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Bryant Lin

Director of the Stanford Consultative Medicine Clinic

Since 2013, Bryant Lin has been the director of the Stanford Consultative Medicine Clinic, where he satisfies his natural curiosity by trying to shed light on medical cases that have exhausted all the normal options. Before landing at Stanford, he got his medical degree from Tufts University (Boston) and studied at the Massachusetts Institute of Technology (MIT). Lin works in Palo Alto (Silicon Valley), where he has also brought out his entrepreneuring side, creating several start-ups for medical devices. 

Living in Silicon Valley has allowed him to start up businesses easily and not fear failure. But being surrounded by the most powerful technology companies in the world doesn’t mean he prioritizes technology over what he believes is essential in medicine: speaking with the patient. At the center he heads up, the Stanford Consultative Medicine Clinic, questions are key to finding answers and finally coming to a diagnosis. For entrepreneuring, he likes fieldwork. This June, he was the keynote speaker at the latest graduation ceremony of the d·HEALTH Barcelona program, which is committed to first-hand knowledge of medical needs. In the digital, technology age, Lin advocates getting back to basics: humanity.

What is the Stanford Consultative Medicine Clinic?

It’s a diagnostic clinic where patients are normally referred from other doctors after having had extensive prior evaluation without a clear diagnosis. This is when they come to Stanford, seeking advice, a fresh set of eyes, and here we use a new process.

Is it the method or technology that makes it different?

Really, it’s a combination of the two. The method is simple: we spend a lot of time doing what doctors used to do with patients years ago: writing down their medical history, what’s going on. Here in Spain, the same is happening as in the United States. Basically, doctors spend less and less time with patients so you have to come to very quick conclusions. Fortunately, the university has given me the chance to spend an average of 60-90 minutes with each patient, to talk and understand their symptoms in detail. Often patients who have been passed from one doctor to another, have spent quite a while trying to get diagnosed, develop a short version of what’s going on. “This hurts,” they say. Or they come in with a sheet of paper with what they’ve been told previously. And that’s not helpful because they don’t know whether what they’re leaving out is important or not. I’m not trapped in the same mentality as other doctors, so I need for them to explain it all to me, to get the whole story.

What role does technology play at your clinic?

After speaking, the second method we use is more technological. Basically, we use a ton of tools that already exist to classify diagnoses. It’s software based on loads and loads of data that allows you to enter some symptoms and get a list of possible diagnoses. The common ones are easy, of course, but they’ve already been discarded for these patients. In these cases it may be something you haven’t seen before or just something that you hadn’t thought of. Computers aren’t good at getting information from people, interviewing them to get what we need to hear, but they are good at compiling a list of diseases that the patient may have based on a symptom that I’ve chosen from the interview and put into the software.

How does being in an innovative setting like Palo Alto affect you?

I started this because I’m drawn to interesting medical cases, because I’m curious, at heart, and not because I’m in this setting. However it is true that I like the idea of putting technology to work, so the third part of the method is our panel of experts we can consult with and we’re now developing a system that, pardon the comparison, is like that column in The New York Times where they publish a case and have people comment, even if they aren’t experts. Well, I want to do something similar for the medical community. Working to open up this area of participative research and to raise awareness of our results. Sometimes looking at similar cases can help other patients.

Do you feel like you’re democratizing medical information?

I’m simply improving the use of data within a framework. Now the information is there but it’s hard to access. My idea is for everyone who wants to be able to use our process.

All of these ideas remind me of the design thinking concepts in programs like Biocat’s d·HEALTH Barcelona. You gave the keynote speech at the graduation ceremony for this year’s fellows. What did you say to them?

Above all, I spoke about empathy, which is an essential part of design thinking and medicine, a human thing: you deal with patients, not anatomic beings. In fact, I ended up telling the story of one of my patients who found the strength in his last days of life to write me a thank you note. I carry it with me at all times and re-read it whenever I need to remind myself why I keep doing this, when I see that I can lose sight of the world because of business, for example. What do I have to remember? That we’re people, human beings, and that technology doesn’t matter, as it will always change. The human aspect is what will never change.

Is that why you particularly like this program, d·HEALTH Barcelona?

Exactly, because it brings out the human side. It allows you to truly connect with patients, regardless of the technology used, and focuses everything on needs. You can't find a solution without understanding the underlying need.

Can a company innovate from an office, or only on the ground?

You can, some people are just programmed that way, but it’s easy to misunderstand the need sitting behind a desk. We are more about democratizing innovation, which means educating people on the process for innovating. And one of the important aspects of the process is having a small, multidisciplinary team: different perspectives can never be bad. However too many points of view can generate an excess of data that we can't process, which is why I always advocate for small multidisciplinary teams.

What do you think of this year’s graduates?

Nine months is a short time but they’ve done great work speaking to people, understanding needs. And they’re tackling huge problems like urinary and fecal incontinence and breastfeeding.

What advice would you give new health entrepreneurs?

I would tell them to work on something they’re passionate about and then to set clear milestones and indicators, steps to reach success. And if they fail, that’s the good thing about Silicon Valley, no one cares. There we think that if you haven’t failed, you haven’t worked at enough companies. Another piece of advice would be to invest in the company. Many entrepreneurs make the mistake of setting up a team specifically to attract investment. No, pick the team you need and if the investor likes your idea, they’ll have someone help you if needs be. In the end, you have to remember that investors are conservative in nature and don’t want to be blamed. They don’t want anyone to say they’ve taken an unnecessary risk. That’s the bottom line.

You’re an entrepreneur yourself. What type of companies have you set up?

I have a couple of companies and consult for some start-ups. I’ve been developing a device to treat nasal congestion and dripping caused by allergies, although it’s also a common problem in people without allergies. It’s debilitating. It isn't serious but it is bothersome, and people often don’t seek treatment. I also created a company to treat sleep apnea, although it wasn’t successful, and another I’m working on now that involves digital health.

Is that a hot field now?

In my graduation speech, I spoke to the d·HEALTH Barcelona fellows about the past, present and future of Silicon Valley, about how things have changed over the years. Honestly, it’s been somewhat for the worse, especially in terms of venture capital for traditional medical devices due to regulatory changes, but also because these things go in cycles and now it’s all about biotechnology and digital health.

Is digital health the future?

People are working in the field but… who knows what will work in the future. There are lots of things out there that haven’t followed the design thinking method, that are on the market even though no one knows what need they address. I think the same of big data, the cloud and mobile health: we’ll have to wait and see, one by one, the solutions proposed and whether or not they work. But, in any case, nothing is done as if by magic. And they make their mark, they’ll be one more tool, especially in monitoring and controlling chronic illnesses.

Is there a bit of hype surrounding this type of technology?

Could be, especially in terms of funding. But two things are true: on one hand, if they don’t invest in it and it doesn’t make it to the market, we’ll never know if it’s truly useful and whether it works. But, on the other, we have to remember that most doctors are against this type of technology. Medicine is conservative. We tend to see lots of new things, but they come and go. Plus, we’re trained to base our decisions on proof and it’s hard to find proof that these new types of technology actually work. 

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