Thanks for moderating @bonedocph.bsky.social Remo! Though not many participate in the #healthxph chat these days, I look forward to our convos … time and space to reflect and catch up. That is still valuable!

T3 Starting over doesn’t require shrinking yourself. It requires separating confidence from certainty. Keep your standards, ethics and decision-making muscle intact—just loosen your grip on being right. That’s how experts evolve without erasing themselves. #HealthXPh

T3 You don’t start over as a beginner—you start over as a disciplined novice. Be humble about the new domain, ruthless about applying your hard-won judgment, and clear on where expertise transfers. Curiosity earns trust early; discernment proves value fast. #HealthXPh

T3. How do you start over as a beginner while still being the expert? #healthxph

Goes without saying, "we are not our work" . I'd also would like to think that we are just adding a skillset or shifting to a career role that better fit the mind and body. #healthxph

T2. How do you manage the financial and identity crisis of letting go? #Healthxph

Agree. It's not anymore achievements that mattered to me. Alignment of values and fulfillment in other neglected aspects of life, was more important now for me. #Healthxph

If you can latch onto any kind of clarity about what you're doing versus what you want to do, that's a good start. #HealthXPh

T1 You know it’s time to shift when effort keeps rising but meaning, learning, or impact keeps falling. That’s not burnout—it’s misalignment. #HealthXPh

T1 Practical first steps: name what isn’t working (role, pace, incentives, values), audit your transferable skills, then create slack—time, savings, optionality—before making any visible move. #HealthXPh

Yeah. Multiply yourself! An educators dream! #Healthxph

T1. A change in rhythm? I think the pandemic showed me that. Cut down clinic from 5 to 2 days. Did other things. But now I want to do other things again 😬. Midlife crisis dunno #healthxph

T1. How do you know when it’s time to shift, and what are the practical first steps? #Healthxph

Good day #Healthxph. Bonedoc here, your mod for today's chat about mid career shifts in PH Healthcare. Who's online? @endocrinewitch.bsky.social @stephaniemiaco.bsky.social @helenvmadamba.bsky.social @docbuboy.bsky.social . Pre chat post here > remomd.com/finding-your...

Hello #healthxph! Is it too late to say Happy New Year? I was absent last week.

More than half of researchers now use AI for peer review — often against guidance www.nature.com/articles/d41... Results "confirm what many researchers have long suspected, given the ubiquity of tools powered by large-language models..."

AI could be hugely beneficial to the NHS, but only if it augments, not replaces, human judgement, and is deployed with strong governance and equity-aware data. Plus of course the challenges of workforce and infrastructure remain! A new piece by me. www.digitalhealth.net/2025/12/ai-i...

What's your strategy for using LLMs to augment your clinical decision-making? (now, if we only had objective data regarding which was "best") #medsky #MLsky www.evidencetriage.com/p/are-you-a-...

New preprint! @marentierra.bsky.social @irisvanrooij.bsky.social & I have been working on what CAIL means to showcase & propagate the idea of thinking very differently to tech industry norms on "artificial intelligence" Towards Critical Artificial Intelligence Literacies doi.org/10.5281/zeno... 1/

A new Perspective seeks to indicate how the lack of security in #AI platforms may increase risk in clinical settings, particularly when these tools are used for translation or when patients share sensitive information. Read the full Perspective: nejm.ai/49PrjYr #MedSky #MLSky

"With few studies moving beyond #AI model design & development stages, there are clear gaps in our understanding of how to reliably validate, deploy, and sustain AI models in #rural settings to advance health in all communities." academic.oup.com/jamia/advanc... #MedSky #RuralHealth #HealthEquity

This is an outstanding analysis of AI in the current milieu. Very useful framing! Looking forward to the book length version next spring. pluralistic.net/2025/12/05/p...

Took a peek at X … because #UPFight. Wala, basura na talaga dun.

Humans and machines make the same mistakes — just for different reasons. On NEJM AI Grand Rounds, Dr. Laura Zwaan discusses bias, cognition, and #AI. Full episode: nejm.ai/ep36 #MedSky #MLSky

Important new, large (N>28,000 women) randomized clinical trial of breast cancer screening: age-based vs risk-based by polygenic risk score, genomics "opportunity to modernize screening" jamanetwork.com/journals/jam...

