Dr. Bryan Vartabedian is connecting whiteboards with patient outcomes - S14/E01

Sketchnote Army Podcast

In this episode, Dr. Bryan Vartabedian shares how he is creating a child-centered, family-friendly healthcare experience using visuals, to achieve better healthcare outcomes and a positive experience for all involved.

Dr. Vartabedian is Chief Pediatrics Officer at Texas Children's Hospital Austin, he is also a full-time faculty member at Baylor College of Medicinea and is professor of the practice at Rice University as cofounder of the Medical Futures Lab.

Dr. Vartabedian is the author of Looking Out for Number Two – A Slightly Irreverent Guide to Poo, Gas and Other Things That Come Out of Your Baby (HarperWave, 2017) and Colic Solved – The Essential Guide to Infant Reflux and the Care of Your Screaming, Difficult-to-Soothe Baby (Ballantine/Random House, 2007).

Sponsored by Concepts

This episode of the Sketchnote Army Podcast is brought to you by Concepts, a perfect tool for sketchnoting, available on iOS, Windows, and Android.

Concepts’ infinite canvas lets you sketchnote in a defined area while still enjoying infinite space around it — to write a quick note, scribble an idea, or keep pre-drawn visual elements handy for when you need them most.

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Running Order

• Intro
• Welcome
• Who is Dr. Vartabedian
• Origin Story
• Dr. Vartabedian's current work
• Sponsor: Concepts
• Tips
• Tools
• Where to find Dr. Vartabedian
• Outro

Links

Amazon affiliate links support the Sketchnote Army Podcast.

• Dr. Vartabedian on LinkedIn
• Dr. Vartabedian on X
• 33 Charts Newsletter
• Rob Dimeo’s Scientific Sketchnoting
• 33 Charts Sketchnotes
• The Sketchnote Workbook

Tools

Amazon affiliate links support the Sketchnote Army Podcast.

• EXPO Low-Odor Markers
• Heavy grade notebook
• Wide nib fountain pens
• Signo Uniball 1.0mm gel pen

Tips

1. Be Intentional.
2. Look for a role model.
3. Keep it simple, keep it clean.

Credits

• Producer: Alec Pulianas
• Theme music: Jon Schiedermayer
• Shownotes and transcripts: Esther Odoro

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Support the Podcast

To support the creation, production and hosting of the Sketchnote Army Podcast, buy one of Mike Rohde’s bestselling books. Use code ROHDE40 at Peachpit.com for 40% off!

Episode Transcript

Mike Rohde: Hey everyone, it's Mike here, and I'm here with my friend Dr. Bryan Vartabedian. Dr. Vartabedian, it's so good to have you on the show.

Bryan Vartabedian: It's great to be here. I think we've been planning this for a number of years, and it never really happened, right?

MR: Yes. Yeah, well, we're both pretty busy people.

BV: Right.

MR: You being a physician and leadership certainly, you know, demands your time for very important things. Probably more important than Sketchnote podcasts many times. But, you know, sooner or later we figured we'd catch you, and it's worked out. So I'm really happy to have you here.

BV: Great to be here.

MR: So, tell us a little bit about who you are and what you do.

BV: By training. I'm a pediatric gastroenterologist. Spent most of my career as a full-time clinician. Over the past couple of years, I've gotten into medical leadership and I helped Texas Children's here in Houston build a couple of their community hospitals, and they recruited me to open our new Austin flagship hospital in Northwest Austin. So I'm merging into medical leadership and it's been kind of fun, a little different.

MR: Cool. And I know that Austin is growing leaps and bounds, so I imagine the demand in Austin for those services has got to be pretty significant, I would imagine.

BV: Yeah.

MR: That's good.

BV: Yeah, big tech explosion going on there. And so, a lot of demand for pediatric services and so we're also offering women's services there too. So high risk kinds of women's services.

MR: wow.

BV: It's a beautiful hospital up in Cedar Park in Northwest Austin, if anyone listening wants to know.

