Key Takeaways
- Combine augmented reality hardware with generative AI to enable real-time access to clinical data and language translation, significantly improving speed and equity in emergency care.
Healthcare AI isn’t just hype. In an industry where seconds count and complexity rules, artificial intelligence offers both a lifeline and a landmine for American medicine. As hospitals confront workforce shortages, patient volumes, and regulatory churn, AI’s potential to reshape decision-making, improve outcomes, and extend reach has never been more consequential.
But AI’s value isn’t theoretical. This is the era where an ER physician can, within days, publish a book mapping out how Apple’s Vision Pro and generative AI might transform emergency care, triage, and patient engagement. That physician is Harvey Castro, MD, MBA, an ER physician, entrepreneur, and AI futurist with deep operational and clinical experience. In his recent conversation on the American Journal of Healthcare Strategy podcast, Dr. Castro—now at {{Guest Workplace Name}}—pulled back the curtain on how AI is colliding with medical practice, why he’s bullish on next-gen tech, and what executives need to know to stay ahead of the curve.
If you’re navigating health system transformation, evaluating investments, or leading teams through digital disruption, his perspective is required reading. Here’s what you need to know.
Dr. Harvey Castro is an ER physician, entrepreneur, and self-described “Nutty Professor” of healthcare technology. He’s launched companies, authored books, and held C-suite roles—“I created about eight emergency rooms here in Texas and at some point had 350 employees,” he shares, illustrating his firsthand understanding of both the front lines and the boardroom.
What makes Castro credible to speak on healthcare AI?
Track Record of Innovation: From building a vitamin company and launching over 30 medical apps—including the first IV medications app for iPhone—to writing the first book on ChatGPT in healthcare in 2022, Castro moves fast and builds at scale.
Clinical Gravitas: Board-certified and active in emergency medicine, he grounds his tech vision in real-world clinical needs.
Futurist Lens: “I take pride in being a thought leader and a futurist,” Castro says. His work straddles the now and the next.
“I literally put on my doctor hat, my CEO hat, and started writing a book about different ideas—nothing that cannot be done today. Honestly, some of the crazy ideas I came up with are just taking different technologies and putting them all into one. I really think that is going to be the future.”
AI, paired with Apple Vision Pro, could revolutionize real-time care in the ER—if health systems act quickly.
Dr. Castro offers a concrete vision: “Imagine you’re my patient, and I have the Apple Vision Pro on. Seconds count in the ER. I might need your X-rays, your labs, your entire medical record. What if I could see all that, in real time, in my field of view, while taking care of you?”
Real-Time Clinical Data Access
“Being able to see your labs, X-rays, and chart while caring for you—maybe you’re unconscious or unable to answer—would be a game-changer.”
Language Translation at the Bedside
“What if the Vision Pro could translate in real time as I speak, giving you information in your language and me in mine?”
AI-Powered Chart Summarization
“Imagine having AI summarize your volumes of medical records on the fly, letting me query specifics while I’m with you.”
Efficiency: Time-to-treatment drops, cognitive load lightens.
Equity: Language barriers and data overload decrease.
Safety: The right information, at the right time, for the right patient.
But Castro is clear-eyed about the politics: “Departments that bring in a lot of profit—like neurosurgery—are able to get this technology first. Less profitable departments may lag, unless we can prove these tools save lives or drive efficiency.”
Widespread AI adoption in U.S. hospitals faces both economic and cultural headwinds.
Castro doesn’t mince words: “There’s always politics. Departments that are financially strong can say, ‘I want this new gadget,’ and get it. Others—often the ones losing money—are less likely to get this technology.” This resource gap risks exacerbating existing healthcare inequities unless leaders focus on measurable outcomes and scalable use cases.
Budget disparities between specialties and departments
Culture and “old ways” of working (yes, many hospitals still use fax machines)
Uncertainty about ROI, liability, and workflow impact
Fear of the unknown—from bedside nurses to C-suite skeptics
Despite these challenges, Castro’s optimism is grounded in recent momentum: “As we start creating use cases and showing that this is saving lives or becoming more efficient, hospital systems will end up funding it—even in departments that wouldn’t normally get this technology.”
