS doctors. So yeah, that's what motivated me to start creating content, which I now do on Instagram mainly, and then cross post to TikTok when I remember to, maybe I need to learn something about how to more efficiently cross post content, and then also LinkedIn, which is a great place really for all things of technology and careers generally.

4:13So yeah, that was my motivation and that's what I'm doing at the moment, trying to help others also achieve some of their goals. Yeah, and I've seen a lot of that content. I get all of that content, quite frankly. I don't know, you're one of the people that every time you post, I see all your posts now. But it's funny because it was actually by seeing your posts and looking at the volume of comments, I mean like serious volume of comments, that it made me stand up and think, whoa, like when I was leaving clinical stuff to explore health tech, it was so the opposite of mainstream. whereas now it's so popular i mean it's hundreds i look at what you're doing i look at what you know the the the peer boys are doing as well with you know they're helping people out into other careers there's medic footprints there's bite labs there's uh you know there's a mere creating health tech content as well there's there's there's all these you know junior doctors or once junior doctors now or resident doctors that are tapping into this really kind of i don't even know how to explain it it's like a movement almost of of so many people having this interest in health tech and i think not necessarily to leave medicine either it's just a genuine fascination or interest or desire to see health tech become more prevalent in health care which i obviously a long-standing mission of mine it's funny because i mean how do you how do you see it in terms of what what's what's driving this is it is it like a frustration of the current generation coming throughout medical school that are just thinking why on earth is it like this is it something else is it people being forced out and looking for just something else to do because what i what i can't i guess join the dots on i think it'd be interesting to get your opinion on is is is just that volume of comments that i'm seeing like it's so many people um and yeah i'm interested in your take on that yeah i think it's a ever ever growing space of interest um and i think it's multifactorial really um you're right i think there is this increasing uh sort of uh need almost to to look elsewhere outside of nhs training um and that's for many reasons you know training posts haven't really gone up in years, competition has skyrocketed.

6:45So there are so many resident doctors now not able to get into a training post. And when in the past you couldn't get a training post, you would go into a fellow post or you do some additional years of research or do something a little bit to further your career whilst reapplying for training jobs. But it's getting to a point where, you know, a lot of doctors, they apply once, they apply twice, they applied three times. And then after that, they're thinking, how much longer can I keep going on this path to find a training post? So they start looking elsewhere. Now, health tech is just one of those places where they look and there's other places, right?

7:20There's a farmer, there's trying to move abroad to Australia, New Zealand, America. But I think it's one of those things is definitely a push factor outside of clinical practice in the UK. There just isn't enough opportunity for all the doctors that are being trained up and also the international medical graduates that are joining the workforce to to progress within clinical medicine so they're kind of forced to look elsewhere which by the way is crazy and and it sucks because i can remember that when i was training it was you know a bit of an annoyance that you had to do your exams at the same time as as training and a bit of an annoyance that you had to do the odd audit and projects and you know some people are going to a phd because that's going to be useful for consultancy people now have got exactly those things to do but as you say without even the feeling of security that they even have a job and yeah and it's interesting what you said that there's a need to look outside of training a need that's a that's an outrageous word in my opinion for a career that should at the very least give you job security because you know the pay is questionable the hours are questionable the stress the emotional turmoil the the all the competition as well all of that sort of stuff you know that all taken for granted at least it was a secure job it's not even that anymore that's correct that's crazy i think i think it's really really frustrating uh for a lot of doctors um and it's it's it's very it's all happened very quickly i I would say, you know, when I was 15, which is now about 13 years ago, I was told medicine is a very secure career with lots of jobs, job stability.

9:13You know, you'd have career talks at school where they would compare different careers and medicine would always be the best career if you wanted job stability and a secure path in the future. And I don't think that's true anymore. I think it's one of the least secure jobs, in my opinion, especially if you can't secure a training post. And even when you become a consultant, from what I hear from my colleagues, it's harder and harder to find substantive consultant posts or salary GP posts. So, you know, the opportunity is... This is where my friends are, yeah. This is where my cohort is, yeah. And I think that's frustrating.

