AI That Gives Clinicians Time Back with Dr James Ries

Send us Fan MailEveryone seems to be asking how AI can do a doctor’s job. We go the other way and it changes the whole picture: what if AI’s best role is deleting the admin work that crushes clinicians and slows down care?I’m joined by Dr James Ries, a board-certified family medicine physician, active duty US Navy provider, and founder behind 20 Mile Medical. James explains how years in telehealth exposed a hard truth about modern healthcare efficiency: the real bottleneck is not clinical decision making, it’s the clutter around it. We dig into where costs actually hide (patient communication, coordination, follow-ups, fragmented systems) and why targeting clinicians first is the wrong optimisation.James walks us through his AI layer, Telora, built to compile patient intake, highlight red flags, and surface evidence-based protocols in one place before a consultation even starts. We unpack deterministic AI vs generative AI, why patient-facing chatbots can be unsafe at scale, and how reducing cognitive load can lead to more personalised care even in shorter visits. We also explore why more frequent follow-ups can improve continuity and reduce the “three-month pile-up” of questions, plus the broader shift in telehealth towards lifestyle and concierge care.If you care about AI in healthcare, clinician burnout, telehealth platforms, electronic health records, and safer automation, you’ll take a lot from this conversation. Subscribe, share with a colleague, and leave us a review with your take: where should AI stop and the human clinician begin?Guest BiographyDr. James Ries is a board-certified family medicine physician, active-duty US Navy Commander and healthcare entrepreneur who has spent approximately a decade working in telehealth.He is Co-Founder of Twenty Mile Medical, a telehealth platform created from his experience of trying to improve inefficient healthcare systems from inside them.After finding existing software poorly aligned with real provider workflows, James began developing his own technology, combining an electronic health record with an AI-enabled layer called Telora. The system is designed to reduce the administrative and cognitive workload surrounding clinical care by organising patient information, supporting evidence-based workflows and streamlining processes such as documentation and communication, while keeping providers responsible for clinical care.His work focuses on improving healthcare access, provider efficiency and patient experience without treating AI as a replacement for the clinician. Longer term, James hopes that dramatically reducing the cost of delivering telehealth could help make care accessible to uninsured and underserved populations.Websites: https://www.twentymilemedical.com and https://www.telora.healthLinkedIn: https://www.linkedin.com/in/drjamesries/Subscribe on SubstackVoices in Health and Wellness is published on Substack, as part of The Diagnostician. Every episode lands there with written notes and reflections you won't find in the podcast feed. Free to subscribe.👉 https://thediagnostician.substack.com/s/voices-in-health-and-wellnessAbout the podcastVoices in Health and Wellness features conversations at the intersection of medicine, lifestyle, and human potential, with clinicians, scientists, and thinkers shaping the future of care.About Dr Andrew GreenlandUK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. Trained in both conventional and root-cause approaches, Andrew helps people optimise health, performance, and longevity, with a focus on cognitive resilience and healthy ageing.