And then you say, hey, I’m in a fight with my wife. How do I apologize? And how do I resolve the conflict? These are two separate things. Then our system says, remember your wife is an ABC and you’re a one, two, three. So, your one, two, three is going to make you want to do this—but that’s actually going to make things worse. And you need to do ABC because this is what your wife really cares about. I offer a lame example. My wife and I just had our anniversary, and I asked my system what to do about it. And it said, remember, she cares more about having a reservation than she does about going to the restaurant. That is my wife. And her knowing that I made a reservation 10 days ago is way better than whatever she’s going to order. That’s just her. And it’s not me.  I was going to buy her a nice present. However, what she really wanted was a reservation at a nice restaurant and to know about it 10 days in advance. This is an easy little example where I’m still doing it. It’s helping coach me or it says, talk to her about this. I still have to go talk to her about that. I still have to listen and respond and pay attention and all those things. So, we’ve built our system to start with that relationship because we think it’s a safe relationship of peers and equals. I want our system to be parent-kid dynamic—but I don’t want to point an AI at any kid’s brain until mom and dad have used it with each other and feel good about it.

Bill B

Let me go back for a moment to the point about the Myers-Briggs or Enneagram or any instrument. We begin with the assumption of the person having a personality. They have a relatively permanent set of traits. Now I’m enough of a psychanalyst to think that the projections that people have on us may be just as important as our personality trait. For instance, with the Myers-Briggs, I created a second tool, which is feedback to people about what other people think their Myers-Briggs type is. This tool provides feedback regarding how other people see us. These projections have to do, in part, with the environment in which we are operating. They have to do with the role we are playing. And that’s becomes particularly important for physicians—because physicians (like judges, police officers and a few other people) have a huge amount projected on them. The projections occur because physicians (and judges, police officers, etc.) operate in an anxiety-filled situation. Part of what’s interesting, I think, Scott, is for people to discover what other people think about me. Because this has influenced how they see me, how they predict what my behavior will be.

We get back to the notion of allostasis and polystasis. We begin to ask about the predictions I make about what another person is going to do or how they’re going to react to my behavior. This prediction, in turn, is going to influence what the real reaction is. I think the feedback you’re getting from your AI system is wonderful. You’re talking about this feedback with your wife. However, it is also important to ask: who is the person that Scott fell in love with? And to what extent is she a little different from what she thinks she is?

Scott

There’s a lot in there. Starting with the physician. Obviously, there’s the white coat syndrome—especially with regard to hospitalists. That’s usually an incredibly scary, overwhelming, important conversation for the patient. That is the most important conversation they’re going to have this month. And it’s your Tuesday afternoon as a physician. You’ve got 40 appointments with these scared people. So, the power dynamic is strong (and scary). Let’s make it very one dimensional and simple. It’s knee surgery. Someone is getting knee surgery. The doctor’s a very good knee surgeon. He puts them on the table, uses the da Vinci machine and the surgery is successful. Then that doctor sees the patient after a wonderful, successful, unremarkable surgery. And they tell the patient, hey, we did great. Here’s five pieces of paper stapled together. This is your physical therapy. Here’s the prescription for the PT. Come back in six weeks and we’ll reevaluate (whatever that is).