Enhance Your Practice Podcast
Enhance Your Practice Podcast
S15 E74: AI Technology in Plastic Surgery Practice
Host: Dr. Diana Yoon-Schwartz
Guest: David Staughton
AI is transforming the world of plastic surgery, and our latest episode promises to shed light on this fascinating evolution. Join us in conversation with David Staughton, an industry expert with a vast background in medical and business consulting, as he shares how AI tools like ChatGPT are becoming indispensable in practice management. Discover practical advice for both novices and veterans on seamlessly integrating AI into daily practice, from drafting patient communications to efficiently planning your schedule.
David's Website: https://davidstaughton.com.au/
Specialist Practice Excellence Site: https://specialistpracticeexcellence.com.au/
you're listening to the enhance your practice podcast series brought to you by ASPS University. I'm Diane Schwartz, chair of practice management committee, and I invite you to check out all of our educational offerings, from professional surgical videos, courses on practice management and much more on ASPS EdNet. Welcome to our podcast. I'm excited today to introduce Dave Stoughton, who will be just discussing AI in plastic surgery and plastic surgery practice.
Speaker 1:David has over 30 years hands-on experience in a broad range of industries, including mining, retailing, hospitality, tourism, medical and business consulting. He's been really passionate about small business and starting to work in his family-owned hardware store at age six. He was originally qualified as a scientist and worked for five of Australia's largest mining companies and then left to start his own hospitality business. He grew a multi-million dollar hospitality business and tourism group in Victoria, Australia, and employed over 200 staff and caterers for more than 2,000 weddings so he's our wedding guy. And then, in 2001, successfully sold his businesses and has since that time been helping other businesses get better results. He's shown owners and managers how to energize their team, attract and delight more customers and significantly increase their sales all year round. I have met David in person on multiple opportunities. I find his talks live to be fascinating and I'm really excited to have him here all the way from Australia to discuss AI in our practice of plastic surgery. So good evening, David.
Speaker 2:Hi Diana, it's terrific to be here. Thank you very much for inviting me along.
Speaker 1:Yes, and thank you again always for your time and interest in helping out members of our specialty. So, david, today's topic, as discussed, will be about AI in plastic surgery and for those of us who are on this podcast, I think there's probably various levels of those who don't use it at all, those who are familiar and maybe a little bit sort of wary, who are familiar and maybe a little bit sort of wary, and then those who are already using it and maybe need sort of advanced information on how to best use it and also on how to acquire sort of maybe even some new infrastructure within their own plastic surgery practice to support it. So I mean, generally, those are the topics that I think our audience would be really interested in. As a confession, I will say I used an outline by putting in onto chat GPT interview questions for the use of AI in plastic surgery. So this is a good segue. So I will put the floor to you and say, as a novice user of any form of AI, what kind of advice would you give to them?
Speaker 2:For most people they're not doing much at all. So all the audiences that I've spoke to, perhaps less than 20% of people are even using it at all. And I say to most of the novices just get started. And the easiest one to get started on is ChatGPT, and what you typically do is put it up on your computer and then just start asking it things, which is putting in a prompt, and if you ask it a question, it'll give you an answer. And you'll be shocked at how great the answer is.
Speaker 2:But the better question you ask, the better response you get. You know, if you say to it, you know, build me a house, it sort of will go okay, well, here's one. Or you know, design me a website, here's one. But the more you specifically ask for what you want, the better results you can get. And that's the answer, the difference between this and Google. It's like having a conversation with somebody.
Speaker 2:Every time you open up a conversation, you can ask for more information subsequent to what you've got. You can say I've got a patient who's complaining, please write me an email in response, and it'll give you one. And then you can say, oh, please make it friendlier, and it'll make it more friendly and then you go please delete the paragraph where it says this and it'll delete that and you go. There's the response, and what I find useful is there are some certain things. Now some of the plastic surgeons that I'm dealing with are starting to get into it. They're using it for Medical Scribe, which is listening into the consultation and producing all of the documentation. Some people are saving an hour a day doing that, using some of these specific medical scribes tools, and that's where most people are starting at the moment.
Speaker 2:Either. Start with chat, gpt, get it onto your phone, you can talk to it and you can ask it any of your questions. I'm also finding people are having more comfort in just working on their personal issues, which which is how can I be fitter? How can I? You know I'm planning a trip to Italy with the kids. What should I see? Those sorts of personal problems is where you start and then from there we can move it into solving some of the practice and business problems.
Speaker 1:You said that with chat GPT you'll get better, I guess, quality of answers based on better quality of questions. So even for this one that I had inputted with you know, give me some interview questions for a podcast on AI and plastic surgery. What other additional sort of suggestions would you add to that Like, do you do then a follow-up after it gives you those answers, or is it basically within the question, putting more info and data into that first question, or is it both actually?
