00:00:00 Dr. Ketan Kulkarni, a pediatric oncologist, researcher, entrepreneur, author, and life coach based in Halifax, Nova Scotia, Canada, discusses his work in pediatric oncology and the global collaborative efforts that have led to significant advancements in childhood cancer research over the past 50 years. Dr. Kulkarni shares how the field's emphasis on cooperation and collaboration has resulted in remarkable progress, with the global pediatric oncology hematology Consortium being a testament to this. He explains that his fascination with pediatric oncology began during his residency, where he was exposed to research projects and collaborative global settings, ultimately leading him to pursue a career in the field. Dr. Kulkarni emphasizes the importance of making a positive impact on patients and their families through both direct clinical care and meaningful, purposeful research. Pediatric cancer is a well-funded and well-recognized area of research due to its impact on families and the significant progress made in the past few decades.

00:05:00 Dr. Kulkarni discusses the importance of brand recognition and advocacy in cancer research. He uses the example of the European Consortium and the Ronald McDonald House to illustrate how having a clear brand helps raise awareness and funds for their causes. However, despite progress in cancer research, there are still challenges, such as access to new medicines and provincial funding issues. Dr. Kulkarni highlights the significant improvement in survival rates for young children with cancer over the past few decades, with leukemia survival rates pushing 90%. He emphasizes the importance of reducing toxicity and morbidity in cancer treatments. Dr. Kulkarni's current research focuses on developing guidelines for cancer thrombosis and drug toxicity, as well as using multiomics, such as microbiome and genomics, to identify patients at high risk of toxicity and prevent it. He also discusses the impact of cancer on a patient's microbiome and how research in this area is shedding new light on the complex relationship between the body and its environment.

00:10:00 Dr. Ketan Kulkarni discusses the advancements in genomic research and the identification of genetic markers for various medical conditions. He mentions how countries like the Nordic ones are banking DNA samples at birth and following patients as they grow, which is not yet common practice in North America. Dr. Kulkarni also talks about the potential for tracking DNA changes in children and predicting future health issues. However, he raises concerns about the ethical and practical implications of such advancements, including privacy, discrimination, and cost. He suggests that figuring out how to integrate these identified genetic conditions into healthcare systems and insurance coverage will be a complex issue that requires high-level advocacy and system-level changes.

00:15:00 The discussion revolves around the Canadian healthcare system, specifically addressing the access to universal healthcare for patients with pre-existing conditions or high medical costs. Dr. Kulkarni explains that while Canada's population is fortunate to have universal healthcare, there are complexities in the system, such as the need for insurance for chronic care and the lack of clear answers regarding how expensive treatments are covered. He shares an example of a friend from Alberta requiring a $200,000 medication, which raises questions about who covers the costs and how to supply the demands for such treatments. Dr. Kulkarni acknowledges that as medical advancements continue, traditional models of insurance and reimbursement may not be sufficient. He suggests that a holistic approach, possibly involving collaboration with government bodies, pharmaceutical companies, and administrators, may be necessary to provide the best care for the entire population. Dr. Kulkarni also mentions the disparity between the number of users and the amount of costs in the system and the unique challenges Canada faces due to its large size and population distribution.

00:20:00 Dr. Ketan Kulkarni discusses the challenges and limitations of being an entrepreneur in the Canadian healthcare system, specifically for those in tertiary care or academic roles. He explains that unlike in the United States, private practice is less common in Canada, and the resources required for academic practice make it nearly impossible to do so without being in a larger center. Dr. Kulkarni acknowledges that this can lead to frustrations and challenges in balancing patient care and other deliverables, but he views it as a career evolution and a necessary sacrifice for the impactful research and leadership roles he pursues. He also acknowledges that private practice physicians in the US have different priorities and limitations, and that everything comes with pros and cons. Overall, Dr. Kulkarni emphasizes the importance of time management and staying true to one's deliverables in the complex world of Canadian healthcare entrepreneurship.

00:25:00 In this section of the podcast, Dr. Kulkarni discusses his perspective on research, emphasizing its importance in patient care, innovation, and creativity. He believes that research should align with one's core values and not be pursued solely for promotional reasons. Dr. Kulkarni shares his personal experience of identifying research questions from his clinical practice and collaborating with teams to find answers. He also mentions the importance of having the right team members and co-investigators for successful research projects. Dr. Kulkarni stresses that research should not be approached as a means to build a heavier CV but rather as an outlet for creativity and innovation. He warns against the pitfalls of focusing too much on metrics and productivity, which can hinder innovation and creativity.

