About this episode
Dr John Whyte is the Chief Medical Officer of WebMD. He's also worked at director level at the FDA and was Chief Medical Expert at the Discovery Channel. John runs a course called Think Like a Doctor to Make Executive Decisions, and I ask about the different frameworks executives can pick up from doctors and use in non-healthcare settings — such as Bayesian logic, and assessing what is a symptom versus a cause. John's also a veteran of the health communication space, and we discuss where the future of health content is going.
In this conversation
- A doctor's edge in the boardroom: Whyte reframes asking for advice — a "weakness" in many corporate cultures — as the everyday consult that makes medicine work, and one of the biggest mindset shifts executives can steal from clinicians.
- The single most useful clinical framework for any leader: separate the symptom from the cause. His example — a platform throwing paid-ad money at "low engagement" when the real cause was seven-minute videos nobody wanted to watch.
- Decision-making with limited data: good doctors know when to stop ordering tests. Whyte and Musty on why "one more study" is often procrastination dressed up as diligence, and how to ask "will this actually change what I do?"
- His warning on health misinformation: a patient who microwaved hydrogen peroxide because a blog told her to — and why people who'd never trust a random influencer with their savings will hand them their health.
- The career philosophy behind stints at the FDA, Discovery Channel and WebMD: "I don't think I've applied for a job in years." Whyte on creating roles that didn't exist, and building the network and writing habit that make opportunities come to you.
Transcript AI-generated
Can I run by you an anxiety that I sometimes have as someone in this communication space? So, physician by background, now doing podcasting and such. I feel like we're about to do a telehealth visit.
Just don't send me an invoice.
I'll send you the copay.
No, no. All right, let's go.
One of the things I think about is that if I go full-fledged into this — it's kind of cool, I make some cool content and it's fun. But at the end of the day, what am I really doing? On the worst days you might just think, this is a load of BS. There are people out there saving lives, doing cool interventions, and I'm making a podcast that maybe improves things, maybe makes someone smile sometimes, but it's not changing the world. Did you ever have that feeling? What's your response to that anxiety?
Part of it is that, as in other areas, the algorithms promote it — you become very focused on what other people are doing, in comparison to what you're doing. And in many ways, as we address anxiety in general, it's about learning to control what you can control, not what other people are doing. We can't control other people.
So I'm not as focused on what others are doing at this point in my career. I'm very focused on what I can do to improve people's lives. Even when I see patients, I'm trying to provide them the best care consistent with guidelines. I'm not thinking anymore, oh, I wonder how other doctors would manage this or treat it. And I'm not so concerned about what other platforms are doing, because I'm trying to make our platform the best one out there in terms of getting you quality information that's going to give you better health. I have great satisfaction from knowing that we do that day in and day out.
Fair enough. I wanted to move on to this really interesting course you've got, Improving Executive Decision-Making by Thinking Like a Doctor. The first-principles question I want to ask is: why is it useful for an executive in a non-related field to think like a doctor? Because a lot of the doctors I meet, although usually academically quite good, I don't think are that smart. Some of them are idiots. So why is it useful to do that?
And thank you for mentioning it — it's this course on LinkedIn about thinking like a doctor, especially when you're not a doctor, to improve your executive decision-making. Actually, LinkedIn approached me, because they have a course, "Think Like a Lawyer," and they said, we really want to do "Think Like a Doctor."
When you think about it, doctors have to manage multiple tasks at a time. You often have to respond with limited information to make a decision. And asking other people for advice is a key component of being a doctor — we get consults all the time. It's really this concept that executives can learn from them.
Take the example of asking for advice. In some areas of the corporate world, if you ask for advice it's almost viewed as a weakness. Like — don't you know enough? Why can't you do your job? You were hired to do this. But in medicine, on the days that I see patients, I'm consulting cardiology, I'm consulting orthopedics, I'm consulting derm. No one looks down on me and says, how come you didn't know what that rash was? Rather, we're all focused on providing the best care to that patient. They'll say, thanks for the consult. That's a mind-shift change. Examples like that are what I was trying to get people to think about in this course. You can be a better executive in your decision-making if you think like a doctor — and not like all the doctor shows out there where everything is drama every minute. There's a lot non-doctors can learn from doctors in terms of how they think. Not always, as you pointed out, but in many ways you can.