Speaker 2:Well, you can do it the one question at a time, model um, or you can give it a bit more of the parameter. So, first of all, I'd say you know, act as the world's greatest podcast interviewer. Uh, so that's telling it who it is, and you're, oh, that's what I'm supposed to be doing. And then you go, um, please prepare some interesting and motivational questions about you know, the topic that we're going to have, um, and this is the topic, um, and this is the outcome that I'd like it to have. I'd like the questions to be short and punchy, I'd like them to be relevant to each other. I'd like them to entertain our audience. The audience is probably going to be, you know, plastic surgeons in america, um, and and there's, there's a few things that you could start with, um oh okay, that was great.
Speaker 1:Actually, that was very helpful because it's not about, like, what the long sentence is. It's about, I guess, training the artificial intelligence to become what you want it to become, and I think that's sort of you know, very useful information, because we're not really thinking that way to you know, kind of create, create, I guess the bot, in the format that you'd you know best like it to answer. So, um, thank you, that was I use the analogy.
Speaker 2:you know, if you ring up somebody, you know, ring up one of the marketing agents and say build me a website, and then just hang up the phone, well, well, you know, um, you're not going to get a very good result. You know well, you'll get, they'll build you one, but then you go well, I didn't like the colors, I didn't like the photos, it's not what I want. So you can do it one question at a time. The more you sort of the better quality question, the better quality. It's called a prompt, the better quality prompt, the better quality response. And this is just using the ChatGPT chat. If chat, if you want to go deeper, you can actually program a whole thing which is a GPT, like a little app where you upload 25 documents about what you're dealing with and then it will. It will use that set of data to give it a reference frame, to give you a much more solid answer.
Speaker 1:And would that be like the like, I guess, pay for version version, or can you comment on whether it's worth it for a basic plastic surgeon to invest in uh more of a subscription model?
Speaker 2:uh, absolutely. Uh, I can't believe that anybody is trying to use the free version. Um, it is, without doubt, even though they've just put the price up. It's now now $25 US on the annual plan per month plus GST. If you're going to use it, just buy one for the practice to use and let the staff use it as well, but it's make the most of it. The paid version is 10 times better than the free version, shall we say.
Speaker 1:And can you qualify in what way?
Speaker 2:You've got it more so you're able to do things like well again. They keep shifting the boundaries, but one of the big ones is in the paid version you get access to all the latest versions of it. So this week they've just brought out and I appreciate this will be old by the time people hear it they've just brought out one called Chatio. That was again a whole other revolution of solving particular problems. We're about to bring out ChatGPT 5, which is a thousand times more powerful than ChatGPT 4. So in the paid version you get access to all these newer versions that are specific to solve particular problems. Io particularly does deep scientific and mathematical problem solving. So that's that bit. The other bit that I absolutely like and I recommend to everybody is when you buy the paid version you get to put in 1500 words of custom instructions of who you are and 1500 words of custom instructions of how you like your output, and it's literally the pre-framing then that it literally says hi, my name's, you know, david, and I'll be a plastic surgeon.
Speaker 2:I'm a plastic surgeon in wherever I happen to be. I specialize in, you know, breast, body and face surgery. I do this. This is the name of my website. This is what I do with my business. These are the types of patients that I'm looking for, and you know, when I do writing and presenting, this is who I'm usually presenting to, and so it gives it a sort of pre-frame as to who you are and it gives you even suggestions as to what to put in there.
Speaker 2:And then for the output, you go. Well, I like my information spelled. You know I'm in australia, so we go, I'd like you to use australian spelling, but you'd go, I'd like you to use american spelling. I like my answers detailed, I like it in markdown format. And then the biggest game changer, a friend of mine told me, was that he said, um, and at the end of every response, please suggest three further prompts and number them sequentially at the end of each individual response. So it gets to the bottom and it gives me a really good answer. And then at the end it says here's three more questions to ask, quick Q1, q2, q3. And I can just type in one of those and it will go deeper and explore the topic in more detail. So it automatically suggests what I should have asked next.
Speaker 1:Okay, and I guess for those of us who are always wary about protecting our personal information and sort of use of that information, I mean, you know, obviously all of this information comes from somewhere. And I guess some of my personal concerns would be, if in you're inputting information about yourself, I mean, can it learn that and potentially use and or expose some of that information? That might be a little wary for people.
Speaker 2:Absolutely. Do you remember in Star Trek they had the Borg B-O-R-G that used to go around and just collect all of the IP from every other race and all the other aliens and things? Well, this is pretty much the same deal. It has what's called tokens allegedly trillions and trillions and trillions of tokens. It's collected up information from everywhere all over the net that it could find, and that's what it's using as its reference base of information.