00:30:00 Dr. Kulkarni discusses the differences between the Canadian and US research systems and shares insights into his favorite and most impactful research projects. He highlights the importance of building a strong research base and solving real-world problems through innovation. Dr. Kulkarni mentions his work on cancer thrombosis, which led to identifying at-risk patients and modifying their treatment, and a desensitization protocol for a leukemia drug, which improved access to life-saving medication for patients in developing countries. He emphasizes that meaningful innovations can come from addressing small yet significant problems and creating low-cost solutions.

00:35:00 Dr. Ketan Kulkarni shares his personal journey of feeling burnt out and seeking answers to improve the healthcare workforce. He explains how he went through extensive leadership training, became a coach, and researched a philosophy of life to create evidence-based, applicable resources. Frustrated by the lack of such resources, he and his team spent two years compiling information into their first book. However, they realized the need for a more engaging format and created a second book that took another two years to produce. Throughout this process, Dr. Kulkarni has been invited to various podcasts and writing opportunities to spread knowledge and challenge the societal definition of success. He believes many people, especially in Canada, feel an inner void and desire to transition from a place of burnout to fulfillment. Dr. Kulkarni's work focuses on creating solutions for individuals to leverage their hard-earned dollars and work in their defined way, emphasizing the importance of financial literacy as the foundation for this transformation. His philosophy aligns with Grand Vision Capital's approach in the coaching and entrepreneurship space, as they also provide financial literacy resources for physicians.

00:40:00 Dr. Kulkarni discusses the importance of pursuing hobbies and passions outside of being a physician, rather than focusing on quitting medicine entirely. He emphasizes that it's not just about supplemental income but the creative outlet and happiness that comes from doing something enjoyable. Dr. Kulkarni also touches on the idea that not everyone aspires to write a book or start a business, and that simple things can bring joy. He and his colleagues are working on creating meaningful solutions to help physicians with financial literacy and wealth creation, recognizing that it's not enough to just create awareness but also to provide solutions. They are focusing on creating easy-to-use tools and potentially national-level investing solutions for physicians. The overall goal is to protect and preserve the highly skilled workforce by focusing on professional wellness.

00:45:00 The discussion shifts to investing and creating passive income, specifically in real estate for physicians. Dr. Kulkarni explains that while real estate investing can generate passive income and wealth, the barrier to entry can be high, particularly in Canada where real estate is expensive. He suggests that education, access, teamwork, and creative financing solutions are necessary to help physicians get started. Despite the challenges, Dr. Kulkarni believes that more awareness and collaboration among individuals will lead to creative solutions. He also mentions the importance of having a solid finance blueprint and understanding the risks involved in various investment strategies. The conversation touches on the high expense ratios and underperformance of mutual funds in Canada, which continue to be popular despite their drawbacks.

00:50:00 Dr. Ketan Kulkarni explains the challenges individuals face when it comes to managing their finances and achieving work-life balance. He explains that most people rely on financial advisors for guidance, but the advice they receive is often limited due to the advisors' lack of access to various investment solutions. Dr. Kulkarni also emphasizes the importance of understanding what success means to each individual and encourages people to explore their hobbies and passions as a way to create balance and find fulfillment. He believes that self-awareness and identifying core values are essential components of a successful and satisfying life.

00:55:00 Dr. Kulkarni discusses the misconception that people need unlimited resources to be happy and create meaning in their lives. He shares that happiness is not about instant gratification but rather about alignment of purpose and meaning, and living in accordance with one's values. Dr. Kulkarni also reflects on the importance of experience in solidifying core values and creating meaningful content for different age groups. He mentions his upcoming projects, which aim to create evidence for these ideas and impact various age groups. Dr. Kulkarni's work focuses on global impact and can be found on savvypatients.com and major book outlets, as well as his social media platforms.

01:00:00 Dr. Kulkarni discusses the importance of addressing global issues such as the climate crisis and humanitarian work. He mentions their organization's efforts in Asia and beyond, focusing on de-addiction, literacy, and environmental awareness. Dr. Kulkarni emphasizes the connection between these initiatives and the goal of living a purposeful and aligned life. He expresses his hope that their paths may cross in the future.