Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marks. Welcome to another edition of Digital Voices. So excited to introduce you to my new friend, Zaina Kayat. Zaina, welcome to Digital Voices. So happy to be here. Hello. this is great we first met we were a guest our podcast signals and symptoms we talk about ai and you're there as a futurist which we'll talk about here in a second and i was like wow this person is like super impressive and i love just uh your personality i love your your effect your persona and and then the things that you shared were so deep i was like oh i've got to steal you and have you on my own podcast so thanks again for doing that and we'll we'll drop all your information, Zaina, in the show notes, because I want everyone, all of my audience to know about you if they don't know you already, but you're a health futurist. We're going to break that down in a little bit and get to know you. So this is great. But the very most important question, Zaina, we ask all of our guests, what songs are on your playlist? Oh, well, you know, I'm a DJ by night. I don't make a lot of money. Z money, Z dollar sign is my DJ. I'm on Instagram. So I've so many, but I'll just pick a couple that I think are a bit eclectic. I've been enjoying. I don't know if you know, Huey Lewis in the news covered the song Cry to Me, which was one of the songs you might remember from Dirty Dancing in the soundtrack. So I'm loving that one lately. It's just got a good rhythm, good melody, and I love his voice. And then there's a great one by Queen Omega and featuring Little Lion's sound called No Love Dub Plate. No Love Dub Plate. Those are two lately. I've got so many more, but those would be nice to add to the mix. Yeah, that's great. Cause we will add it to our Spotify playlist for digital voice and DJ. Like how did you get into that? That's so interesting. You know, midlife crisis, Edward, when you're like, you need some creative outlets. So I went to DJ Academy. I was like the only student taking notes, double the age of everyone else in the DJ Academy. And now I mostly DJ when I speak at conferences, I'm like, you know, the evening event or like people's 50th or 60th birthday parties. and my daughter's, you know, high school events. That is so cool. Yeah, we'll have your picture, obviously. Maybe it'll be with you, you know, as your DJ character. That's awesome. That's so cool. What about life message and mantra? Are there sort of words that you live by that guide you? Yeah, maybe a couple, you know, and we'll get into why, like, these are mine, given, you know, a bit of my origin story. But, you know, one I often think about is how do you maximize your surface area for luck. I think even me meeting you, Edward, was maximizing my surface area for luck. And who knows where this relationship will go just by saying yes, you know, to be on that podcast that day. Right. That's one. And I think another one, it's maybe a little overused, but this idea of attaching yourself to, you know, I call it my massive transformational purpose, my MTP, or, you know, just your purpose or your calling. And when you know what that is, like really obsessed about attaching yourself to that instead of to a place or an organization or a sector, you know, which we, you know, we do often tie our identity with where we work. And I think being attached to purpose matters. And I think that's how you keep your power. You keep your peace. And you might remember Toni Morrison, I thought had a great quote of like, if when you find that calling, or you can find work in that calling, and you know, it took me 50 years to get there, but I got it, that then gives you the, then you have to give that power and that freedom to others. And that's a lot of why I think you and I do what we do is to kind of empower others to kind of find that purpose through some of this type of work. Wow. This is great stuff. That's why we asked this question. We actually are putting together a playlist also of everyone's sort of quotes or words that they live by, life mantras. I love that whole, I loved all the different concepts that you spoke about and actually could do a whole, I'm not going to go there. There's so much temptation in my mind right now to jump into some of those, but they're so important. And they may come out during the rest of our conversation. So Zaina, yeah, I think people listening are already like super interested. Like, oh, tell me more, tell me more. Like, who is Zaina Kayat? Who are you? Tell us your life story. So I'm probably an archetype. So daughter of immigrants that came from Lebanon. So grew up, you know, speaking only Arabic, I think until I was 14. in Windsor, Ontario, which is right near Detroit, Michigan, very big Arabic community. We were in Detroit multiple times a week to get access to food and kind of our people. So I very much grew up actually American because our only TV was from Detroit, our only radio Detroit, which is why I'm very much into soul and hip hop and R&B as my musical genre as a DJ. So daughter of immigrants, which means, you know, you know what immigrants want their kids to be. What are the three things? doctor, lawyer, engineer. And so I kind of went down the doctor path because I thought that would keep my parents happy. And then got into a bunch of med schools after undergrad, because, you know, I worked really hard at school and did very well to