Necessity—and frustration—drove Castro’s AI journey.
“I was coding a patient, gave the nurse an order, and she had to look up the dosage in a textbook, do the math, and it took forever. I thought, ‘There has to be a better way.’ So I taught myself to program and created the first IV app in the world.”
Fast forward to ChatGPT’s launch, and Castro recognized a similarly seismic shift: “It was my iPhone moment all over again. I thought, ‘This is going to change medicine.’” That realization fueled his book, ChatGPT and Healthcare, and catalyzed his mission to educate clinicians on AI’s possibilities and pitfalls.
Innovators are made, not born: Frustration + curiosity + action = transformation.
Tech adoption is a mindset before it’s a process: “I tend to be a very creative person in that space,” Castro notes.
Education is a force multiplier: Early adopters must become teachers, demystifying AI for others.
The biggest risk isn’t that AI will replace doctors, but that it will mislead patients or clinicians.
Castro doesn’t sugarcoat the hazards: “Non-physicians may use ChatGPT like Dr. Google. They’ll put in symptoms and, if ChatGPT says they’re okay, they may skip seeing a doctor. Outside the U.S., where you can get drugs at a pharmacy, this is even riskier.”
He’s wary of self-diagnosis, medication misuse, and “hallucinations”—AI-generated errors—which, even at a 4% error rate, are unacceptable when stakes are life and death. “Even if the newer models are saying they can get the error rate down to 4%, to me that’s 4% too much because this is life or death.”
Patients: “Use ChatGPT, but always run its advice by your doctor.”
Clinicians: “Physicians five years out of residency, with real clinical experience, are best equipped to discern when AI gets it wrong.”
Hospitals: Post clear warnings, educate both staff and patients on what AI can and cannot do.
Certain uses of AI can save time, but must be clinically verified.
Castro walks a fine line: “It’s tough because of medical-legal risk. Even medical students can be fooled by AI. The sweet spot is clinicians with enough experience to know when AI is wrong.”
Examples of “safe” AI support:
Personalized diet or wellness plans, reviewed by a doctor
Automated medical record queries and summarization—if the output is validated
Integrated tools (e.g., AI meal plans plugged into grocery delivery apps, but confirmed by clinicians)
“If it’s used together—doctor and patient working with AI—we’ll get great outputs. But it has to be verified.”
Data privacy laws like HIPAA and GDPR set a baseline, but “AI food labels” could bridge the trust gap.
Castro, an avowed capitalist, hesitates to advocate new regulation, but sees the need for transparency:
“If I had to pick, I’d create ‘food labels’ for AI. Anyone—doctor or patient—could pick up that AI and see, here are the positives, here are the negatives, here’s the training, here’s why it has bias, here’s how it should be used.”
Why not more? He sees current privacy protections as sufficient—“HIPAA already covers that.”—and worries about stifling innovation. But consumer-facing “labels” can inform choices without slowing progress.
AI’s “black box” reputation and uneven tech literacy fuel fear. The remedy: education and transparency.
Castro’s approach is hands-on: “I created my own AI Healthcare course, I’m giving lectures around the world. If we explain how this works, it takes away fear.” He suggests “knowledge graphs” tracing AI’s logic, so clinicians can see how conclusions are reached.
Key drivers of fear:
Opaque algorithms (the “black box” problem)
Variability in technology comfort across clinicians
High stakes—errors aren’t abstract, they’re personal and potentially catastrophic
“When there’s an outcome, create a knowledge graph so doctors can see how you got from point A to B to C to D.” Custom, clinically trained models for high-impact verticals (think diabetes, radiology) could further mitigate risk.
Find a pain point, combine it with passion, and don’t be afraid to do things differently.
Castro’s entrepreneurial arc is a lesson in problem-driven innovation: “I was told I was spending too much time with my patients, ordering too many tests. That pain point upset me, so I built a different culture: more time with patients, more praise for doing the right thing.”