Speaker 2:So again, the difference between the free version is that when you upload information, that's being added to the collection, whereas if you have the paid version, and allegedly, if you tick the box, it will keep yours in a little separate file, and so it's just for your use. And you can have a Teams version as well, which is just for a number of people in your team that share that information. So a Teams version, this is not Microsoft Teams, this is ChatGPT Teams. For an extra $5 per month per person, you can have it amongst two or three, so you might have your own one and you might have one for all of your staff, for example.
Speaker 1:So so obviously again, you know, not everything is free, correct?
Speaker 2:Well, someone once said that you know if you're not paying for it, then you're actually being sold. Was the deal Correct? You know, and it's the nature of all software there. You know you can. You can be free, but they collect up all of your information and your IP and data and sell it to someone else.
Speaker 1:Yes, I think that would be a huge concern for many of us. So yeah, and you know, I know that you mentioned about scribing techniques in the office. Could you elaborate again as to the exact program, or did you mention an exact program for that?
Speaker 2:Yes, I wrote a blog on it recently because everybody was asking what's happened. In Australia They're're using one called heidi health, um, there's also another one called lyrebird and there's another one called um mai scribe, m m a, I scribe, or my scribe, if you like, and, uh, there's three that I've been getting some rave reviews, but I think I've listed about 50 on my blog, some of them that are specific to the american ones. Um, it depends whether you want something small for your small private practice or whether you're in a bigger group and they're using the sort of corporate you know industrial strength versions, and some of them are being already added into your practice management software or your EMR software that you're using. So that's the hottest thing is to add these AI recording devices in is to add these AI recording devices in the surgeons that I've had that have been using it.
Speaker 2:As I said, they're saving an hour a day. They get permission from the patient, they switch it on, it listens into the conversation and then it completes a templated summary of what the surgeon said for their own notes. Then it also does the patient education notes. It also does references and referrals to other medical providers, and some of them even suggest things as well, so you can create any templates you want and you can have it. And the big advantage is you're listening into the patient and you're putting all of your eye contact with the patient. You're not necessarily typing it all into your screen or writing notes.
Speaker 1:So I guess if it's listening into the conversation of, let's say, the patient consultation, I mean, does it also, or can you train it to say, you know the patient acknowledges XYZ because it's listening in now, and then that potentially can sort of you know, really help you in any kind of potential litigation matters, or is that sort of dangerous?
Speaker 2:No, no, it's fine, you exactly do that. You explain what's going on and you can get the patient to put their two cents worth in. The whole thing is not recorded and stored, is my understanding. It is just keeps the notes. But whatever you say in the notes is there. It's certainly, from the ones that I've seen, leaves most people's documentation for debt. It literally is 10 times better than the documents that you write yourself. It explains things. It's in terms of reducing your risk for medico-legal claims. It's phenomenal.
Speaker 2:I've been involved in about 16 medico-legal claims and I've seen some of the documentation that some surgeons wrote and truly some of it was a disgrace. Some of the junior guys. A few scribbles and some notes here and then you went. You know you went to court with that. So I would absolutely take anything that AI had over. Some people's notes is my thought. You get to read the notes and you have to check them and you have to read them and you'll see what's been written. But again, a quick, just get one tip, go and get a medical scribe and have a go and there's a learning curve, like with everything. A lot of surgeons sort of get started on something and then stop, just do it for a while and see what's happening, um, but, as I said, the guys that I've got are raving over it. They think it's been the best application ever.
Speaker 1:Um, happy with them okay, and then what about some of the ai technology that's being used to guide clinical decisions? Are you aware of any of those specific for plastic surgery? And you know, I guess, technically, from a medical legal sense, like who's really responsible if AI is used as a tool and maybe isn't you know the proper outcome, or something.
Speaker 2:Always the doctor is going to be responsible. That being said, already now, in radiology, the interpretation of cancer in radiology and the interpretation of skin cancer in radiology is better by AI than it is by a doctor.
Speaker 1:So I'm going to assume that that was a study that was already finished.
Speaker 2:Yep, they've already got the study, they've already got that, they've worked out that they can do. You know, it's much better assessing pre-cancerous conditions and, as I said so as a patient. Now this is a big question that says would I prefer? Would I prefer the ai radiology tool to do it rather than the radiologist to do it? Yeah, probably is the deal.
Speaker 2:Okay, yeah, and that's that's really scary because everybody goes. But you know, but that was my job, you go. Yes, um, diana, have you been down to, um, you know, the supermarket lately where, um, they've got rid of all of the checkout chicks. They've gone, and, uh, I was in mcdonald's the other day and they've got rid of the girls at the counter and it's just now an interface that you, you know, put your order in yeah, I mean a lot of places, uh, in new york, especially some of the fast food, you have to do the order through that.
