Clinician-Led AI: The Future of Mental Health Care

WAIV Magazine Clinician Interview Series

We had the opportunity to sit down with Dr. Nidhi Goel, Founder of HealMed, to discuss her path from treating patients one on one as a psychiatrist to building a company meant to scale mental health care itself. Dr. Goel spent years in interventional and geriatric psychiatry before turning her own frustrations with the system into an AI platform designed by a clinician, for clinicians. What follows is our conversation about the moment that started it all, the guardrails she refused to compromise on, and what she's still trying to get right.

WAIV Magazine: You went from treating patients one on one as a psychiatrist to building a company meant to scale mental health care. What was the moment you realized the old model just couldn't keep up anymore?

NG: The journey started when I was on a night call at the hospital and my friend called to wish me a happy birthday. I started venting about issues I was facing during the call, how things should ideally be, and he started asking questions. What's the solution to it? I rattled off this whole idea about how AI can improve physician efficiency so we're delivering clinical care instead of spending our time on administrative tasks. His next question was, what's your business plan? Then, what's your exit strategy? I was dumbfounded. I said, I'm talking about a new idea and you're already asking about exit. But that same night I wrote a business plan and shared it with him in the morning. And the rest is history.

WAIV Magazine: HealMed's site talks about a 75 to 80% reduction in provider workload. Walk us through what a psychiatrist's day actually looked like before that, and what changes for them now.

NG: In mental health, we rely on history, which takes an hour or more when we meet a patient for the first time, what we call the initial evaluation. Unlike almost any other field of medicine, where history is brief and the rest is labs and imaging, this is where most of our time goes. Then we spend another twenty to thirty minutes writing the notes. That leaves us with effectively ninety minutes per new patient, and thirty to forty-five minutes for a follow-up, so our capacity to see patients in a day is limited from the start. EMRs and insurance-related tasks add another layer on top of that, and we end up spending our own personal time finishing notes and admin work that has nothing to do with clinical care.

A lot of that work can be done by a lower-cost staff member, so to speak, freeing up our license to actually be used for what it's for. HealMed does the pre-visit history taking the way I would do it myself in conversation: verbal, non-judgmental, comforting, at the patient's own pace. Then it compiles that into a syndromic category and finally a transcribed note, so the clinician spends a couple of minutes reviewing it instead of building it from scratch. Providers can see up to five patients in the time it used to take for one. Even seeing two in that window effectively doubles their efficiency.

WAIV Magazine: You're trained in interventional psychiatry, things like TMS and Spravato, which are deeply hands-on. How do you square that clinical instinct with building a voice-based AI assistant that never touches a patient?

NG: Treatment is the last leg of patient care delivery. HealMed handles the evaluation and diagnostic part and streamlines it, so more meaningful time can go toward discussing relevant, newer treatment modalities with patients, and offering them cutting-edge, technologically assisted treatment efficiently, and monitoring their progress through measurement-based assessment. It helps quantify something that's always been treated as qualitative and self-reported.

WAIV Magazine: Patients often worry that an AI asking about their psychological, medical, social, and family history feels colder than a human doing it. What have you seen in practice that surprised you about how people actually respond?

NG: Honestly, people are more comfortable talking to an app these days than to another human being. A lot of patients feel shy or embarrassed in front of a new doctor and end up minimizing their symptoms, and it takes time for them to open up. They don't feel that with an AI app. They freely share what's going on in the privacy of their own home. It's a judgment-free, safe, secure environment.

WAIV Magazine: You've spent years in geriatric psychiatry, a population that isn't exactly known for embracing new tech. What's the real adoption story been like across different age groups?

NG: COVID gave technology a real tailwind. It changed a lot of perceptions, since most visits were suddenly happening remotely through tele-visits. Smartphones and tablets have also made the interface easier, so it's more the norm now than the exception. HealMed doesn't require patients to read or write anything, or navigate much of anything really. They just speak to it the way you'd talk to Siri or Alexa.

