YouSaid · the spoken record

Daniel Nadler

lines on the record: 49
first: 2025-09-05
most recent: 2025-09-05
sittings or episodes: 1
sources: podcast

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“School, I've never had, I've never gone to one business school class. But I have friends that have, and there are people I respect that have done those things. And a lot of that world is like how to motivate people, how to inspire people, like how to give people constructive feedback and constructive criticism and all of this stuff. And I think there's definitely a body of knowledge there. You can definitely do better or worse at doing those things. But what I seek out in recruiting are the people for whom all of that is just entirely redundant because there's just no like they're just driven on their own warpath and the best you can do is sort of get out of their way.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“I quickly learned in my first company even that There is a there's only a moderate correlation, there's like a 0.65 correlation between freakishly smart and output. I think you have to find people that are obviously exceptionally intelligent, but to all the things I've been saying, have some propulsion system. They don't need to know where it comes from. But we've all met people that are extremely aggressive, are extremely driven. They might have very little understanding of why they are. That's better, not worse. better. And those are the people that end up, you know, that I tried to recruit and that I seek out in recruiting because then all the other stuff that is, you know, I actually don't like management and I don't want to practice the art of management. And so much of management needs to come into play in the absence of those things, right? Like a lot of this stuff, you know, I'm not an MBA by background. I've never had never gone to business.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“I don't need more of it, and quite the opposite. I resist trying to discover what the propulsion system is. Most propulsion systems originate from trauma. What's now become this sort of famous Sequoia methodology of Doug and these guys of talking about your early childhood and all this stuff. I think there's a lot of truth to it, except you don't want to go too close to that stuff because you'll actually kill the propulsion system in analyzing it.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“No. And actually the opposite. One of the things I think is unhelpful about the contemporary cult of psychoanalysis and psychology and psychiatry that sort of traces its origins to early 20th century in Freud and these guys is it doesn't appreciate that in the analysis and description of something you kill it So I've actually resisted exploring trauma I've resisted going back to the origins of my motivation. I've resisted going back to the origins of my aggression. I have kind of like a partially developed map from childhood and other experiences. But the second I feel myself going close to analyzing it, I resist the urge to analyze it because in the analysis of something is the deletion of it in a way.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“It's the same as it's no more creative than let's go to the moon. Let's do something really hard. What are the hard things?”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“To prove that person wrong or that person is a parent or a friend or a teacher, I mean, how many famous examples are there of people trying to prove a teacher wrong that is literally dead, you know, and that this person's, I've met these people, they're 75 years old and they're trying to prove a teacher wrong that it's been dead for 30 years. But it turns out that those things work and those ingredients work. And it doesn't need to be proving someone wrong. It could be people that have are born with an enormous amount of aggression and found a constructive way to channel that aggression. You know, in my case, I was born with just an unbelievable amount of aggression. And through a combination of trading my intellect and just luck, I found a more useful channel for that aggression. But you need to find this sort of perfect storm of things. And it has very little to do with ideas. The idea for open evidence is the most obvious idea in the world.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Everything that waterfalls down today to what MBAs or why combinator kids believe, which is just like, you know, so tell me, Daniel, when you had the idea for open evidence, were you in a coffee shop? What kind of coffee shop? What coffee were you drinking? Like, what was the circumstantial thing that gave rise to the idea, right? And all of that is actually just a derivative idea of Cartesian thought. And I think a more useful question for people than what coffee shop, what was the person drinking when they had the idea for something they admire is where can I find a level of motivation that is almost compulsive, right? And that's different for different people. There's no one answer, right? There are a lot of people that find that from proving somebody wrong, somebody said something to them when they're a kid that really just hit them in the right way when they were really psychologically vulnerable. And they've spent the rest of their life.