Episode 1
What would healthcare look like if GPs had the time, tools, and data to treat every patient like an elite athlete?
In this episode of Beyond Longevity, I am joined by Dr Angus Perry, a practising GP, clinical AI builder, and performance-medicine enthusiast with experience supporting Formula One teams and elite athletes. Dr Angus is focused on closing the gap between what preventive medicine can achieve and what is realistic inside a ten-minute GP appointment.
He shares the path that led him here: a childhood ambition to become a GP, an early pull toward technology, and a personal family experience with chronic disease that clarified why the current model is failing both clinicians and patients. We talk candidly about GP burnout, time pressure, and why meaningful lifestyle support is so hard to deliver at scale.
Two data points frame his urgency:
-The Lancet Standing Commission’s 2024 report estimates that around 45% of dementia cases are potentially preventable by addressing 14 modifiable risk factors across the life course.
-A 2018 JAMA Network Open cohort study of 122,007 adults undergoing treadmill testing found cardiorespiratory fitness was inversely associated with long-term all-cause mortality, with a median follow-up of 8.4 years and no observed “upper limit” of benefit.
Dr Angus then walks through the two-part platform he is building:
- A clinician-facing tool that helps generate chronic disease and preventive-care plans (including areas such as diabetes, hypertension, and dementia prevention).
-A patient-facing app designed around daily check-ins, habit tracking, nudges, milestones, and adherence dashboards — aiming to “close the accountability loop” between appointments giving clinicians the data they need and whilst keeping patients genuinely engaged with their own health in-between appointments
We also dig into what responsible clinical AI looks like in practice: hallucination risk, governance, compliance, and the line between augmentation and undermining the clinician–patient relationship. And we explore whether tools used in elite sport (including dynamometry for strength and fatigability) could become more relevant in ageing and sarcopenia care — including for patients using GLP-1 medications.
Dr Angus is clear about where things stand today: the app has had a very promising soft launch, clinician feedback driving iteration, early NHS pilot conversations, and outcomes data still being gathered. The episode closes with a sober assessment of where healthcare may be heading without greater patient empowerment — and a reminder that many of the biggest longevity gains are still driven by environment and lifestyle, not expensive interventions.
Rapid-fire highlights: why passion beats rigid planning, the single habit he prioritises most (sleep), what he would have done if medicine had not worked out, and why a simple daily gratitude practice can have outsized downstream effects.
Links:
Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission
GeneralPractice.AI | Healthcare
Dr. Angus Perry - PAP - Pioneered Athlete Performance
https://uk.linkedin.com/in/dr-angus-perry-b49918128
In this episode:
00:00 — Welcome + introducing Dr Angus Perry, GP and clinical AI builder
01:39 — Origin story: why general practice, early tech roots, and high-performance medicine
03:26 — Why standard GP wasn't enough: chronic disease, system limits, and burnout
05:12 — The personal wake-up call: family experience and lifestyle-driven disease
08:55 — From experiments to product: early LLM tools and the lifestyle research that changed everything
10:52 — The evidence for prevention: dementia risk, fitness and mortality
13:12 — Introducing the platform: clinician tool and patient app for behaviour change
14:07 — Patient activation and empowerment: making people the CEO of their own health
15:57 — How the app works: risk factors, activation scoring, check-ins, and accountability loops 19:26 — Early launch feedback, adoption questions, and the road to NHS pilots
21:05 — What's next: AI agents, EHR integration, and removing workflow friction
22:56 — Clinician concerns about AI: augmentation vs replacement, and can AI extend healthspan? 25:08 — ChatGPT for health: useful, but the doctor–patient bond still matters
26:03 — What responsible AI means in healthcare: governance, risk, and regulation
27:38 — Does technology change how he practises as a GP?
28:20 — From Formula One to primary care: treating patients like elite athletes
31:40 — Performance technology that could reach clinics: muscle testing and the realities of G-force data
33:25 — Dynamometry explained: measuring strength, imbalances, and fatigability
35:41 — Why muscle mass is a longevity cornerstone — and how it declines
38:01 — Where GP and preventive medicine are headed in five years
40:08 — Is longevity medicine only for the wealthy? The 70/15/5 reality
43:28 — Rapid-fire advice and final takeaways on making innovation practical
Transcript
Welcome to Beyond Longevity, the podcast that explores not just how we age, but how we can build a longer, healthier future for ourselves.
Speaker A:Today's guest on beyond longevity is Dr. Angus Perry, a practicing GP and a clinical AI builder.
Speaker A:Normally on Beyond Longevity, I speak with a broad mix of individuals such as clinicians, researchers, founders, investors, policy leaders and AI engineers, each one approaching ageing and health from their very own, usually siloed perspective.
Speaker A:Dr. Angus, however, brings several of those worlds together alongside his work on the front line as a doctor in general practice.
Speaker A:He began building clinical AI tools after recognizing firsthand how much time, inefficiency and administrative burden were taking away from the direct patient care.
Speaker A:Rather than simply accepting those constraints, he set out to design systems that could support clinicians more effectively.
Speaker A:He has also worked with elite athletes, including teams in Formula One, where precision and marginal gains are part of everyday performance.
Speaker A:Today, we explore what happens when frontline medicine, clinical AI and high performance thinking meet, and what that might mean for the future of healthcare and longevity.
Speaker B:Before we dive into AI and all the wonderful technology you've created, I'd love to start with you and your journey.
Speaker B:How did you originally come into medicine and how has your way developed?
Speaker C:Sure.
Speaker C:So I've always wanted to be a GP from a very young age, and that's probably because I had an exceptional GP as a kid and I. I always looked up to my GP and I always wanted to be like him.
Speaker C:And so it was really that.
Speaker C:That moment where I decided I must have been maybe 8, 9, 10.
Speaker C:I spent some time with a different work experience and, and I just loved every minute of it.
Speaker C:So that's when I kind of made that decision to be a gp.
Speaker C:But also I. I have a strong tech background as well.
Speaker C:My dad set me up with a computer when I was 4 years old and so I. I really enjoyed that too.
Speaker C:And you combine that with just my sort of personality of, as always being quite curious and always wanting to learn new stuff and, and that's kind of what you get at the moment.