Speaker 1:I mean, somebody's still handing you the food, currently at least, but all of the ordering is done on a computer screen or something like that. So yeah, I mean, obviously the reduced use and need for manpower is through every industry, and certainly for me. I guess you know, not being in radiology and or dermatology you know to some degree I feel a bit protected. But where do you see some sort of, I guess, creep into our world as practicing plastic surgeons, or are we protected to some degree because ours is a hands-on surgical specialty?
Speaker 2:Well, funny. You should ask that. I've just been to the International Bariatric Surgeons Conference and there they had all the lovely robots and they've obviously gone down the robotic path, probably more so than the plastic surgeons, and they've obviously gone down the robotic path probably more so than the plastic surgeons. And, interestingly, watching where AI was being applied to the data collected and the information that those robots have, I could see that you were having less and less and less need for the surgeon Was the deal In the future. That would be really interesting.
Speaker 2:It dawned on me that you know ai runs on data. Data is the new oil. Anybody that's got lots and lots and lots of data. The value of their share price is going up because ai can interpret that data and and make it much more meaningful. And you know again, all, all surgeons, or all professionals, think they're fantastic because of their expertise. They're effectively running a little expert system in their brain.
Speaker 2:If this, then that, if this, then that, and if I've never seen it before, give it your best shot and make it up, and that's where we explore things. You know, um, that's where it's at. You know, based on my gut experience, this is my, my thought of what we should do. But if you've got, you know, as some of the robotics devices already have now, you know, as some of the robotics devices already have now, tons and tons of, you know, megabytes of twillibyte, terabytes of data, if you ran that through a machine, you can literally say whether this is good or not. Um, what it was doing, um, with augmented reality in the, in what I show, what they showed at the conference was, it was um, color coding the bits of the internal organs. They're going, yeah, don't touch this bit over here and I'd be doing some stuff over there.
Speaker 1:That was really interesting and I know that some of the new robots interestingly have you know what we call haptics built into it where they're actually memorizing sort of the actual physical motions for different parts of the procedure. So I guess some of those sci-fi movies where the body is entered and then the computer is operating on somebody on a ship somewhere uh, certainly is, is is a possibility correct it is and you think, well, when's this?
Speaker 2:oh, you know, everybody wants to know. Will I be retired by then? Diana is the thing you know. So for my buddies that are 60, you're kind of like, yeah, you're safe, but if you're 50 it's going to be a bit more interesting, and if you're 40, I'm not sure what you'll be doing in 10 and 20 years time. Um, because what I'm seeing with ai it is literally doubling every week, as in it is much, much, much better than it was, you know, last week yeah, I mean, I think from a sort of training and future terms of education, I think it will play a huge factor.
Speaker 1:Again, it's not the tool but how it's used, right.
Speaker 2:Absolutely. In most practices, it's just get the simple stuff done, so help us improve our workflow. One of the things is that it can take a staff member maybe an hour, maybe a morning, to respond to something difficult, a difficult problem, whereas if you put it into ChatGPT or any other of the AI tools, it will give you perhaps 80% of the answer and you've started. So, instead of starting with a blank screen or blank sheet of paper, it will give you a really, really good answer. So the other morning sorry, a while back one of my surgeons asked for the specifics of kind of like a job description for what they wanted the anaesthetist to do in theatre.
Speaker 2:No, it wasn't the anaesthetist, it was the assistant, his assistant, assistant, his assistant, and so I spent a half a morning kind of coming up with you know what a really really really decent list of things that the assistant should help with and what the expectations were for the assistant, and it looked really good. And then my wife said let's do it with ChatGPT, and she actually made a better one in about 20 minutes, and then what we did was we fed back the one that I'd made back into chat to VT and had one that was better than both of them in about another five minutes and that was just a really simple little thing about you know, systemizing a little bit better, basically spelling out your expectations for the assistant and then the anesthetist, yeah, I mean I think a lot of our practices you know sort of some of the day-to-day routine or you know different responses when different calls come in are very specific to that practice and the I mean I personally call it protocols in the office.
Speaker 1:Yes, and I would say, like with AI, you know, I mean I have over 15 years plus of a practice, so there's a lot of that already built in. However, I could see for a newer practice if you just sort of set what your goals and parameters are with regard to those kinds of questions or you know prompts. You know you could give an example like oh, a patient calls in for this specific question, like what should be our answer, and I would say that AI would certainly. Now, would you stay with like a chat GPT type of format, or do you know of any other platforms? Might that might better serve some sort of um use such as what I explained, um.
