Building Doctors Who Can Fix Healthcare

Dr. John Shufeldt joins Dr. Mitchell Rothstein to discuss his life and the need for change in the US healthcare system. Dr. Shufeldt talks about the changes he has made in the healthcare space, from starting urgent care clinics in the 1990s to his healthcare venture capitol to his focus on indigenous populations and training the new generation of doctors. The two discuss the need for doctors to have a more flexible mind frame, the burgeoning role of AI in healthcare, and a focus on treating to biomarkers instead of treating to symptoms. Join the fascinating conversation with this healthcare disruptor.

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Transcript

Welcome To MedEvidence

Announcer 0:00

Welcome to MedEvidence, where we help you navigate the truth behind medical research with unbiased, evidence-proven facts, hosted by cardiologist and top medical researcher, Dr. Michael Koren.

Meet Dr. John Schufeldt

Dr. Mitchell Rothstein 0:11

Hi, this is Mitch Rothstein with MedEvidence, and today I have the privilege of being joined by Dr. John Schufeld. And thank you for joining us, Dr. Schufeldt. And I wanted to tell everybody a little bit about your background so they know the kind of expertise that you bring to the table on some of the topics that we'll talk about. Dr. Schuhfeld got his medical degree from Chicago Medical School in 86. He did his emergency medicine residency at Christ Hospital and served as chief resident there. He got then an MBA from Arizona State University in 95, and then followed that with a JD from Arizona State in 2005. His first venture into the entrepreneurial world was in 1993 when he founded NextCare, an urgent care facility uh program that he expanded from one to 60 facilities and exited as the CEO in 2010, at which time he started one of the first of its kind telehealth programs called MEMD, and that connected uh 500 medical and mental health providers across all 50 states, and that was sold to Walmart in 2021. In 2015, he started Tribal Health, which after witnessing some of the disparities in healthcare delivery, especially in indigenous lands, became vehicle for improving that delivery system. And then in 2021, he entered the venture capitalist world, starting Accelerant Ventures, specifically looking at helping healthcare startups. In 2025, he co-founded Viva Med Biopharma, drug development company, which currently is looking at, from what I read, 150 molecules, if is that correct. And most importantly from my aspect, in 2025, he also made a donation to the Arizona State Medical School and helped them expand their program to that which now involves not only growing physicians

An MD Plus Engineering In Four Years

Dr. Mitchell Rothstein 2:24

with medical backgrounds, but also with engineering backgrounds, specifically AI. Do I have that right, John? Did I and one of the things I was interested in and had a little bit of difficulty kind of assessing out the kind of aspects of when I applied to your medical school now, it does it take me four years to come out with an MD and a medical and engineering degree? Because I had a difficult time with just the medical part of it. I can't imagine adding on anything more.

Speaker 2 2:58

It does. You get a master's in engineering and then an MD, a doctorate in in medicine in four years. So they're fine programs.

Dr. Mitchell Rothstein 3:08

And did that require rehashing the entire curriculum of the medical school?

Speaker 2 3:14

It does. They have very team-based reverse classroom learning. So they're they're little these 10-person classrooms with computer whiteboard, eight students, a PhD, and an MD, and then they go after it and they combine engineering and medicine in the same coursework. And so they look at a very systems-based approach to fixing

Reverse Classroom And Team Learning

Speaker 2 3:34

the healthcare system, but they also look at very structural things in the body on both an engineering and medical perspective.

Dr. Mitchell Rothstein 3:40

And when you say reverse, you said reverse learning, what what what does that mean to me?

Speaker 2 3:45

Well, so back in the day, Dr. Chaklas stood up on the board, on a blackboard and drew, you probably remember, drew the femoral triangle and multicolored chalk. Now, I'm not an artist and I couldn't reproduce that if my someone held a gun in my head. And you'd be like, oh my God, because you had Frank Netter's textbook, those days are over. Now they're small classrooms where eight students basically teach the MD and the PhD their topic for the day. And so their topic for this last week was basically an immunology topic where they had to go in and do a deep dive into immunology, and they spend all day, every day going through these problems that they suss out. And they're basically they get presented with patients and they go very deep into the diagnosis, the treatment, the pathophysiology behind it, the microbiology and everything related to it, the biochemistry, everything related to the project, to the to whatever disease state they're looking at, and any engineering aspects that are applicable.

Dr. Mitchell Rothstein 4:41

And that that starts year one, day one. Day one. Yep. Yeah, because as I remember, and I'm sure you do also, and medical school, the clinical part really didn't start till your third year when you started to interact with patients. And the first couple of years was very didactic kind of book learning. And that sounds like it gives them a leg up. And in some of the articles that I've read that you're looking to help develop uh physician entrepreneurs, and through this kind of combination of the engineering and the medical background, how do you think that helps prepare people better to kind of change things going forward?