Speaker C:You get.
Speaker C:Myself, yeah, I went to medical school, went to Southampton, trained there, moved to Oxford for a bit, did my GP training, and I've been a GP now for, I suppose, six years now almost.
Speaker C:And.
Speaker C:But also in the background, I mean, doing all the things that you mentioned, working with athletes, learning about lifestyle medicine, learning about exercise physiology and all the other aspects which I feel are quite relevant to sort of general health and optimization.
Speaker C:So that's kind of what got me to where I am today.
Speaker C:And of course, I founded GeneralPractice AI as well.
Speaker C:There's a whole story behind that as well, which I would be happy to go into.
Speaker C:That's my sort of overview of how I've come to be in this situation.
Speaker B:That's fantastic.
Speaker B:We'll hold off on diving into the platform you've created, because I think it's.
Speaker B:It's quite something unique and special.
Speaker B:But there was obviously something that you felt being a.
Speaker B:And I don't mean that in any diminishing, but a standard GP just coming into clinic in the morning, doing your work just wasn't enough for you, or wasn't where you saw yourself.
Speaker B:How and why was that not enough or made you want to do more?
Speaker C:That's a really good question.
Speaker C:So if I reflect on my experience so far as being a gp, when I speak to patients with chronic conditions, chronic diseases, and I do my best to support them, it's quite challenging, within the sort of confines of the system that I operate under, to deliver the sort of level of care which I.
Speaker C:Which I really want to deliver.
Speaker C:And I see lots of ways in which we can improve things.
Speaker C:And I'm never sort of content with the status quo.
Speaker C:I always want to do my best to get the best possible care I can for my patients.
Speaker C:And so I realized that if I'm going to really make some change, then I feel that there are many ways you can do that.
Speaker C:You can do that just by being an advocate in your community.
Speaker C:You can do that through academia, you can do that through social media.
Speaker C:But the area in which I have more expertise is probably technology.
Speaker C:And technology has a tremendous ability to really transform in any sector, particularly for health.
Speaker C:So I'm thinking to myself, you know, I. I've got.
Speaker C:I'm working with a population of people who are struggling to.
Speaker C:To look after themselves, struggling with the burden of chronic disease, and in a system which is overwhelmed.
Speaker C:And I'm.
Speaker C:I'm thinking to myself, how can I improve this?
Speaker C:And so it's really just, how can I be a better gp is fundamentally why I've.
Speaker C:I've gone down this particular route.
Speaker C:I'm just not willing to accept that this is the status quo, that this is how things will just always happen.
Speaker B:Was there a specific moment or a specific patient or specific experience that made you say, oh, something has to change, or was it sort of a gradual realization?
Speaker C:There were many moments.
Speaker C:There was one particular moment actually with a.
Speaker C:With a particular family member who I can give sort of the general gist of it, who perhaps wasn't looking after themselves.
Speaker C:In the way that they should be neglecting themselves.
Speaker C:But very simple things, aspects of their lives, you know, exercise, diet, just generally looking after oneself, reaching the point where actually becoming quite frail.
Speaker C:And for me, it was quite scary, but then having this realization that actually the healthcare system which we live under is not really optimized to help people in this kind of capacity.
Speaker C:So that was a very strong call to action to me, because this is obviously family and it's quite personal.
Speaker C:And there's this realization that the healthcare system that we have, as good as it is, it's not geared up for this sort of intervention.
Speaker C:But you combine that with my own practice, I see a lot of chronic disease, I see hypertension, diabetes, obesity and so on.
Speaker C:And my consultations tend to last quite a bit longer than perhaps they should.
Speaker C:And one of the reasons is because I like to address the lifestyle aspects that are driving their chronic disease.
Speaker C:And for much of chronic disease, a lot of the underlying factors are lifestyle related.
Speaker C:But the consequence of that for me is that I'm burn myself out a little bit, because I give a lot of myself to my patients and I spend a lot of extra time to, to give that information that I believe that they need in order for them to be empowered and to succeed in managing their own health.
Speaker C:And so it's not sustainable for me because I would run late in my clinics, my day would just take a while, and it took a lot out of me.
Speaker C:So it's the aggregation of all of that, the family situation, that really thought, you know what?
Speaker C:I can't work in this system as, as it is, because I can see that there are issues and I have to do something about it.
Speaker C:That was the call to action to me.
Speaker C:So it just sparked something, you know,
Speaker B:what I have great respect for, and what you're saying is the fact that you didn't just throw in the towel when you came to that realization, you know, of being burned out.
Speaker B:And it's just not sustainable because many of your colleagues, I think, or a lot of them, you know, share the same feeling.
Speaker B:It's not rocket science to realize that the system is not working as it should be, or not working, you know, as ideally as it is, it could.
Speaker B:And the current system, you know, the NHS system is more geared for healing the sick, but it's not even healing the sick.
Speaker B:It's sort of intervening once it's maybe not too late, but certainly very late.
Speaker B:Rather than being preventative, which I think would be so much more beneficial to everyone involved, the patients, the NHS as a whole.
Speaker B:The doctors and all of it.
Speaker B:So I find it very admirable and also certainly very rare to hear that your own solution to the problem was not run away or go into private practice or completely, you know, change speciality, which is sort of the easy option.
Speaker B:But you sort of took the bull by its horn and said, I'm going to actually fix this broken system as much as I can and create a platform that helps me, that helps my colleagues and ultimately the patient, which I think is, is incredible.
Speaker B:Tell me what was in your mind.
Speaker B:Where did you start?
Speaker C:Okay, well, interestingly, you mentioned about the burnout aspect, because there was a time where I was very burnt out at one point in my, in my life where, you know, I almost was contemplating taking a break through, should we say, not, not, not entirely giving up, but, but taking a prolonged break.
Speaker C:But I, I, I didn't actually do that.
Speaker C:What I did was I just, I stepped back a little bit.
Speaker C:I didn't work as much and I just gave myself a little bit of time to breathe and reflect.
Speaker C:So what happened?
Speaker C:The call to actions, the events that occurred over the past maybe five years or so.