9:52It's the wrongdoing of the system. But, you know, there are several other reasons. as well. I've described a push factor, but we should also look from the pull factor sides. I think health tech is becoming increasingly known or prevalent within the NHS. You know, previously, if I would speak to my colleagues about what technology they're seeing or being deployed in the NHS, they wouldn't be able to name so many. But now, you know, everyone is talking about Heidi or everyone is talking about another ambient voice technology. They're talking about having used or heard of Acurex. They're talking about patchwork for rotor management.

10:32So I think like the technology companies that have really innovated and planted themselves in the NHS have really increased the almost the branding for health tech as like, you know, this is what technology can do for you. This is how exciting this space is. And why don't you come and work in the space. So I think there is this increased excitement about health tech, which I'm really, really happy about. And I think there is so much we can achieve in healthcare with technology. So that's a pull factor almost, encouraging more clinicians to think outside of the career that they've been taught. And in medical school, they've been said, you need to go through training, you need to become a consultant.

11:11Maybe then you become a professor or you keep progressing in your clinical career, but you're never really told to think outside. You're never told to think about what are the possibilities of consulting or what happens if you go work for Big Pharma. So I think health tech companies have done a really good job. Some of the great ones have really grown within the NHS to increase the publicity almost for health tech. That's one core factor. The other thing I would say is social media. Social media is good when it's good, bad when it's bad. We won't go into the details of that. But I think in this case, it's been really good to spread the word, really.

11:51Like you said, there are so many people creating content and everyone's perspective and everyone's journey is so different. So I think it's really important that there's even more voices to share everyone's individual differences and how they got to where they got to and what helped, what didn't help. And social media plays a big role in increasing this demand really for health tech and more people wanting to move it. So just from my experience, if I can describe, like you said, I think some of my posts got crazy amount of comments that even for me was shocking to see. There was one post with over a thousand comments of clinicians wanting to make that move.

12:30And that really just highlights to me that a lot of these clinicians that are looking to move are out there and there's loads of them, but they don't get the content surface to them in the places that they exist. For example, if I can explain that, you know, previously I would post a lot on LinkedIn, but if you consider LinkedIn, it's a place where people who are interested and already actively making a decision to move into that space exist, right? So someone who's got a LinkedIn profile or someone who's trying to connect with other people, they're really interested in making this move or they've done some groundwork to get started at least.

13:05But there's so many more people that haven't even made that first jump onto the LinkedIn platform. And these people exist on TikTok and Instagram. These are junior doctors, resident doctors now, several, several thousands of them struggling for training posts and have several pull factors into healthcare technology. But they didn't until quite recently have access to content, which was supporting them, giving them more confidence to explore this space, right? I think it's a little bit like when you're trying to market a product, but you're in the wrong place, marketing it to the wrong audience, you're not going to capture that interest.

13:45So for me, it was just thinking, okay, where are these people that I could help? And I quickly realized actually it's on Instagram and TikTok. That's where the people that haven't even made that first move are watching content, getting insights. And what I realized is there's a, There's a lot of clinicians that have made the move abroad to New Zealand, Australia, America, making so much content about how other clinicians might want to consider that or think about that. And I thought, OK, let me give these people that are looking at this content a bit more of a balanced view. Let me start talking about health tech and get that health tech voice out there so that clinicians exploring other possibilities can look at a wide number of things, not just moving abroad.