He distills his philosophy into three steps:
Find your pain point—what frustrates or limits you in your current environment?
Get passionate—does the problem matter enough to fuel real change?
Think outside the box—“Just because something’s never been done doesn’t mean it’s wrong.”
Castro’s advice to aspiring entrepreneurs, especially in healthcare, is as much about mindset as it is about market opportunity.
Healthcare AI is already reshaping the clinical and operational landscape—if you know where to look, and if you’re bold enough to bridge the old and the new. Dr. Harvey Castro, MD, MBA, ER Physician & AI Futurist at {{Guest Workplace Name}}, exemplifies the blend of frontline experience, creative problem-solving, and operational rigor required to lead in this environment.
For U.S. healthcare executives, clinicians, and policy leaders, the call to action is clear:
Invest in educating your workforce—both to adopt and to question AI.
Demand transparency from technology partners (“AI food labels”).
Start piloting use cases that address real pain points—especially where time, access, and equity are at stake.
Maintain clinical oversight at every stage, never letting tech replace expertise.
“We need to be advocates for our patients… if AI is used together with doctors and patients, we’ll have great outcomes.”
Ready to lead the next chapter? The future is already in the ER—and in your boardroom.
<p>[Music] hello and welcome to the American Journal of helor strategy uh I am your host s sadiki and I'm joined here today by a great member in uh AI I'm very lucky to be joined here do you mind introducing yourself for audience yeah my name is Dr Harvey Castro am a ER board certified Emergency Physician and basically I call myself The Nutty Professor in that I do a lot of a lot of stuff uh ranging from starting my own iPhone app company having some uh vitamin company earlier in my career to writing books during med school uh and then when uh the first iPhone came out had my first IV meds application and I made about 30 apps in the uh App Store uh to the most recent now is uh I did the first book called chat gbt and Healthcare back in 2022 and so a little bit of a lot of stuff that I'm doing that's really really cool you recently published a book can you tell me a little bit about that yeah so you know I I take pride in being a thought leader and a futurist and I literally got I wasn't going to buy the Apple Vision Pro and I literally decided you know what two days in I'm I'm just going toe and get it and when I put it on my mind just blew up I thought holy cow what if I use this in medicine outside of surgery what if I I did all these different things and then the best part is I love AI so I took AI the Apple Vision Pro put it together and then obviously my Healthcare and entrepreneur spirit and put it all together and decided to write a book and the crazy part is within 10 days of the Apple Vision Pro coming out I had this book out in the market talking about how to use it in healthcare oh wow yeah that's a really fast turn around how are you able to uh I guess manage going from this whole uh I guess the sensation of like figuring this thing out deciding to join it with AI and immediately coming out with a book you know I I call it the paino you know we all have a paino in healthcare I'm really passionate about how can we do how can we use technology and Healthcare and I'm literally playing with it and I tend to be a very creative person in that in that space and so I literally put on my doctor hat I put on my CEO hat at one point I forgot to mention uh I created about uh eight emergency rooms here in Texas and Soom had a 350 employees and so I know what it is to run a hospital run an ER have uh be in a SE Suite in healthcare and I thought man if I owned uh an ER and then I was working in the front lines what could I use what would I like to do so I literally put all these worlds together and started writing a book about different ideas nothing that cannot be done today uh honestly some of the crazy ideas I came up with is just taking different Technologies and putting them all into one and I really think that is going to be the future what were some uh other ideas that you s sort of showcased in your book yeah so we we talk about different uh platforms obviously the the one that makes me most passionate as an ER doctor um and I actually saw epic uh the electronic medical record uh showcase this and I saw some slides um but the skinny is this imagine putting in the Apple Vision Pro imagine you're my patient and being able to have the information when seconds count as an ER doctor I may need your X-rays I need need some blood work uh results and so how nice if I had this thing on that I'd be able to see it and simultaneously take care of you and so maybe you're unconscious or something's going on and I need that x-ray being able to have that immediately in my vision and being able to see you and see maybe possible lacerations or trauma and then see what your labs are in real time and then the best part is um again now this has been adding a little AI to it imagine you spoke another language and I couldn't really understand other than using a phone call and having to do this conversation but what if I use the Apple Vision Pro and as that input started coming to me it's translating in real time and I'm able to hear it and then as I'm speaking to you in English it's translating and then giving it to you in your