Speaker 2:I'd start a chat. Gpt will give you the answer for that one. Chat GPT will do a great job. Um, equally, um, there's co-pilot and Gemini. Um, if you're doing research based stuff and you want it all fully, you know right now what's the best program to do text to video. You'd use something like perplexity is good for that. But if you just want, um, some answers, um chat gpt will be a great place to start.
Speaker 2:Um, you will get a whole lot of faqs. Give me all of the faqs related to breast, breast and lift surgery, for example. Then you have to go through that and say, uh, you have to double check that the faqs that have come out there are, um, what we do in our practice. Because, having helped many, many practices now, every practice is slightly different and you know what's your advice for recovery after you know, um, I don't know, um, tummy tuck surgery. Uh, some surgeons go do not have a shower for two weeks and and other people go, no, you're good to go after three days. So you have to customize it to your beliefs.
Speaker 2:So I have a thing called preferences, opinions and beliefs, and every surgeon is different. You can type into chat GPT. You know what are the controversies over. I don't know facelifts, and it'll give you all of the different. You know 100 controversies and every surgeon is at a different end of the scale. Similarly, for you know, how do you do your breast lift surgery. Do you use this method or that method? A lot of the ones around recovery are interesting. What should we say? You know, does the surgeon particularly believe in something you know, like Arnica or Arginade or any of the products that you know may or may not get a better result afterwards? So you have to start with something, and this is where CHAT-GPT is. Great Many of the junior surgeons ask other surgeons to you know, can, oh Diane, can I have a complete copy of your systems protocol? Standard operating procedures?
Speaker 1:And, to be fair, that's your 15 years of IP and you're probably not that keen to give it over to a new competitor up the street. So Now for a regular, you know, smallish type of office. I know that you know there's a lot of information about the use of AI platforms requiring more, both data storage and capabilities. Are there any? I mean, I'm assuming, for ChatGPT. There isn't a lot of other electronic or data-driven infrastructure needs, but what kinds of areas where you know we need to take a look at that part of our practice as well in order to support if we start using a lot of it, like I guess that's really the question is are there any added costs and any additions to infrastructure that's really important or necessary and that even goes with? Do you need a better computer, or you know better Wi-Fi, or you know if you could comment on that?
Speaker 2:Sure, sure. If you're going to just most of the chat GPTs run through, you know your browser, so it doesn't require any extra effort. You just have to pay the subscriptions for all these things, and sometimes the subscriptions can add up a fair bit for these different programs, of which there are many that are tailored to do things. If you're going to do image and video manipulation then you're going to need a lot of storage. Someone showed me the other day that you can literally rent um a large server somewhere for by the hour, do the image manipulation, sort of load up all your information and then delete it all at the end, and you can do it that way if you don't want to buy like a big heavy duty image graphic processing computer um so it's like an hour service rental thing and then it'll process everything and then shoot it back to you.
Speaker 2:And then it'll and then gives you the responses and stuff. And so this is if you're going to use things like stable diffusion or mid-journey to really really create some amazing images that you might want to use to for education purposes or whatever, and some of the image creation tools are absolutely fantastic you can create some images and this is where we're getting really, really scary, because you know you can do fake before and after photographs if you're ethically bent, like some of the overseas countries, and they will look spectacular and you can process them like that. But what we're trying to do in marketing is you know what's fair and reasonable about what we should put out for our marketing. Already, in Australia they've sort of banned a whole lot of the social media, wild images and things, but certainly in America you're still up for that at the moment. So creating those what's called scroll stopping or viral videos and things there's a whole suite of tools that will do that for you they will require a bit of, they require extra processing power.
Speaker 1:but yeah, and I guess for those of us who are either starting or very involved in social media, and you know that requires a lot of human input, and they say you know, for authenticity, that it should be done by yourself. But I guess what you're saying is, if you can teach the AI to do the same sort of creation that you normally would have anyway, based on your data of your past creations, I guess it could learn to be you and help you save time, correct?
Speaker 2:You're absolutely spot on. It's called Style and Tone or your brand guide and again really spelling out your preferences, opinions and beliefs. You know I never do this, I always do this. Sometimes I do and sometimes I don't. The more you can spell that out, you can upload that and then it will be you, it will be literally. You know you can have your own Diana GPT program thing and whatever it writes is going to be 95, 99% on the money.
Speaker 1:Yeah, I mean, I think for those who either want to maybe create a little bit work-life balance and not be on the media, I think that might be a very welcome solution, and certainly for those who are starting off, you know, just to create your own bot to then, in the future, save yourself time. So that was really great information and, again, any dangers or pitfalls to look out for when you're doing stuff like that. I mean, I guess you get to review all your information, all your information, but is there a chance that, again, if you don't buy the subscription version, that your novel ideas can be taken away from you and shared.