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Then you'll succeed. But that's not a fairy tale that you can tell to why combinator kids or to MBAs, right? And there's this tension, and this has been discussed by many people at length, but there's this tension in the history of Western thought between rationalism and will, right? reason and will or the intellect and will and the enlightenment was this sort of Cambrian moment and the explosion of rationalism and ideas and this sort of faith and it really is a faith because the irony of the enlightenment is that the notion that reason is supreme was not arrived at through reason but through faith and there was this faith that reason would ultimately govern and that humans are in their first order rational and cogito ergosan And so much of”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Think if you build it, they will come as true, and nor would I say that Apple or Steve Jobs is a story if you build it, they will come. To me, Apple or Steve Jobs is a story that if you have extraordinary”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“That and minimum will be very refreshing and different and will lead to them considering the thing with an open mind. And in all likelihood, we'll break the mold that has typically been the rate limit of the adoption curve of whatever had defined that industry.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“While medicine is obviously very specific, the human psychology is not. And everything that was true and that we've seen through the sort of hyper-pace consumer internet growth curve adoption by the most traditionally skeptical knowledge workers shows that in any industry or subfield that tech might want to touch the same basic rules of the game psychologically apply, which is if you address people as people and as consumers and if you speak to them in a way they've already spoken to before and if you sort of hit them different you know in a way that no one's ever kind of come at them in that way before”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Just feels like now at least you can have a sort of more open conversation around if you want to at least mitigate the risk of neurogeneral disease, continue to do all the things Sanjay Gupta do. If you're left-handed, right with your right hand once in a while, if you're right-handed, right with your left hand once in a while, just silly things like that that will form new neural pathways.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Think the pendulum swings back and forth. I think all these issues are deeply entwined. I think that we're now for the first time in a long time having a more open conversation that is not just reduced through the lens of identity politics around health, life choices. And it's not just obesity versus, or it's not just overweight versus not overweight. Let's use something that has nothing to do with weight. Neurodegenerative. Now, there's a strong genetic component to neurodegenerative, and there are definitely people who have never used their brain in their entire life and never get Alzheimer's. That's obviously true. No serious neurologist will dispute the fact that a mitigant to neurodegenerative disease is to continue to use your brain over the course of your life.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“You can almost eat anything if it's in the right portions. They don't gouge themselves on food. They eat until 70, 80% full. All these things that are famously known. And I think at least we're having a conversation about it now in the United States. For the longest time, you had things that every doctor believed. There's no, I've never met a doctor who disagrees that, you know, as you get past a certain point in body weight, your risk of all sorts of things goes up. But 10, 15 years ago, no one wanted, no doctor would have wanted to say that out loud because it sounded like...”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Concepts in their culture of what Plato called a good life, but in Japanese culture, a good life is inextricable from a life with purpose. An idle life cannot in Japanese culture be a good life. Like those are incompatible notions, idleness and fulfillment. And so there's no concept of fetishizing like, I'm just going to work really hard, make a lot of money at 65, you know, I'm going to hang out on the beach. That's just not a concept really in at least the traditional culture absent the Western influences. So people work past 65 into their 70s, into their 80s. You know, that's when it really matters, right? Like, you know, that's when risk of mortality starts to go up a lot. And then, of course, famously, diet sort of, it's not just, you know, a sort of a pescatarian scooped diet, but it's also the fact that”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Disclaimer, disclaimer, disclaimer. But there isn't some net new list. So I was in Japan a couple months ago, and it is striking. It is shocking the extent to which, especially if you go outside the big cities and go to places like Kyoto or smaller cities like Hakone or so on, they're all walking. They're all just the average Japanese and at all ages. You have 70, 80-year-olds who are walking 10,000, 15,000 steps a day as a walking culture. And it's not just my sort of romanticized illusion as a white Western looking at it. Like I've gone pretty deep on this. I've been there, again, like a dozen times. I've had long conversations with people that are there, not just academics and scholars, but just ordinary people on the street taxi cab drivers and so on. They like walking. And also the older they get, the more they like walking. The younger kids actually are, you know, the ones that are 65 and 70, they'll just go walk four miles to work. They don't retire. They don't fetishize retirement.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“This is not going to be a popular answer or a politic answer, but. You go spend five seconds in Japan. I'm obsessed with Japan. I named my first company, Kensho. I was in Japan two months ago. I've been in Japan like a dozen times. I'm obsessed with Japanese culture. The difference in why there's so many differences, some of which are genetic, but a big difference in why they're so healthy in Japan is they just do all the things that everyone knows. And I'm not generalizing to all Japanese, and there's now Western food and Western culinary traditions that enter Japan, and it's all complex. We live a globalized world. But Japan.