14:31and I think we need more creators really to share this especially I don't see many creators in the sort of big pharma consulting space ex-clinicians that have moved into those spaces so it'd be really nice to to get more more people sharing more content. Definitely I think you've done a fantastic job man and I think there's a couple of things for me I mean the first one is a criticism that's been thrown at me on more than one occasion is that I'm encouraging too many people to leave and it's it's a it's a fair criticism that I've got to you know look at and take on board and and think about um and I'm wondering that you probably have had the same criticism thrown at you but based on what you've said before there's a there's a there's a need to help those that have a lack of job security figure out what their options are and that's quite interesting because I've never I've never thought of it that way and I can't claim to have done anything that I'm doing or delivered talks with that in mind but it doesn't stop it being any less true i'm wondering if that's how you do frame that in your mind and i'm wondering what your vision is here because you you know you're saying that you know it'd be great if people from consulting or pharma or these people that have moved share their journey i guess the question there is like to what end is the vision here for like everyone finds their place the right people go to the right places the right people stay in medicine the right people stay out like is that is that broadly what your what your mission is here because yeah but the reason that's by the way man is that it doesn't it's not it's not an easy job creating that volume of content like i saw your post the other day that just said you know just finishing up doing the week's content and it was like sunday or something or late on friday i can't remember when it was but like because i was doing the same thing as well by the way i was like editing health tech pigeon and i'm like yeah a bit of solidarity here this guy's doing the content thing too and people could asked me the same question what's the goal of health tech pigeon i'm actually like i don't know i just know that it solves a massive problem because health tech news is all over the place and no one has a clue where to get it or what's relevant and i i don't actually know i can't really point my finger at what my goal is here with health tech pigeon which i get asked all the time so i'm gonna land the same irritating question at you what's your goal with your content what's the vision that you have for the world here that you're trying to imagine yeah that's a really good question and um i just want to track back to an earlier point you said about you not knowing what your vision was with Health Tech Pigeon and the Health Tech Podcast.

17:16And this podcast has been one of the very important reasons or one of the very important resources that helped me move into health tech early on. So, you know, I was listening to your episodes early on with Babylon, with Flow, with lots of different industry leaders. And that helped me to get an appreciation of what health tech is, how products are made, how really good products are made, and how these leaders think about different hiring processes or just generally as well. So, you know, credit to you there. So that's, I just wanted to. Thanks. Thank you for saying that, man. Like it really, honestly, it's nourishing hearing stuff like that because as you might know, one of the problems with content creation is that apart from the comment sections, which can be all over the place, like it's very difficult to know what sort of impact you're having.

18:09So it's nice. It's nice when you say stuff like that. so I appreciate you. Thank you. Yeah, no, absolutely. And then to answer your question, what is my goal? What is my vision here? I would say I try to be balanced in my content creation. And I think that's really important. I say like my motto, or if you read many of my captions, it's to help others explore health tech with confidence. And that's really what it is to explore health tech. In my content, I try to break up, you know, things that will help someone get into health tech if they wanted to. But at the same time, I also say, you know, three reasons why you shouldn't go into health tech or, you know, these are top reasons why clinicians that move into health tech don't thrive or eventually fail and go back to clinical training.

18:54So I try to keep a balanced approach to let people know, hey, there is this thing called health tech. This is what it's all about, but also bear these other things in mind. And for some people, or actually for a lot of people, it's most likely not the right thing, but there is this small subset of people where they would really thrive if they had the confidence to make that pivot. And, you know, it's at the end, the very end of the day, like you said, it's getting the right people into the right places. And that's why I think, again, like we need more creators from other spaces creating content, because I do believe, you know, even though I've built this following around 25 ,000 people on social media, I think, you know, quite a lot of them are not fit for health tech, but might be better fit for pharma or even staying within clinical medicine.

19:40So it's for me, it's not to get people into health tech. And now that's that in itself is a tricky thing, because if you look at what works in terms of content creation, it's these powerful, bold hooks. It's this, you know, retention methods that would be like, you know, this is how much better my life is since moving into health tech. Do these three things and get a 100k health tech job. Yeah, exactly. Exactly. You know, so it's a, I think it's a challenge to create content that's balanced yet good enough that it will hit the algorithms as I want it to, because I do want to spread the word. So yeah, no, to answer your question, my goal is to help people explore health tech with confidence.

20:25It's not to break into or secure a health tech job. That's not the primary goal. That's the goal. If that's the right person and that's what they're interested in, that's what would fit them in terms of their skill set, their interests, what energizes them. Then sure, then my content might help them with that. But for many people, it's also to let them know that, you know, this is the reality of working in health tech. And if you understand that, you can make a confident decision that it's not for you. So it's both ways for me. and why I do all of this in the first place. Like, what do I get out of it?