Do you think there's ever a hubris with doctors? I'm really interested in how domain expertise in one area can give you the impression — a kind of halo effect — that you'll be very good in different areas too. The question I'm pointing to is: experientially, or from evidence, have you seen that doctors, or other highly academic people, perform better in these types of roles? Or is it just a case-by-case thing?
I don't know for sure. On hubris — historically there's been an elitism in the medical profession. I've gone through so many years of school; it's very hierarchical. The surgeon is in charge, is the decision-maker, and everyone else just goes along.
I think we've made a lot of changes over the last five, ten years, where it's really about a care team. The doctor's not always in charge of everything, and the doctor is not necessarily the best person. We have increased specialization. Part of the challenge is we have an explosion of medical knowledge, and one person can't manage everything. So in some ways we're democratizing information too, by making it more readily available, but also helping people become experts in smaller areas so they can provide the best care in that space.
So it's not a direct answer to your question, but an example: I had an eye issue one day and called up an ophthalmologist friend of mine to ask her a question. And she says to me, John, I'm retina, you need cornea.
I'm like — what? You're an eye doctor. You still don't remember? She's like, no, seriously, you really should call a cornea specialist. And I do think there are some problems with that. So to your question, in some ways I don't know if they're better, because people become very tunnel-vision, just knowing their area. But what I think is interesting about a lot of doctors — not all, and it's true for some other professions too — is a curiosity. We want to learn the reason why someone has a certain condition. We want to learn the pathophysiology. There's a natural intellectual curiosity in a lot of people who go into the medical and health profession.
Can you go over two or three of the most useful frameworks, or patterns of thinking, that executives — in health or outside of it — can learn from doctors? If you had to distil down two or three of the big lessons, what would they be?
“Low engagement is the symptom. You have to look at the cause — and the cause is your videos are too long. They were treating the symptom; I'm saying look at the root cause.”
John
I mentioned asking others for advice. But I think it's also about learning how to make a decision with limited data. When a patient comes into the emergency room, or into the doctor's office, you have a limited amount of time — not just in that session, and in the ER particularly — but you have to make a decision. So you make a preliminary diagnosis, and then you order lab tests and imaging to confirm it, or maybe give you a different one.
We all know friends in medicine who haven't succeeded, particularly in ER settings, because they simply can't let go of getting more data. I just need one more test, one more imaging study, one more diagnostic study. To be a good doctor, you have to understand when there's enough data. And that's the same in executive decision-making. You can't always have more consultants look at the information; you can't sponsor another study of your marketing strategy. At some point you have to make a decision. That's a key component of what doctors do — learning how to deal with limited data.
The other aspect is symptom versus cause. We learn that a lot in medicine. A good example: often you look at social media platforms and someone says, well, we have low engagement, so we need to spend more money on paid — we're going to do more paid advertising. The issue is, low engagement is the symptom. You're paying more money to get more people because you have low native engagement. That's the symptom. You have to look at the cause. And I've done this in different roles — you see the cause of the low engagement is that you're doing seven-minute videos, eight-minute videos, when it has to be two minutes. So it's really about looking at the root cause. They were looking just at a symptom — I have low engagement — and thinking that's how I'll treat it. And I'm saying, you need to look at the cause. The cause is your videos are too long, and may not be appropriate for who you're trying to reach in the way they present the content. That's one of the biggest discussions I focus on in the course: how do you make that distinction between a symptom and a cause? That's something doctors deal with all the time.
I want to build on your first point, because the biggest learning I've had from medicine applied to the real world is exactly what you were saying — this Bayesian logic. Thinking, this is a tree, these are decisions to be had going further, and I'll adjust the probabilities based on new information I get. But I realised, especially in primary care, that when I didn't have a clue what was going on, it was very easy for me to just order more tests.
