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We explore the powerful intersection of artificial intelligence (AI) and appreciative inquiry (AI) in health care. Anesthesiologist Wael Saasouh and health care executive Lisa Scardina share their insights on how technology can support collaboration, boost morale, and improve clinical practice. Joined by physician advocate and physical therapist Kim Downey, we discuss the importance of finding purpose, maintaining healthy connections, and fostering a supportive environment for both clinicians and patients. Discover how positive inquiry and thoughtful AI integration can inspire hope and drive meaningful change in health care.
Wael Saasouh is an anesthesiologist. Lisa Scardina is a health care executive. Kim Downey is a physician advocate and physical therapist.
They discuss the KevinMD article, “The role of AI in improving health care: artificial intelligence and appreciative inquiry.”
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Transcript
Kevin Pho: I’d welcome everyone to the show. Subscribe at KevinMD.com/podcast. Today, we bring back Wael Saasouh, Lisa Scardina, and Kim Downey. Wael is an anesthesiologist. Lisa is a health care executive. And Kim, of course, is our physician advocate who brought everyone together. Today, we’re going to talk about artificial intelligence, the role of AI in improving health care, artificial intelligence, and appreciative inquiry.
Kevin Pho: Everybody, welcome back to the show.
Lisa Scardina: Thanks, Kevin.
Kevin Pho: All right, Kim, as always, we’ll start with you. So, I’m not going to ask you how we brought everyone together because we talked about that last time. Instead, let’s dive into the role of AI. How did this topic come up with everyone here?
Kim Downey: I interviewed Wael and Lisa for my own YouTube channel, and we talked about so many things during that episode. This came up, and that’s how we ended up writing the articles—because there were so many good nuggets in our conversation, it was too much for one article. So, we divided it into two.
Kevin Pho: Perfect. What did you guys talk about during your show? As you know, AI has its tentacles in so many different aspects of health care. What were some of the highlights when you talked to them?
Kim Downey: Well, I thought Wael had some great points about the ways that AI could help that I hadn’t been directly thinking of. I had mostly thought about it in terms of making things easier for physicians when they’re with patients. But he brought up things like direct recognition, gamified reward systems, employee education opportunities, fostering collaboration, and research and academic advancement. I hadn’t really considered those aspects before our conversation.
Kevin Pho: All right, so I’m interested in hearing everyone’s perspective. We’re going to talk about appreciative inquiry and its intersection with AI. Lisa, tell us more about that.
Lisa Scardina: Yeah, I think there’s an interesting and obvious play on words between AI as artificial intelligence and AI as appreciative inquiry. I have a certification from Case Western Reserve University and have really enjoyed getting to know more about that model. The idea of asking positive questions is a marker of a high-performing team, and it really takes a strengths-based approach to working in teams.
When Wael was sharing his thoughts about the technology solutions, as Kim just mentioned, it complemented what he was speaking about in terms of thinking: How does this land with people? That’s the work we’re doing and the conversations we’re having with our teams—to understand technology, think about its implications and opportunities, but to do so in a way that works from where a team is at. We aim to ensure there’s a healthy culture within the team as we think about technology implementations.
Kevin Pho: Lisa, give us some examples of positive framing at the intersection of AI and health care.
Lisa Scardina: Sure. It’s interesting that this model comes from Case Western Reserve in Cleveland, and the original research was done at the Cleveland Clinic. So, it really has its DNA in the health care setting. Ultimately, it’s classic when a team looks at a scorecard in terms of performance. We have a human habit of focusing on the reds and thinking, “OK, what’s wrong here?” That creates a deficit mindset. Teams back up and say, “Yikes, I don’t want to be part of that conversation.” But when we look at the greens and say, “What’s going well? Where is the strength in this group?” it changes the perspective.
We know that high-performing teams have three to one or even five to one positive to negative comments. For me, in a practical way—both with my group and in the physician recruitment space where I work—it’s about those cultural underpinnings. Teams lean in when there’s a positive environment and a shared sense of strengths. It’s hard to quantify, but it’s about whether a group approaches things with a positive or deficit mindset. Wael spoke about this in our previous conversation and continues to build on it.
Kevin Pho: Lisa, with the adoption of AI, are clinicians approaching it with a growth mindset or a deficit mindset? What are you seeing?
Lisa Scardina: From what I see, there’s curiosity about AI’s opportunities in health care. However, during recruitment processes or as physicians and APCs consider new practice settings, culture plays a significant role. Questions like, “Is this a healthy culture?” or “How do decisions get made?” are critical. That’s where appreciative inquiry and a strengths-based approach come into play.
Kevin Pho: Wael, Kim mentioned AI scribes earlier as a current use of AI. What are other ways AI is infiltrating health care?
Wael Saasouh: AI’s impact can be seen in two ways: how it helps and how it hinders. Some clinicians fear that increased efficiency through AI will lead to increased workloads. The thought is, “If we’re more efficient, does that mean we’re expected to see more patients to cover the cost of AI?” That fear can make hesitant adopters even more resistant.
On the flip side, AI can alleviate burnout if used correctly. For example, gamified reward systems can boost morale and foster collaboration. However, the success of such systems depends heavily on the culture. If the system fosters unhealthy competition, it won’t work. Instead, the goal should be to create a healthy, supportive environment where AI adoption is seen as beneficial to both individuals and teams.
