
Inside View:  Alternate Career Pathways — An Interview With José Morey, MD
        By Justine Kemp
        Radiology Today
        Vol. 19 No. 4 P. 26
José Morey, MD, is chief medical innovation officer for Liberty Biosecurity, a senior medical scientist for IBM Research, a visiting assistant professor in the department of radiology and medical imaging at the University of Virginia, and director of informatics for Medical Center Radiologists in Virginia Beach, Virginia. He is also a member of the Health Informatics Leadership Council at the VA, a medical technology and artificial intelligence advisor for NASA iTech, chief engineering counsel for Hyperloop Transportation Technologies, and associate professor of radiology and internal medicine at Eastern Virginia Medical School.
How did you get  started on your alternative career paths?
        I was bitten by the entrepreneur or start-up bug around the  time I went to fellowship at the University of Pennsylvania. It was intrinsic  at first; I had a desire to be involved with technology and all the amazing  things that I felt that medicine was not taking advantage of. At the University  of Pennsylvania, there were a lot of opportunities, especially with the Wharton  business school where I audited some classes. I went to the undergrad campus  and met with people in engineering and 3D printing. I went to the vet school  and saw some of the cool technology they were using. I started creating my own  applications and technologies. I had a couple of attempts at early start-ups  and then started creating clinical support decision tools. 
        
        Then I started working with IBM. By working during the day  and networking in the evening, I got in their ecosystem. Now, instead of  specifically doing radiology/academic projects for papers, I am working on  research projects from a business perspective. I am interested in ideas that  can be commercialized and go to market. I currently work as a consultant with  IBM, Liberty Biosecurity, NASA, and Hyperloop. I also work with hospitals to  evaluate emerging technologies. 
Would you have done  anything differently?
        I would have taken this [technology] path sooner. One of the  biggest problems in health care is that we spend so much time and money getting  to where we go, and then we feel like we have to stay in our field to make as  much money as quickly as possible. We are scared to take risks to branch out  and try something different. It requires a risk/benefit analysis, and we do it  every day in our lives and our educations. You can plan to minimize the risk. 
How do you feel that  your radiology training has helped? 
        Medicine as a whole and radiology specifically teaches you  critical thinking. For the most part, any innovator needs to think critically;  they need to look at what's going on, identify the problem, diagnose the issue,  and figure out what the next steps are. For years, we are taught how to  critically think and also make assessments and plans. Critical thinking is a  skill set that can be taught and nurtured. 
A lot of other educational paths do not teach that or prepare people for that. A lot of companies do not care what your background is, but they highly value critical thinking and problem solving. If you have people that are good at critical thinking, a company can immediately plug them into certain roles. They may have to get up to speed on some things—like aerospace medicine or microgravity effects—and it can be scary, but it can be completely exhilarating. We do not ever know where we are going to be in five to 10 years. By stepping out of medicine, you can find a huge world with challenges that need critical thinkers.
Who is Liberty  Biosecurity, and what is your role as chief medical innovation officer?
        I first met them while doing work for NASA. They were  working on a pharmaceutical for radiation mitigation. As I got to know the CEO  and the rest of the team over the course of a year or two, I knew I wanted to  be [involved with them]. They are working on things as diverse as radiation  mitigation, artificial intelligence [AI], and anti-aging medication. 
When machine learning  and AI technology becomes advanced enough, do you think that these programs  will be viewed as replacements for radiologists? 
        The purpose of AI projects such as IBM's Medical Sieve is to  augment what radiologists do, not to replace us at all. If it ever does happen,  I do not see it happening in the next few decades. It will allow us to spend  more time with patients and perform more valuable tasks, instead of measuring a  nodule or an aneurysm that anyone can measure. 
From a VA perspective, AI could do a lot of the early work that residents normally do in many hospitals because residents are a luxury at the VA. AI will also help with the democratization of medicine, helping radiologists to provide a specific baseline of medical care. That is not the case right now, where there is not even subspecialty care in some places. Subspecialty care is typically limited to the people who are in midsized to large hospitals. With the kind of AI that Medical Sieve represents, everyone will get the same level of care regardless of whether they are in a rural center or a large teaching hospital.
What are you focusing  on with NASA? 
        As NASA iTech's medical technology and AI advisor, I am  helping to evaluate health care and AI companies that want to work with NASA. Companies  with ideas for addressing the problems associated with colonizing Mars will  eventually submit papers on how they plan to solve them. I will then evaluate  the feasibility of the technology, how innovative the technology will be, and  the potential for commercialization of the technology on Earth. The technology  will hopefully have dual viability to be used both on Mars missions and Earth. 
You've written about  Hyperloop technology. How do you think this will affect hospital systems? 
        My foray into Hyperloop is nonmedical, but I still view it  as an extension of my medical practice. We, as physicians, can develop extreme  tunnel vision in regard to caring about point of care for one patient at a  time. But if you step back and look at health care in a holistic sense, point  of care is kind of the last step. Social factors—diet, exercise, and other  socioeconomic factors—influence a patient's state of health. 
        
        From an architectural perspective, perhaps patients don't  have access to good grocery stores, gyms, education, and medical clinics. We  need to revolutionize how we think about patient care before the actual point  of care and after point of care. Where do patients live, where do they commute,  what do they do for a living? In the era of big data that is exploding, we have  access to all of this information—we can evaluate peoples' taxes, social media  feeds, etc, to see what encompasses a patient population entirely and what  impacts them before they even come to see a physician. There is a growing pool  of data that demonstrates how physical separation leads to many social ills  that divide people. Technology like the Hyperloop can bring us together in more  than just a physical sense. As healers, it is our duty to mend more than just  the wounds of illness. 
Do you still practice  clinical radiology? 
        I do clinical work 20% to 30% of the time. I still do  clinical work because I think it is valuable—you cannot be an innovator if you  do not feel the "pain points." Similarly, in any business where the CEO makes a  decision to address a problem, the solution itself can cause other problems or  may not fix the original problem. This happens because the people making  decisions do not really know what the problem is in the first place. I feel  that clinical work grounds me and gives me a greater appreciation for what the  pain point is. I like the mental challenge of it. 
How do you suggest  educating clinicians who aren't innovators about these topics?
        I would start by having medical school courses that cover  topics outside of medicine. Even though a clinician may not be an innovator in  creating a new procedure, clinicians can still be innovative in their own  practice—in how they see, interact, and think about their patients. I think we  need to start teaching more than just clinical medicine, whether that means  adding or expanding another year outside of clinical medicine. Technology and  society are advancing at a rapid pace. Clinicians, regardless of specialty,  need to understand this pace and be willing to adapt. If we don't adapt, the  probability is that we will be left behind, disrupted, and dislocated from what  we do. I believe this is one of the reasons that clinicians as a whole are  often highly dissatisfied with their jobs. They are being disrupted, don't  understand why, and are not adapting to the change. 
— Justine Kemp is an MD/MBA candidate at the Tulane University School of Medicine and AB Freeman School of Business in New Orleans. Find her on LinkedIn at www.linkedin.com/in/justine-kemp-4408b0109.