21:01For me, I've always had this like motto mentality that along my journey, many people have helped me along the way. You're one of them. I've had many mentors. And my ethos, my way of working is always just to give back and help someone else do the same thing or something different. And I had this great opportunity to help. I have all this knowledge about how to secure a health care job what the industry is all about what clinical product is what clinical safety looks like what ai and healthcare looks like um i've learned all of this and so it only feels right to share that knowledge and if it helps even just one person that's that's enough for me i love that man and i actually think you know people can say that quite a lot and and it becomes a bit of a soundbite like oh if it just helps one person then it's worth it it's funny because i did um i had some uh career coaching back when it's probably 10 15 years ago i had some careers coaching when i had the director job at the digital.london accelerator and i did this like really in-depth myers-briggs test i don't know about the myers-briggs test personality test like yeah istj i came out as i think yeah istj um which basically i'm very very very introverted but i was what was described as out of preference so there's like eight things that make up introversion and i had seven of them like whopping great introversion but i was out of preference for expression so i was extroverted when it comes to expression but introverted in everything else that makes up introversion and i think that's you know knowing oneself myself just the fact that i can express myself in health tech pigeon and on this podcast is incredibly satisfying to me so add then the fact that it can help people as well and i you know grateful to receive stories like you just told about how it's helped you there's like a personal gratification to that that doesn't necessarily need any uh financial metrics or this metric or that metric or you know having to justify it for any reason beyond the fact actually i really enjoy expressing myself i really take great pleasure in hearing stories of how that's helped people and that can be enough and that's great you know you don't ask an artist why are they painting it's because they like painting and i think that's just it's a version of artistic expression i think in the modern world is you know digital content creation and i think it can just be that it can just be that to five people and five followers it can just be that to 25 it can be that to two and a half million but actually if you just enjoy the thing like that is enough and it's noble and it's great to be doing in an area that helps so much um of course but i also really respect the fact dude that what you said around you know the the lack of bold hooks as you would call it the rage bait or the the pithy lack of substance promises and all of that sorts of stuff i've actually found it relatively i was gonna say difficult i guess i haven't found it difficult and that's the funny thing but i can see why some people do find it quite difficult to not lean into that particularly when they want to grow really quickly i actually the the bit that takes me longest of how to write to post is like not falling into that trap or or you know rewriting and rewriting the first line of linkedin posts and the rest of it so that i don't sound like i'm bragging so i don't sound like i'm humble bragging and i actually work really hard to be like what's actually the point of this that i'm trying to deliver like what's actually the value i'm trying to deliver here and let's not try let's actively not try and fall into the traps that you know the listicles of the light like all that stuff if it's not if the value is not baked into there if it's not 10 things that will actually change your life like what is it 10 things that it will do it'll tell it'll be 10 things that make you think about how to do that would be 10 things that set you on the path to finding out the one thing that works for you and that's far more difficult to say it's far more clumsy to say but to find a way to do that i actually think what it is is that you end up with the people following you that respect you and that matter and i noticed this on linkedin in our world of health tech and you'll probably notice this too with the the accounts that do that will be doing it with i imagine the purest of intentions because who is in health tech that doesn't want to help people but i think what ends up happening is that and i see this what ends up happening is the growth that they get is not amongst the people that respect that type of thing and actually the harder job is to build slower of the people that will respect your long form that doesn't have that or your you know and even just just the way that you create content i think is interesting with you know stock i say stock footage or b-roll but like b-roll that you've created of yourself doing a thing and then actually you're comfortable writing but you found a way to post reels because you put all that in the caption you put it in the in the the header you put it in the comment like and you find a way to do writing which you're more comfortable on clearly than you know voice or face the camera and you know and again that is just a respect for yourself of like well this is where i'm comfortable i'm happy building an audience who responds to this and that'll take as long as it takes i'll make the impact that i'll that i'll make and i think that's a really nice way of doing it i actually think gone are the days man of like expecting to start accounts now that just go to 50 million people and you know you're going to do cpm metrics on ads and you're going to make a fortune and like all that sort of stuff people ask me about this on the podcast why don't you get sponsors to do ads and all this it's because i because i would make 12p because actually like okay we're niched and maybe it wouldn't be 12p but like you know on 10 000 12 000 downloads a month like you're not going to do cpm metrics on that and yes we could get big sponsors but then people are going to switch off because they've got to listen to it and do i need that will not necessarily if if I'm just happy expressing myself so anyway that's a long-winded monologue of saying I really respect the way that you've developed your content and I actually wonder if people can learn from you on that so what was your process to figuring out okay I am who I am I like what I like I'll be who I want to be but how did you go through the process of taking that and then going well this is the style that I'm gonna do and I think anyone that's expressive that wants a voice can probably learn from this yeah yeah good good question and i completely agree with everything you said there as well i think um being authentic is so so important to the longevity of your content creation career um i think you can do a lot of like hype stuff trend stuff and grow quickly um but then like you said the quality of those followers is generally quite weak uh the unfollow rate or like if you're in business terms like the churn churn of those followers is quite high.