Speaker C:I started experimenting with technology, with large language models, the earlier models, the ChatGPT, freeze, that sort of thing.
Speaker C:And I realized that these things are extremely powerful.
Speaker C:And I created a sort of a basic, sort of minimal viable product where I had all these different tools, I could do different things like a consultation scribe.
Speaker C:And I was even experimenting with chronic disease, writing chronic disease management plans.
Speaker C:So it was just a little bit of an experimental phase at that point.
Speaker C:And the large language models got more and more powerful.
Speaker C:The, the parameter size and all the other metrics and, and the quality of the outputs, and it just, just got greater and greater.
Speaker C:And then suddenly all this sort of new emergent ability kit happened and I realized actually there is something here.
Speaker C:And I would say the other realization was that if you look at the sort of sum of all the recent medical literature that's coming out with regards to the impact that lifestyle has on our susceptibility to chronic disease.
Speaker C:It's pretty enormous now.
Speaker C:And so it's the timing of those two of the research and also the technology that's kind of led to where I am at the moment.
Speaker C:And I do want to spend a little bit of time covering the research because it's quite fascinating.
Speaker C:And even as I explain this to clinicians and fellow GPs do seem quite surprised.
Speaker C:And that for me is almost an even stronger call to action now.
Speaker C:And when I say research, we all know that healthy Lifestyle is very important for longevity and so on, but do we know quite how important it is?
Speaker C:And the value I see in all the research that we're seeing now is actually, it's really defining the actual value of what lifestyle actually does for us and how effective it is at treatment and prevention of chronic disease.
Speaker C:There's a couple of papers that I keep quoting all the time and probably people are getting tired of hearing me talk about it, but I'll keep saying this.
Speaker C: was Lancet Commission in June: Speaker C:And they estimated that about 45%, almost half of all dementia is actually preventable.
Speaker C:If you optimize a list of what are modifiable risk factors.
Speaker C:And so if you lived an optimal life and all your modifiable risk factors, I. E. The things that you can change, you can't change your sex, you can't change your age, you, those things you can't change, you can't change your genetics, but you can change your lifestyle and so on.
Speaker C:If you optimize all of those, you can reduce your risk of dementia by 50%.
Speaker C:And to me that's quite remarkable because dementia of course is a, is a horrible condition.
Speaker C:It's, it's one of the worst.
Speaker C:And so we've, we've got that.
Speaker C:What about exercise?
Speaker C: that was published in JAMA in: Speaker C:But they Also, of that 120,000, they grouped them into five groups, so elite fitness, good average, below average and poor.
Speaker C:And, and they looked at the sort of survival rates per group and essentially if, if you're in the elite group, you're about six times less likely to die over a ten year period than if you're in the poor group.
Speaker C:But even if you just go from the poor group to below average, so one tier above, your risk of dying drops by a half over a 10 year period.
Speaker C:So that's quite remarkable.
Speaker C:And, and there, there's a bunch of other, other data as well, which basically is just quantifying how important our lifestyle is.
Speaker C:So I'm reading all this data and I'm seeing all this technology come, all this AI technology and so on.
Speaker C:I think Gosh, there's.
Speaker C:There certainly is an opportunity here.
Speaker C:And so I thought, well, why don't I use this AI to help actually create personalized plans for patients that can help, that will generate plans that are specific to that particular individual, that will help them optimize their own risk factors.
Speaker C:That's fundamentally right where it all came from.
Speaker C:So it's the confluence of personal aspects, family things, the research, the technology, it all kind of just happened at once.
Speaker C:Plus my background in sports and exercise medicine, it just felt like, well, this is it, this is there.
Speaker C:There's.
Speaker C:There's something happening here.
Speaker C:And then, like, crazy, what I created, seriously, it.
Speaker B:It's unbelievably impressive.
Speaker B:Please tell our listeners exactly what this fantastic platform is that you've created.
Speaker B:Because as far as I understand, it's sort of twofolded, right?
Speaker B:There's a site that the GP uses to make his daily work load and work life easier, doing a lot of administrative work, which in turn frees him up to spend more time with the patient.
Speaker B:But there's also, as you mentioned, the sort of the patient side, which, as you already explained, helps the patient to sort of be the CEO of his own life a little bit, which I think is what needs to happen in today's society.
Speaker B:I think a lot of people are just very complacent and they think, oh, you know, we don't need to do anything and if there is a problem, we'll go to the doctor and he'll give us a pill.
Speaker C:You're absolutely right.
Speaker C:I want to go over that point.
Speaker C:I'll cover the app as well.
Speaker C:I do think there is a need, a fundamental need, to change the way we view our health.
Speaker C:And I would say perhaps we.
Speaker C:We do practice this kind of paternalistic style of medicine where you come to the gp, you get told what to do.
Speaker C:This is it.
Speaker C:The GP controls your health.
Speaker C:I do feel like now we need to change that a little bit.
Speaker C:We need to empower the individual so they can take more control over their healthcare.
Speaker C:In my opinion, that's the only way we can run a sustainable health service in the UK is through empowerment.
Speaker C:Because, of course, if you do empower, there is a tremendous amount that the individual can do themselves, to look after themselves, and that's a much more sustainable way of delivering care.
Speaker C:There is some wonderful research around patient activation.
Speaker C:There's this patient activation measure.
Speaker C:It's a series, it's a questionnaire, or PAM for short, and it basically assesses, you know, how much control the individual believes that they have over Their health, and the data is very clear on that, is that the higher the level of activation is, the better the health outcomes are for those particular individuals.
Speaker C:And so I see that this patient activation is kind of the missing link.
Speaker C:It's kind of like you want to find out, where is the patient right now in their activation journey.
Speaker C:Now, as a gp, I see patients in the whole spectrum of that.
Speaker C:I see people who are particularly low confidence, low agency, they have absolutely no control over their health at all.
Speaker C:And they come to you, myself as a gp, to say, right, help me out, doc.
Speaker C:And my role there is to basically walk them up that activation journey so they become the masters of their own life and their own health.
Speaker C:And that's where I think what we need to do.
Speaker C:Now, the reason why I'm explaining that is because that's precisely what my app intends to do.
Speaker C:You're right.
Speaker C:The app has two features.