The authors of a new editorial write that #AI scribes for clinical practice show early promise for improved productivity and lay out the conditions under which these tools may substantially improve productivity in the future. Read the full editorial: nejm.ai/48aLhvx @kdpsingh.bsky.social

Oracle says 57% of its $523B backlog comes from OpenAI, projecting $74B losses by 2028. Nvidia invests $100B, OpenAI commits $300B to Oracle, Oracle buys Nvidia chips, a $610B circular flow. In the dotcom bubble Lucent collapsed at 24% vendor financing; Nvidia’s exposure is 67%.

Naalala ko yung sabi ng nanay ko - para kang bawang, laging sinasama sa paggisa. 😅

It's sad how people cling to power because it's part of their identity.

T3. PGH department of Medicine has QUIPS quality improvement and patient safety team. Dr. Lachica regularly holds huddles with them. Sentinel events and adverse events are reviewed regularly. Pathways are finalized, implemented, and tweaked as needed. #healthxph

T2. Most of the clinicians here use EMR, and it has proven to cause less mistakes in prescribing, and it is also faster… just printing out and verifying and cuts down plenty of time. Also, easier to send medical records to the physician you are referring to. #healthxph

T2. Medical calculator apps or websites at your fingertips. I can also show pictures on my phone to patients when explaining. I’d like to say the EMR ;) but reactions there will be mixed. #healthxph

T2: Name a simple digital tool (or tweak) that saved clinicians time in your setting; what made adoption inevitable rather than optional? #healthxph

Let's start the convo rolling. T1 up ! #healthxph T1: “When introducing a new interprofessional procedure or pathway, how do you start it—who you brief, what you measure on day 1, and what safety stop builds trust?”

T3. In grade school, I had a teacher who was strict, but got results. In high school, a very intelligent teacher who made science so engrossing. In college, a literature teacher who had a melodious voice who was able to pick apart a literary work and got us hooked on more exploration. #healthxph

T3. The witches of endo - my mothers in the section were tough mentors with high expectations. How to balance that with encouragement to do better - that’s a gift! #healthxph

In the last few minutes of our chat, I'd like to bring up T3. Quote tweet and add #healthxph to share your thoughts!

T2. A good teacher is a change agent. Students are the next generation, hence the future. Our hope is that they become better than us. #healthxph

By necessity/progression, it seems, for all of us. #healthxph In PGH, it was always taught that we would need to teach the juniors, as often as possible.

T1. I was clerks’ then interns’ monitor as a resident. I was interns’ consultant then straight interns’ consultant so that’s how I got started teaching. #healthxph

Hello Ma'am Iris! Good evening! :-) Honoring our esteemed Teachers and Doc Buboy @docbuboy.bsky.social ) tonight via the post! Topic is on teaching! :-) #healthxph

Recently had the chance to hear @carlbergstrom.com on information foraging in the current space of LLMs. He and @jevinwest.bsky.social have crafted a course that touches various facets of LLMs. Just finished reading through its 18 modules. Absolutely loved it! thebullshitmachines.com

I ask residents to explain what non compliant means when talking about patients. It usually end up with poor patient communication on the part of us. #Healthxph

And just like that, the #healthxph hour is done. Thanks @bonedocph.bsky.social @stephaniemiaco.bsky.social @jkatzaman.bsky.social for joining me! Until next week …

I have patients who tell me they are “valedictorians” because their blood chem results which they think of as their “grade” have H all over (high). It may be helpful to follow the patient’s lead in the framing used? #healthxph

T3. Context, awareness, empathy and listening a lot more. Might have a better influence on health outcomes. #Healthxph

Words used elsewhere in conversation like “pasaway” creep into clinical care where the implication is heavier? We need to be conscious of the crossover. #healthxph

T2. Very very conscious ma’am, everything I say is measured out and deliberate. I always think of changing a person’s experience with Psychiatry for the better. #healthxph

T3. I find that gentle and consistent correction works. Letting residents and fellows know that saying “non-compliant” is not acceptable. And also explaining why. Some think that’s standard. #healthxph

Let’s go to T3. #healthxph