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“The hope, and this is kind of where we're in the midst of this, is that under resourced areas as an example, we have physicians using open evidence in every state electoral county and zip code in the United States, including rural Alaska and southwestern Georgia. And we get letters from doctors because when you make something awesome that's free, when you make something awesome that has a subscription, I think people like it, but they don't send you fan mail. When you make something awesome that's free, they send you fan mail. So we get fan mail from southwestern rural Georgia from an oncologist who's like, I'm one of two oncologists on a 50-mile radius serving a 75% African American population with a median household income of $43,000 a year. And I use open evidence as my curbside consult, which by which he means, you know, as my panel of other. So that starts to bridge it. And I think increasingly, certainly in rural areas and healthcare deserts at the fringes.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Is they really are sort of at the vanguard of thinking about distributed decision making. If there's a patient with a complex fact pattern, let's bring in sort of interdisciplinary, let's bring a group of doctors across disciplines and look at this in an interdisciplinary way. Let's have a cardiologist and a neurologist and an oncologist. Look, the issue is that's very expensive as I'm describing this. I'm just thinking real time it's really expensive to do. So then there's this equity issue where it's pretty clear what the right way to practice medicine is in 2025 in light of this explosion of treatments in the golden age of biotechnology. It's not clear how to pay for that because now it's not just one extremely expensive specialist. Now it's three or four.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Who wouldn't want physicians asking a panel of other physicians who might also know something about it, about the thing? The demands on a knowledge worker are highly correlated to the number and complexity of the tools available, right? Like in 1917, at the end of World War I, your tools were basically nothing. You had gauze and some scissors, right? So this is all very, very new that getting into my early example, like IL-17 inverse resile 23 inhibitors and biologics and the treatment of psoriasis where someone has a neurological comorbidity like that's all the last like five seconds from a historical perspective so of course the profession has to change and it's going to change evidence-based medicine curbside consults distributed decision making you know that's a big part of it like a lot of what's so incredible about all these famous places that are rightly famous mayo cleveland ucsf mg others”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“So, curbside consult sounds fancy, but it just means go ask some other physicians who might know something about this. I mean, all of these things sound obvious. Who wouldn't want evidence-based medicine?”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Do differently. They encourage evidence based medicine, not just guideline based medicine. They encourage the curbside consult. They basically try to solve the problem of information overload through distributed hive mind.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, it's going to change. It is changing. There are these very avant-garde. Approaches to residency at some of the top places like Mayo, Cleveland, UCSF, which are trying to deconstruct the 50 year old model.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Aha, okay, sort of wink, wink kind of thing. That is going to more or less invert where the continuing medical education is going to be the majority for medical education. And that's already happening. That's not a future projection, right? If you speak to really phenomenal world-class physicians, they will tell you very openly that 90-95% of what they practice, they learned postgraduating medical school. And in most cases, post their fellowships that they had fellowships and residencies for the residencies. And some of the greatest physicians that I've ever met and spoken with tell me extreme things like the majority of what they practice today, they learn in the last two years. And I've had a 70-year-old physician tell me that. Now, these are world-class people. But what that shows for everybody is that you're going to need to invert the construct of that change.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“I think medical education is going to radically change. I think doctors are going to be in the loop for a very long time. They have been in a loop since the ancient Greeks, if not the ancient Egyptians. I think you're going to be in the loop for a very, very, very long time and for the rest of our lifetimes, if not longer. Medical education is going to change radically because it's just, you know,”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Yeah, they don't have bodies yet. I mean, you can start to reason by analogy. Would there be any more of a mass public movement to have computers land planes if you still had a cockpit? If you just remove the two seats, no one wants that. Okay. What if you keep the two seats, but they're empty? I still think no one wants that. What if you keep the two seats and there are mannequins, essentially? that Act as visual surrogates for the computer system and what it's doing. I think if you were to pull people, that'd be the first time you see this little uptick in willingness. I think it would still be the minority.