language and so I thought man how amazing like this is something that that would make a huge difference and so it's all about having information and being able to use it the other example real quick would be again using AI uh and The Vision Pro uh a lot of times a patient will come in and and say you know what it's all in my medical record and so when I start going through the medical record it's just volumes and volumes of of information and and um in the interest of time you know I asked the patient can you tell me XYZ and and they're like no it's in the record well imagine having AI having this being able to speak to it getting the record as I'm seeing you and being able to look at it in real time and you don't see it because it's all virtual but I'm seeing the screen and so these things in in real time would be amazing now obviously there's uh I don't know if you know this but there's some neurosurgeons that are already doing neurosurgery with apple Vision Pro and then there's some general surge that are using it and so there's already a lot of people using this technology uh which is amazing in healthcare do you feel as if this is something that could be done within the next few months I know you mentioned some people are already using it you think this can be something that could be spread to emergency medicine to different Specialties or it will just take I guess more time like another year or two or maybe even longer no excellent question and unfortunately the hospital system there's always politics and within the hospital system those departments that are doing very well financially and bringing in a lots of profit I.E neurosurgeons some Specialties in surgery they're able to tell the hospitals hey I want this toy or I want this new Gadget and they're able to have it in their funds because it is in their budget whereas some of the other parts of the hospital literally lose money and so those uh departments are less likely to get some of this technology with that said I truly believe as we start creating uh use cases into the point where we're showing that this is saving lives or becoming more efficient the hospital system ultimately I believe in some departments will end up uh funding it when normally they wouldn't what made you interested in AI you know uh I got to give this story I was coding a patient I literally had just graduated residency uh it was literally the iPhone 1 was out and as I'm coding the patient I gave the nurse an order to get a certain medication and and I was just amazed that she went and got a textbook out started thumbing through it found a page verified the dose got a calculator out and I thought oh my gosh this is taking forever and so big picture I thought you know what let me teach myself how to program let me help and create a application that you just tap three times and it gives you the dose and I literally did it and I created the first IV app in the world and it went viral and because of that moment that explains it fast forward I'm playing with chat GPT it's 2022 and I'm uh going through it thinking oh my God it was that iPhone moment that I had when I was making the apps I thought oh my God this is going to change medicine this simple tool is going to make just so many changes throughout Healthcare and I got so excited I wrote a book on how to do this and fast forward I'm just fascinated because I'm thinking on so many levels uh we need to help people out there but then you know finances or we don't have the tools I thought man this technology if used correctly we're going to start giving access to people uh in a different ways of healthare we're going to improve our Health Care system by using these types of tools and I thought man this is going to be the future so you know fast forward we're a couple years later I'm starting to see you know big companies starting to integrate this into the workflows I'm starting to hear uh different organizations saying spending money into AI to help improve patient care so big picture I'm really excited about you know AI in general obviously it's it's something that I feel like uh it's just going to help humanity and not just here in the United States in fact uh I do a talk on this and I I really think it's going to help people outside of the United States more than people in the United States because some countries especially developing countries they don't have health care they don't have health Healthcare in certain parts of their country and so I really think this technology is going to be used in certain ways that we won't use here in the States because we have Physicians and there's a lot of lobbyist groups and whatnot but I'm really just excited to see where where we go from here with many big corporations and organizations sort of integrating AI into Health Care do you feel there are any aspects that we as Humanities should be careful of moving forward yeah it's a good question you know obviously I'm I'm more worried of non-physicians and individuals outside of the United States ironically and let me explain why non-physicians don't know medicine uh by definition right and I'm more worried that they're going to use a chat PT like they use Dr Google that they'll just put in their symptoms and I'm worried that some patients may decide you know this is too expensive to go to the doctor I'm just going to ask chbt what's wrong with me and if chbt says I'm okay then I'm not going to the doctor fast forward if I'm talking