get in. And then I was like, I have no desire to heal anybody physically, emotionally. It's like probably in my life, the first time I had to be honest a little bit about what I'm trying to do and not do what my parents wanted. And then, of course, I didn't know what to do because I didn't want to go to med school, but I was just like overachiever. So of course, then you do more school. So I went and entered a PhD program in the Faculty of Medicine at the University of Toronto. That's where they discovered insulin and now GLP-1s. And so I was in that kind of group, the diabetes kind of research community, very well funded. I did a PhD. And then again, I was like, I have no desire to be a scientist. This is like 96 to 2001. Just good timing at the peak of the dot-com when I was finishing my doctorate and wanting to get out of science that McKinsey and BCG were desperate for staff because all of their historical Harvard MBAs that they would have recruited were off becoming dot-com millionaires. And so they're like, we're not taking a crappy strategy consulting job, which used to be the holy grail if you went to business school. So then they went out to the field and looked for lawyers, doctors, and PhD scientists to fill their pool. Perfect timing. I ended up at Boston Consulting Group. So now I'm doing big business for 10 years, traveling all over the world, learning my business acumen. And then as you know, you find a client you love and mine was in the innovation space in healthcare, technology, adoption, all the things you know and love. And that kind of then that was my, that got me down that track. I worked for a place called Mars. I went to Europe for a year and then came back to be like a chief innovation officer for a large Canadian health company. But I decided my title would be futurist. And I was kind of shedding the word innovation. And that's kind of is now what I do. And we'll get into it. But now today I get paid like four ways. I'm a professor in the business school at the University of Toronto at the Rotman School of Management. I'm a futurist in residence with Deloitte in their healthcare team in Canada. I do a lot of keynote speaking with the Speakers Bureau. And then most recently, I don't even know, I think I was talking to you when I just started. I'm now three days a week as the chief program officer for a foundation in Canada where we give away money to build leaders for AI and health care. So I'm like AI all day, every day in health care. And that's what I do now. Wow. Yeah, that's cool. And I love that diversity. You forgot the fifth one, although it's minor. Yeah, the DJ. But I've yet to get paid, Edward, so it don't count. that's so cool i could see how some of those can all come together at one time for sure yeah so i think you've already described several but what is one pivotal moment in life that sticks out that fundamentally changed your trajectory i mean you talked already about sort of that med school moment but is there anything else i say the absolute life moment i remember the minute where where I was how I felt the whole scene was you know so my first job interview right So I was a student for a very long time up to my PhD. My first job interview was Boston Consulting Group, and it was my first job. The day they called me to offer me that job, it changed my life forever. You know, the learning environment, the pay, the quality and caliber of people I got to call colleagues, it changed everything. And that basically set me up for life. I will never forget that. Yeah, I could see how that would definitely rock your world. It's super cool. So yeah, so we learned a little bit about how you came to be who you are in terms of the academics and your career. So let's talk a little bit more about being this sort of applied health futurist. And And I love what you said earlier about, you know, as opposed to like an innovation officer or things like that. And this was sort of your sort of interpretation of all that. So can you tell us a little bit more? So for the audience that may not understand, oh, what's health futurist? Can you share a little bit more? I mean, I think if we go back and let me know if this resonates for you, given your pedigree, you know, healthcare goes through these eras of building some new capacity, right? Remember the quality improvement before there was no chief quality officer, no scorecard. Okay. Now everyone had that. Then it was IT or technology. So you had a chief technology officer or a chief information officer. Okay, now that's there. Then I'd say like kind of 2000 to 2015, 20 was innovation, chief innovation officer, chief medical innovation officer, whatever you want to call that. But that capacity started becoming, let's call it mainstream. Now it's pretty much there everywhere. It could report to different places. And that's where I groomed in this area. I led health at a massive innovation hub and platform in Canada. I got the bug. I started teaching an MBA course called healthcare innovation. I still teach it to this day since 2012, two or three times a year. I update the course literally every hour. I just found that in healthcare, when you hear the word innovation, it could mean 100 different things. So there's a whole world that thinks innovation equals technology. Others think innovation equals research. Others think innovation is commercialization. Others think innovation