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“That's a domain or an industry where there's no debate really as to whether the technology is there. And yet you don't see this sort of mass movement of airline passengers to get the pilots out of cockpits. There just isn't. I'm not aware of one mass movement to get pilots out of cockpits. Then the question was why? And of course, that is a attribute of human psychology that we are anthropologically tribal. And we don't abstract trust well. We personify trust and we trust things that we personify and anthropomorphize. And there's a whole history”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Getting difficult. The definition of a singular event horizon is you cannot even project into the near future, let alone the far future. And I think we're probably in the midst of something like that. With respect to doctors in the loop, planes have been able to land themselves for a very long time. It's a peek into, in a way, a future by analogy”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“A civilian, what a p value is. And I think that's probably not a constructive outcome. So it's a balance. We encourage physicians to use open evidence to produce patient handouts, especially where guideline-based medicine is concerned.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“At the same time, you don't want, you can imagine all the failed cases where that could go wrong, where they're coming and saying, well, why aren't you putting my mother on this drug with their own handouts? And the answer might be a very technical answer, right? The answer might be that because your mother also has this other comorbidity, and if you look at the p-value, the p-value of the efficacy of this drug is not statistically robust in the presence of this other comorbidity. And the patient is like, what's a p-value? But they're not going to just stop at what's a p-value. They're going to get really upset. It says in this case that this other treatment is effective. And then you're just in this endless circle where the physician who has, by definition, taken at least one graduate level statistics course is trying to explain”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“And so I'm sympathetic to the idea that a patient simply finding some clinical trial published in the New England Journal of Medicine because it was mentioned on CNN or Fox News, and then going and trying to read it. Especially through the lens of fear or hope, is not necessarily going to result in the most sort of constructive decision-making process. I mean, there's no good answer. The reality is very tough, right? You want to give patients with all the answers that are clear in consensus. And certainly, you want to give them the tools to make sure that their physician is not missing anything.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“So, I've experienced both sides of this. So I've been on the patient side, and I'm very sympathetic to that because the reality is medicine is not perfect if it were everyone would be living to 80 or 90 years old. So clearly medicine is not perfect and in a world where it's not perfect, patients should definitely have some role in agency in that. What we have done is encourage physicians to use open evidence to generate patient handouts. And that's actually a very widely used secondary. It's mainly clinical support, but we have all these secondary use cases like prior authorization letters and insurance appeal letters. And one of the most common of those sort of secondary use cases is these generating these patient handouts. The other side of this that I can appreciate is it took me personally taking my first graduate level statistics course at Harvard to really understand these clinical trials.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Scale and the speed of it. And more common cases are cases in which the leadership of the hospital system are very avid users. So the entire, you know, this whole senior leadership of UCSF, of MGH, of Mayo Clinic, of Cleveland Clinic, of New York Presbyterian, Mount Sinai, Cedar Sinai, right up to the chief medical officers, the chief physicians and the CEOs in many cases are personally avid users.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Never been said before do something that hits different. And long story short, we did that with doctors and it wasn't the complexity of the idea. It was just no one who had ever addressed them as consumers before. And, you know, we had this realization, which is pretty obvious that while this wouldn't have been possible 20 years ago, today virtually every doctor in America is walking around with a computer in their pocket that they own called an iPhone or an Android phone usually. And they own that computer, right?”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“And download a free app and start using it. And it sounds so stupidly simple, but it was really profound and it was really effective because no one ever done that before. It's kind of almost analogous to in relationships, whether friendships or romantic relationships, people can get caught in these sort of cul-de-sacs where there's a rigidity to their dynamic and to their relationship. And then there's a breakthrough where one person says something that they've just never said it before or they've just never said it in that way before. And then there's like a breakthrough. It hits different, right? And in psychiatry or psychology and therapy, a lot of that field is encouraging this behavior in others is to just sort of break free of cul-de-sacs of dialectics, of relationship dynamics, and just say something in a way that”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Systems. I was like, it's an interesting way to organize the medical system and the health system. And you start to investigate and pull the thread a little bit and you start to understand why there are very few things that people can agree about in America. They can agree Congress is dysfunctional. And they agree that American health care is dysfunctional. It's like bipartisan universal consensus. But you start to really investigate and you come across two or three things and you're like, maybe that begins to explain the dysfunctionality, right? And to me in particular, the idea that doctors who were the fiber pilots, who were the knowledge workers, who were the people who have that MD on the line and have to make that high stakes decision weren't even their own gatekeepers as far as the technology they used. That was a pretty profound realization. And so we did something that had never been done before ever, which is we treated them as consumers and as people that could go onto the app store.