Speaker C:There's a clinical facing app, which is the clinician uses, like myself, to generate the plan.
Speaker C:And there's a patient facing app, which is a native app on the app store, Google Play, where the patient can interact with their plan on their phone.
Speaker C:So the idea is, is that you can create plans for particular chronic conditions like diabetes, hypertension and so on.
Speaker C:Or you can create preventative plans like dementia prevention, that uses all that data that we mentioned, exercise optimization, health optimization in general.
Speaker C:So the key features are one, you identify the risk factors, or the modifiable risk factors, I should say, or the habits that are key for that particular disease.
Speaker C:So, for example, if it's hypertension, then you will look at diet, salt intake, exercise and so on and so forth.
Speaker C:You get the patient to assess how they are in all the modifiable risk factors and habits that are key for successful management.
Speaker C:In that process, you'll identify particular areas where they may need to improve on.
Speaker C:Then you will assess activation.
Speaker C:So how activated is the patient?
Speaker C:Are they low confidence, high agency and so on and so forth.
Speaker C:Then you can add some resources and other information like blood pressure diaries and whatever else they need to actually manage their blood pressure.
Speaker C:You can add information about medication or anything else.
Speaker C:It puts the plan together, it creates a plan for the patient.
Speaker C:The most important aspect is that you can also create what's called check in questions.
Speaker C:So these are like daily things that you should be doing.
Speaker C:So did you avoid this today?
Speaker C:Did you avoid smoking today?
Speaker C:Did you eat less than X amount of salt today?
Speaker C:And so on.
Speaker C:They spend 10 seconds.
Speaker C:Every day they get a nudge or a notification.
Speaker C:Can you check in today?
Speaker C:So this collects longitudinal information about their habits.
Speaker C:Let's say they don't smoke for five days in a row, they'll unlock a medal.
Speaker C:It's 10 days, it's a silver medal, 20 cases of gold.
Speaker C:It creates a dashboard so you can see all the things that they're doing well, all the things that are not doing so well.
Speaker C:So you actually have data on adherence that the GP can look at and then iterate the plan accordingly, so you can then focus on what's important.
Speaker C:The problem with GP consultations at the moment is that the advice is often quite generic.
Speaker C:You say, go away, do some exercise, I'll see you in a year's time.
Speaker C:Here, we're actually collecting data on how they're actually doing with their health, which I think is quite important.
Speaker C:And I. I call it closing the accountability loop.
Speaker C:This is different to, say, other lifestyle apps, which there are plenty of, where you just give them the app and off they go, you never see them again.
Speaker C:I've designed this so it actually brings the patient and the clinician closer together, because the patient knows that actually the GP is seeing this data.
Speaker C:They're seeing actually that you're doing well, actually, or maybe you're struggling with your diet, you're struggling with this.
Speaker C:It actually gives more useful information, but also it helps to reinforce the good habits as well.
Speaker C:So eventually, it may not even need the app anymore, because actually, through the help of the app, it's reinforced those important behaviors that needed in the first place.
Speaker C:That's the vision, that's fundamentally what it does and what I hope it will do in the next sort of three, four years or so.
Speaker B:And it creates accountability, which I think is very good accountability for the patient who knows his doctor is looking at it.
Speaker B:So we all want to be liked and do well, whether we're little kids or adults.
Speaker B:So I do think that accountability is very good, but it also creates, I think, accountability to the GP to not just say, oh, here's a leaflet going, read it, come back in a year.
Speaker B:Because they feel also accountable to interacting more with a patient and looking what they're doing and giving feedback, giving direct feedback and applicable feedback.
Speaker B:So I think it sounds excellent.
Speaker B:How is the patient compliance?
Speaker B:What has been your feedback?
Speaker B:Do they accept it?
Speaker B:Do they like to be not monitored, but do they like to be accountable for some.
Speaker B:I'm sure it's sort of a, oh, no, I don't want to have to tell my doctor every breath I take and whatever.
Speaker C:With regards to the feedback, we launched it around September, October time.
Speaker C:And we did a soft launch where we had some clinicians who express interest beforehand and we've.
Speaker C:We've done it on a very sort of gradual stage, because we don't.
Speaker C:Of course, when you launch new technology, there will be teething issues and bugs that you want to fix promptly.
Speaker C:So I've received some very good feedback from the clinicians and we're probably at the point now where actually reviews will be coming through.
Speaker C:So actually, as in clinical reviews will be coming through, so we should be getting that feedback pretty imminently.
Speaker C:But you're right, it's probably not going to be for everyone.
Speaker C:Everyone has their own preferences to how they receive care, but equally, there are levels of personalization.
Speaker C:You can have much less check in question, you can only have two or three if you want, or no check in questions at all.
Speaker C:It's entirely down to the preference of the individual.
Speaker C:But, yeah, that will be coming forthcoming.
Speaker B:Do you have any data yet as to what percentage of patients in any given clinic take up that offer?
Speaker C:Yeah, again, it's similar to the other answer, really.
Speaker C:We're collecting that data at the moment and then we're going to sort of aggregate it and see what happens.
Speaker C:But it's all entirely in the private sector at the moment.
Speaker C:We're having discussions with.
Speaker C:With the NHS as well and trying to get some pilots going.
Speaker C:That will take a bit longer, of course.
Speaker C:That was.
Speaker C:That's where I see this having perhaps the biggest impact.
Speaker C:But that's going to take many years.
Speaker C:Pilots tend to take many years to collect that data, but that's what I'll be hoping to do.
Speaker C:But it's been useful because actually the clinicians who are using it have given me some very good feedback, which I've directly iterated into the product.
Speaker C:You know, we had to be very agile and respond to their needs.
Speaker B:From the GP side, how do you see the app evolving from where it is now?
Speaker B:I understand right now it sort of helps the GP with administrative paperwork and all those things, saving them time at the end of the day to be more available to patients.
Speaker C:The way I see it is that fundamentally I want to facilitate how we deliver chronic disease management with that strong emphasis on lifestyle and prevention.
Speaker C:And there is some key data that needs to be collected before the assessment.
Speaker C:And that data includes what is called patient reported outcome measures, or information relevant to their risk factors, that sort of thing.