about patients that are outside of the United States where you literally can go to a pharmacy and pick up whatever drug then I'm really worried that they're going to self- diagnose they're going to go to the pharmacy and pick up some medicine that may end up hurting them and so um I am worried about this being used the wrong way and so right now I'm telling my patients you know what I'm fine with you using chaty PT but whatever it says please run it by me please bring it to the office with questions because I don't want uh Chachi BT to quote unquote hallucinate or give the wrong answer answer and then that you go through that and it's the wrong answer even if the new the newer models are saying that they can get the error rate down to 4% to me that's 4% too much because this is life or death these are situations with your health and so in my mind like that that we got to be very careful I I actually um last year it's been about a year now I wrote a book on uh Chachi p and empowering patients and I go through a whole algorithm explaining okay how can we use it in healthcare but basically it boils down to we need a make sure we're having the experts verifying that information saying yep that is correct or not do you feel as if there's any information where we can use AI or chat GPT for that doesn't have to be run by a physician can sort of save time in that front you see that's a tough one and it's a a medical legal issue and with healthc care is just really tough because I I call it the bill curve you know you may be amazing at medicine and you may know a lot but there might be someone that does and to give advice to two different individuals is it's still tough you know and and with that said there's medical students that can use chat PT and be fooled by chat PT because again they they don't have the full training I think the sweet spot is going to be uh physicians in my mind that are somewhere five years plus out of uh residency that they've been seeing patients that they have the clinical gal to know that if AI is lying to them saying things that are not right that they could tell the difference uh I'm on a mission to teach uh Healthcare professionals around the world on how to use it what to do what it's doing right what it's doing wrong um what are the things we need to worry on the patient side um I really think we need to be advocates for our patients we need to have signs in our clinics in our hospitals saying hey here are the issues with Chachi PT or different AI we need to warn them with that said I think if it's used con right now conjunct uh together with the doctor and the patient we're going to have great outputs I know Chachi PT is doing a way with plugins in the next couple of weeks but I think this would be a great use example say I have a diabetic patient and I know their hemoglobin A1c is the average of their sugar say it's really high and I know that it's probably their diet well I can use chachy PT tell it hey give me a keto diet uh this person hates fish they don't like fruit and then it'll customize then you're with me and I can give you that that output and then I can take it down to a whole meal plan but then the best part is with the plugins I can plug it into your insta cart and then by the time you go home all the things that we talked about they're in your house already ready for you and I think that is the new way of using Healthcare using AI I'm verifying it making sure it is correct and then I'm taking your data putting it together and then leveraging technology for us to give you a better outcome that's true yeah that's very very interesting um so I guess it sort of falls into the way we use AI rather than making everything all out there you know what regulations do you think should be put in place so AI isn't misused in certain instances no that's a good question you know I as a capitalist and I'm here in Texas I'm I'm obviously I'm I'm hard against regulation I it's a cash 22 I want to see this progress I want to make sure that it's going forward uh to some degree there's pseudo regulation in that in healthcare we have Hippa and in Europe we have the gdpr which is basically privacy rules and there's all these laws that we have to stay uh confined to with that said if I had to pick some some laws or regulation against it obviously I want to make sure we protect our privacy with our patients and that we're not using chat gbt to the point where open AI has all this information about my patients uh but the good thing is Hippa already covers that so that's there's already regulations against that now if I had a one I actually would uh I like the concept of creating what I call food labels let's create labels for AI and whenever anyone uses any AI a doctor patient they can pick up that particular Ai and say okay here's the positive here are the negatives here's the training and here's why we do not um encourage XYZ because it's got bias in the data set or this is how it should be used that way the average consumer can pick it up just like they buy you know like I have a some yogurt here with the food label well grab my Ai and it tells me these things and I think that kind of Regulation would be good because it's not slowing down Innovation it's not hurting us but it's making us as a consumer more aware of what we're using I've heard many people talk about sort of the risks involved with AI and utilizing it um I know you mentioned earlier that it's a life or death situation so 