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Well, I served both. So, this was a hack. I wanted to build a consumer internet company for knowledge workers. And I don't think that had ever been done before. So, I didn't want to build a healthcare company at all. I love Sequoia's quote that open evidence is a consumer internet company masquerading as a healthcare company. I had zero interest in building a healthcare company. Open evidence is not a healthcare company. I wanted to build a consumer company, but I wanted to do something that no one had ever done before, which is treat knowledge workers like consumers. So my whole career had been prior to this dealing with knowledge workers, right? People have a reductive view of consumers. They think of 14-year-olds on TikTok, and that tends to be like their archetype of what a consumer is. And it's one type of consumer. But traders on Wall Street are consumers and people. Lawyers are consumers and people and doctors are consumers and people. And what I realized is no one had ever treated doctors that way before. Doctors were just kind of treated as these appendages of health.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Because AI is golden, gold out, garbage, and garbage out. So they know this is not training on tweets. They know this is trained on New England Journal of Medicine and JAMA and the rest. They know that we have these partnerships, these strategic partnerships with the gold standards of medical knowledge. They know that they're not going to get an answer from open evidence. They're going to get a routing to a source that answers the question. And so I think all these things sort of stack into something that feels just like a pro tool.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Hard to do two things. It was hard to describe a complex patient scenario or a case into a search engine and have it come out with anything useful. And it was hard to find from the tens of billions of tokens, if you want to think of it as an engineer, that constitute the world of peer-reviewed public medical literature. It's very difficult to find the seven snippets that are directly responsive to a question and to the semantic meaning of the question as opposed to a few keywords. So we just did those two things, just did those two things extremely, extremely well. We framed the right social contract. We picked our audience extremely well. And all of those things start to stack into something that looks more like a Bloomberg terminal for doctors where it's just a pro tool. They're using this because it has the right data that goes in.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“The time. I would say it's almost the default behavior of a user to start with some complex query that you could not put into Google for the reasons I mentioned, because it's a paragraph long. And then have it produce within, you know, from a search space or a surface area of 35 million biomedical publications, the exact three to five canonical landmark phase-free RCTs or guidelines or other sources of information that are responsive, not answers that are responsive to their question. And then I would say almost the default behaviors, then they go out. I think we're one of the largest sources of referral traffic to the English Journal of Medicine after Google, the rankings, I don't know if number two or three or four, but we're one of the largest sources of referral traffic to our partner, the English Role of Medicine. That's a testament to the way people use it. Historically, it was very...”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Absolutely. So there are areas of medicine where there's a lot of conflicting evidence. To the phase 3 RCT in the English Journal of Medicine. And maybe the conflicting phase 3 RCT in JAMO, right? And we'd route them to both.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“So, the first way to deal with that third bucket of ambiguity is ensure that your users are physicians and not patients. And we've made that strategic decision. And we keep thinking we're going to change that decision. And we've been talking about changing that decision since the inception of the company and so far have not changed that decision. For all the reasons implicit in your question, there's an enormous luxury that we have as builders in having doctors as users because the MD is attached to their name, right? So they need to protect that MD and they're going to use us as a tool in the same way as a Wall Street trader might use a Bloomberg terminal. If a Bloomberg terminal, for example, produced an inaccurate quote on a bond that was very obviously inaccurate. It was off by an order of magnitude and the trader in a hedge fund just sort of, well, that's odd.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Of the query in the way that another human physician would semantically understand that query. And then it's actually quite deterministic and simple after that. Once you semantically understand the query, you can, from the world of published biomedical literature, you can find the exact snippets in a phase three RCT, a randomized control trial in the New England Journal of Medicine that tested each of these things and found that one aggravated MS and the other didn't, right? So once you have a semantic understanding of the query, the rest is fairly deterministic and it's almost a search problem. But all of the juice is in connecting the very complex semantic meaning of a medical scenario to the answer where the answer might be in a phase three RCT in the New One Journal of Medicine and in a snippet, not even in the abstract, but in the methodology section or in the population.