Why is a physician so engaged in advanced advertising?

I have always loved television. I must have watched 6-8 hours per day. My mother claimed as a small toddler, I would play with the TV in the background, and pay close attention during the commercials.

I developed a passion for computers. My high school had a teletype machine which served as a terminal. In 1976, I wrote a program in BASIC which automated the student college financial aid application form. I had a commodore64 when they first came out.

I had the benefit of a liberal arts education as a philosophy major at NU.

I attended the Johns Hopkins School of Medicine, I got involved in early online medical education with an experimental system there. I was also exposed and interested in quantitative methods in public health. I did biological research at the NIH in Bethesda, close to my home. I became interested in motivation, human behavior, and knowledge. One of my favorite professors was a pathologist, a world expert in lung cancer. He was also a chain smoker. He died of lung cancer during my residency.

I did a residency and fellowship training in anesthesiology, with a subspecialty interest in anesthesia for neurosurgery and neuro intensive care. In 1989, at age 29, I was asked to become the section head of anesthesiology at the Wilmer Eye Institute at Johns Hopkins. I learned that if a field is sufficiently circumscribed, one can become a recognized expert very quickly. This was at a time of great upheaval in health care, with DRGs and health reform on the agenda.

My interest in the business of public health led me to get a Masters degree in health finance and management, from the Department of Health Policy and Management at Johns Hopkins School of Public Health (now Bloomberg school). I worked part-time as a hospital management consultant with Arthur Andersen.

This was also the time I got involved with a large research project, the Study of Medical Testing for Cataract Surgery. This was a prospective randomized study of 19,000 patients to determine if ECGs and blood testing made any difference to the outcomes of cataract surgery. I was the Site Principal Investigator at Hopkins. This gave me a great experience in the gathering, analysis, and use of large data sets. This was also the time of the Flecainide studies. Flecainide was a pill that prevented arrythmias after heart attack. Several studies proved it was effective at preventing dangerous irregular heartbeats. It got FDA approval. Only later, with large studies and data analysis, was it found that although the drug was good at preventing irregular heart beats, patients who took the drug had twice the death rate, from many causes. This taught me that truth is not found in things that make sense theoretically, but that important decisions should be based on evidence from good, direct, empirical data.

I was recruited to the Cleveland Clinic to lead anesthesia at the new Cole Eye Institute. As our boys got a little older, I found more time for hobbies. I loved TiVo, but I did not like monthly fees. I did not want to pay for multiple systems in the house. I had several computers that I was not using. I upgraded them and installed software to act as media center PCs.

I read about addressable, or targeted TV advertising. I understood the great business advantages. I understood how it could make for more enjoyable television. I also understood the hardware, market, and privacy challenges that were obstacles to implementation. My experience with the hospital workstations showed me that a secure, private, and useful network was possible. At this time I also became interested in Libertarian political philosophy, the power of free decision-making. It occurred to me that a network of home theater PCs, like I had already built, would make an excellent platform for addressable ads, solving the hardware, market, and privacy challenges.