Speaker 2 5:23

Well, I think the students are really geared. Many of the students are already engineers, they already have their bachelor's in engineering. I mean, but there's also history major and an English major in the class as well. But they're really trained to look at healthcare not only as the patient in front of them, and there's a very strong humanities aspect of the curriculum as well, but not only as a patient in front of them, but the systems around the patient. How do they get there? How's healthcare delivery affected by them? How do they affect healthcare delivery? So it's really more of a global perspective, and not just created another set of physicians, but physicians are going to really change

AI Privacy Deepfakes And Data Security

Speaker 2 5:58

the system.

Dr. Mitchell Rothstein 5:59

And a strong part of the program obviously involves AI. And as you know, in the community right now, there's a lot of concern about privacy issues with AI, and people are concerned about it. And there's been some dents in the uh mantle of integrity of the medical community itself itself, looking at kind of how things back looking at how things were handled during COVID. Are there things that we should be doing now individually or as an industry to help ma have the community understand how this is not going to put them at their privacy at jeopardy and how it's going to help them?

Speaker 2 6:42

I mean, the data security is obviously incredibly important for a myriad of reasons. And so I think my people, myself included, and I think I'm pretty pretty adept at this, still gets almost clickbaited into things and still has to be cognizant, like, oh my God, do I really need three levels of the security here? And so, yeah, I think the we have to be just a higher level of awareness with these deep fakes, particularly now with uh with the gender of nature of AI and the voice fake and the video fake. It's interesting. We're looking at a company right now with Accelerant that uses radar to analyze someone's voice to make sure it's the actual person talking and not an AI, and not an AI model of their voice. So more and more is coming to try to subvert the male people with male intent.

Dr. Mitchell Rothstein 7:33

And that that will obviously increase the security of the system overall. And as AI will eventually, I guess, become the gatekeeper of that data pathway for all patients, right?

Speaker 2 7:47

Correct.

Dr. Mitchell Rothstein 7:48

So that that's uh uh I think something that we still uh need to kind of uh assure the community that you know we have control of this, even though we've got some of these AI systems kind of invading other AI systems during their test planning, but it'll be something that'll obviously change over the next couple of years.

Speaker 2 8:09

It will evolve. I totally agree. It will evolve over time.

Why Urgent Care Had To Exist

Dr. Mitchell Rothstein 8:13

Yeah. It's uh looking looking at the your kind of pathway and your development of the entrepreneurial aspects of medicine, was that something that you knew while you were in medical school that you just didn't want to be, you know, an ER doc doing your, you know, f 25 shifts a month, uh that you wanted to do something broader than that even while you were in medical school, or did that come in kind of during your clinical experience in the real world, or how did that happen?

Speaker 2 8:45

I mean, I was entrepreneurial since I was a little kid. I made candles and sold them door to door and made chocolate and sold them door to door. So I was always kind of that entrepreneurial spirit in medical school. I worked on an ambulance, I ran the student notes service where we distributed notes in the class to all the other students in the class. So I've always had that kind of mindset. My the problem I have is I see something and then I go, well, I'm not the sharpest tack in the box. I can't be the one I can't be the only one seeing this. Someone else had to figure this out. And then I'll go research it. I'm like, God darn it, no one else figured it out. So I'm like, all right, well, I guess it's me. And that's how urgent care started. I was, you know, seeing patient after patient that didn't need to be in the emergency department. And I went, you know, I did I did I did a knife and gun club ED residency, which is what I liked. And seeing UTIs and sore throats is totally fine, but that's not what I trained to do. We gotta get these people out of here. Where can they go? Well, let's go to an urgent care. And this was before the days of NPs and PAs, few PAs around, but it was all physician driven. And so we opened our first urgent care in '93, and no one knew what urgent care was. We had to convince the plans that we were something, convince the patients. And now, you know, you can't spit without hitting an urgent care. But in 93, people thought this was the craziest thing in the world.

Dr. Mitchell Rothstein 10:02

Yeah, it completely changed the landscape. How did uh staying on that topic though, as a newly minted ER doc, or relatively newly minted ER

Scaling Hard Lessons And Risk

Dr. Mitchell Rothstein 10:12

doc that required, I'm sure, a lot of organizational skill and a lot of financing to kind of start uh an ERG care center and then to grow it. How how did you uh organize those aspects of it in terms of the organizational people for the infrastructure and then the financing?