MR: I don't know that I've been in that region, but I've been to some other regions around Austin so I'll have to look on a map when we're all done. So you've been doing that. I'm really curious now, like — so we talked a little bit, I warned you that we're gonna do, they call it the superhero origin story. Like, how did you get to the place where you are. We know where you're now, but how did you get here?

And more importantly, for this audience, how did visual thinking using your whiteboard to explain very complex topics to patients is what I remember we talked about in my book 10 years ago. How did you end up integrating that into your practice? 'Cause it doesn't seem like that's something — I mean, you know, the big joke is "Doctor's handwriting are impossible to read," and it sounds like your handwriting is quite legible. So how did you end up in that place? I'd love to hear that story and—

BV: Mike, it's a good question because I think I have been using large whiteboards in my exam rooms, I guess now for over 20 years. And it started with these little whiteboards, these little tiny whiteboards that they used to have in exam rooms that would sort of tell the nurses — you've seen these in like hospital rooms?

MR: Yeah, yeah.

BV: The nurse's name, like who the assistant is and what time the lunch trays are coming in or whatever. And so I used to try to — I found myself sort of sketching pictures on these little tiny boards. And it was sort of unsatisfying 'cause I was so constrained.

And maybe it was around Y2K, I had the manager invest in some larger boards and larger dry erase boards, which really expanded my ability to kind of develop a kind of an intentional use of graphics in the exam room with families.

And I just sort of fell into it. And the real tipping point, you know, around the time smartphones were kind of new, and I noticed mothers would hold their phones up and take pictures of what I had drawn.

And it was kind of at that moment, and the remarks that I got from families about how images, and even just bullet lists and arrows and things were so instrumental in helping them understand what was going on with their child. As you can understand, you know, physiology — you know, anatomy can be tricky to describe. A gallstone in a gallbladder.

MR: Yeah.

BV: Or a poop back up in the colon. When you make a picture of that, it really, really is a lot easier for someone to understand. Even beyond pictures, you know, even just bullet lists, a bullet list with arrows or two bullet lists with an arrow going between the two.

Something as simple as that for a young mother with an eight-week-old child who's exhausted, if you try to explain some of this stuff without any supporting media to help them even remember what the five things in the list are, it's impossible. So I don't even know how people practice medicine without this kind of visual.

MR: I think back to like when I've had x-rays done, like you could show me the x-ray and you could explain to me how it works, but it still doesn't make sense to me because I'm not practiced in understanding how to interpret that.

So you almost really need, like, what you're talking about. And, you know, I'm looking at the Sketchnote Workbook sample that we have here. You're talking about a gastroparesis likely—

BV: Gastroparesis, yeah.

MR: — you were sort of drawing this symbol, and we'll put a link to this in the show notes so you can see what I'm talking about. You almost need — so there's like the situation and there's a conceptual component to it where you're explaining the concept of what's happening, why it's happening, and how we're going to address it in this simple way. Because even showing pictures like X-rays are not gonna be helpful to, again, a mother who's tired and has this eight-week-old who's crying because they hurt, you know?

BV: Yeah, absolutely. And you know what's so interesting is that we — are you in Wisconsin?

MR: Yes. Yeah. You remembered. Yeah.

BV: Yeah. So we use the biggest EHR program I think in the world called Epic, Colorado, Wisconsin.

MR: Yeah.

BV: Big Wisconsin company. And, you know, I think our hospital paid 15 million to implement it. And it has some amazing abilities, but something very, very interesting, and it's funny, has happened, I'll go through a 30-minute consult with a child who's not growing or whatever, and I'll make a note, make my impression docs. Have a thing called the impression, which is what we think is going on. And that's often we refer to when we go back in the notes, what was I thinking back then?