Kevin Pho: Wael, how do we prime the culture for AI adoption with a growth mindset?
Wael Saasouh: It starts with identifying what’s going well within a team. A team that’s burnt out won’t see AI as a priority. Begin by addressing morale and engagement. Once a baseline is established, layers like gamified systems can be added to enhance performance and collaboration. Culture is foundational—AI should augment a team, not overwhelm it.
Kevin Pho: Kim, after hearing Wael and Lisa’s perspectives, how has your view of AI in health care evolved?
Kim Downey: As someone who calls herself a technology dinosaur, I’ve been fearful of AI. Wael’s insights make me more open-minded. Lisa’s points about involving people and focusing on positives resonate. However, I’m cautious. I remember when EMRs were introduced, and we were told they’d give us more patient time. That was the biggest lie ever. So, honesty with the team is crucial.
Kevin Pho: Kim, I know you talk to a lot of physicians who are burnt out. Are you seeing AI making a difference? For instance, are AI scribes moving the needle for some of these physicians?
Kim Downey: It’s still mixed. Some physicians are able to use the scribes effectively, while others remain fearful. My perspective, as someone who works within health care operations, is that we often think of AI in grand terms. But many small efficiencies are already embedded in workflows. These incremental changes are forms of AI that can aid operational efficiencies.
There are certainly larger opportunities, as Wael described, where AI can come into practice settings. What I see as bright spots are physician leaders stepping up, promoting new ways of working despite the physician shortage and the opportunities technology provides. For instance, team-based care or even ways to augment existing workflows with technology can drive efficiencies. However, it’s critical to highlight and build on the bright spots within organizations where leaders are successfully integrating AI.
Kevin Pho: Lisa, are administrators approaching AI with an open-minded perspective? Are they listening to the tenets of appreciative inquiry?
Lisa Scardina: Over my 20-year-plus career in health care, I’ve seen the physician voice come into leadership differently, and it’s exciting. Especially given the complexity of information today, becoming more of a learning organization is vital. Structures like medical group boards allow physician leaders to make recommendations and contribute directly to decision-making.
The presence of the physician voice at the leadership table is a positive shift. That perspective allows for an emphasis on good work and storytelling around bright spots, which helps address gaps and deficits contributing to burnout. It’s about leveraging AI strategically to solve real problems, not just adopting it for the sake of innovation.
Kevin Pho: Wael, if you were advising administrative leaders at health care institutions about adopting AI, what questions should they consider before implementation?
Wael Saasouh: The key is defining your parameters. If someone asks, “Should I implement AI?” my response is, “What do you want from it? Where do you want to apply it?” Be as specific as possible. For instance, if your goal is to increase revenue, a billing system might suffice. But if you’re looking to improve morale, that’s a completely different set of AI tools.
You need to align the implementation with the culture of the institution because not every tool will work in every environment. Knowing your “why” and matching it to the culture will ensure success. A mismatched tool can do more harm than good.
Kevin Pho: We’re talking to Wael Saasouh, Lisa Scardina, and Kim Downey. Today’s topic is the role of AI in improving health care, artificial intelligence, and appreciative inquiry. I’ll now ask each of you to share take-home messages for the KevinMD audience. Lisa, let’s start with you.
Lisa Scardina: I would encourage listeners to learn more about appreciative inquiry. It’s grounded in psychology, and how we make decisions and interpret information matters. As a leader, I’ve found it valuable to understand how asking positive questions helps teams feel better. That’s a small but significant step in combating burnout. The fact that this model originates from health care research at the Cleveland Clinic adds credibility for this audience. I hope listeners remain curious about this approach.
Kevin Pho: Wael, your take-home messages?
Wael Saasouh: I’d urge everyone to maintain a sense of purpose and a desire for self-improvement. Altruism is core to medicine—we’re here to help others. But remember to focus on yourself as well. If you’re not OK, your patients and colleagues won’t be either.
Simple gestures matter: a smile, a “thank you,” or a “please.” Technology should enhance humanity, not replace it. Maintain that human aspect of care, and everything else will fall into place.
Kevin Pho: Kim, we’ll end with you. What are your take-home messages?
Kim Downey: First, regarding artificial intelligence, I see its potential to help doctors, and I sincerely hope that happens. However, leaders must not expect doctors to produce more as a result. Doctors need time with their patients, and there’s no substitute for that. Patients crave connection with their doctors, and no robot can replace that human interaction.
As for appreciative inquiry, at its heart is improved communication, which benefits everyone. Personally, I continue working on my communication skills and have seen a tremendous difference. Recently, I had a thoughtful dialogue with a friend of differing political views because we share trust and safety in our relationship. Similarly, as a patient, I’ve had meaningful conversations with doctors that improved both our perspectives. These interactions matter deeply, and they inform how I approach future appointments. I’ll end with the concluding line of our article: “Artificial intelligence needs appreciative inquiry.”
Kevin Pho: Thank you all for sharing your perspectives and insights, and thanks again for coming back on the show.
Wael Saasouh, Lisa Scardina, and Kim Downey: Thank you. Thanks for having us, Kevin.