Speaker C:And that information can be collected directly when you're in front of the patient.
Speaker C:Of course, that can take a bit of time.
Speaker C:There are some tools we're Looking into where actually we could use AI agents, for example, to help collect that data and present it to the clinician expediently.
Speaker C:So when they are in front of the patient, it's all ready for them.
Speaker C:So actually they just need a quick glance.
Speaker C:And I think, right, okay, I can see everything here.
Speaker C:I can see all the key information and you can generate plan very quickly and then that will integrate seamlessly into the patient's medical records or their electronic health records.
Speaker C:And so the fundamental vision there is to make it as frictionless as possible, just to make it so, so easy for anyone to deliver high quality, lifestyle focused, prevention focused care.
Speaker C:It's always difficult when you're introducing new technology.
Speaker C:It's another thing for someone to do.
Speaker C:It's another tool for someone to log into.
Speaker C:You are creating some friction there.
Speaker C:And that is a problem when you're trying to innovate in healthcare because you have to create something, you want to improve things.
Speaker C:But there is this wider ecosystem which you have to fit around and you can't ignore it.
Speaker C:And so that for me is the biggest challenge is actually completely eliminating the friction.
Speaker C:So it's just so, so seamless.
Speaker C:So that answers your question.
Speaker C:But yeah, that's, that's the overarching aim for the, the arc.
Speaker B:Part of the friction that you mentioned is that maybe also sort of awareness of using AI.
Speaker C:Oh yeah, that's a good topic in itself.
Speaker C:Yes.
Speaker C:I think a lot of clinicians, not just even healthcare, I think a lot of people are wary of AI because of course, job displacement, I think features quite highly on a lot of people's minds.
Speaker C:I have a very strong vision with how we should be using AI in healthcare, and that is fundamentally using it for augmentation purposes, not for using it to replace what we do.
Speaker C:Because if we use AI to replace what we do, I fundamentally believe there is an art in healthcare.
Speaker C:There is an art which I don't think can be replaced with a large language model or a chatbot.
Speaker C:And the more and more we offload onto AI, I think we diminish the art of healthcare and that would be disastrous.
Speaker C:So my vision is to augment rather than to replace.
Speaker C:And so what this does is actually allows a clinician to do more.
Speaker C:There's an AI working in the back end to write the app and write the code and so on.
Speaker C:That's purely at the behest of the clinician.
Speaker C:So it's a really good question and hopefully I've answered that in terms of my overarching vision.
Speaker B:So do you think that AI, maybe not today, but in the future, hopefully in the very near future, can extend the health span at a population level.
Speaker B:Or do you think that's still a bit too ambitious right now?
Speaker C:It's so hard to predict because of the, the rate of development is, is staggering.
Speaker C:You know, I, I remember using ChatGPT free and that was impressive.
Speaker C:And that was only, that was only a couple of years ago.
Speaker C:And you look at what it can do now.
Speaker C:Of course Chat G P T Health has, has been released at least in America and, and so I don't think I can really say where we're going to be in even two, three years time.
Speaker C:It's really hard to predict now because we're sort of going beyond Moore's Law in terms of the acceleration of technology to the point where I don't want to make a prediction because I imagine that I'll be proven completely wrong.
Speaker C:But like I said, I think augmentation is key here.
Speaker C:I think how can we use this technology to broaden our reach and what we can do?
Speaker C:But I think you're right.
Speaker C:I think people use it all the time.
Speaker C:I think people now use ChatGPT, ask about their health, hey, what can I do to this?
Speaker C:What can I do for that?
Speaker C:I was getting my hair cut the other day and the hairdresser was saying that, yeah, I had problem with my health and I asked it and it gave me a great answer.
Speaker C:So I think that's going to exist.
Speaker C:There's no question.
Speaker C:But I still feel that there is that place for that clinician, that relationship between you and your clinician.
Speaker C:I think that's important and that can't be replaced in the same way.
Speaker C:We have key relationships with other professions in our lives.
Speaker C:Those are so important, those fundamental relationships and human interaction.
Speaker B:I do hope you're right.
Speaker B:My daughter is studying to be a doctor, so I do hope she has a career in, in the next few years.
Speaker C:Of course she will, but.
Speaker B:Yeah, no, no, but I think you're right.
Speaker B:I think one needs to live with AI and not work against it.
Speaker B:So I think, you know, and medicine is no different to, quite frankly any other field these days.
Speaker B:We have to implement it and I think use it the best way we can.
Speaker B:Now a lot of people are speaking, you know, about responsible AI.
Speaker B:Does that have a meaning in your day to day life and your day to day practice in how you see, you know, your platform evolving and what is responsible AI for you?
Speaker C:Of course, when you're using AI in healthcare, there is a certain level of clinical Governance you must adhere to and you must of course use it responsibly.
Speaker C:And there are risks associated with AI, of course, you know, hallucinations being one.
Speaker C: s of jargon and acronyms, DCP: Speaker C:And so that's an absolute prerequisite in healthcare because healthcare is a highly regulated space.
Speaker C:And then of course you've got medical device regulation as well.
Speaker C:So you have to be responsible in healthcare, otherwise it can be very dangerous.
Speaker C:And of course I've jumped through those hoops and it's absolutely necessary to do so.
Speaker C:Perhaps in other sectors other than healthcare, there isn't such a need to be as responsible when lives aren't directly at stake.
Speaker C:But yeah, I think responsibility could be things.
Speaker C:Yeah, I said just deploying safe solutions, but also responsible from an environmental point of view because these do use a lot of compute.
Speaker C:So you want to make sure you're building AI in a way that's efficient but also responsible in the sense that you don't want to go down the wrong trajectory with your profession.
Speaker C:As I mentioned before, you don't want to be designing systems that actually aim to eliminate professions from their roles.
Speaker C:I don't think that's a very responsible use of it.
Speaker C:So I. Yeah, it's a poor question.
Speaker B:It definitely is.
Speaker B:Has your involvement in technology changed the way you work as a gp other than using your own platform?
Speaker B:But has that any effect in your daily work life?
Speaker C:That's a good question.
Speaker C:I've never been asked that before.