Yeah.
And it was very important to think: in four weeks, when this patient comes back with the results, has that really changed anything we're going to do? If it's not going to impact that, I probably need to think twice about doing the test, because we're not really achieving anything. That's a big learning — that framework of thinking that a lot of the time information-gathering can be time-wasting, or procrastination, when you really need to make a decision.
Absolutely. That's a good doctor's approach. I do the same. When I work with residents and students, I always say: what are you going to do with that test? How's it going to change your decision-making? Sometimes they're ordering it just because it seems like what they should do, or it's this scattered approach — I'll do a whole bunch of things and see what I get, cast this wide net. That's not how most successful doctors think. It's a much more targeted approach.
With that, you also have to be willing to acknowledge you could be wrong and change your decision based on the data. There are always some doctors sticking with, it's the thyroid, I know it's the thyroid, I just need to look at the free thyroid now, the thyroid-binding globulin — and they don't let it go, because they have this bias in their decision-making. But I love that aspect. That's how we think: we come up with a preliminary diagnosis and use data to confirm or change our opinion.
I guess another thing doctors — especially in high-acuity areas — deal with well is risk, uncertainty and stress. Have you taken any learnings for executives from that, in terms of how to handle high-risk, high-stakes decisions, but also high-pressure, quick decisions?
Too often on the executive side — and probably on the doctor's side too — everything isn't as high-risk as we make it out to be. Part of that is because we've delayed decision-making for a while and haven't had a comprehensive strategy; we're just ordering things when we really have no idea how to manage it.
It's also about time management, and, as I referenced early on, asking other people for advice — but asking at the right time. Too often we ask people at the last minute, in a crisis, when we need help. That's never the time to be asking. That's when you don't look as competent, because you should have planned for it, prepared, had a strategy. Sometimes there are last-minute decisions by virtue of the exigencies of business that require a decision — but that goes to your point, you have to learn to act with limited data.
You also have to learn that, despite thinking everything is decided and you move on, sometimes it's an interim decision. You might make a decision, but there are still caveats where, based on more information, you might change something. It's almost like the drug approval process, where you have an accelerated approval — you make it sooner, based on a surrogate outcome — but you want those phase-four confirmatory studies later that may or may not change your decision.
It's the broader issue of dealing with stress in our lives, which is a much bigger discussion. But you're not always going to get it right in decision-making. I've made lots of mistakes over my 20-plus years, but you learn from them and move on. No one's perfect. Sometimes you're going to make the wrong decision, and that's okay — you pick yourself back up and move forward.
Well, John, let me ask you the reverse. What things should executives not learn from doctors, or do a complete 180 on? Another way of asking: when doctors enter the executive or corporate world, what do they need to unlearn? What bad habits do we have?
There's still a lot of arrogance in many doctors — I'm the doctor, I know best, this is my decision, this is how we go. That doesn't work in a business world. A lot of doctors — and some specialties more than others, maybe internal medicine less so — are still not the team players they need to be in the business world. They all think they're the CEO, even though that might not be their title. That can be a challenge. Some doctors aren't always team players, and that's a problem in our environment. To be successful, you need to be a team player.
And it goes to your point — you need to know your area of expertise. Not all doctors have learned financial management, P&L management. I've had the opportunity to do that in my roles, and it's been a wonderful experience. But you also have to know what your skillset is, and then be willing to take the time to learn new and additional skills — perhaps through additional coursework or training. Sometimes doctors are a little reticent about it, because we've done it for so long. Who wants to go back to class? Who wants to do another course? Or, you'll figure it out on your own. That's not a good approach either.
I want to pick your brain on the future of health comms. As a veteran of the industry, having seen the shift over the past few decades, what do you see in the next five or ten years? Very general question — but where are things going? Are we going to more extreme, high-attention, highly provocative content? Are we going to rebound from that?
“Would you listen to any influencer on social media who told you how to invest your money? People say, no, that's my savings. But when it comes to your health, why are you willing to just listen to someone you don't know?”