is quality improvement. And it's not any of those. Right? So I just found like if I had that title as chief innovation officer, I'm like, no, then everything is going to be thrown at me. Right. You know, that's slightly different from status quo. And I knew the unfinished business was to create next practices, next business models, not improve the current or even innovate on the current, which is innovation. And so I had the chance to give a job title. And so I was the future strategist with this large national health care organization. Then I had to like figure out what is these methodologies of futurism. Some people call me a futurologist. I love all the words. We did write a book called The Future of Aging as part of our work because we were in senior care. So that got me pretty good on my methods. And then now that is dominantly what I do in my position because I think it's the unfinished business. Yeah, that's awesome. And we are going to dive in to sort of your thoughts about the future when it comes to primary care and hospitals. But before we get there, I was super curious. So you speak a lot. And well, again, we're going to drop all this information in the show notes. What are you typically asked to speak about? Obviously, there's going to be this health care side, but I think you also speak to maybe some other industries or sub industry. What are some of the popular topics? So I'd say there's kind of three. So I'm trying to no longer just do a keynote, although that's often what people want. I try not to like I'm trying to be very ruthless about not entertaining and just being the keynote because I can. So I try to always couple it to an applied workshop. I'll even do application in my keynote if they won't give me another 30 minutes to kind of apply the ideas. So it's more of, I'd say, my preference are education sessions, usually with three audiences, the board of directors, very hot area right now in terms of a new competency and their competency wheel of any type of work. the senior leadership team or some complement of a leadership layer of a health and care organization or government or industry or whatever. Or it'll be like a whole community of 200 or 300 people that want to build futurism competency. So that's kind of the focus. And it's literally why futurism needs to be the next competency. And then how do you do it with lots of examples of how other peers are building futurism into how they make planning decisions, choices, and bets. That's mostly it. Now in my new job as the chief program officer for this foundation where we fund people who we think will lead the AI revolution in healthcare, of course, as a futurist, I really need to have a working point of view of what futures might emerge due to AI so that I can translate that into how we design our programming. Yeah. So interesting. My mind's just like blowing up, trying to think where to go next. I have so many questions, but you mentioned futurism must be the next competency. So can you share just maybe one or two things? So like I'm a CEO of a hospital and I'm hearing you and I agree, oh my gosh, everyone needs to have this sort of capability. Are there one or two tangible things that someone might be able to do to help or myself, like I'm thinking selfishly, like, okay, I need to make sure that I have that as a competency. What are one or two practical things that might help people? I mean, maybe the easiest would be to show the opposite of futurism, which is nowism, which is kind of what we do now. So whenever you're going to make a strategic bet, an investment, make a plan, you're going to decide to allocate scarce resources, whether that's your time. Often the context is strategic plan. So that either in healthcare, they're often refreshing, you know, one that's already out of date, even though it's supposed to last for five years. That's a good sign. Or they're about to do a new one and they want to anchor the choices they're going to make in the future and work backwards instead of nowism, which is looking at today, the trends, the signals, the environmental scan, the SWOT analysis. Look, I teach strategy. Okay. I get how we do it today. That'll never be enough. And so some proportion of how you make choices or bets informed by the future. And I often say at a minimum 10%. Lately, when I work with healthcare delivery organizations, given there's so much uncertainty about what futures may evolve, we're talking 70 to 95% of the plan in 2025 that they're going to make a bet on is informed by either the future that they want out of the multiple futures that might unfold or the future they don't want. There's actually sometimes a risk. That's basically it. It's like we call it backtesting instead of forecasting. So and I'm vigorously taking notes for those who are just listening, although we're now starting to also share this visually as well. So, yeah, let's turn now to health care. So 80 percent of the audience is health care related. Some thoughts from you on the future. I want to do future primary care and then also the future of sort of hospitals. Yeah. Yeah. Just little topics for a 30 minute podcast. It's like a one week conference, but here we go. So I have this thing about words I think should be banned in healthcare because when we say them like, like innovation, they can mean so many things. I would ban the word patient centered. And I think I would ban