Speaker C:I would say my clinician work has obviously greatly affected what I'm doing from a technology point of view because a lot of the inspiration really for, for what I've created has come through my, my workings.
Speaker C:But I wouldn't say it's the other way around because fundamentally I, I always want to deliver the best possible care that I can and within, within the confines of that I can.
Speaker C:And so it's that one way relationship.
Speaker C:I'm just using tech to basically fulfill that, that vision of mine.
Speaker B:And talking of tech, just to pivot just a little bit, I know you're involved with Formula One and trying to help them be their best and elite athletes.
Speaker B:How does that fit into your world of being a gp?
Speaker C:I like this question.
Speaker C:So of course if you look at a Formula one driver or a professional footballer, every aspect of their health is as Optimized as possibly.
Speaker C:And that is, of course, one of the reasons is to enhance performance.
Speaker C:Even tiny little changes to their sleeping habits can influence lap times, for example, and what they eat and so on and so forth.
Speaker C:So everything has to be completely optimized.
Speaker C:And so I feel like through that, they've created a roadmap of how you can truly optimize human health and longevity.
Speaker C:And when I got involved in this, I was aware of all these different professions which I.
Speaker C:Which I wasn't aware of before, like strength and conditioning and the role that physiotherapy has in this, and dietitians and so on.
Speaker C:And I realized that they're all working together to optimize these athletes so they can perform as best as possible.
Speaker C:And I had this realization that, of course, this is.
Speaker C:We could apply this model into healthcare.
Speaker C:And maybe that's a challenge in the.
Speaker C:In the current restrictive nature of the NHS as it is, but in healthcare in general, you know, if we were to treat our patients like elite athletes, then I think we would.
Speaker C:We would do extremely well.
Speaker C:And so I almost use that framework.
Speaker C:So, for example, I've spoken to some amazing exercise physiologists.
Speaker C:There's a guy called Christian Vassello who I've got a tremendous amount of respect for.
Speaker C:He's based in Swansea University, and he's taught me so much about exercise physiology, about how to train, about.
Speaker C:About what happens when you do specific exercises like Zone two training and so on.
Speaker C:And I realized that, you know, you could apply this.
Speaker C:Why can't we use this kind of methodology with our patients?
Speaker C:So I do that.
Speaker C:So there has been a bit of cross fertilization between what I've learned from the elite side to how I practice, general practice.
Speaker C:And so I think it's a great framework for.
Speaker C:For longevity, if you want to call it that.
Speaker B:A good friend of mine is actually a sports medicine doctor who is using hyperpoxy therapy.
Speaker B:So it's not what.
Speaker B:In the uk, I guess the hyperbaric chambers now have become very popular.
Speaker B:So this is not what this is.
Speaker B:This is giving a lot of oxygen and then going down, you know, to 70% of oxygen within half an hour.
Speaker B:Yes, you see, it's not very commonly known here, which is crazy.
Speaker B:I know.
Speaker B:He is now at a football club in the uk.
Speaker B:Ooh, I don't know which one.
Speaker B:Don't hold me to it.
Speaker B:The German football team has been, you know, all the.
Speaker B:Not just one, but, you know, overall, they've been using this for years and years and years.
Speaker B:And it's incredible because, you know, it, it makes the mitochondria work better and it's, it's quite a simple, very effective therapy.
Speaker B:Not really invasive, you don't feel bad.
Speaker B:But it's, again, it's geared for elite athletes to help them recover better.
Speaker B:But again, this can and should be applied to the general public.
Speaker B:So I guess it's only a matter of time for things like this to trigger down.
Speaker B:A lot of it, I think, is a shame that, you know, it doesn't happen faster.
Speaker B:But I don't know how you see that.
Speaker B:Yeah, direct things that you can implement, you know, in your clinic right now that doesn't require some expensive machinery that obviously Formula One can.
Speaker C:Yes, and that's a very good point.
Speaker C:And I suppose when the, when the market aligns and when these techniques, these technologies become more accessible and affordable, then.
Speaker C:Absolutely, if I can think of anything, we do a lot of muscle testing for athletes, as in how strong are their muscles?
Speaker C:Like, what is their peak force?
Speaker C:And that's important because, let's say, the context of Formula one, they need to use their neck muscles a lot for all the G force.
Speaker C:Yeah.
Speaker C:Just to give you a little, a little explanation there.
Speaker C:So every time you break, maybe it's about 6G, your head weighs about 4 kilos, helmets about 2, let's say collectively it's about 6, 7 kilos your head, multiply that by 6, you've got sort of 42 kilos of force which you're going to have to withstand to keep your head upright.
Speaker C:You multiply that by the number of breakpoints in a lap, multiply that by the number of laps that you do.
Speaker C:Your neck is getting tremendous workout.
Speaker C:So there is value in being able to test the strength of the neck and how it can sustain that level of endurance.
Speaker C:Now, the testing technology, it uses load cell technology, and that, that technology now is becoming very affordable, and I envision that being used in primary care.
Speaker C:Why would you not want to test the strength of your muscles and actually identify weaknesses and imbalances, which is what we do in athletes, particularly people on GLP1 injections, which we know can cause weight loss?
Speaker C:I think there is, there's value in using that kind of technology as just one example, and I'm sure there are many other examples, and that's also an example of the technologies becoming more accessible as well.
Speaker C:So I think with time, these will become more available.
Speaker C:And actually that's what I'll be doing in my own clinic.
Speaker C:So, of course I have nhs, but I have My own clinic as well.
Speaker C:I'll be using this sort of technology.
Speaker B:Incredible.
Speaker B:Oh, that's exciting.
Speaker B:Look who just, you know, follow up on that.
Speaker B:So can we infer overall muscle strength from the, the neck strength?
Speaker B:Is it sort of like, you know, the grip strength gives you an, you know, general idea how strong your muscles are?
Speaker C:Oh, yes, yes.
Speaker C:So, so the, the technology that I'm referring to is, is called dynamometry.
Speaker C:And I use the neck strength as an example just specifically for formula one, because that's, it's one of the areas of the next strength is very important.
Speaker C:But you can assess the next strength.
Speaker C:You can assess the strength of any muscle potential or any major muscle group.
