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Hey guys, welcome to another edition of Bootstrap MD, the podcast for physician and healthcare entrepreneurs. My name is Dr. Mike Meng. I am a 20-plus year physician entrepreneur.

And today I want to talk about a little story that happened to me last week. You know, I believe it was a Wednesday. And then I was seeing some patients in my telemedicine practice and the EMR was working and the Ambient AI that has was just running where I have it record once the patient agrees to being recorded and it's running in background. And after the encounter was done, you press save, it records it beautifully, everything is put in the right place in terms of my sub note and I remember thinking very specifically, you know, this is amazing, it's very helpful, it's saving me time.

It's not the future, it is just a typical Wednesday. And then that night I went into social media and every social media post that I see where it talks about physicians and AI is AI is going to replace us, AI is going to save medicine, here are 47 AI tools you need to be using right now or you're going to be left behind. And I sat there thinking there's a gap between what AI is actually doing for me in a real patient encounter and what the internet is screaming that AI is about to do to all of us. And the truth is most doctors we really don't need more AI tools.

But we need to know what's actually worth using right now and why. And that's what I want to talk about in this episode really. So if you've been quietly overwhelmed, let's say you opened a ChatGPT tab or Claude and stared at it and you closed it, you're in the right place. So, let's talk about it.

What's working now for physicians with AI? And I want to give you some real talk. If you feel behind on AI right now, I want to say something that I don't think anyone has said to you out loud. The confusion is not your fault.

It's not because you're not smart enough. You've gone and graduated medical school. You have memorized the Krebs cycle. I mean, how many of you and I use the Krebs cycle these days while sleep deprived and being emotionally unavailable.

See, you've done hard things. You can learn anything. And the confusion is structural and I think there are three things that are happening all at once. First, there is this signal-to-noise ratio which is broken.

Every newsletter, every conference, every guru on the internet is shouting about AI. And most of them are chatting about tools they personally don't use on patients they don't see in a workflow that they don't have. They're trying to sell you excitement. You're trying to run your practice.

You're trying to just be a good doctor. You're seeing patients. And those are different jobs. Number two, the hype cycle is way, way ahead of like the workflow.

You know, at many conferences, there's a thing that gets demoed on the stage. And then there's the thing that actually integrates with your EMR, with your billing, your compliance team, with a human in front of you who's worried about their lab results. So, demo to deployment can be a long, sometimes even not pretty road. And most physicians are being shown the demo and then asked to feel behind because they haven't deployed it.

And number three, the fear is doing real work on your nervous system. Underneath all of us, there's this quiet question that I hear from physicians in my mastermind groups all the time. Am I going to be obsolete? And I want to answer that question directly because it's worth answering directly.

No, you are not going to be obsolete. But as I've said numerous times, I would rather be a physician who knows about AI, who deploys AI, than one who is going to be replaced by AI. The physicians who are going to win are using AI as leverage. They're going to pull away from the ones that don't.

Not in 5 years, but honestly, I'm thinking about 12 to 18 months from now. So, there are actual stakes involved. It's not being replaced, but I think it is separation. Some doctors will use AI to take back their evenings, their weekends, and their balance sheet.

And hopefully, I'm talking to doctor right now who wants to do exactly that. Because there are others who are still going to do it by hand and wonder why they're always tired. So, there are two groups. The same tools are available to both, just different decisions.

And then 12 to 18 months from now, we'll have very different lives. Now, I know that could make a few of you uncomfortable. That's good, cuz I want you to stay with me. So, here's what I want to give you today.

It's something really simple and something that you can actually use the next time someone tells you about a new AI tool. I call it the three-bucket AI method. Just three buckets, that's it. Every AI tool you encounter goes into one of three places.

Bucket one is you're going to use it now. So, these are tools that save you time, money, or mental load this week. Not someday, this week. They're proven, they're stable, they integrate with something you already do, and the cost of them trying is low.

Maybe it's a free trial, but sometimes it's nothing. It's free. Bucket number two is you watch. These are the tools that are interesting, but they're not ready for prime time.

Either the tech is too early or the workflow integration is too rough. Or the use case doesn't really fit your practice right now or at least yet. Now, you don't ignore these, but you bookmark them. You check them in a few months because watch tools have a way of becoming use now tools faster than you think.

And then there's bucket three. These are the ones you want to ignore. So, these are the tools that are noise. They're hype, they're solving a problem you don't have in a way you don't need for a price you shouldn't pay.