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“And cancer. But even that kind of statistic kind of understands it because that's just looking at death, right? In the case of, in my example, this patient is not going to die as a result of taking an IL-17 inhibitor. She's going to have a relapse of MS. And so it's not just that medical error historically was a leading cause of death. It's that as many people die from medical error, probably a factor of 10 to 100 as many people had a comorbidity or condition that became aggravated and got worse and so on. So coming back to your question, that whole string is the search query. And so you can't just do search in a traditional way where you sort of say, you know, aisle 17, because that's not really what the questions about, nor does the physician have the time to go read book chapters on this stuff. What you need is a semantic understanding of the”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“It. That's kind of what you know. So, your question then is for a 40 year old female patient with Margaret psoriasis, is an IL-17 inhibitor, an IL-23 inhibitor, more appropriate and more safely tolerated with respect to not aggravating the MS. Now that's not a academic question that's a very consequential question. IL-17 inhibitors will actually make the MS worse. IL-23 inhibitors are safe and well-tolerated in case of MS. That's an example of where medicine can go wrong because even five or ten years ago, either you're referring that person to a neurologist, in which case you're just getting referrals and circles and medicine is not happening, or unfortunately, what would more likely happen is they would just 50-50 and that MS might be aggravated. And, you know, it's well known and it's been often repeated that medical air is a third leading cause of death in the United States after heart disease.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Worse and you are not a neurologist, you're a dermatologist, so neurology is not your specialty, but you don't want to go refer her to a neurologist because you want to treat her psoriasis. And if you just keep referring people in circles, medicine never happens. From the ether, you might have heard as a dermatologist that the new classes of psoriasis treatments, which are biologics, they're IL-17 inhibitors and IL-23 inhibitors, might have some interactivity with the neurological dimension of a patient's condition. That's about all you know. You didn't learn this in medical school because IL-23s were FDA approved in 2019, right? So one of the great themes of open evidence is that the sort of golden age of biotechnology is sort of the dark ages of physician burnout because it's just impossible to keep up with all the new drugs and all the new mechanisms of action and so on. So it was approved in 2019. You might have graduated medical school in 2005, right? So you didn't cover it in medical school.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Yes. One way to sort of simplify it down is at its foundation, it's a search problem, but it's a very semantic search problem. So most search traditionally works with keywords, right? So like, you know, flights to Barcelona or hotels in Barcelona, most of the keywords there can be captured in like a couple of words and certainly in a sentence. And that's sort of traditional Google search. Even if you were to think about clinical decision support as a search problem, simply describing your search query, if you want to think about it that way, usually takes many sentences. So an example I like to give is you have a 44-year-old female patient. She has moderate to severe psoriasis. That's the red stuff on your skin. You're a dermatologist. That's so far so simple. You would just prescribe one of the many creams you see commercials for on television. Except she has MS. So now it gets interesting because you want to treat her psoriasis, but you don't want to make the MS.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“Those things are part of the workflow of being a doctor, but the stakes and the consequences are different if you get it wrong, you can go back and do it again. That's not the case with a patient. You have to get it right. You have one shot to get it right. And so clinical decision making of which clinical decision support is in service of is unquestionably the highest stakes area of medicine. We're probably the only company working at the tip of that spear. Most people have self-selected themselves out of the problem of high stakes. Clinical decision making certainly through an AI lens because they view it as ambitious.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT
“As much as we would like to think that it's going especially well for us, I would sort of say as a qualifying point that in all of the sub-industries of AI, you're seeing an acceleration and compression, right? So the adoption cycles, even outside of open evidence before we get to open evidence in other fields of knowledge work and coding and so on are hyper compressed, right? It used to take half a decade or a decade for something to become standard and now it seems to happen in two years or a year. So the same things happened with open evidence. In about 18 months, it's become the operating system for clinical knowledge in the United States. It is used something like 20 times more than the next most used platform of any kind in our specific segment, which is high stakes clinical decision support for doctors. So high stakes clinical decision support for doctors is a specific category of medicine. It's distinct from, say, paperwork or it's distinct from scribing.”
2025-09-05 · No Priors · A New Operating System for Physicians with OpenEvidence Founder Daniel Nadler · IDENTIFIED FROM THE TRANSCRIPT