Reimagining Medicine Through Technology and Humanism

I began my training in general surgery in California, but soon realized that my desire to improve medical care extended far beyond the operating room. As a humanist trained in history and philosophy, I became interested in the broader intersection of medicine, science, and patient care, which led me to pursue internal medicine. While practicing internal medicine and emergency medicine for more than 20 years, I founded multiple medical groups in Los Angeles. These experiences showed me I could provide quality care that aimed at both patient and physician satisfaction, with each reinforcing the other. These ventures allowed me greater flexibility, enabling me to spend considerable time in Argentina, my home country. Experiencing the healthcare systems of the United States and Argentina gave me a unique perspective on different approaches to organizing care and on ways I could develop systems to improve patient care according to specific needs. This helped me quickly find a team of extraordinarily talented software engineers who helped me develop Praxis Electronic Medical Records.

After years of practicing medicine and working in different medical groups, I had witnessed firsthand how much of medical practice was determined by the process of record-keeping. I wanted to implement a system that would optimize this process and help every doctor practice their best medicine. Although my experience in programming was limited, I surrounded myself with a team of talented engineers who were able to transform my vision into a novel medical record software. Our system highlights the importance of the provider's way of thinking in the production of a clinical history. Rather than creating a template-based medical record system, we used a neural-network, AI engine to tailor our system so that physicians could imprint their own voice and clinical reasoning into the note-writing process. What began as an effort to rethink the way physicians document their work ultimately became a much broader attempt to rethink how technology could support the practice of medicine. For me, the goal was never simply to make recordkeeping more efficient. I aimed to create a system that understood that medicine is fundamentally a thinking profession, and that the medical record should reflect that.

Argentina is my home, and it was always part of my plan to come back with hopes of making an impact here. Because of the structure of Praxis, I can alternate between online meetings to keep the software up-to-date and on-site visits to the different healthcare organizations that use it. Although the Argentine healthcare system is not at a stage where Praxis would make a significant impact on medical practice, I found several other ways I could improve the country. I started the DIJ foundation to bring computer science and informatics education to Jujuy, a remote region in the Argentine Andes. I have also had the honor to serve as health advisor to President Raul Alfonsín and later serve as president of the Yale Club of Argentina.

The Yale System allowed me to explore my interests outside of medicine and attempt to find ways to connect them to my future clinical practice. On Friday afternoons, I would go from studying dissections during pathology conferences at Fitkin Auditorium to reading about the history of Pasteur’s discoveries and how the scientific community received them.

The freedom to move between disciplines shaped the way I approached problems throughout my career. Whether I was thinking about patient care, healthcare systems, or the design of medical software, I learned to question assumptions and look at medicine from more than one perspective.

Yale School of Medicine is not a place that just prepares you for your career but rather a place that gives you the tools to make a lasting impact and transform your profession. For me, that has meant carrying the curiosity of a historian and humanist into the world of healthcare innovation.

Medicine is a key that opens many doors. Whether it is entrepreneurship, service, or scientific discovery, try to find novel ways to apply what you learned during medical training. Do not limit yourself to the traditional paths that medicine offers. The goal is not to think outside the box but to find new ways to shape the box and set the standard for new ways of thinking. Your medical training gives you a way of seeing the world; the challenge is to decide how you want to use that perspective.