But I've had parents, I've gone through the chart. You know, a patient comes back two months later, I look at my note and my note maybe isn't that great? Then the mom pulls out her phone and shows me the sketch note that I did on the board. And within seven seconds I can see like everything that we discussed without even, — you know, more than seven seconds, I can just tell. So it's so interesting that a visual can be a better way to document kind of what I was thinking, what I was doing even more than, you know, a hundred million dollars software package.

MR: Yeah. I've had this theory that it's something to do with the mapping or the use of space and the mapping ability of a visual. So you're not only working with words, but you're always putting them in context to each other. So there's more implied and even explicit relationships that you can draw but because it's using the space where typing and text gets crunched into this text, even a list, right. Like it's got its limitations.

So it'd be interesting to see, you know, does Epic allow you to upload your pictures? That might be an interesting way to solve that problem, right? Well, while the mother is taking a picture, you are too, right?

BV: So it does, it absolutely does. And I've yet to pull the trigger on that. There is a very interesting thing that's come up, which is, what about liability? When I write on a whiteboard, does that become part of subject to what's called legal discovery. Let's say I made a mistake with a diagnosis, could a mama pull out my whiteboard picture and use that in a court of law?

And probably, honestly, so it's probably the good if our hospital attorneys are listening, they're like, "You need to get those in the chart immediately." But I think it's always bothered me a little bit that I do these images and they're honestly very powerful, but I think they do probably carry — I haven't gotten in trouble yet, but I do think they can and should be part of the medical record.

MR: Yeah.

BV: You know, you were talking about, I don't know, giving context maybe to what we're discussing. One of the things that happens when I have these whiteboards and once I launch into a discussion with a family, these visuals become the center of the discussion, and it becomes really powerful with a family that doesn't speak English.

If I have a migrant family that speaks Spanish, maybe not super educated, and, you know, I draw a simple picture of a stomach or a colon or a liver with red hash marks to mean inflammation, it's almost universal.

And we gather around the board —I've even had patients participate in the sketch noting to sort of add things that are missing. And especially, it's really powerful with kids who are probably pre-teen and older who can really kind of add to it or correct what I've put up in terms of symptoms and that sort of thing.

But the point being that it kind of becomes this center, and even when I have a translator, the translators know me and they go to the board and they're pointing. And so, it just all kind of works, you know.

MR: There's some collaborative nature to that. I know in the work that I do, when we collaborate on boards together, it's much richer than if it's just me preaching to the other people. I invite people to come up to the board and it becomes much more valuable because then everybody's really adding to it and adding dimension, because you can't know or see everything, right?

You can't feel what the patient's feeling. So you have to rely on their ability to describe to you, and maybe they don't even think about it until they start writing, and that might reveal something they couldn't verbalize, right?

BV: Yeah, absolutely. And, you know, the past 10, 15 years we've been seeing this rise of participatory medicine where patients are more empowered with what — you start with the web and all that. It used to be the doctor was a priest and the priesthood and all that sort of thing. Now people are more —- there's more participatory.

And there's also, there's a movement called shared decision-making in medicine where patients participate in deciding on the plan in a collaborative way. And when we put four or five options listed one through five on the right side of the board, which is where I always put them, we can negotiate that a little bit. And it just lends to weighing things when you can see them written down.

MR: I would imagine too that the idea of a collaborative to whatever degree with the patient would also mean their buy-in to actually, so if there's a part that you do and then there's a part they have to do.

Medications, physical therapy, I don't know, variety of things that they are responsible for, that if they feel like they've had a hand in making that choice, they're gonna be more likely to actually fulfill their part of it, which means a better outcome, right?

BV: Yep. There's some evidence to support that, but I can just tell you I see that firsthand and yeah, for sure, once they're involved in it, they definitely are more invested for sure.

MR: Yeah, I know I am. I can only speak for me, I guess, but that's pretty cool.

BV: It's been a fun journey and we've had interest from — the docs of the Mayo Clinic have called me and it's like, "How do you do this?" And I think we even kicked around maybe a decade ago. I thought I should make like a white paper to teach doctors how to do this, and I never did it.