And here's the part that's going to feel uncomfortable. Most of you what you're being sold is in that ignore bucket. Not because the tools are bad, a lot of them are really technically impressive. But impressive is not the same as useful, and useful for you is the only thing that matters.

Now, how do you decide which bucket something goes in? So, I have three quick questions that I ask myself. Now, I want you to write these down or at least remember them. So, question number one is, does it plug into something I already do every day?

Not a new workflow, an existing one. This could be my example at the beginning. I have an AI that works seamlessly with my EMR. It does flawless, effortless chart coding.

This could be email, this could be for patient education, for marketing, for reviewing your billing. So, if the AI tool sits inside something that you're already doing, use now is what you want to focus on. It's on the table. If it requires you to invent a new habit, build a new workflow, and learn a new interface, then that's a watch tool.

That's a watch it best. It might even be an ignore tool. So, question number two is, what does it actually save me? Is it time?

Is it money? Is it just my brain bandwidth? Be specific. Not that it's cool, not that it's the future.

Does it save me 30 minutes a day in charting? It's a use now. Does it save me 4 hours a month on patient handouts and email drafts? It's a probably a use now.

Does it let me generate an AI avatar of myself for reasons I cannot articulate? You know what? That's fine. That's a hobby bucket.

We all have one. But do you really need to co-create a AI avatar that has 4D and punches you in historical places? Probably not, and it probably isn't solving any of your problems right now. And then question number three is, what's the real cost if I'm wrong?

Now this is the one physicians kind of under weight. If a tool fails, what happened? Did I waste 30 bucks on a subscription? Fine.

Did I leak private health information into a model that wasn't HIPAA compliant? Well, yeah, that's a different conversation. Now if a tool touches patient data, that bar is it cool? That bar is it compliant?

Is it contracted? Is it audible? Period. So that's the framework.

Three buckets, simple. Is it a use now tool, a watch tool, or an ignore tool? Three questions. Does it plug in?

What does it save? What's the downside? Now if you do nothing else on this episode, just do that. The next time someone shows you a shiny new AI thing, run it through that buckets before you run through your credit card.

So what does this look like in real life? So let me make this concrete for you. Let me walk you through how I actually sort tools right now today into these three buckets. And I want to be honest with you about where my expertise stops.

Now I'm in the business of actually helping other physicians learn and integrate AI. So I'm a little bit different because I don't mind testing things. I don't mind spending money so I can save my clients money on so they don't have to. But in my use now bucket right now is my ambient AI documentation.

It's a tool that's already built into my ER. It listens to the visit, it drafts the note, I edit it, and then I electronically sign it. Honestly, this is already giving me back 45 minutes to an hour a day. That's not a small number.

That's a different life. So that's the one I can speak to you with my hands on the wheel. There are a lot of standalone ambient AI scribes out there. I'm not going to pretend I've test driven all of them.

I haven't. I'd rather tell you what I actually use than perform expertise I don't have. Also in my use now, I use general purpose AI for non-clinical work. And here I want to be specific because I use AI for non-clinical work is exactly the kind of vague advice really that doesn't help anyone.

So, last month I had a long consultation with a physician who's in our mastermind. It's a real conversation, it's about 30 to 40 minutes, about what was working in their practice and what wasn't. And after the call, I took a lot of notes here. I have just pages of notes and the kind of notes that you take and then never look at again.

I dropped these notes into AI and I asked them to turn it into a patient education handout on a topic we've been discussing. 20 minutes later, I had a clean branded one-pager. I edited it, it was done. That handout done by hand used to be a 2-hour project I would never get into.

Now, it's a 30-minute project that I actually finish. And here's the pattern that I see almost every physician that I coach with. Most of you are using You're using AI like it's Google, like it's a smarter search tool. Sure, it can do it, but it's not what it's for.

That's not where the leverage is. AI is not a search engine. It's a delegation engine. You don't ask it questions.

I use AI to give me tasks. So, summarize this, turn this into that, draft the first version of this, take these messy notes and give me a clean handout. So, that's the shift from asking to assigning, from searching to delegating. If you only change one habit after this episode, change that one.

Stop asking AI things, start giving it work. Now, notice what these tasks have in common, men. None of them are touching patient data. All of them touch the parts of my week that used to drain me.

Now, in my watch bucket, I have things like AI-powered diagnostic support tools. Now, this tech is moving fast. The integration into real EMRs is still uneven. The medical-legal picture is still being written.