Speaker 2:Yeah, look, my biggest one would be don't use free chat GPT. Use paid GPT and keep control of your data. You know you wouldn't leave your medical records out in the corridor, you know, for anybody wandering around to play with and it's the same sort of thing. So you know already. Now some of the staff are just possibly using ChatGPT and sharing some of your data online, and in big corporates and government they're saying you know, don't use AI for these things, but the staff are doing it. That's because they want to solve their problems and it's quicker and they're working from home and that's probably one of the biggest issues at the moment. So at least give them the proper tools.
Speaker 2:I can't stress it enough. I mean I'm not paid by ChatGPT to say, buy the paid version, but for goodness sake, you know it will save you 20 to 40 percent of your staff's time if you use it well and all of the problems and things. If you improve your systems and processes. You'll have a lot less band-aids to be put on. If you educate the patients better and have it online and have all your frequently asked questions on your website and you send it to people and you make videos and educate them and do all these sorts of things. Then you have less people ringing you up at three o'clock in the morning with either a problem or an infection or whatever it is. So you can either put you can either do best practices or you can do band-aids. You choose.
Speaker 1:And did you say for the paid version that you have to specifically turn off the feature of sharing?
Speaker 2:yeah, there's a little button in there. Yeah, that just goes um. Please don't share my stuff to the internet okay, so that's important.
Speaker 1:So you certainly don't want to pay for that and then still be sharing the information.
Speaker 2:So that's right, yeah, for those of you looking. I'd certainly also start with um. You know, yes, um, chachi pt can literally, literally do what medical scribes do. It can listen in and, you know, transcribe what's going on, but, um, you're sharing it. You're sharing it to the world. I wouldn't do that, um, I'd use the proper, uh, secure versions. Um and yeah, that's.
Speaker 2:You know that's what we're trying to do. Remember that. Um, if you are doing some things with chat, gpt, start with the very, very generic stuff. It's not like you're giving away the secrets. I wouldn't be uploading anybody's files or any of your patient data type stuff. Anything you do sort of see if it's perhaps the identified you know, you can post, paste in an email from a patient that's complaining about something and it will suggest to you a fabulous response, but I wouldn't put the patient's name in there. I'd add that in afterwards. Does that help?
Speaker 1:All right, and I mean, you know I'm trying to think of major issues and problems in plastic surgery and so this will be kind of like a speed round of things we endure and maybe there is an AI solution, but there or there isn't. So you know, for most of our practices as you were talking about patient data and identifiers we take a lot of pictures and you know some of the struggles that we have is, you know, just kind of like an automatic feed and load, and I know there's different programs that do that. You know where every picture from your you know, in-office camera goes straight into the database and is already organized. But is AI at all or any programs involved in sort of helping with that and actually de-identifying that information? So it's almost coded so that we don't have to identify it as the exact patient, or you know if you can just comment on that? Maybe it doesn't exist, but you know, I just wanted to ask.
Speaker 2:There's fabulous image. There's programs that will help you organize your images. Even Google Photos on your phone now will automatically go through it and find all the people and all the photographs of your daughter or your son or whoever you've got, so that's already existing. Whether you want to go down that path with all of your patient files and photos up on the Web is a bit more interesting. Probably wouldn't. We're leaving it literally to the companies you know, like your Nextex and your Patient Now and your EMR systems for photo sorting, manipulation, decoding. You know that's their gig. And there's some AI. Well, there's just programs and AI tools that will be able to help you with that in the future, and I'm sure they're working on it because, yes, there are fabulous ones that will help you sort and improve and fix your images if you like those of us who are on, are there any training programs for, let's say, the novice plastic surgeon who wants to work alongside AI tools?
Speaker 1:Or, you know, what do you suggest in terms of? I mean, this podcast is obviously a great start because you've helped us with a lot of the ways to sort of input the questions. But I mean, do you have a training program or do you know of any training programs where physicians and surgeons can get exposed to what's out there for them?
Speaker 2:Absolutely. I'm not trying to make any money from it. On my website, I'm always updating because I keep speaking to different people about AI, and I go here's what I found. That's new, and it's literally improving all the time, but there are fabulous programs. I think Amazon's just released a whole series of five free programs of what you could do, and there's a whole lot of other ones, depending on what you're trying to learn.
Speaker 2:If you're just trying to learn, you know basic chat, gpt interactions and things. There's ones that will teach you how to do what's called prompting and prompt engineering. Then there's other ones that will teach you. You know imaging and videos. It depends what your interest is. It depends what problem you're trying to solve. The best thing of all, though, is just either ask perplexity or ask ChatGPT. You know which programs or which training programs can I use to do this, and it will give you the answer. That's what it does, and it has the latest, hottest versions, so I'd probably type that one into the free program, perplexity, and go. This is what I'd like to learn, what would you suggest? And it'll give you online recordings. There's also people that are producing lots and lots of videos.