the word primary care only because I think when you say primary care, what in your head is completely different from somebody else that's listening to this podcast. And therefore, we can't actually agree of what the future of it or the current because we don't even have a normative definition. So there's a difference in the literature between primary care and primary health care, right? And so when I think of primary care, I think of actually more primary health care So my definition or the standard is if you engaging in primary health care there four types of service or care One is the one that primary care which is kind of episodic reactive sore throat weird thing on my skin kind of your transactional respond to symptomology But that's only one of the four. And in my view, that should be 25%. And I think why it dominates the discourse is it's like 90% of what primary care practitioners spend their time on. and we're up to, but then we squeeze out the other three. So the other three is of course, chronic care management. So, you know, what Christensen would call the facilitated network model of care where it's repeated over many years with lots of people in the full care team. And that not just primary care people on the primary healthcare team. The third is all the coordination referrals. So that gateway role of primary healthcare, you know, for subscriptions, prescriptions for labs for imaging for referrals to specialists all that quarterbacky stuff is the third and the fourth of course is prevention that's why it's primary um which is not reacting to symptoms at all it's stopping you from ever having to do the other three things so so if those were equal leg of a stool or it's where i think it needs to go i don't think that's where it's gonna go i find because we attach a person called a family medicine doctor to this activity and we attach a place called a clinic. I think until we emancipate from that mindset, I don't really see a good future for primary health care, particularly in your country and mine. In Canada, six and a half million of us do not have any attachment at all. That's like 20% of the population. I believe in the U.S. it's like 110 million people, like a third of your population. To me, that's the equivalent of saying your kids just can't go to primary school, public school. We don't have it. It's like, no. Anyway, so that's it. So what's the future of it? Look, the ideal, there's a lot of ideology. It's the bedrock. It's primary. It's the first line and that it's longitudinal with the same kind of providers over your whole life. I just don't think that ideology is achievable, you know, mathematically or any other way. So I think there's a reconstitution of the job to be done of primary health care and who and what way will architect humans and machines and other capital to deliver that job to be done is the future of primary health care. And I think there's flavors of that now with some of what we see with, say, one medical or, you know, a lot of these others. I'm just going to end with there is, you know, as a futurist, we work with working scenarios. Like if different trends continue, this could happen or that there's no locked in view. There is a scenario being talked about that we're, we're done, will be done with physician-based primary care in the next kind of couple decades. If you follow a couple, you know, so that's kind of scary, right? So as a futurist, I work with that scenario when I'm meeting with colleges of physicians or medical associations or medical schools. Because if you don't confront that possible future, how are you going to make smart choices today? Nobody wants to hear it. I'm like quietly asked to leave. Yeah. No, I think you're spot on. So let's take it one step further in the hospital space. So what are you foreseeing? I know Canada is a little bit different, the United States, but you've been doing a great job. We're modeled off you guys. So no, we're very similar. Yeah. So I think my favorite line about a future for hospitals, it was from Eric Topol. I think when we had him at NextMed, Daniel Kraft's kind of annual conference on the future medicine, that, you know, at the end of the day, all a true hospital and the definition of hospital, back to definitions, needs to be is OR, ER, and ICU. Strip it down. And more and more, all three of those, especially ER, because of Dispatch Health and others, could be done in a different location than this place called a hospital. So even then, what is a hospital? I mean, it was so attached to place and these types of humans doing things in that place, hospitalists or whatever, and kind of acute and emergent care. But then now it's got all the outpatient and all those others, in theory, do not have to happen at a hospital. So as we've been seeing, the shift of hospitals is to become this kind of hub of health and very, very porous in terms of where care is happening. That doesn't necessarily mean in these kind of four walls. That to me seems to be consistent, and I'm sure you see it with what most forward thinking hospitals are doing. Yeah. Now that's, again, I think you're spot on on the future. So you're speaking to boards and they're going to ask you, okay, given what you just said, the major change in primary health and hospitals, what do we do? So what are one or two things that you would advise people to really be shifting? So I'll be very