Speaker C:You just need a way of applying a force to the body.
Speaker C:So, for example, if I were to measure your bicep strength, I would attach something to your hand and pull you in the opposite direction.
Speaker C:You would withstand that.
Speaker C:So that, that's called sort of eccentric muscle testing.
Speaker C:And the point at which I overcome your muscle, the strength of your, of your bicep is, is your peak force.
Speaker C:So therefore I've got a profile of how strong you are, how strong your biceps are.
Speaker C:We would then change the position to say, do your tricep.
Speaker C:We would do your lower limb, your quadriceps, your hamstrings.
Speaker C:We would adopt certain testing positions and then find out how strong we are.
Speaker C:That's peak force.
Speaker C:We can also measure your fatigability.
Speaker C:So how much does your muscles fatigue?
Speaker C:And to do that's very simple.
Speaker C:You have your peak force.
Speaker C:You would half that.
Speaker C:So let's say, for example, you can generate 20 kilos of force on your right bicep.
Speaker C:That's half it, 10 kilos.
Speaker C:How long can you hold 10 kilos for on your, on your right bicep?
Speaker C:So we get a function of time and force, and that's your fatigue ability.
Speaker C:So with that, you can actually define the strength of your entire.
Speaker C:Of all your major muscles in your musculoskeletal system.
Speaker C:And you've got a blueprint of yourself with that.
Speaker C:Like, why is that useful?
Speaker C:Why would you want to do that?
Speaker C:Well, you might want to identify weaknesses or imbalances.
Speaker C:Maybe perhaps you've got a neuromuscular disorder and actually you want to quantify how, what the imbalances are so you can actually have targeted physiotherapy for the particular area that you're weak.
Speaker C:Or perhaps you just want to become stronger and actually get validation for your exercise program.
Speaker C:Am I actually improving my strength?
Speaker C:You'll only know if you test It.
Speaker C:And so there's a lot of clinical and I suppose lifestyle value of that approach in its own.
Speaker C:And as I said, that's just one example of a whole multitude of tests that are adopted in the elite athlete world which I think are translatable to primary care.
Speaker B:Absolutely.
Speaker B:And I think muscle strength is undervalued or underrated when it comes to, you know, longevity, because that's one of the major issues that people have in old age.
Speaker B:They do not have enough muscle mass and most of them don't know that they look fine visually, but they have zero muscles.
Speaker B:And I think it's vitally important for people to know their basic muscle mass.
Speaker B:And if it's adequate, it's not even for training purposes.
Speaker B:That's sort of the icing on the cake that if you know, oh, you know, my training is effective or not, of course that's fabulous if we know that.
Speaker B:And we can also then adapt our training and make it even more efficient.
Speaker B:But I think at a very, very basic level and sort of going back to what we heard at the beginning of the conversation, it's being able to be the CEO of your own health and life and life expectancy, you need to have muscles.
Speaker B:That's a basic foundation of longevity, is having enough muscle mass.
Speaker B:And if you don't check it, you wouldn't know it.
Speaker C:Indeed.
Speaker C:And it, it kind of creeps up on you as well.
Speaker C:And beyond the age of 60, the, your muscle mass decline drops off quite sharply unless you do interventions.
Speaker C:But actually you can maintain a high degree of muscle mass as long as you do the requisite resistance training, for example.
Speaker C:So it's, it's so, so important.
Speaker C:And you're right, it can be masked.
Speaker C:There's a condition called sarcopenic obesity where you may look like you have a lot of muscle, but actually if you do it, let's say you do an MRI or you actually do cross sectional imaging to see or you want to define that muscle mass.
Speaker C:It's very little and it's such a, such a high cause of mobility and mortality.
Speaker C:And so I have this falls prevention plan and one of the aspects I assess is actual muscle strength.
Speaker C:It's so, so important.
Speaker B:Absolutely.
Speaker B:There's no question.
Speaker B:And people are now realizing more and more, not just people who are active within the longevity field, but they realize, you know, you need to have protein, you need to build muscle.
Speaker B:It's becoming, maybe not general knowledge, but certainly much broader than before.
Speaker B:But again, if you don't know how to check that you have enough muscles, you don't know if you need to do more exercise or even different exercise.
Speaker B:You could be doing, you know, a lot of exercise, but it's the wrong one if you have no muscle growth, which can happen easily.
Speaker B:Especially older people, they're not aware of the machines, they don't really know how to do it.
Speaker B:So where do you see medicine, and especially GP medicine going in 5 years time?
Speaker B:Do you think it's sort of all downhill from here?
Speaker B:The trajectory at the moment, unfortunately, I think does not look great.
Speaker B:I don't think it's a, you know, it's a preventative medicine that we certainly in the uk, mind you, most countries, I think it's, it's a reactive rather than proactive.
Speaker B:I don't really see it changing very much and certainly not fast enough.
Speaker B:Even though, you know, I have people like you on and lots of other people who are changing the system and want to change it.
Speaker B:But are there enough people like you around to actually change it?
Speaker C:You know, that's, that's a good question.
Speaker C:It's very hard to answer if I'm completely honest.
Speaker C:In five years time, I, I have my concerns because the problem is, is that we are trapped in this sort of reactive loop at the moment and I know this because I, I do work part time at an NHS practice and, and I know the problems that we're facing on the front line and we are just barely keeping our head above the water and there's almost not a lot of time or even to actually implement these sort of strategies to actually change.
Speaker C:And I don't know if this is why I'm doing what I'm doing because I feel like I don't have any political capital or.
Speaker C:I fundamentally believe in improving the autonomy and knowledge of the individual, empowering the individual.
Speaker C:And I feel whatever we can all do to do that collectively will help improve the healthcare.
Speaker C:And I don't want to wait for politicians to do that.
Speaker C:I don't want to wait for something, someone to come around and save the day, because I don't think that's going to happen.
Speaker C:I think if we can all collectively help one another to become more empowered, I think that's how we get out of this situation.
Speaker C:But I feel like things will probably get a bit worse before they get better, unfortunately, until things perhaps get so difficult that drastic change is the only option.
Speaker C:But we'll see, we'll see.