27:59And, you know, you just keep attracting low quality followers. But what I found by trying to be as authentic to myself as possible, like you said, I do write better than I speak. So I leaned into that a little bit. I like being creative with videography and sort of lighting and all that kind of stuff. So I just tried to get really clean b-roll footage and then use that to my advantage um so i just leaned into everything that i was found enjoyable for myself for example if i start creating talking head videos uh i would probably not last more than two weeks of daily posting because that would be quite a a chore for me it's the cognitive load yeah 100 it's exactly exactly so i found this like system that really really works for me and that came through trial and error so I did do those talking heads I did do some like day in the lifetime videos um all the different trends I tried them one by one see what stuck with me um but also the audience as well because I think to some extent that's a little bit important because sure you can create something that's really really enjoyable for yourself but then if it's not uh you know landing with the right audience or helping or you know adding value then you might still eventually find yourself stopping that yeah 100 yeah yeah so it's good to get that balance and yeah to answer your question it came through experimenting i for some of the people that i listened to this will know very early on i started on youtube i had a youtube channel um i went down the whole sort of like ali abdall route worked with ali abdall for a while as well um did some videos with like on productivity and day in the life of medical students, study tips, all those kind of things.

29:49But that was quite intensive in terms of, you know, scripting, filming, editing, and it just wasn't sustainable. So although I saw really good growth when I was in medical school, as soon as I started working in the NHS and the rotors were really hectic and life was just really busy and I was just trying to spend every bit of free time I had to either sleep, rest or recuperate some sort of energy so I can go back to work. I found that, you know, that just wasn't sustainable and I stopped that YouTube side of things. And then I got onto Substack because I realized I do enjoy writing. And I started a newsletter.

30:26But even then, because I held myself up to a very high standard, like you said earlier, I didn't want to just rage bait or I just didn't want to write content that was, you know, mainly from ChatGPT. I wanted to make really authentic content. I found that my standard for approving my own content was very, very high. And eventually meant that I didn't keep up my weekly consistency. I'm trying to get back into it now. I'm writing like twice a month just on my own schedule because I found twice a month is manageable for me. Once a week was not. So again, it's like finding this balance that works for you and that will be sustainable for you long term.