John
I think there's been fundamental change over the last three years, really during the pandemic. We've seen the growth of influencers — we had them pre-pandemic, but not to this degree. My concern is the number of people with no health expertise — I'm not just saying medical expertise, but any health expertise — giving advice on how to get healthy, how to treat medical conditions.
I saw a patient a couple of months ago who came in with a very bad burn of her left ear. What she'd done is microwaved hydrogen peroxide and put it in her shower, and it caused a very bad burn. I asked why she'd done that, and she said she'd read a blog that said you should microwave hydrogen peroxide, make it hot. This person had no medical expertise, but she listened to it.
I've been talking lately — it's interesting, given the economic climate — I say to people: do you believe every financial gimmick you read online? Would you listen to any influencer on social media who told you how to invest your money? People express a lot of reticence. Some still do it, but others say, no, that's my savings, I have to be careful. And then I say: but when it comes to your health, why are you willing to just listen to someone you don't know? You have no idea of their credentials, no idea of anything, yet they tell you to try this remedy and you're willing to try it. Or you're willing to forgo treatment. We see that with cancer treatment — people trying alternative therapies that sometimes cause harm, and also cause harm through the opportunity cost.
So I'm really concerned about the growth of influencers, and how we manage the amount of misinformation out there when it comes to health. But something I'm really excited by is the democratizing of information. We have so much more health information online from credible sources — WebMD, the CDC — and we're really personalizing content to what people are looking for on their health journey. And then connecting content to care. In the past, you'd search online about a health condition, then wait six weeks or longer to see your doctor, and you'd print it all out. Now, on many platforms, you search "signs and symptoms of STD" and we can connect you with a healthcare provider through a telehealth appointment, or arrange a lab right then that can be sent to your home. You don't have to wait. So I'm empowering the consumer with more information, bringing that care straight to their home, and putting them in charge of their healthcare data and information. We still have a lot of progress to make there, but that's what's exciting.
We're just from the waist up here — I can't tell whether you're wearing a smartwatch, or what I'm calling smart jewelry. Are you wearing one?
No, no.
Okay. But we have so much data from these wearables and trackers and sensors. What are we doing with it? That's your data, that you're collecting over time. Health happens outside the doctor's office, and what I really care about is what's happening to you on a daily basis. I have the data and the technology to do that — but how are we utilizing it? That's where I'm putting you in charge of your information. And that's why it's so important where you're getting your health information. Are you getting it from a healthcare professional, or just asking your friend?
In the old days, if I told you at your appointment that you had diabetes, you'd listen, nod your head, go home and look online — then what? You'd call a friend, someone you know who has diabetes, or who knows someone who has diabetes, and you'd hear that story. Now, it's not your friend or someone you know — it's some random person who may or may not even be real. It might be a bot, I don't know anything about them. So why am I listening to them for my management of heart disease, or diabetes, or obesity? That's the real challenge. And by no means are all of them like that — there are many very good, credible influencers who do a great job presenting health information. I'm concerned about the ones that don't.
On that first point about the rise in health influencers, potentially some without any healthcare background giving erroneous advice — what solutions do you see? Some might be around moderation from healthcare professionals. Another might be a tiered system where you have a kind of verified tick.
That's been some of the biggest discussion, because it always becomes about the First Amendment — what are people allowed to say? But my concern is this: I live, as we referenced early on, in the DC area. If there's misinformation about politics, I'm concerned about that. But if there's misinformation about health, that can impact how long you live and the quality of your life. So that's a big deal.
We really need to address it. There's lots of discussion about a verification program, which I think is a good idea — some objective, transparent checklist that we use and have discussion around, to give some type of verification of the information. I think people would be responsive to that. And I think there has to be moderation to some degree, to make sure it's not harmful. Sometimes it can be wrong but just not harmful; other times it's wrong and harmful, and that's what we really need to be careful about. We've had pluses and minuses of that in terms of moderation during the pandemic — a lot of lessons learned, and we need to keep improving. But if we don't do anything and be proactive, this is going to get worse over time, not better. So I do have a lot of concerns about it.