WAIV Magazine: Every health AI company says it reduces burnout and improves outcomes. What's a number or a story from HealMed that actually proves it, something you didn't expect to find?

NG: We recently presented a paper at the National AAGP conference on real-world data showing how HealMed has improved efficiency and the patient experience of the app. This is a patient-focused platform, but a clinician-driven one, not one of the million mental health apps out there designed by so-called tech people. HealMed carries the deep domain knowledge of a seasoned psychiatrist with decades in the field, someone who understands how clinicians think and how patients actually feel. I've experienced firsthand the pain of different technologies existing in silos and making the workload heavier instead of lighter.

We know AI hallucinates and can be dangerous. HealMed was built before ChatGPT was a thing, before OpenAI even existed in the public conversation. The LLM and every algorithm behind it were created by us, with clearly defined boundaries. So we don't worry about the system asking inappropriate questions that could be detrimental to patients. And honestly, what better testimony is there than the fact that I use it in my own clinical practice, which has grown tremendously in a short span of time.

WAIV Magazine: Mental health data is about as sensitive as it gets. What's a guardrail you insisted on for HealMed that a purely technical team might not have thought to build in?

NG: The whole system was designed by me, with input from other psychiatrists and real patients who tested it and gave feedback. I'm the biggest critic of my own product, and the tech team sometimes gets frustrated with me. They'll say, this is how tech works, and I'll say, well, that's not how healthcare works, so fix it. I have an in-house tech team, and I worked full-time alongside them through every step of development. Now it's mostly support and upgrades based on customer feedback. We're currently working on new features for the care delivery support system, with the goal of making HealMed a one-stop place for both the people who seek mental health care and the people who deliver it.

WAIV Magazine: You've built this as both a working clinician and a founder. When those two roles pull in different directions, who wins, the doctor or the CEO?

NG: In the current healthcare system, a clinician doesn't have control over a lot of things. It's dictated by payers, EMRs, and big healthcare corporate systems. Physicians largely don't have a voice anymore in how care gets delivered. It's become a big corporate business, where physicians and patients end up on the losing end, when they should have been the primary focus all along.

As CEO of my own health tech company, I was very aware of those pain points and empathetic toward them. But becoming a founder was its own huge, steep learning curve, especially for an immigrant woman of color. It's a different world, one that favors a set stereotype of who gets to lead. I guess I love a challenge, so I bootstrapped it and built the product on my own terms, to keep it meaningful, and so far I've avoided turning this into a house of cards built on big promises that ends up just being a numbers game.

WAIV Magazine: If you had to guess where AI in mental health goes wrong first, where's it going to be a crutch instead of a tool?

NG: Teens using ChatGPT as a therapist is a big scare for me. AI hallucinates, and it answers differently depending on the prompt you put in. Sometimes it gives dangerous advice to a suggestible young mind. AI can be a weapon or a tool, depending on how it's used.

WAIV Magazine: Five years from now, what does a first psychiatric visit look like for someone who's never talked to a human provider at all, and is that a future you're rooting for or one you're trying to prevent?

NG: It's inevitable. Right now, over 60% of U.S. counties have no psychiatrist, and that number climbs to 80% in rural counties. We're also looking at roughly half of the current psychiatrist workforce retiring soon, without enough new providers coming in to match it. Around 50% of adults and 80% of children who need mental health care don't get access to it in any given year. My goal was, if I can enable existing providers to increase their capacity by even 20 to 30%, they'll be able to help a lot more people.

It's also worth keeping in mind that we have a newer generation of providers now, nurse practitioners and physician assistants, stepping in as mainstream mental health providers, even though their clinical training is much less extensive than an MD's. HealMed can help bridge that knowledge gap and support them in providing better care, as a clinical decision-support system.

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Dr. Nidhi Goel is the Founder and CEO of HealMed Solutions. She is a board certified Adult, Geriatrics and Interventional psychiatrist, and an advocate for physician-led AI in behavioral health. Learn more about her work at healmedsolutions.com and wwwhealmed.org