4% is 4% too many where do you think this fear sort of originates from and should we focus on I guess whatever the cause is for this fear no that's a great question and yeah um you know we I I agree that we are afraid of the unknown um that's why I'm a big advocate of Education I created my own AI Healthcare course I'm literally going around the world giving lectures on this topic because we don't know but here's the thing if I can go into the SE Suite if I go into the hospital systems and explain how this works then they have a better understanding obviously AI we call it this big black box we have no idea how this thing is getting out it we don't know the data like the average person has really no idea and it's kind of scary like how does it know and then we have a distribution of Physicians and Health Care Professionals that vary in technology understanding and so we have some people that really love technology and are early adopters and are bring it into Healthcare and then we have some latops and some Skeptics that are saying to the point hey if AI comes into my hospital I'm just going to retire and so we got to make sure that we're educating these individuals and explaining the good the bad the ugly explaining to them how uh take the fear out you know one thing that has been talked about is when there's an outcome uh that you put in a question some output comes out of chachy PT why not create a Knowledge Graph and so then the doctor can say okay I see how you got from point A to B to C to D and these kind of models would be able to do it the other thing is chat PT was not meant for healthcare but people are using it we need models that are trained with medical information that we're having Physicians and healthc Care Professionals that are doing reinforced learning on these models to say yeah this is correct this is wrong and then when we have these outputs we need to start focusing on certain verticals for example everybody's heard of radiology and how AI is helping it but we need to start working on maybe diabetes and then really creating the right uh large language models for that particular problem making sure that we're reinforced learning and then we're taking this to the next level and so these are really key important things that we need to do as a society and so as we move forward we need to make sure that we're educating we're teaching and then if you out there listening and you're getting better at this then you turn around and teach others around you and that's the only way that we're going to start really being able to understand this Ai and Healthcare and really taking it to the next level it's true it's a domino effect you know we're all helping each other uh one final question I know you have a long history of Entrepreneurship uh you're talking about your emergency uh medicine Department which you created and sold you created a few companies as well you uh written books what advice do you have for those that are sort of interested in the entrepreneurs side of healthc care is it sort of just finding a problem and a solu thinking of a solution that goes with it or is there more to it than that you know I I'm obviously I'm passionate about Healthcare and Ai and I'm going to say that's the secret sauce I think you need to find something that you're very passionate about obviously it's a pain point I'll give you two quick examples I was in the emergency room working and I'm going to say the principal called me into the office saying I was spending too much time with my patients I was ordering too many tests and I thought okay I'm a doctor to help I'm not a doctor to uh make the hospital money I'm here to help people and so that pain point of not being able to give my all to patients really upset me and so I took it to the next step I I literally got a group of investors I literally started creating emergency rooms and I started doing a different culture a culture that was the opposite the more time you spend with patients the better the more praise and more you were doing for the patient the more praise you were getting from the company and so exactly that I took a pain point I took something that I was passionate about and I did something about it and I really think that's the secret sauce entrepreneurship having the passion finding that pain point and then really thinking outside the box that's the the third part you know the things that I I would do and the solutions I would come up with sometimes seemed radical to others because it had never been done but just because it wasn't done didn't mean it was wrong it just meant I was doing it a different way you know there's no reason from to go to from point a B to C I could go to a to d if I had to if it was the right situation and and that's the part of AI healthc Care Professionals are fighting against some of the old ways of doing things you know I know some people don't know this but hospitals still use fax machines you know and you thinking what they're still using fax machine yes a lot of hospitals are still using fax machines yeah I think it all comes down to progression and sort of adapting to the times and changing with it and that's why your work in AI is very important and I'm very fortunate to have this discussion with you um thank you so much Dr Harvey Castro thank you so much for your time I was honored to be here and I look forward to coming back course take care</p>
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