Speaker 2 10:31

Well, I would like to say that it was all well thought out and well planned and just went super smooth like a rocket ship. None of that would be true. It was trial and error, it was mistake after mistake, it was triple mortgaging my house, and you know, having the having the nurse manager embezzle $80,000. And I mean, just the stories go on and on, and they're laughable. Now, you know, there's that Soren Kierkegaard quote, life can only be understood backwards, but has to be lived forward. And I look back and where I am today, I'm like, oh, it makes total sense. There's this pathway here, and it one follows the other, but going forward as it was just, you know, throwing stuff at the wall.

Dr. Mitchell Rothstein 11:08

So it wasn't a straight it wasn't a straight walk from one to sixty centers. There were some ups and downs along the way.

Speaker 2 11:15

There was yeah, more than more than some. But you know, looking back, it you know, it's old the old saying that success is stumbling from failure to failure with no loss of enthusiasm. You know, I'm the eternal optimist and very enthusiastic. So although there are a lot of nights I talked to the ceiling fan at 3 a.m. Um, and it never really responded back to me, um, I would do it all again in the second because the you know it's not the it's that's always a journey, not the destination.

Dr. Mitchell Rothstein 11:41

Yeah. Well that uh it it's it just from reading your bio, it has been having quite a journey. And I I abbreviated it because I wanted some time to talk to you during the time that we had together.

What Venture Capital Looks For

Dr. Mitchell Rothstein 11:53

So now you're entering the the kind of ventured capitalist uh marketplace and you're looking at new bio startups. When you when you look at a company and you're evaluating a company now, are there certain things that you that that hit you and you say, you know, yeah, that's something I want to be part of? Is it is it mostly product or company culture? Or when you do your evaluations, what are the kind of the main points that you hit looking at companies?

Speaker 2 12:20

I mean, we look at things that are non-consent. What I try to do is find things that are non-consensus and right. And what I mean by that is things that that when someone tells you them, you're like, huh. This person's either crazy, they're out of their mind, or they may be on to something. And I personally had a few of those. Mostly I've been crazy, but a couple of times it's like, wow, that actually made some sense and got market validation. So we look for things that are non-consensus and right. We look for people trying to solve problems that are expensive to solve, difficult to solve, repetitive, and that have a decent mode around them. So no one else can just jump in and try to solve them as well. And we find a significant amount of those, but we also see a significant amount of people with these crazy cool solutions. But when you drill down to it and say, okay, this is cool, but what problem are you trying to solve? And the problem might be really small or very personal to them, which is great, go for it. But it's just not a it's just not a big business opportunity for us. And the other thing we look for, and this I have a I'm still having internal dialogue with. I always look for, you know, I look for founders who are coachable, they they demonstrate humility, they treat others with kindness, blah, blah all the things we like in humans. However, then that's and that's the that's the kind of the construct I use. However, you know, what I've invested in Elon Musk, what I've invested in Steve Jobs, in Mark Zuckerberg, who shows up late and Steve Jobs done showered and flip-flops, I probably wouldn't have, but that would have been a mistake. So this whole pattern recognition thing that I have going on in my head, I'm like, oh my gosh, I've got pattern recognition because I've been a founder, maybe entirely BS. It may not be the way to look at it. So that that's been uh that that's been the internal dialogue.

Dr. Mitchell Rothstein 14:12

Well, I it it's interesting, and I I enjoyed your uh comments about the founders and funders, and I place myself in the second category uh primarily as a uh right-along funder.

Better Matching Patients To Providers

Dr. Mitchell Rothstein 14:25

But currently, right now, uh what do you think as you see the landscape in healthcare from your perspective, where are the areas of biggest need for innovation and change in terms of whether it's in terms of either therapy or in terms of healthcare delivery or in terms of reimbursement? What do you see the landscape of medicine doing over the next decade? It's clearly not going to stay the way it is now.

Speaker 2 14:57

Nor nor should it. I mean, anybody who's been a patient or a provider, and I'm sure you had this too, I probably had calls three to five times a week. Can you help me, John, navigate something? I've got my friend has this issue, I have this issue, my child has this issue, and I'm getting nowhere. So fortunately, I'm old and have gray hair and met some people who are best in class, and I can call you up and say, hey, I needed the best sleep medicine specialist, who do I go to? And you could say, Oh, you know, 10 of them off the, you know, off in your off the back of your hand. So we need to figure out a better way to bring the right patient to the right provider at the right time who makes the right diagnosis for the right price. And I think we're close. And that's gonna involve everything from AI to genomics to epigenetics to pharmacogenetics, making sure the patient's treated with the right medication who can metabolize the medication, and then treating these people in real time. So that's that I think is the big area for oper big area of opportunity. The challenge is gonna be figuring out how to work with the health plans. And I've had a flip in this. I mean, I'm a capitalist and then some, however, this ain't working. And so you look at the you know, the health plan CEO salaries and the multiple, multiple layers of people trying to figure out a way that the patients don't get care from the from the physicians and ways to pay physicians less, that's that that that can't be sustainable. And so I'm actually migrating towards a single-payer health system. And even though I don't know if Canada or the UK has figured it out, I think we can. And it probably won't be in my lifetime, but something does have to change.

