Summary
“There’s so many downstream effects of having people work in an inefficient environment.” Dr. Alfred Atanda, a pediatric orthopedic surgeon, shares his experiences of dealing with the inefficiencies in a clinic environment and the stress that results. Every day in his practice, he sees how broken workflows ripple out—straining providers and the patients who rely on them. Dr. Atanda highlights how DAX Copilot, an AI-powered solution, aims to simplify doctors’ workflows by recording patient visits and drafting medical notes, potentially improving efficiency and patient care. Dr. Atanda highlights the benefits and limitations of using DAX, emphasizing its role as a helpful tool rather than a complete solution.
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Dr. Alfred Atanda Jr., M.D.
Chief, Center for Sports Medicine, Department of Orthopaedic Surgery
Director, Clinician Well-Being, Delaware Valley
Nemours Children’s Health, Delaware
Alfred Atanda Jr. is a pediatric orthopedic surgeon at the Alfred I. duPont Hospital for Children in Wilmington, Delaware where he serves as the Chief of the Center for Sports Medicine, the Director of Clinician Well-Being, and is also an Assistant Professor of Orthopedic Surgery at the Sidney Kimmel Medical College at Thomas Jefferson University.
His clinical interests include sports medicine, orthopedic trauma, general pediatric orthopedics, and injury prevention in youth athletes. With his expertise in these areas, he is frequently invited to teach and lecture locally, regionally, and nationally.
A graduate of the University of Pennsylvania School of Medicine, he completed residency at the University of Chicago Medical Center. Dr. Atanda also completed fellowships in pediatric orthopedic surgery, at Alfred I DuPont Hospital for Children, and in sports medicine surgery, at the Rothman Institute at Thomas Jefferson University.
His future goals and aspirations are to re-imagine how healthcare is delivered by leveraging digital health and telemedicine technology to appropriately triage, navigate, evaluate, and treat orthopedic patients. He is the chief editor of the world’s first textbook solely dedicated to telemedicine in orthopedic surgery and sports medicine, and founded a telemedicine concierge service for the parents of youth athletes: “ SportsLinkMD”. He is a physician expert for numerous digital health companies providing strategic advice and e-consultations to urgent care, emergency department, and primary care physicians, as well as a second opinions directly to patients. In his administrative role, he has been working to optimize the physician experience, bringing awareness to the many ramifications of physician burnout, lack of well-being, and physician suicide. In addition, he optimizes clinician workflows by leveraging digital health solutions such as artificial intelligence and mixed/extended reality. He is a physician well-being TEDx speaker and has been featured on many physician well-being podcasts, including KevinMD.
Transcript
DDx SEASON 11, EPISODE 3
The Workflow Conveyor Belt
RAJ: This season of DDx is produced in partnership with and sponsored by Microsoft.
DISCLAIMER: In this episode, we feature a conversation with Dr. Alfred Atanda. Dr. Atanda is an independent user of DAX. He has received no compensation for participating in this episode and the views expressed are his own.
Dr. Atanda: I’m in the clinic space. I’m the only physician in that particular clinic, I look at the four rooms and they’re all filled with patients. And I start with patient number one, but I know in the back of my head that patient number two, sometimes the visits with that individual family can be long, can involve a lot of tension and anxiety. Then I can see, you know, patient number three. Oh, I know He needs an x-ray to be seen and evaluated. But oh, yeah, last time he was here there was an issue with his insurance and I’m not quite sure if we ordered the x-ray ahead of time or if he’s able to get the x-ray on our site. And then the fourth patient has a ton of records and MRIs and notes and things that I need to look at. So that is when I’m most stressed. And most frazzled and I feel like I’m nowhere near as efficient as I should be at this moment because everything is just piling up on that conveyor belt.
RAJ: This is DDX, a podcast from Figure 1 about how doctors think.
I’m Dr. Raj Bhardwaj.
This season, we’re looking at a new AI solution for doctors.
It’s called DAX Copilot.
The idea is simple: you walk into the exam room and start talking with your patient.
No typing.
No notepad.
Just a conversation.
While you’re focused on the patient, DAX listens.
It records the visit, drafts the medical note, and promises to save you hours of charting.