Speaker B:We'll have a little bit of an un popular question.
Speaker B:Do you think that health care is not an elitist area at the moment, but do you think that health care really now is driven by who has money and who doesn't, or effective health care.
Speaker B:I'm not talking about, you know, obviously even the nhs, you know, it's fantastic.
Speaker B:If you have cancer, you know, they go all out, you know, you have, they have the best, you know, physicians, the best clinicians, the best, you know, that's not the question.
Speaker B:But I'm saying, unless you're really knocking on, on death's door, I think, or, well, that's my question.
Speaker B:Is medical help or, you know, the field of longevity just for the, the people that can afford it?
Speaker C:No, because, okay, this, this will take some unpacking.
Speaker C:So what is longevity?
Speaker C:I mean, I guess we need to have that defined and I guess some people will say it's, you're trying to optimize for health span rather than lifespan, like good quality years.
Speaker C:And then if that's the outcome that you want, you want to promote a health span, what are the key determinants to a health span?
Speaker C:And I would say I don't have the direct numbers, but if you can see what moves the needle the most, I would say about 70% is your environment, your exposures.
Speaker C:Maybe 15% is going to be seeing a doctor, getting medication, maybe then the remaining 15, 5% is going to be that sort of high end longevity, NAD plus effusion, rapamycin, all this kind of experimental stuff, DNA methylation, methylomes, all that kind of stuff.
Speaker C:The biggest movers of the needle are the things that are available to everyone.
Speaker C:I live in Scotland and there are some of the most beautiful nature reserves you've ever seen in the whole of the United Kingdom and they're free to anyone to use.
Speaker C:We have access to, to clean water, we have access to an abundance of food.
Speaker C:A lot of the interventions that deliver the greatest improvements are available to everyone.
Speaker C:And, and so I, I think there is a compelling argument to say that actually longevity medicine is available to everyone.
Speaker C:Those high end IV infusion kind of stuff, those, those booty clinics, fine, that's going to be available to the, to the elite, as you say, but that only moves the needle ever so slightly.
Speaker C:So I think longevity is open to everyone.
Speaker B:Oh, I like that.
Speaker B:You've given me and the world hope.
Speaker B:Yeah, I agree with what you're saying.
Speaker B:Actually, I think it's very true.
Speaker B:I think we've become this mindset that, you know, longevity is something unachievable for 90% or 95% of the population.
Speaker B:But I actually agree with you, it's very much about just Educating people about what is good and what isn't.
Speaker B:Because unfortunately people I don't think are aware of that anymore.
Speaker B:But yes, I like that.
Speaker B:Made my day by, you know, being so positive about that.
Speaker B:No, because a lot of people aren't, you know, and often rightly so.
Speaker C:But yeah, I honestly believe this.
Speaker C:I honestly believe this to be true.
Speaker B:Yeah, I think you're right.
Speaker B:But listen, Dr. Angus, thank you so much for spending all this time.
Speaker B:I could go on and on and on.
Speaker B:You are incredibly fascinating.
Speaker B:Your views, what you're doing.
Speaker B:Maybe we'll have a follow up podcast.
Speaker B:I have so many more questions.
Speaker B:It's really, it's been amazing.
Speaker B:I do have five rapid fire questions that I ask my guest.
Speaker B:Here we go.
Speaker C:Of course.
Speaker B:What's the single best piece of advice you would give your younger self?
Speaker C:Follow your passion.
Speaker B:Name one habit everyone should adopt for.
Speaker B:For a longer, healthier life.
Speaker C:Sleeping better.
Speaker B:If you weren't in the medical field, AI technology, longevity science, what career would you have chosen?
Speaker C:That's a hard one.
Speaker C:Quick, quick fire.
Speaker C:I'd probably like an engineer.
Speaker C:Like a.
Speaker C:Maybe an engineer, something like that.
Speaker C:Yeah.
Speaker B:What Microdose habits, sort of a five minute routine or small daily action do you think yields outsized longevity benefits?
Speaker C:This sounds a bit cliche, but.
Speaker C:Well, this is more from a psychological point of view, but just being grateful for a lot of things that I have in my life and actually just taking a moment to actually just think I'm really grateful for some amazing people in my life, that makes me feel quite happy psychologically and that kind of puts me in a good frame of mind for the rest of the day.
Speaker C:And then that probably leads to downstream benefits.
Speaker C:So I think just.
Speaker C:Yeah, being grateful.
Speaker B:And the last question is, what's the craziest longevity myth you've encountered and is there any truth to it?
Speaker C:Oh, gosh, do you know what?
Speaker C:I know I've encountered so many, but over the years, but I can't actually think of.
Speaker C:I just can't think of one.
Speaker C:It's, you know, I'm gonna have to pass on that one, but that's gonna bother me now.
Speaker C:I'll get back to you when I can think of the craziest one.
Speaker B:You know what?
Speaker B:You're not wrong.
Speaker B:There are a lot of crazy longevity myths around, so.
Speaker B:Yes, but get back to that.
Speaker C:Ron.
Speaker C:Yeah.
Speaker B:Well, as I said, thank you so much for making the time.
Speaker B:It's.
Speaker B:It's been truly inspiring to hear you speak and to hear that you're actively trying to do something to fix a system that maybe if it's not, you know, completely broken, but that certainly needs help.
Speaker B:Thank you for doing all you're doing.
Speaker B:And yeah, watch this space, I guess.
Speaker C:Well, thank you for having me.
Speaker C:Much appreciated.
Speaker A:What this conversation makes voice very clear is that real innovations in healthcare starts with the everyday reality.
Speaker A:Longevity research may advance in laboratories and clinical trials, but impact happens inside the healthcare system, and progress only translates when those systems support the way clinicians actually work.
Speaker A:If longevity is to move from scientific progress to to practical impact, healthcare must evolve alongside it, becoming more precise, more scalable, and better aligned with clinical reality.
Speaker A:Subscribe to Beyond Longevity on your preferred podcast platform and join us in advancing the conversation around ageing.
Speaker A:Let's redefine what it means to live longer, to live healthier.
Speaker A:This is your invitation to understand the future.
Speaker A:One discovery, one insight, and one conversation at a time.