But something that's sort of akin to sketch notes for clinicians, you know because I think I do have a methodical way that I do it, a way that I use the geography of the board to optimize the space and, you know, what do I use bullets for? Where do I put the plan? And so on and so forth.

MR: Almost like a language.

BV: Yeah, but I thought of formalizing it, which I haven't yet, but I probably should.

MR: I have some potential inspiration. My friend and colleague, Rob Dimeo is a physicist. He started using it in his practice as a physicist and found it really valuable, even though he had to modify the way he did it. He wrote a paper that basically explains how he uses sketch notes in a scientific setting.

It might be a really interesting reference to start from and see how he structured it, and then maybe produce something along the same lines could be interesting. So we'll put that in the show notes too, and I'll make sure you get that.

BV: I don't just use visual thinking in the exam room, you know, in the spirit of Austin Kleon, who's sort of a cartoonist here in Austin, Texas, I keep a journal and I do a lot of my thinking and kind of visual thinking, not as beautiful as you do. But when I'm sorting through ideas, I use a lot of the sketch notes elements to sort of help me understand how I'm thinking about things from basic, you know, brainstorming to mind mapping to everything.

MR: That's really great to hear that's used privately as well in your thinking.

BV: It's maybe that's how I started doing it in the exam room too because this is kind of — and you said this just a moment ago. I don't know what I think until I write it down sometimes. I can't tell all of an idea, but it's like, until I put it into some sort of construct. There's also, you know, different media stimulate me to be creative in different ways. For example, I do a lot of writing and I type I use an app called Ulysses. It's kind of like writing—

MR: Yeah, I use that too.

BV: — app. But there are times when I'm stuck and if I take to a white sheet of paper with your sketch notes elements or just let myself go free things come out that would never come out on a keyboard.

MR: Yeah. I use the same tool and I run into the same challenges when I do workshops. Sometimes I just need to take a notebook and go to the cafe and get coffee and dump on the page, and they're not beautiful, but I get so much information then what I do is I'll take that more mapped visualization, then I'll come back and then I can write again. It sort of opens up the, detail that I got stuck on when I'm trying to type. My typing fingers don't work as effectively as my visualization fingers, I guess.

BV: I see.

MR: If that makes sense. Yeah. How did you end up — so when I look at the work that you do, it seems like you got quite good handle on visualization. Were you trained in any way? Did you just naturally do this? Did you draw when you were a little kid? Where did these basic skills come from?

BV: I did a lot of art when I was very young. So it's interesting you should say that. I never thought about it, but I did. And honestly, with what I do on the whiteboard, and I have other images too, the elements of what I do are pretty simple.

MR: Yes.

BV: And almost like what you outlined, it's got — and this is the reason why I think anyone can do this. Any doc can do this. And in a minute, I'll get into what some docs do and what they do wrong when they try to do this, but like writing, I think maybe in the book there's a picture of an esophagus and a stomach, and the esophagus is two lines going down. The greater curvature of the stomach is a big curve, and the lesser curvature is a little curve, and anyone can do that.

Red hash marks are a inflammation universal sign. And a little round circle is an ulcer. And, you know, so I'm kind of a minimalist in terms of what I do on the whiteboard. I try to use basic elements. I try not to overdo it. I try to write it with the understanding that the mama's gonna take a picture of it, and I want it to be clean enough and legible enough so that when she goes home to dad over dinner, she can point and she can do the teaching.

MR: Yeah.

BV: One of the mistakes I've seen is some of my colleagues start getting very you know, hyper graphic and hyperkinetic and very, very busy, which can be kind of natural for some people, but the end result can kind of be hampered, I think, on some level. So I try to keep it intentionally on the clean, maybe in the way that you would do a sketch note at a meeting.

MR: Right. Doing something clean and simple is actually harder than doing it messy because you don't have to really think, when I say this thing what is it conveying? Is it necessary? Those kind of questions you have to ask. I guess the other thing about leaving it open and clean is if you're doing this collaborative work, I'm looking at the sample here, you've got some stuff drawn in black, and then you've got a a movement shape in green. It looks like it's moving out of the stomach. And then you have Prevacid is one of the choices versus Bentyl.