That’s the pitch.
But does it work?
We’re asking doctors what it’s really like to use this technology.
Does it help?
Does it get in the way?
And what does it mean for the doctor-patient relationship when DAX is in the room too?
Today, we’re tackling the problem of inefficient workflows.
They don’t just frustrate clinicians.
They can also hurt the quality of patient care.
We’ll look at DAX and ask: Does it really solve this problem?
Can it ease the administrative load?
Can it give clinicians the mental space to focus on their patients?
And if it can, what does that mean for care teams, efficiency, and outcomes?
Dr. Alfred Atanda has lived this challenge.
Every day in his practice, he sees how broken workflows ripple out—straining providers and the patients who rely on them.
Dr. Atanda is a pediatric orthopedic surgeon and sports medicine chief at Nemours Children’s Health in Wilmington, Delaware.
CHAPTER 1: THE PHYSICIAN’S CHALLENGE
Dr. Atanda: Sometimes it just makes me sick to my stomach because this is the beginning of the day and I’m already behind the eight ball.
RAJ: For Dr. Atanda, it’s not just the workload—it’s the entire system.
It slows things down and the work piles up.
And the ripple effects?
They touch everything, from how care gets delivered to time with patients.
Dr. Atanda: When you work in a chaotic, inefficient, fragmented healthcare system, you’re spending a lot of time on nonclinical tasks and documentation burden and all the external regulatory stuff you kind of lose sight of what it is that you’re even doing every day, but even more importantly, you lose sight of why you’re doing it. In my opinion, the number one thing that suffers is patient care.
RAJ: Makes sense, right?
You can only focus on so much at once.
So, you rush through patient visits.
You miss things—details, moments.
And in the end?
Dr. Atanda: You can tell when someone is in a rush or you can tell when someone is distracted. You can tell when there’s other competing priorities in their brain at that time. So what happens is the patients don’t get the best experience.
RAJ: And there are broader impacts too.
Dr. Atanda: We know that the chaotic environments that we work in, from a well being perspective, definitely leads to an increase in medical errors, in poor productivity from physicians. It eventually leads to turnover because you can’t take good natured, well intended, hardworking people and put them in a suboptimal, inefficient environment. There’s so many downstream effects of having people work in an inefficient environment.
RAJ: Dr. Atanda hit a breaking point about eight years ago.
Dr. Atanda: When I got divorced, my kids were six and three, and when I moved out I quickly realized that I’m going to be alone. I’m going to be a single dad. And I knew being a traditional day to day surgeon and working ten, twelve hours a day, that’s not going to be sustainable to be the dad that I wanted to be. So I knew I had to make a change.
RAJ: But what could he do?
Dr. Atanda: I had no other skills. I wasn’t particularly that good at anything else. So then you kind of like, feel like you’re stuck because you don’t have any other options. So, I think that’s a realization that a lot of physicians come to.
RAJ: Dr. Atanda was eventually able to lighten his clinical workload, but for most care providers that’s not an option.
So what then?
Dr. Atanda: Historically, it’s always been up to us as physicians to roll up our sleeves, put your head down and just get through it. And that’s really unfair. We weren’t trained on digital health transformation and workplace efficiency. We weren’t given the tools that we need. A lot of times people, when they talk about solutions to improve burnout, they talk about yoga and mindfulness. But I’ll tell you this much. There isn’t enough yoga in the world that you can do that when you show up back to work on Monday morning in a chaotic, fragmented, inefficient environment, that’s going to make you feel any better.
CHAPTER 2: RESOLUTION – TECHNOLOGY AS A TOOL, NOT THE HERO
RAJ: Dr. Atanda first heard about DAX in passing—some colleagues were chatting about how it might make their lives easier.
Dr. Atanda: The way that it was described to me was that it’s ambient listening technology. It’s something that you would use on your mobile device and it would integrate and correlate with the electronic health record that we use at our hospital and it would allow you to be more efficient in the office.
RAJ: That piqued his curiosity.