It's still very murky. I'm not watching it. I'm not deploying it. I am having it do do some SOAP notes, but I ultimately am reviewing everything.

AI, another tool that's in the watch tool or not bucket that's in the watch bucket is AI for patient facial triage and intake. Really promising, early compliance landscape is messy. I'm just watching it. Right now, we're just using it for intake forms, but it's not here to replace my medical decision-making.

And then AI agents that promise to run pieces of your practice on autopilot. We're using it for marketing our practice, for patient education. We're not using it for diagnostics. It's still early in the wild.

We keep retuning it. We're almost there, and I'm working currently with a group of physicians who are doing some amazing things in their own practice. So, stay tuned on that. Now, in my ignore bucket, anything that requires me to upload patient data to a tool with a privacy policy that reads like a haiku.

Anything sold to me by someone whose entry credential is, I built a course about this. Anyone whose pitch is, I'm going to replace your specialty in 18 months, but pay me $5,000, I'll teach you how to survive. If a tool's sales page is built on fear, the tool is built on fear, so ignore it. Now, your buckets are not going to be identical to mine.

As I mentioned, I test a lot of different tools as an AI educator. But even a surgeon's use now tools can be different from a primary care doc's use now tool bucket. A physician or psychiatrist who has compliance considerations has to think about certain different things than a dermatologist might be. A physician entrepreneur with a side business may have more use tools for someone who is an employee who is involved in investing.

So, that's fine. The buckets are yours. The framework, however, is the framework. Now, before we close, I want to plant one seed for where we're going next.

The three bucket method is a tool question. It helps you sort out tools. But there's a bigger question underneath, a better question, and it's the one I want you to start thinking around in your head. Stop asking what tools you should use.

Stop asking where your leverage is leaking. So, what part of your week is too slow? What part of your week is eating up mental bandwidth that should be going somewhere else? What are you doing things by hand that a system, AI or otherwise, could care for you?

So, those questions are evergreen. Tools can change every 6 months, but leverage questions don't. Now, we're going to spend a whole episode on these questions in a few weeks, but for today, just start noticing where does your week leak? So, here's what I wanted to leave you for today before the prescription.

Most doctors don't need more tools. They need a system, a way to look at every new AI thing without flinching, without panicking, and without buying. So, over the next few episodes, we're going to keep building this out. We're going to go deeper on each bucket, and we're going to talk about specific use cases for clinical work, for content, for income, for the parts of your practice that drain you.

Now, I've been quietly building this framework with a small group of physicians I've been working with in the last month. Real cases, real workflows, real numbers. And it's small on purpose, and right now we're full, but we're going to be opening up another small group probably in the next few weeks. It's specifically built for physicians who want to build something a side practice, a course, a product, a second income stream.

You want to automate the practice, but just for some other reason haven't started. So, if you're someone who's collecting a lot of tools and information, but nothing is actually being executed, then this might be for you. I'll have more details in the upcoming episodes, but I just wanted to let you know about that what's coming up. All right.

So, here's what I want you to do this week, not someday, but this week. Make a list. Three columns, a use now bucket, a watch bucket, and ignore bucket. Take every AI tool that's currently running around in your head, the ones in your bookmarks, the ones that have been mentioned in your podcast, the one your colleague keeps texting you about, and put each one in a bucket.

And then just pick one tool from your use now column. Just one. Use it for 7 days. Track whether it actually saves you time, saves you money, saves you brain power.

And then give it tasks. Don't just ask it questions, delegate it. Don't searches. Number three, notice where your week is leaking, where you're slow, where you're tired, where the bandwidth is going.

Don't fix it yet, just notice it. And we're going to come back to it. AI is worth paying attention to. I really believe that, but only through a practical lens.

The winners over the next few years are not the be the physicians who have the most tools, they're going to be the physicians with the clearest systems. In 12 to 18 months from now, that gap between the two groups is going to be a lot wider than people think. So, which side of the gap do you want to be on? If this episode helped you, share it with one colleague who may be quietly overwhelmed by all of this AI stuff.

If you haven't subscribed to our podcast, I encourage you to do so. And if you got a question, what part of AI feels most confusing to you right now, feel free to reach out to me. You can go to bootstropmd.com, there's a contact there. If you're interested in being part of this next cohort, let me know as well.

But I take your questions, and you know, the best questions that you guys send me often become future episodes. So, guys, as a physician entrepreneur, you're going to have your highs and your lows. Do something a little each day to get you closer to your goals, and keep moving forward.