Speaker 2:On my website, I've also listed a whole lot of people. I follow them on Facebook groups. There's one called AI Savvy, there's another one called well. There's a whole pile of different little groups and literally they show you how to do things. All the time. They make little mini demonstrations of it. So I've listed a few on my website under the AI resources section, but every time I find something better, I put up a better one, so you can do that. The main thing is to just get started, and this is my biggest concern, probably, diana, is that most of the surgeons are busy doing what they're normally doing and most of the staff really are comfortable where they're at and they have no interest whatsoever in making themselves either more productive or more efficient or creating systems, which always blew me away they don't particularly have an interest in. They like it the way it is. So if you're doing all these changes, they don't like that. They don't want to show you how to build all these systems out, because that might make them less needed in the future. So that's what-.
Speaker 1:The office staff right.
Speaker 2:Yeah, the office staff, right, yeah, the office staff particularly. Yeah, they, you know I, I am here and you're paying me because I know things and in order for me to leave and you to replace me might be a year before that person gets up to date. So for me to build as a staff member, to build out all of those systems and processes of how we do things and the training and stuff which is in why in most practices they're hardly ever done. So ChatGPT and I've just done in the last two days a full set of like 200 systems and processes for a business and I was blown away by what it came up with, given the parameters and again, probably 80, 90, 95% on the money, and it just needs a little bit of tweaking about how we do things differently around here. So, yeah, I'd be looking at that. That's, you know, that's going to help.
Speaker 1:So, David, while I have you your website address, just in case people don't have the title version, is it? Can you just repeat your website address for people?
Speaker 2:Yeah, sure, For the plastic surgery ones, I'm collating specifically AI for plastic surgeons on my plastic surgeon website, which is specialistpracticeexcellencecomau. I'm from Australia, it's not com, it's comau, so specialistpracticeexcellencecomau. And then for people who are just generally interested in AI, not specific to plastic surgery all the things you can do in your life. I've been just collecting a whole lot of free resources and that's on just my own website, davidstoughtoncomau, and I've got a bunch of.
Speaker 1:Is there a link from davidstoughtonau into that as well?
Speaker 2:Yep, there is. There's a link from the Plastic Surgeons one that says here's the big list of resources that are red hot today, depending on what you're trying to do, and it also lists all of the people that have got directories, all of the experts, all of the trainers. What I'm trying to do in speaking at these events and things is to just get people to go do something, do anything you do, do, do. And if you've got kids, someone took me out to dinner the other night with this 17-year-old who was the smartest one I've ever seen, and he's there going. What should I study at university and what should I do in the future? And it was really an interesting discussion because, you know, I said go and learn all this AI stuff as much as you can. Go all you know. That's where the game is, and if you're smart, you can do an awful lot with it. So we'll see, AI is both awesome and extraordinarily scary as well.
Speaker 1:And any major pitfalls other than the shared information for us as plastic surgeons, as we continue to delve into this matter.
Speaker 2:No, they're the two big things. Be careful what you're sharing um to with your ai tools, um. And then the other one is make sure that someone's run their eye over you know what's coming out, so that there's there's occasionally it's got some things that are not right, although they're fixing that. The biggest one at the moment I think I mentioned um in the in the presentations before was a thing called hallucinations. If you ask it for references, particularly, it's very keen to please, so sometimes it will completely make up your references and citations.
Speaker 1:Really.
Speaker 2:So they had a lawyer, a case recently where the senior lawyer asked the junior lawyer to get some, you know, legal cases that were for the defence, and he came up with a whole lot of them and they submitted them in front of the court, in front of the judge, and the other team worked out that they were all completely made up. Oh God, and I've done that before when I've asked it for medical references for a particular article, and it'll give me a whole lot of articles and it'll quote the you know know, the asj and the plastic surgery journals and it'll quote the volume number and the articles and things and then you go there and it goes that's not there, that's not an article that doesn't exist. So that's probably the biggest one. That's called hallucinations, um, is.
Speaker 1:That is that sort of a medical problem for the ai tool is called hallucinations.
Speaker 2:It's called hallucinations. It's just not a medical one, it's in every one. It's literally. It will give you. I don't know what it's doing. It's kind of so eager to please. It will just make some up.
Speaker 1:But I guess that's the lingo in the AI world. When it does something that you know is an answer, but it's only just aiming to please, is called a hallucination, correct?
Speaker 2:Well, it's giving you sort of a bit of a hint as to this is what we're looking for, but it didn't actually correctly reference the article. So what I've done in the past, what I said, we are writing medical articles here. This is a matter of life and death. Please, no hallucinations.
Speaker 1:Okay, and it will then follow that order.
Speaker 2:No.