practical. I'm going tonight to I do a three-hour board session and to explain. So I do two things. I do a bit of the why I believe foresight is the next competency in any governance board, whether you're a Frito-Lay Corporation, IKEA, or, you know, Brigham Women's Hospital. And so just the context there of why is, you know, boards, traditionally, their role was oversight, judiciary oversight over the CEO and the operations to protect the interests of the shareholders, whether you're a nonprofit or corporate, it doesn't matter. That was what boards were created for. Not enough. In the last kind of 20 years in the digital era, internet era, they added insight to the competencies. So they'd bring an ed on to their board, you know, or someone on digital or who understands cyber or has done a major M&A or whatever they need to supplement to have insight. Not enough. The new competency to add, and they're all integrated, is foresight, which is if you as the board are not getting educated or you don't have, you don't know that your management team is getting educated about what futures may emerge. You are not doing your fiduciary responsibility for your stakeholders because we used to do foresight ed on 10 plus year horizons. Yeah. No, I'm on three to five, you know, so it's now compressing. And so practically, So today, so I'll do that at the board tonight, which is a board in addictions health care that just is just worried about all these changes in the future. And then and then I go through seven tactics that I've seen boards of directors adopt to build this competency. They're kind of like on a ladder. So level one is like minor level seven is like you are fully in. So I'll just give two examples. One cluster of those is kind of getting educated about the future, bringing in a you or me to the board to describe the future of whatever they're doing. Maybe sending some board members to like, you know, a South by Southwest or HLTH in Vegas, you know, with your leadership team. That's kind of education, just building some literacy, let's call it. But the next level is, you know, boards of directors now that are carving one third of their agenda. And, you know, they only meet like four times a year and they got to do audit and risk and all the oversight. One third of the agenda is generative, which is about the future. It's about what may be. And they never shy away from that. And even more, it's the first thing on the agenda. because if you put it last, guess what's getting squeezed out every board meeting, right? So that's kind of, and I find that the ones that are doing like a third of the agenda generative and building and then adding to their competency wheel, like a board member with futures expertise or whatever, they're in the holy shit industries, sorry to swear, but like that have massive, massive risk of no longer being relevant in the next five years And in my view that almost every incumbent in healthcare today Yeah Powerful words and great practical examples That what I love about your style As you described earlier, it's like, you don't just want to give keynote, which is important, but it's the applied health futurist aspect. This is so good. And I really want to talk a little bit about leadership. Obviously you're a great leader. So I want to tap into your your experiences there. So tell me this, because, you know, you've talked about being an immigrant. Is there something that your parents forced you to do when you were a kid? You sort of rolled your eyes. But now that you look back, you're glad they did it. You know, there's a lot of things I got forced to do that I rolled my eyes and I'm glad they did. I think one was just this kind of bit of like generosity when someone comes into your house. Like, I didn't appreciate how a lot of people don't do that, like get them a drink, make sure they're comfortable, you know, make them feel so welcome. And so I guess I translate that into my house being like whatever space I'm at, whether it's an event or a workshop, like I really am looking out to make sure, you know, because it's a lot of risk to go to these things, especially when we bring in patients or family caregivers, like it's very overwhelming. Yeah. I think that one, you know, like, but I would get the death stare from my mom if I didn't like jump and get a drink within a minute of them walking in the door, but I don't get that. So, but I think I've got a little bit of that kind of hostess. That's good. Yeah. Yeah. That's important for a wide variety of reasons. Yeah. I convene a lot, right? So the conditions for convening are really important. Yeah. What do you do to stoke your creativity? Obviously you're always thinking, you've got this great mind, But when you need rest, what do you like to do? So for sure, DJing, like you can get so lost in it. Our DJ professor or whatever, she was like, you should be 10 to 12 hours a week. Not like because you're telling yourself to just where you end up because you're so into it. So I have some weeks that are like that. It's just I need to be on my gear and I'm often not home. And then for me, it's like I read like one or two fiction books a month. I will not read nonfiction no matter what. All the incredible books, I'm sure you've had guests recommend them. I just read so much for my job. Yeah. So I get lost in nonfiction. So in two different book clubs. That's great. And Zaina, what are one or