Best Practices: Michael Docktor

The pediatric gastroenterologist and tech entrepreneur on how great technology, design, and user experience can change how doctors engage in care — and not get burned out along the way.

In addition to fulfilling the destiny prophesied by his last name, pediatric gastroenterologist Dr. Michael Docktor is helping to expand what doctors have available to them in their digital toolkits. Using his love of good mobile app design, he’s launched several innovative concepts meant to improve doctors’ efficiency and ability to communicate with patients, most recently the HIPAA-compliant task management platform Dock Health. Read on to learn what this healthcare founder and CEO thinks about the future of digital medicine and how it can improve doctors’ quality of life.

How did you get started in medicine?

Well, with a last name like “Docktor” you can’t go into much else. It was always something I wanted to do: As a young child I was fascinated by science and the body and trying to understand why things are the way they are. There’s even video evidence of me at about five years old saying that I was going to be a doctor when I grew up.

And why pediatric gastroenterology?

When I was around 10, my sister was very sick. They thought she had inflammatory bowel disease. Her doctors brought in an expert from New York City to evaluate her, and he was a pediatric gastroenterologist. He really saved her, and followed her for many years. When I was getting into my career, I did rotations with him, shadowed him, and went into the same field as him. I was inspired by this guy who saved my sister’s life.

Are children reluctant to have conversations about their gastroenterological health?

Absolutely, I’ve spent a good part of my medical career drawing pictures on paper, trying to get kids to engage with their bodies and understand them — the idea being that if they understand and they’re engaged, they are going to get better outcomes. If you have a patient newly diagnosed with Crohn’s disease and they find their colonoscopy results icky or completely uninteresting, they will have zero understanding of the disease and why things are the way they are.

Is that where Health Voyager, one of your earlier start-ups, came from?

Exactly. Health Voyager is a joint venture between Boston Children’s Hospital and Click Health, a Toronto-based design firm. It’s an engaging and educational tool that leverages new technologies to create a custom experience for patients.

Typically, when I’m diagnosing a patient with Crohn’s, for example, the report I create will have these one-inch snapshots of their insides — a majority of the time, patients or their parents will have no interest in looking at them because the photos make them uncomfortable. And, on top of that, the photos themselves are not that informative. But my job is to educate these kids, and to explain why they might feel the way they feel and why they need to take their medicine.

With Health Voyager, we can take what we find in a colonoscopy and use game-creation methodology to recreate a cartoon-ified version of the results of the procedure that’s much more interesting for the patient, allowing them to explore what’s going on in 3D on a tablet or phone. We did a clinical trial, and it led to more engaged patients and families. The hope in the long run is that this improves care and lessens the anxiety around these issues.

Now you’ve shifted your focus to Dock Health, another app-based start-up meant to improve the quality of care. Can you explain it?

Dock Health is a HIPAA-compliant task management system for healthcare teams. As a clinician who’s spent half of my time doing innovation work, I’ve gotten to see these great task management systems, like Asana and Trello, outside of healthcare. I was amazed that there was nothing like that for working within healthcare.

I knew a user experience designer, Keather Roemhildt, who was willing to work with me on how to deliver a better way to manage all my tasks using great design. We looked at the best of what was in the consumer space and borrowed from those concepts and applied it to healthcare.

What motivated you to create the app?

Well, I had worked for years at Boston Children’s Hospital mapping out our mobile strategy and if you rewind to the dawn of the App Store, I had worked to create some apps, including a potty-training app. I’m super enamored with user interfaces, user experiences, and design. Many physicians don’t know about user experiences and entrepreneurship, but I’ve had a lot of on-the-job training in it, and Dock Health is the culmination of all those experiences.

At the same time, I was struggling with my own clinical load, and all the to-dos that are part of taking care of patients. I was feeling burned out, like I might drop a ball or miss something. There’s the stress related to the job — while incredibly rewarding, taking care of patients is also inherently stressful — and then the sad reality that doctors are these administrative machines. They say that for every hour we spend on patient care, we spend two hours on administrative work. We went into medicine to spend time with patients, but medicine has now become very focused on billing and documentation. So there was a real opportunity to solve a problem. My problem.

Isn’t that where all entrepreneurship comes from, solving your own problems?

Right. I was solving my own problem. And it’s ultimately why I’m so passionate about it.

How did you know you were burned out?

That feeling of “I’m going to spend another hour on the phone with this insurance company trying to get this medication approved? Really?” had me very short-fused. I had zero tolerance for one more thing. On Fridays I would leave work and feel this incredible weight of worry that I had forgotten to do something that was important for a patient. I was always concerned that I was going to show up on Monday morning and learn that a patient had been struggling over the weekend because they didn’t have their medication. It was the terrible feeling that maybe I let someone down. Once we developed Dock Health, that Friday afternoon stress went away.

How has your brand of entrepreneurship meshed with the culture of medicine?

The entrepreneurship I’m interested in is non-traditional in the sense that it’s not a drug or a device or a typical healthcare innovation. But digital health is increasingly interesting and exciting, and more and more people see the value of it.

The hard part is human nature. You learn in medical school that the amount of time it takes between when a landmark paper comes out recommending that we change how we do something and when we actually make that change, is 10 years. Changing behavior is difficult. If you polled a bunch of doctors and asked them what Jira or Slack or Trello was, 85% or more would have no idea. So we have the unique challenge in educating the market on what task management is.

Has COVID-19 accelerated digital health innovations?

For sure. There has been immediate, and lasting, impact on healthcare. I’ve practiced telemedicine for 8 years and firmly believe in it. Now, all of a sudden, everyone’s like, “Wow, you can actually see a patient and take care of them outside of a clinic!” and I’m like, “Yeah, that’s what I’ve been saying for the last 8 years!” But payers are finally paying for it, and the government has made it easier to provide care across state lines. So digital health is going to stay, for sure, and we’ll see a bump in remote patient monitoring. That will be the silver lining of this disaster — that we’re going to be able to provide better, cheaper care at scale.

Five years from now, what are you going to be able to do that you can’t do today?

Doctors are not going to be writing notes anymore. As we shouldn’t be. We’ll be talking to patients and the voice technology will be transcribing, processing, and figuring out who is saying what, and also making a clinical note that checks the box for billing purposes and the electronic health record. Digital health will help the pendulum swing back to where clinicians are talking to patients again. Hopefully, without masks.

What are the limitations of digital health technologies?

Software, data, and technology can augment our ability to take care of patients, not only allowing us to see more patients more efficiently, but also giving us a better understanding of what’s going on with them to provide better care. But you can’t replicate the human aspect of care with technology, and I hope you never can.

Lastly, what is the best part of treating children?

There’s just something joyful and innocent about children. I love seeing them smile. Knowing that I might play a role in them growing up to live happy, healthy lives is incredibly rewarding.

Vital Signs

What’s your secret talent? I’ve become very good at baking sourdough bread.

If you weren’t a doctor, what would you be? A farmer. I love gardening and using my hands. And I have a small vegetable garden that brings me tremendous joy.

Where are you most looking forward to going when we can travel again? The French countryside.

Best thing you’ve cooked at home recently? Bread! My kids love bread. I made bread for their birthdays instead of cakes.

What is one health habit you wish everyone would adopt? Eat healthy. Half the healthcare problems we have are a result of what we eat. Eating healthy is the key to a healthy microbiome, healthy heart, and healthy brain.