Dr. Atanda: I found this very intriguing because I feel like as physicians, when we do work in suboptimal, slightly inefficient environments, you often come to a fork in the road. You’re sitting there with your patient, and you could do one of two things. You could, A, talk to your patient, connect with them, but then at some point, in the back of your mind, you’re thinking about, I’m going to have to document everything that’s going on, and that can be very stressful. The second option is that you could do the note in real time, but if you’re typing a note, then how well are you going to be at connecting to that patient? And this is quite the conundrum because I feel like I’ve experienced this thousands of times in my career.
RAJ: DAX promises to drastically simplify a doctor’s workflow by allowing them to just focus on one thing at a time, in this case, their patients.
Dr. Atanda: It just took away some of that inefficiency, right? Like why go and talk to a patient for 30 minutes and then go sit in front of a computer and type a note when it can all just happen simultaneously in the background. That kind of blew me away when I realized that, because that was something for the first, 12 or 13 years of my practice that I just never experienced.
RAJ: And solving workflow inefficiencies isn’t just about saving time.
It’s also about making better use of everyone’s expertise.
Dr. Atanda: It really enhanced how we worked as a team, not just me as an individual.
RAJ: As a sports medicine surgeon, Dr. Atanda is supported by two athletic trainers. In the past, they’d join him in the exam room, acting as scribes—taking notes and summarizing details.
Dr. Atanda: But that creates a problem, because if you see patient number one with your athletic trainer, and then you come out of the room with your athletic trainer, you need to go in and see patient number two. If you go right in and see patient number two, and you take the athletic trainer with you and they’re doing the note, then nobody’s doing the things that patient number one may have needed or nobody’s looking ahead to do the things that maybe patient number three needs.
RAJ: By taking care of some of the charting, DAX freed up his staff to handle follow-ups for patient one—or get ready for patient three.
Dr. Atanda: It freed them up from a lot of the mundane scribe type responsibilities and it let them do other higher level things so that they can work to the top of their license and reach their fullest potential, but also, it allows us to divide and conquer.
RAJ: So a technology like DAX makes a number of promises in terms of improving workflow.
But to what extent does it deliver?
Dr. Atanda: Obviously I think DAX has been very good for workflow on my part, but what I also think is that it helps all other members of the team reach their maximum potential and do the most valuable work and services that we would like for them to do.
I think just like a reflex hammer is a tool, just like a stethoscope is a tool, there are certain times and places where utilizing DAX just makes sense and there’s other times where it doesn’t.
RAJ: For example, Dr. Atanda doesn’t use DAX during really quick visits, like certain post-op visits, minor fractures, wound checks or cast changes.
Dr. Atanda: I prefer to use DAX when there are visits where I know there’s just going to be a lot of talking. Surgical discussions. MRI review, lab result review, second and third opinions, a patient that’s had a chronic problem with lots of issues, many procedures, because that’s where you get the most bang for your buck because those visits take me 30 minutes of just talking.
RAJ: But as helpful as technology can be, there’s always a catch: no matter how advanced the tool, the responsibility for making sure everything is accurate still falls squarely on the physician.
Dr. Atanda: It’s AI, so it’s not perfect. You may have to take some time to sit down and look at the note and edit the note. But if anybody writes your notes whether it be a scribe, whether it be a resident or a trainee, that’s just part of your responsibility as a physician is to ensure that the note that is being put in on your behalf for a patient is as accurate as possible.
RAJ: AI isn’t perfect.
It’s a tool, and like any tool, its power lies in how you use it.
Dr. Atanda: It’s one tool in your toolbox that you’re going to use, to slay the documentation dragon and you have to understand how to utilize it most effectively for your particular situation.
RAJ: Thanks to Dr. Atanda for speaking with us.
This is DDX, a podcast by Figure 1. Figure 1 is an app that lets doctors share clinical images and knowledge about difficult-to-diagnose cases.
I’m Dr. Raj Bhardwaj, host and story editor of DDX.
Head over to figure1.com/ddx where you can find full show notes, speaker bios and photos.
This season of DDX was produced in partnership with and sponsored by Microsoft. Thanks for listening!y editor of DDX. Head over to figure1.com/ddx where you can find full show notes, speaker bios and photos.
This season of DDX was produced in partnership with and sponsored by Microsoft.
Thanks for listening!