31:04But the important message in all of this is you don't have to do anything. Like, you know, if content isn't your way of expressing and maybe talking to real people in real life is your way of expressing, then you might choose to go to more networking events, more meetups, more in-person things and express yourself there. You know, tell other people about health tech in these places, have one-to-one conversations. Sure, your reach will be much more limited, but your impact might be just the same. your personal satisfaction might be just the same so i think it's about first figuring out what you want to do and why you want to do it secondly experimenting to figure out what's sustainable for you and uh what uh is um giving you the right level of satisfaction and then continuing it if you want to that's really important no one no one should just do something because um you know because my account is growing i shouldn't keep going uh thinking if i stop it's going to stop growing i keep going because i i enjoyed this and i i like helping other people and it's it's bringing me a level of satisfaction uh that i would give up you know my sunday afternoon to do this uh rather than just sit in front of the tv watching netflix and you know it's it's a personal decision uh as to why you want to do these things and no one should just do something because because of some yeah reward uh at the end of it it should be all personally driven yeah completely agree um because there are enough pressures frankly there's we you know we actually talked about this on the team call this morning right it was so funny that um jess was talking about uh she took the team call on a walk this morning because she started wearing an ultra human ring that has a vitamin d plug-in that will tell you if you're getting enough vitamin d and it told her she was getting like less than one percent of the vitamin d that she should be getting so now she's out for a walk and it was funny because then we started all talking about the pressure that we all face to get enough vitamin d and then it's like it's not any vitamin d though is it it's like you've got to you've got to drink eight glasses of water a day you've got to floss your teeth twice a day you've got to eat this amount of fiber you've got to eat these vegetables you've got to make sure you've got enough protein and grams per whatever the you've got to do this you've got like adulthood just in general is just full of all of these pressures and then you add the professional stuff in if you're a medic of going i've got to do the job i've got to revise for the exam like we talked about earlier i've got to do so i've got to revise the exams i've got to do my audit i've got to do this i've got to do that i can do the other but i make sure i'm doing this make sure i'm doing that i know that you're a new dad as well i've got that going on as i've got to do all that i've got to be present with the kid but i've got to make enough money that to give the to give the kid a good life so i've got to balance all of that i've got to do this i've got there is enough pressure going on without throwing content creation at relentless consistency into the mix because at the end of the day i'm fortunate that i've grown some extra point where i have a team of people that can do the odd thing on pigeon and the podcast and the rest of it which helps the consistency here um it's not always been like that but you know i'm in a position now where it is um but this sets a really unattainable standard i think for people starting out and you don't know what other people's lives are looking like and you're absolutely right that you finding what's good for you is the answer finding out the level of consistency that you can have is the answer because i can guarantee if you can't find more consistency in that it's because you're finding it in other areas and you've probably got some balance in your life which is not a bad thing so if you've got friendships that you maintain if you've got a relationship that you maintain if you've got a family and kids that you maintain if you've got hobbies if you've got sports if you've got exercise then where does content fit into that world well probably not anywhere easily so actually like take the pressure off yourself like you're doing okay because people that have got that level of content creation probably don't have some of the other stuff i don't know 100 i think one of the other examples of this is the apple health fitness rings right people people close fitness rings because they need to or you know they somehow feel this pressure that they need to close their rings.

35:18So it might be like 10pm and they haven't had enough exercise or stand up time. Suddenly they start walking outside for like 20 minutes around the block just so they can close their ring and they get back and go back to bed. And I think this kind of like pressure for no reason is really actually can be quite damaging to you personally in the sense that, you know, you give yourself additional stress that there was no reason to put yourself in and you know just because you missed out on your health fitness rings one day out of your entire life or like week or let's say it's not going to make a huge difference um i think in terms of your overall health if you're mostly consistent um i like to follow this rule two-day rule um and i think it's a very famous rule.

36:10It's essentially that if you have a habit and it's doing good things for you, then sure, you want to keep that habit and you want to make sure it's sustainable. But you're allowed to miss a day. There's no harm in missing a day. You're not going to suddenly become really incompetent at running if you run all the time and then you didn't run for one day. You'll just pick it up the second day you start again. So this rule is just that you can miss something once or Like if you have a schedule, you can miss it once in that schedule, but you just got to keep going the second time and pick it up. So I always try to follow the two day rule, but it's a it's a it's a two streak rule for me.

