Episode Full Transcript

Length: 01:24:55
Host: Patrick Francey
Guest: Nasim Afsar

• ---

  [0:04] Opening and guest introduction

  Patrick Francey: Welcome to The Everyday Millionaire podcast… (show purpose and setup).

  Patrick Francey: “Clarity creates velocity, and in complex systems, confusion is expensive…” My guest today, Dr. Nasim Afsar… (bio: Oracle Health, UCI Health, UCLA Health, COVID response, policy advisory). This conversation is about decision-making in complexity and how systems actually change.

• ---

  [2:39] Welcome and “what do you do”

  Patrick: Dr. Nassim Afsar, welcome.

  Nassim Afsar: Thank you, Patrick. Please call me Nassim.

  Patrick: If someone meets you and asks, “What do you do?” how do you answer?

  Nassim: I think about creating, innovating, and making large-scale impact. Earlier it was bedside care. Then it became building reliable systems of care, population health, and moving beyond the four walls into homes and communities. During COVID, it included field hospitals and testing and vaccination. At Oracle, it was leveraging technology to advance health globally. Now, I’m writing Intelligent Health, which comes out next March with Wiley.

• ---

  [6:32] The “scale” instinct and where it comes from

  Patrick: You’ve been asking “How do we scale?” since you were young. Where did that come from?

  Nassim: It is part of the fiber of who I am. I come from practical engineer parents, so systems thinking was baked in. In high school I created a community service commissioner role and scaled participation to about 25% of the student body. It was about connecting pieces that already existed to create something bigger.

  Patrick: That mindset is rare, especially that young.

• ---

  [14:05] Growth through discomfort

  Nassim: You have to be comfortable being uncomfortable. If I’m comfortable, it is time to leave.

  Nassim: During COVID we built a mobile field hospital. I relied on experts, asked the right questions, and trusted the team. Leadership is creating signal out of noise.

  Patrick: Did you develop that mindset later, or was it always there?

  Nassim: I get energy from discomfort. Even as a teenager I pursued things I was not naturally good at, like basketball. I loved being part of a team and growing. At Caltech, I created an art history major because it pushed me.

• ---

  [22:26] Purpose, privilege, and the “dark side”

  Patrick: You seem deeply aligned with purpose.

  Nassim: Yes, and I’ve felt privileged that even intense workloads did not feel like work. The dark side is the constant sense that we are not doing enough. In healthcare, people are injured, misdiagnosed, alienated, and priced out. That tension drives me, but sometimes I want to turn it off.

• ---

  [24:46] Intensity, empathy, and teams that last

  Patrick: How intense are you in the trenches?

  Nassim: I’m intense and ambitious because the mission is bigger than any one person. But I also value different ways people operate. I’ve maintained real relationships with teams across two decades. Teams enable work to outlive any one leader.

  Nassim: I recently returned to UCLA and saw people I recruited now leading and expanding programs far beyond what we envisioned. That full-circle moment is powerful.

• ---

  [30:00] Leadership development, feedback loops, and culture

  Patrick: Do you study leadership?

  Nassim: Absolutely. I read constantly, mostly nonfiction, a lot on leadership. I ask for feedback after meetings. I ask teams what worked and what did not.

  Nassim: We use a “pissed off rule.” If someone does something that upsets you, you have 24 hours to raise it and set a time to talk. It prevents silent resentment and fixes friction points. I want people to give that feedback to me too.

  Patrick: Culture has to be intentional, or it gets defined for you.

• ---

  [37:40] The book: Intelligent Health

  Patrick: Why write Intelligent Health?

  Nassim: The idea started 17 years ago. I saw preventable tragedies, including people who saw doctors many times yet still ended up with late-stage disease due to gaps and fragmentation. I didn’t want an aspirational book until the tech was real. In the last five years, it became feasible.

  Nassim: The premise is:

  1. Unify health and care data, including the 80% that drives outcomes outside clinics.
  2. Apply intelligence to make sense of it and personalize what works.
  3. Make it consumer-owned and consumer-driven so incentives align around the person.

  Nassim: We should have human goals, not just clinical targets. Energy, clarity, graceful aging, less pain. Data plus intelligence can help people achieve those.

• ---

  [49:00] Personal responsibility, made easier

  Patrick: Do we need to help people take responsibility for health?

  Nassim: It is complicated, but it does not have to be. We have made it complicated. Technology can reduce cognitive burden. Example: your calendar and food ordering data can predict a rough day and nudge a better choice. People still choose, but small improvements compound.

• ---

  [55:00] Sedentary life, delayed care, and wellness noise

  Patrick: Are we getting less healthy because of technology and sedentary life?

  Nassim: Yes, for multiple reasons: more sedentary work, delayed care, and growing chronic complexity as people live longer with multiple conditions. One good shift is more intentional consumer health behavior, but the wellness market needs evidence and sanity.

• ---

  [58:37] AI: powerful, but not infallible

  Patrick: Where does AI fit?

  Nassim: I use large language models heavily. In health and care, AI can transform workflows and access, especially for rural or off-hours support. But it is a tool, and it is fallible. Used irresponsibly, it can harm.

  Patrick: Education needs to shift toward critical thinking and questioning, not memorizing facts.

• ---

  [1:10:57] Money and mission

  Patrick: Money hasn’t come up much. Where does it land for you?

  Nassim: Economics are essential. “No money, no mission.” Financial sustainability enables the mission. I learned to translate “right thing to do” into operational outcomes and dollars. That is why I got an MBA. We can’t blow up healthcare, we have to evolve it and realign incentives toward health, not sick care.

• ---

  [1:17:37] Rapid fire

  Patrick: Apple or Android?

  Nassim: Apple.

  Patrick: Favorite music?

  Nassim: K-pop, because of the kids.

  Patrick: Favorite movies?

  Nassim: Sci-fi, things like Apollo 13, The Martian, Dune.

  Patrick: A book you recommend?

  Nassim: Humankind by Rutger Bregman.

  Patrick: If God exists, what do you want to hear?

  Nassim: “You left the world a little bit better than you entered.”

  Patrick: What are you grateful for?

  Nassim: My family.

• ---

  [1:24:21] Closing

  Patrick: Thanks for listening. Please rate, review, and share. For questions: CEO@reincanada.com (spelled out). Until next time.