BV: Oh, yeah, yeah.

MR: Indicate that Prevacid in that context that 15 milligrams is better, and you use a red marker to sort of circle that.

BV: Right.

MR: So you've got this language that it's really simple, but you're using this language to annotate. And if you pack that full of stuff, not gonna have any room to really do that annotation and still have it clean and understandable. You would think.

BV: Yeah. And I try not to overdo the colors either. I tend to stick to two or three typically because it's the colors aren't that important but it can add an element that's helpful. It's funny, Mike, I sometimes tell my colleagues about this, and they say, "Oh, I do that, and I do it on the butcher paper, on the exam room table."

You've seen the doc sketch with the pen on the paper, it's kind of a primitive kind of sketch noting, but my problem with that is it's not intentional. It's not intended to create a product at the end for the family. It tends to be, you know, scratched and scribbly. It's very hard to read.

I think it's better than nothing maybe, but again, I think of the whiteboard, or even if you don't have a whiteboard, you can take a large oversized notebook and do that. If you're a doc listening, you can use a large oversize notebook with a Sharpie or a nice one-millimeter gel pen and get a good result.

MR: Something that could be photographed. I could imagine some physicians might like to carry that book around with them from room to room. Maybe they don't wanna be leaving it on a board or erasing, that maybe carrying it's better for them. That could be—

BV: I carried a whiteboard around with me in the hospital for a while, believe it or not. Yeah, it was sort of a trademark. But it became difficult because you'd forget it half the time, so.

MR: Yeah. I know there's some startups that have happened. I don't know where they're at now, but there were these books, they were whiteboard inside, but you would fold it up and had a strap like a Moleskine notebook. You could get them in different sizes, like quite big. So you could literally carry it around, had a little clip for the marker so you could pop it open and do like a whiteboard drawing on the spot, which was kind of a cool idea.

BV: You know, I've been tempted to use Procreate or something to sort of do these visuals on a pad, and then share digitally with a family. I just never quite get into that because I like the size and the grandeur of a large 5 ft whiteboard and the — you know what I'm saying?

MR: Yeah. I think probably there's something about the whiteboard and the simple tools that makes it more approachable if you do wanna have family involvement. Drawing on your iPad or drawing on your notepad might feel like they're invading, whereas a whiteboard feels more neutral or something.

BV: Yep.

MR: And it's more common. One of the things I discovered when I started teaching Sketchnoting is I got fancy notebooks and pens and all this stuff, and I found out that actually, it was really intimidating for students to work with these really fancy tools.

So now, when I do workshops, I just have them order a ream of paper and some flair pens and we're good. It sort of drops the level of the tool to the point that it almost is forgettable. You leave behind the paper or the pen and like, I'll just get another one. It's so simple. So I imagine that's the same thing.

BV: And Kleon jokes — he's a cartoonist, again, I'll bring him up, but he's always joking, people email him and ask him what pen he uses, you know, as if, if they bought the same pen, they'd be just as talented. It drives him crazy because that's not the point, you know. Everyone's got their own favorite gel pen or the whatever.

MR: You have to adapt it to your needs, right? That's part of the game. That's really interesting. So we sort of are stumbling into tools. So maybe we should just go there. Before we go there, I'd love to hear, is there something current that you're doing? Obviously, you sound like you've moved to a new location. Are you thinking about how you might use visualization in this new position? Or maybe start sharing these concepts with physicians there something new that you're doing that you might wanna talk about?

BV: Yeah. Of course, the first order of business is to get whiteboards in our new clinics in Austin. So I've got that rolling. I have done workshops for my faculty locally here through the years and they love that. And as I suggested, people — they kind of do this on their own, but they've never done it with that intentionality of using it to create a product.