36:48So if I'm doing something once a week, I'm allowed to miss one week as long as the next week I get back onto it. And that's the kind of flexibility I give myself because life just happens. As you described earlier, you know, socials, especially when it gets to like summertime, there's just more going on with friends and family, especially on the weekends. and you want to be there, you want to soak up in all those memories. And those are really actually, you know, at the very end of the day, those are the things that actually matter. The time you spend with people, the memories you build and all those kind of things, that's what really matters.

37:20So having this flexibility to still allow for all of that and then keep on top of what really makes you happy is, yeah, it's so important. And I think we all need to, yeah, not be so regimental in everything we do. it's funny because one of the things that you talked about there was wearables influencing behavior and we talk about this a lot actually on the health tech pigeon podcast side because it's always in the news um the recent news cycles have been talking about how all the wearable companies are about to and google and fitbit being i think the first one ultra human have come out with it in the last couple of days but they're sticking the ai layer in between the device and you to start contextualizing the ridiculous amount of data into actually actionable personalized contextual information as you'd want it now i haven't trialed it i've got an ultra human ring it's funny i've actually taken the thing off because i felt like i got what i needed to it It was very repetitive.

38:30And when the information I was, I lead a very similar routine based life. So actually the information that I got from it was like, you could do more cardio. I'm like, cool. I've known that for many years and being told it has, being told I need to do more cardio has quite literally never increased my amount of cardio. So this isn't going to start doing that. However, it was another interesting data point that did make me go boxing twice. in a three month period. But I now need to know, well, I now know that there's a very different thing that I need to do to actually increase the amount of cardio.

39:08And it's certainly not being told to by an app. However, it is interesting to me that this is now starting to come through. And I think it's better than us just having a huge swell of data. Because on UltraHuman, for example and by the way i've got the ultra i've actually got the ceo of ultra human coming on here um in a few weeks which would be like super interesting um i don't maybe won't say exactly as i've just said it to you i might modulate but i'd be quite interested in their new ultra human pro ring so i'll try and be nice to get that um but i think it's interesting i think i think the ai layer is interesting because actually if something was a bit more contextualized and personalized to me would it affect my behavior change because ultimately these sort of trying to do right well i go to and fro with all this stuff because i'm like oh but i'm not i'm not the highest leverage demographic that can be affected by prevention and actually that's we need to be getting these rings to people that can't currently afford them like that's where i feel most drawn to in terms of my passion is that the right way like i i don't know i feel more fired up thinking about how do we make that happen than yeah how do we get a load of middle class people with small businesses to do a session of cardio a week extra than they're doing currently you know but i don't know man like what's your view on like the the wearables world and all that stuff you're talking about before about you know are we are we just peddling more anxiety in the middle class are we really solving a problem like how do you think about all that stuff i i think you're um spot on in terms of the wearables currently mainly targeting the wrong audience um well it's not necessarily the wrong audience but is the people that don't really need these insights anyway because the type of person who would go out and buy a whoop is perhaps already someone who's health conscious is already doing something about that and maybe has a fitness program that they're following or is already looking into their sleep and is making some changes and has good sleep hygiene so a lot of times it's for these people it's more of an affirmation tool to say hey you're doing great keep going uh or it's i confess it was fantastic when it did that for me i loved it but genuinely genuinely the positive reinforcement loop of like you've slept amazing today james like and you went for a walk this morning and you're and you've played tennis last night this is amazing like aren't you brilliant and i was like yes i am thank you very much yeah maybe there is an argument that exactly exactly i mean maybe there is an argument that in the long term this sort of positive affirmation will encourage you to keep going and maintain these habits for for the rest of your life maybe there is something to that uh that's true exactly um but i think for me it's it's a case of these wearables have great potential as you say in the people that uh really need it for example i know whoop and both ultra human now have uh blood pressure technology which i've tested i've got the ultra human as well it's it's relatively you know i'm not going to make any claims that i'm not from ultra human i'm not sponsored by them um and i don't know the science behind it i haven't read all the papers but it seems or feels relatively accurate uh in comparison to a blood pressure monitor so in in in my way of thinking about these things i think there's great potential for the NHS really to be working with these wearable companies and providing mass markets, sort of remote patient monitoring systems.