Dr. Mitchell Rothstein 16:36

And if you migrate to that kind of system, and then you obviously have a set amount of money per patient per year, do you think that has a downstream effect on reducing the entrepreneurial aspects of medicine that we're kind of currently moving forward off of the kind of fringes of a private

Biomarkers AI And Smarter Drug Development

Dr. Mitchell Rothstein 16:58

healthcare system?

Speaker 2 16:59

Well, it's it's certainly not the health plans generally. I mean, some of the health plans have venture capital arms, but it's certainly not the health plans generally that are driving the need for more tech more better technology. It's, I believe, physicians and other healthcare people immersed in the system who are saying, like, all right, this has to change because this doesn't work. And maybe it's a very personal experience, or maybe for a physician, it's just the things that he or she sees every day that just grinds them and and their colleagues down. And so we see a lot of that on the drug development side using AI, we've reformulated a lot of medications that are on the patent cliff and use them and focus them towards the biomarker of the disease and not the disease itself. Because, as you know, two people with asthma, me and a 20-year-old woman, probably have a different root cause for our wheezing and it may be a biomarker cause. We need to trace, we need to direct our care towards the our treatment towards the biomarker, not towards the symptoms. So that's how that's how we're approaching that. And that's a very sophisticated AI model.

Dr. Mitchell Rothstein 18:07

Yeah, yeah. I I think uh, you know, compared to hanging theophiline drips back in the day without, you know, even an automated uh IV where we were counting drops per minute, things have come a long way in the last 40 years. So that's really uh quite a quite a telling statement. And I I did want to, before we close, again congratulate you on the medical school and this whole idea of kind of changing uh the way we're approaching medicine from the beginning of the training period, which is when we really need to do it. Otherwise you get kind of concrete thinkers, which a lot of people in my age group were, because that's the way we were trained and didn't really have well, our energy was really kind of devoted to doing the the way we did things and not really

Fixing Indigenous Healthcare Disparities

Dr. Mitchell Rothstein 19:00

looking outward towards the way we could be doing things. So is there is there one particular aspect right now that you would like to see if you could change tomorrow? And I know healthcare delivery is primarily what your interest is, but other than healthcare delivery, what would the next thing that be in terms of the healthcare industry that you would like to see change? Is is the uh from your aspect and your legal training, is the regulation overwhelming at this point? Is it too much or too little, or is that something we should be tinkering with?

Speaker 2 19:36

Or I mean I it takes quite a while to get drugs to market, and that's changing. I think the FDA is changing as well, so I'm less concerned about that. I think after spending so much time and in Indigenous lands treating, you know, uh Native Americans, there's a huge, huge health care disparity between what what what we in the zip code who won the zip code lottery think of as good health care and those who live in Indigenous who are forced to live in indigenous lands. That has to change. That's unfair that they've been treated unfairly for 400 years. And I think if a anybody goes out there and witnesses how folks live, I mean they're incredibly gracious and thoughtful and and wonderful people, but boy, if you stacked up all the odds they have against them, most of us would just crumble. They're they're resilient as hell, but now's the time to right that wrong and fix the healthcare disparities among all the other disparities that they're faced that they face. I'd fix that.

Dr. Mitchell Rothstein 20:42

Yeah, well, that is well

Where To Learn More And Wrap

Dr. Mitchell Rothstein 20:44

said. And and John, if people want to learn more about the John Schufeld School of Medicine and Med and Medical Engineering, what what should they do? Uh your website or how should they get a hold of you?

Speaker 2 20:58

Certainly this the Exuthern Adventures website. Um certainly does it. LinkedIn works as well. I try to be responsive to both. And uh so yeah, either way works.

Dr. Mitchell Rothstein 21:09

That's great. And I can't tell you how much I appreciate your time. Of all the busy people, I don't know if I've ever met anybody busier.

Speaker 2 21:16

So uh I literally haven't worked a day in my life. It's been it's been a blast.

Dr. Mitchell Rothstein 21:21

Well, thank you, and thank you for taking the time to speak with me.

Announcer 21:24

Pleasure mine. Thank you. Thanks for joining the MedEvidence Podcast. To learn more, head over to Medevidence.com or subscribe to our podcast on your favorite podcast platform.