You've led a super interesting career and continue to do so — stints at the FDA, Discovery, WebMD, et cetera. Have you always had a master plan? Or have you just jumped at your curiosity between things? Is there an organising principle or philosophy that's meant you've been able to do a non-traditional path and a lot of fun stuff?
People always ask me, what's your five-year plan? Not so much — that's because I'm older, I don't know. But I've never really had a five-year plan. I've gone to places and tended to stay about seven years on average, because I don't go to a job and then start looking for my next job.
What I've done is be open to opportunities. I don't necessarily solicit them when I'm in a role, but I'm willing to listen. And what's really interesting — I teased someone the other day — I don't think I've actually applied for a job in the past few years. What I mean by that, and not to be pretentious: the Chief Medical Officer role at WebMD didn't exist prior to my arrival. They had a different type of role. My role at the FDA — director of professional affairs and stakeholder engagement — that office didn't exist prior to my arrival.
So my point is, I always network with people, because I like talking to people. And I worked with those hiring managers about the role that I wanted, that I'd like to come to their organization to do. That takes a lot of work, and some creativity. But that's why I've moved on from different roles — because I found one that was going to be even more fulfilling and let me have an impact on people's lives. That's been my compass. Be open to opportunities, but also ask: what's your dream job? How would you find it? And better yet, how would you create it? That's what's important. Sometimes people get opportunities — talk about it, not just what it says on paper, but what it could be. People often aren't willing to do that. It takes more time to get right, but it's well worth it in finding the right role for you.
But opportunities don't just jump at you in a vacuum. So what have you done well in terms of networking, relationship-building, maintaining those relationships? Any philosophies or practical things you've done to enable those opportunities to fall at your door?
I'm very active on LinkedIn — I referenced that, and I do think it's a good site for thought leadership. I've been fortunate to have a lot of speaking opportunities over my career, so I've met a lot of people through speaking, and I was able to make my positions and competencies known that way.
But the other thing I've done, where I've networked a great deal, is through writing. When I was growing up, you still had to submit something to your local paper — and I did, I was always writing editorials, even when I was young. Now you have a lot of different platforms: Medium, in the past Huffington Post, so many of them where you can submit an article or your own blog. That's what I'd encourage. Get your perspective out there, get engagement on what you're thinking. That's going to bring opportunities to you — and the right opportunities, because you're transmitting your viewpoint on something. Obviously you want a good fit between what you're going to do in your professional life and your goals and aspirations.
The last thing I wanted to ask: have there been any habits, or ways you approach problems, that you think have helped you get to where you are today?
“I'm much better nowadays at just pausing when there's a problem. Early on, when we're younger, we have this knee-jerk reaction to respond to everything.”
John
I'm much better nowadays at just pausing when there's a problem. Early on, when we're younger, we have this knee-jerk reaction to respond to everything, and to respond right now. So I've learned over the years — maybe don't send that email right now. Maybe don't make that call. Think about what might be going on in other people's lives; maybe that's why their behavior is a certain way.
I've become much more introspective — what do I want to accomplish, how might I manage this situation in a better way? Let me think about it a little longer, be a little more contemplative rather than responsive immediately. I've benefited from that. I've been guilty in the past of firing off some emails that I would have rephrased differently the next day.
And being more empathic — even when there are challenges at work with employees, sometimes it's what's going on in their personal lives that's making it difficult to do their job as best they could. We have to be cognizant of that, and give our employees resources and tools to manage it. There are challenges with the blurring of our work and personal lives. When we work from home, we're working many more hours than we might have if we actually commuted to and from. So it's a lot of challenges right now for folks. I think we have to be a little more empathetic.
I hope you enjoyed that episode. You can find all my links by going to bigpicturemedicine.co.uk. And if you've been enjoying the podcast, please consider leaving a review. You can find links to John's course on LinkedIn in the description. Thanks for listening.