So I do wanna pull it to Austin with me. I need to create some collateral material that teach people how to do this on the web kind of like you've done with workshops. And so, I would love to do that, but we're building this $700 million hospital and I gotta hire 200 doctors and—

MR: Little time-constrained, Bryan.

BV: Yeah, time-constrained. Time constrained. But my reputation precedes me 'cause everyone asks like, "You're gonna have the whiteboards?" And I'm like, "Oh yeah. Oh yeah."

MR: Maybe we should cook up some kind of a weekend workshop where we'll record it with you and I'll be your host.

BV: That'd be fun.

MR: And you could get your whiteboard out and show us your practice and we'll record it, and then you can share it with whoever wants to learn your techniques. That'd be fun.

BV: You know what's so interesting, Mike, is that since, you know, one of the great things about the internet, not like the internet's new or something, but there emerged this population of physician artists, and there are — I can, you know, point you to a bunch of illustrators and cartoonists who are, I mean, real professional cartoonists who are physicians who obviously with the emergence of the web, they became discoverable. Right before the web, no one, you know, how do you—

MR: How would you know? Yeah.

BV: How would you know there's a guide like sketching and so there's some real talent out there and what's amazing, we think of docs as sort of these narrow people, but there's a whole population of docs doing very interesting things with illustration and with graphics and cartoons. And so, it is kind of cool to sort of follow these people and see what they do.

MR: And you are part of that community, in your own way, doing it in a different way.

BV: Yeah, it is. What I do is very practical. You know, I'm doing it for a purpose and for an endpoint as a — well, I guess they are too, but you know, it's very different.

MR: Their purpose is different, right?

BV: Yes.

MR: It might be more like medical illustration, which I'm aware of what it's explaining through medical illustration, which is a kind of a different, you know, practice, but you do need that skill to understand what something really is. If you misrepresent that, that could be pretty dangerous.

Well, you know it sounds like your tools are pretty simple. I'm guessing it's whiteboards, and do you have specific markers that you prefer to use? Is there a certain color, certain brand, any of that kind of thing that you could share?

BV: We use EXPO low odor. The odors of some of the whiteboards can be pretty strong, and for kids with reactive airway disease and other airway problems, it can be an issue. So we try to keep use the low odor. In my personal work, I have a thing for fountain pens, and so I use a nice heavy-grade notebook with wide nib pens. And so, I enjoy doing that. They require a little maintenance. Beyond that, I do a one-millimeter Signo Uniball, which is my favorite gel.

MR: Nice broad tip. I like the one-millimeters as well. Kind of juicy. I say juicy, I like it juicy, so.

BV: Yeah. Kind of slippery and all that sort of thing.

MR: Yeah, exactly.

BV: And I'll even practice on a notebook. Sometimes I'll be stuck in an exam room trying to figure out how do I express a concept of, you know, gallbladder motility maybe, and I'll just take out a sheet in my notebook and just start scribbling and come up with some real simple representations. And that's how I come up with what I use.

MR: That's how you build sort of your library at the visual library that you use, right?

BV: Yeah. I use probably 10 or 20 of the same kind of images suited to what's going on with the kid, and, you know, you mix and match them, but yeah.

MR: That's a very simple tool set. And, you know, I neglected to ask this. So how do the kids react when they see this? Does that change your relationship with them? Do they feel more like they can enter the discussion when they see this kind of work?

BV: Yeah, certainly for the teenagers, they definitely participate sort of on that intellectual level. What's so interesting is with a four-year-old who may not be engaged in the conversation that I'm having with the mama, when I go to the board, they light up and they see the colors.

Oftentimes, I'll give them a marker and let them go to the lower part of the board and goof off and make — I've had kids try to copy what I'm doing, so it's kind of fun and cute. But yeah, they do.

Kids are very drawn to pictures. And so, one of the funny things I'll do if I have a reluctant three-year-old, it works great with three-year-olds, who doesn't want to be examined, I'll have mom pull up their shirt and I'll say, "That whiteboard so that I can draw a picture of your belly button."