Speaker 1:Oh, okay, okay, and it will then follow that order.
Speaker 2:No, oh, okay, no, but it will be a bit. The other interesting one, diana, is it's I'm not sure. It's kind of like having, I don't know, a work experience kid on the job. They're giving it their best efforts, but occasionally you know well, maybe it's teenagers on the job they're not doing it exactly right. So occasionally you'll ask it to do something and it goes. It'll come back with an answer that says oh, you can find that information on the internet, okay.
Speaker 2:And I go yeah, I can, but I want you to find it. And then all of a sudden, you'll go back and it'll find it for you. And my perception is that there's, like you know, buildings full of servers processing all of this information and if at the moment that you, you know, asked for something, it was overwhelmed with other requests. It just kind of triages you and goes, yeah, come back later or now's not a good time. So you can sometimes get a really good. If you ever bounced out, you can get a thing called just try again, and it'll go. It'll do it again.
Speaker 1:Um, so would you recommend, if you have, um, let's say maybe some data intense queries, that you do it while everybody else in your general vicinity is asleep, or something like that? You can't be aware on the um, I guess traffic of the system.
Speaker 2:Exactly. So at this point I don't understand, I can't. I can't. Haven't found where they're telling. You know how busy we are at the moment. But, remembering, I did see a presentation the other day that showed what percentage of people were using ChatGPT and India was at the top of the pile. It was, like you know, 70% of the people are absolutely slamming it in India, and some of the other less developed countries Australia and America were like way down the pile at maybe 20% of people. So they're the ones that are really, really working it hard and doing a lot with it.
Speaker 1:Are you talking specifically about ChatGPT?
Speaker 2:ChatGPT and other free tools. They're all over the free tools because the ones that have less access to either money or the resources that we have in the more developed worlds they're seeing this as their pathway out of poverty.
Speaker 1:Oh, okay, that'll be an interesting human experiment, so interesting Okay. So just in wrapping, up.
Speaker 2:I'd like to just say please do something with either currently it's ChatGPT or Gemini or Copilot, which is built into your Microsoft software. Very shortly Apple was supposed to have released the Apple intelligence, but they're a bit delayed. It hadn't even come with the latest Apple phone, but that will be a game changer. That'll be on phones all around the world. The AI so it's the battle of the AI models. Microsoft's got one, google's got one, claude's got one, grok is the one from Elon Musk, nvidia's got Alarma and much like. You know all these different search engines. In the day we had all these many different ones. One of these will become really amazing. I believe there's a health GPT on its way. They've just released in a trialing search GPT which will take out Google searches. You know know, ranking in the top 10 for google and seo will be dead in the water within three years.
Speaker 1:That's good to know.
Speaker 2:so you want to go to all of those different chat engines and so tell me what it knows about dr diana and then tell me you know everything you know about the name of my business. You know it's not grass plastic surgery and you want to make sure that you're in there. You also want to be testing, if you type into any of those things, who's the best you know tummy tuck surgeon in wherever you are you know, new York, california, whatever and see that you're at least making it onto the list. This is the new search engine. This is what's called generative search engine or optimal search engine. Very shortly I will not be Googling stuff, I will just be talking to my guide, my little AI helper.
Speaker 1:Now will that be algorithmed as a paid service, in the same way that, you know, like search optimization, Google has its little algorithms.
Speaker 2:It certainly will be using an algorithm. What it's doing, though, is that it you know how do we decide, so I've been doing this for a while now, since it's come out. You know, in Australia, we do a lot of breast reduction surgery, so you go who's the best breast reduction surgeon in Melbourne? And it gave me five of them, two of which were facelift surgeons and one of which was based in a different city.
Speaker 1:So, early on, the responses were pretty poor but again it's getting better and better every time. So, but you can game. The algorithm has to be how do you get on the best list? Yes, correct, I mean, I think that'll be a whole like business and service of its own right.
Speaker 2:They'll also be running ads in it very shortly as well, which will be interesting joy boy, more stuff.
Speaker 1:Okay, okay, great.
Speaker 2:All right Well.
Speaker 1:David, thank you again for you know, taking the time all the way from Australia and you know, as more information and different products develop, I hope to have you on again, but again, thank you for helping us get started. I think we are probably definitely at less than the 20% use rate and hopefully, you know, plastic surgeons are usually pioneers in terms of the medical world and I hope that after listening that, we'll be at 100%.
Speaker 2:Very good, very good. Thank you very much for having me on. Happy to come back anytime, okay great Thanks, david.
Speaker 1:We hope you enjoyed this episode of the Enhance your Practice podcast series brought to you by ASPS University. You can listen to our other episodes on other podcast platforms or you can download recordings directly from ASPS EdNet. New episodes coming soon.