March 4, 2026 Forum

The March 4th, 2026 Salus Forum was convened for the nineteenth time. In attendance were Mitch Applegate, William Bergquist, Jeremy Fish, Bill Gillanders, Mark Vukalcic, and Jack Westfall. The Trigger topic for this forum was provided by Dr. Fish who brought in the opportunities and challenges associated with the use of Artificial Intelligence (AI) in health care. The ensuing dialogue centered on the potential role to be played in contemporary health care systems by AI.

Here is a narrative based on the conversations we had during this forum:

Jeremy

When you’re discussing something as challenging as primary care behavioral health integration, which we’ve accomplished at a pretty high level here in the John Muir Health Family (Medicine Residency Program, I think it’s important to acknowledge that human engagement is a complex matter and cultural convergence in healthcare is a complex matter. And so it is not surprising that business people like to bypass the human condition and create an artificial way of doing things to substitute for expensive, complex human beings with emotional needs and social needs and relationship needs and all the other needs we have and bring to the table. So I want to present primary care behavioral health as an opportunity around an integration that needs to happen.

I think we would all agree that the primary challenge to U.S. and probably worldwide healthcare is the fragmentation that has occurred because of our somewhat overzealous desire to break things down into parts. There’s a part of the human thought process that is based on the assumption that if we can break something down to its smallest element, we can explain everything. And yet, when we look at our colleagues in the discipline of physics, we find that when they broke those atoms down to the smallest levels, they found that they couldn’t figure out where they were or whether they were witnessing a particle or a wave.

They get very confused and then they move on. So, there’s a mystery at the bottom of our reductionistic way of thinking.

And there’s probably a mystery under the reductionistic way that healthcare gets taken care of. So all of us train in separate silos. And then we spend the rest of our careers complaining about what terrible communicators the other professions are and how they’re making life difficult for us and that we don’t have any role in the complexity that’s been developed.