So I look at their belly button like I'm studying it, and they'll make sort of a swirly figure on the board, and they just go nuts and they love it. And you get immediate buy-in. 'cause they see the thing and they look at their belly button and they say, "Oh, that's my belly button."

MR: That could be a good trick for other visual thinkers who need to get the attention of little kids.

BV: Right. So it's kind of fun. I may use it in a lot of different elements, so.

MR: So this is a point in the podcast where we typically will do tips. I like to frame it that imagine someone's listening, they're visual thinking, whatever that means to them, and maybe they've hit a plateau or they just need a little inspiration. What would be three things you might encourage someone to do to help them break out of that rut or just to have a little inspiration?

BV: Yeah. You know, I think that we talked about docs writing on butcher paper. You know, I might challenge people to sort of take it up a notch. Obviously, putting up a whiteboard as sort of a little bit of a challenge for a lot of people in clinics and it's wall space and that sort of thing.

So again, a large pad can do the trick and maybe take that step to try to be more intentional with the educational material you're using. And you gotta kind of just jump in and try. So I would say, you know, be intentional. That maybe be one tip.

The second tip might be look for a role model. I mean, you can look at the pictures that were in sketch notes, and I think I've got some online. I need an Instagram page, is what I need. But, you know, you can look up medical sketch notes, some of my blog posts I put on there. I just get a role model and see how people do it and what they do. And that's another thing to kind of get you unstuck. You wanted three, right?

MR: If you got 'em three would be great.

BV: So yeah, keep it simple. Keep it simple, keep it clean. I think that I'm a minimalist and I think families, again, you want to think about what you're creating for families when they go away and have fun with it. I mean, to me, I've had more fun in medicine doing this than anything else. You know, it's been a little bit of a side gig for me, and it's also great for families and makes it more enjoyable for me.

MR: That's fun. And it serves the purpose and it communicates.

BV: Yeah.

MR: And in the best case scenarios, it integrates the patients with you which means better outcomes, which everybody's driving for, right?

BV: Absolutely. Absolutely. Maybe that's the golden ring, is to try to connect whiteboards with disease outcomes, which if I had the right study design and the right person helping me coordinate it, I think we could do it. But so that might be a great project to aspire to.

MR: That's the next thing after you get this Austin clinic all set up and rolling.

BV: Yeah. And come down and visit. We'll give a tour.

MR: Yeah. Maybe I can do a little teaching. I can teach some basics.

BV: Yeah. We could do a live podcast from one of the exam rooms.

MR: There we go. That sounds good. I will take you up on that. Austin's one of my favorite cities, so wouldn't be hard to convince me to come. Probably in the springtime though.

BV: We'll get some barbecue. We'll get some barbecue.

MR: Probably in the springtime.

BV: Yeah.

MR: Well, Bryan, this has been really great to have you on the show. Thanks for sharing your thoughts and sort of the way you approach things. Of course, we're gonna find a variety of things. I've got some things up here I can share in the show notes, but I would love to hear where are the places that you hang out most. Do you have social media that you hang out? It looks like 33 charts.com is your site and your blog. Are there any other places we should go to?

BV: So I have a newsletter at 33 charts.substack.com, so it's the 33charts.substack.

MR: Great.

BV: I write a lot about — not a lot on visual thinking, which I should do, but a lot on technology and medicine and change and humans and how humans use technology. But you can find me there, 33 charts. I occasionally post there. People can reach out to me. You can find my contact, I think on my—

MR: On that site. Yeah. On the site or on the substack shoe. Great. Well, thanks for making time.

BV: Awesome. It's been great.

MR: Yeah. This is a lot of fun.

BV: It's great finally meeting you. Yeah.

MR: Yeah, same here. And I wish you the best in your next venture, and for everyone listening, it's another episode of the Sketchnote Army podcast in the Can. So, until next time, we'll talk to you soon.

BV: Take care.