two things that have really helped you? Like leadership skills. So obviously forward thinking, future. What are some other skills that have really helped you get to where you are today that listeners might be able to adopt themselves? Yeah. And I'll just say, and maybe some of your listeners can relate, I don't at all equate leadership with positional hierarchy. So the title, like that's the last thing I want, because as soon as I would get a chief title and I tried an EVP title for a year, then like 40% of my time is the bureaucracy of being a leader in a complex org. I don't have time for that. Like I just, I can't. So I think, so for me, my definition of leader and the skill I develop is unlocking in others a belief that they can take on seemingly intractable challenges or opportunities in healthcare. So that's my skill that I work. How do I unlock and untap others to go do amazing things? And maybe they'll be the C-suite. It ain't going to be me. and then the other is like i said a little bit earlier like being obsessed about the mission and the end the outcome and extremely flexible about how to get there and i think we tend to attach ourself you know if you're a hammer everything's a nail right yeah and so it's kind of like polymath approach you need to have i think um because otherwise you're going to miss if you're focused on i'm a doctor or i'm a tech guy or or i'm a whatever the way to get to the result you want might not be the thing you have in front of you. And then finally, and I teach this in my MBA, and this is always the favorite lecture that I pulled a little bit from one of our professors at Rotman, Tiziana Cascaro, of being a super connector. So I think, Ed, you would probably be a super connector. So in any population or ecosystem, 3% are super connectors. What's a super connector? The one that when you join an org everyone's like you need to talk to this person even though hierarchy wise like they're the mover and the shaker everything goes through them i'm a super connector and i i invest in that and so i always tell people either be a super connect connector or find the super connectors that will short circuit your time by about 85 percent no i love that zedekiah you're you're amazing human. That's why I was immediately attracted to you when we first met. We talked about so much. I have these crazy notes all over the place. That's why if people see me looking to the sides, because I've been writing down so many things, good things, this will all be transcribed as well. But we talked about everything from your very incredible beginning, you know, from Lebanon and immigrating to ultimately Canada, all the different things that you do. I'm hesitant to summarize everything just because of the time that it would take. And I want to definitely end with your last word. But yeah, you dropped so many golden nuggets on us. I think I will just save it for the transcript. It's just amazing. But I love the diversity of your life as well. Not just your upbringing and ability to speak Arabic and those sort of things, but being a DJ, adopting that later in life. You continue to transform yourself. Your whole message has been about sort of this transformation and having this future orientation and you're living it. And I say you're very similar. I think we've got a similar journey, which is great to see. Yeah. So Zaina, so you get the last word. Did we miss something or is there anything you want to? I think there's a paradox that needs unpacking and I can't say I know the answer. I'm just going to give two observations and maybe you or your listeners can weigh in. One, you know, all this tech around us for prevention, early monitoring, the wearables, the longevity economy, which I've lost track of how big it is. Peter Adia, Huber, blah, blah. When you ask anyone what's keeping them healthy, it has nothing to do with any of those tools. Right. It's, you know, Ed, you're running. You know, me, I really work on my sleep and the food I put in my body. So it's just like, at the end of the day, why all this tech? one. And then the second paradox is, you know, I'm here in Canada, right? Like we're like 25 years behind on things that aren't standard of care. Okay. Ed, in your country, even though I know Americans aren't that impressed with their own health system. But for example, there are things that Kaiser Permanente put in like 25 years ago or Mayo or Cleveland. I follow the NHS in England that we aren't even having a discussion about right now in Canada. Yet every metric of prevalence rates of illness, outcomes, same. Right? So I'm like, at the end of the day, biology has a plan for us. Yeah. Complex systems are complex systems. If we implemented in Canada, any of like a fraction of what I see happening in the rest of the world, I actually think everything's going to be the same at the end of the day of outcomes and the amount we're spending. So the point is, I just wonder of why you do what I do, what I do, what I do, your listeners, is we just toil like a hamster because we have a human nature to just make things better. And that's just what our work, I don't know, I'm struggling with it. Yeah. No, I hear you. That's a great way to end. Just leave everyone just to ponder that and think deeply about that and then make change. Zeta, amazing, like I said, amazing human. Thank you for being my guest in Digital Voices. Thanks for doing this.