42:49And now this ties in a little bit to my previous role at Dockler where we were doing remote patient monitoring. So I feel like maybe a little bit biased in saying this, but I think there is a lot of opportunity to do sort of health prevention programs, so diagnosing blood pressure early on and supporting with lifestyle measures because like you say these devices do tell you that you know you've not slept enough or you've you haven't done it for steps today you can try a bit more on that um and these are the people that stand to benefit from it so the people that are like already in the high risk categories um and it will it will you know see really good outcomes and improvements off the back of it.

43:31But having said all of this as well, it's how you, you know, having a wearable, I don't think actually makes a difference in the health decisions that you make. It's more that you are probably already going to make that change anyway, or you had started to make that change and the device is helping you continue that. If I can give you an example, you know, I might buy an Apple Watch because I started or I wanted to start running and I could track my runs and I could see my progress and so I keep my Apple Watch for a bit and I get you know that positive affirmation I keep going and then eventually I build a habit once I've built a habit I'm not really looking at my Apple Watch anymore and this is true in my personal experience as well you know I have this habit of doing 10 ,000 steps a day and then when I first bought my Apple Watch I I checked every day to see how I was progressing there.

44:29Eventually, I learned from myself what 10 ,000 roughly looks like because I'd done it so many times using the Apple Watch that soon I stopped caring about the 10 ,000 steps figure specifically because I knew I was roughly doing the amount of going out or walking the dog or doing activities that would equate to 10 ,000 steps. So I stopped carrying on the wearable itself and I continued that habit. So where I think the real potential for wearables is to help build those habits so that people can continue them. And a wearable really helps with this as opposed to not doing it with a wearable. So I think that's one of the areas where it has great potential.

45:09and I want to bring up that point you mentioned earlier about AI. I think this is a really hot topic and obviously one that needs to be discussed with a lot of caution especially when it comes to the regulatory side of it and who bears responsibility for the advice that AI gives based on someone's wearable insights. I think for the right person it's really great and the right person in this context would be someone like you and I, someone who understands healthcare, someone who is a working professional, who can decipher between good advice and bad advice. It's like what you get taught in school about, you know, looking up websites, you learn how to decide what's good information, what's bad information, what's a good source, what's a bad source.

45:58And this is the kind of AI literacy that you need to have in order to get the most out of the AI insights and to use it in a safe way. You know, for example, if I got an AI insight from, let's say, Apple Health, they launched something and I have this AI health assistant, and it tells me that my blood pressure is okay. But actually, I look at the numbers, and it's like 145 over 90 or 150, and it's like tracking upwards. Maybe it's just a small trend. I know for myself, that's not okay. But that's because I have a healthcare background. And it's possible for AI to make these kind of mistakes when it doesn't do as it should.

46:39So for the right person, it's good who can know what's good and bad and make those decisions. But for the lay person, I think it's currently in a stage where it's very risky, I would say, to provide those kind of insights. And it can influence health decisions. I know for example with WHOOP Labs they are trying to essentially get someone to do their blood panels and then off the back of that provide some AI health assistant insights to say you know you should be eating more carbs or you should be eating less carbs because your HbA1c is high or whatever and I think this could be quite risky for the wrong person because you know if someone just starts to follow all of this advice and starts making all these changes and then they have some other underlying health condition or something else that's going on that suddenly gets flared up or something worse happens as a result, then really they should have probably just gone to a healthcare professional in the first place who could have better understood with better context about that person in front of them and told them better advice.

47:47So I think it can be really risky, especially in its current infant stage. From what I see, even Aura came out with a a women's health AI assistant just last week. All of these tools are claiming to provide personalized insights based on the data it has available on you in the app. Now, this is risky because that's not how we do healthcare. That's not how we do medicine. In medicine, we don't just provide insights off the back of a set of bloods. We do it off the back of the patient's context, how old they are, where they're from, what their socioeconomic background's like, like what their ethnic backgrounds like, what their past medical history is, what medications they're currently taking, what recent surgeries or other medical problems they've had.