One thing people don’t realize is that even if you don’t use Medicaid—even if you never would use Medicaid—your ability to access care, and your ability to access healthcare providers like me, will be affected in some way or another by every cut or barrier to Medicaid. Nobody will be unaffected.

This is a fascinating example because it's exactly what a bullshitter does and what gives him away. He leans into the little cues you give them, and riffs on those cues ,making stuff up. "It's a real, verifiable peer-reviewed publication" (To be clear: there is no "Swedish magpie" paper.)

Celeste Roberge’s sculpture “The Weight of Grief” #art

My body is not my own. What does that mean for intractable, hot button bioethical debates? open.substack.com/pub/familyme...

jamanetwork-com.proxy.lib.duke.edu/journals/jam... from @jama.com If AI were a medication, we'd be putting it through far more rigorous testing before wide deployment...

Hope springs eternal... familymeetingnotes.substack.com/p/a-machine-...

www.npr.org/2026/02/14/n... I wasn’t expecting “whether you want it or not” to feature so prominently so soon in using AI in health care…

What do clinicians do when trust runs thin? open.substack.com/pub/familyme...

Full disclosure: I haven't read the book they discuss in this episode of @geripal.bsky.social so my comments are just related to the convo. geripal.org/ai-and-healt... #medsky

My book has a cover! I wish I could share it with you right now, but unfortunately you'll have to wait until August 18, 2026. But you can preorder it now if you want. www.amazon.com/Resisting-Th...

Sure would be nice to have a functional federal regulatory agency techcrunch.com/2026/02/03/l...

Really troubled by this question in a popular surgical critical care study book… Surgical Critical Care and Emergency Surgery Topic is early v late dialysis and so much on this topic is know and just disappointing to this question…. The keyed answer was….

The consent form Louis Waskansky signed before undergoing the first-ever human heart transplant, in 1967.

Media outlets sharpened their pens by telling us that cars and trucks hit pedestrians and cyclists instead of drivers. Now they rinse and repeat with AI.

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It is not "attribution and sourcing" to generate post-hoc citations that have not been read and did not inform the student's writing. Those should be regarded as fraudulent: artifacts testifying to human actions and thought that did not occur. www.theverge.com/news/760508/...

Coming back to this, I'm still struck by the implication that academics should care if the AI pushers "trust" all our work that's done without AI. I don't know, man, you all seemed to trust our work enough to steal it from us wholesale.

To what extent is it our job as consultants to manage or attend to clinician distress? What happens when that clinician distress leads to conflict? #medsky Guests Sara Johnson, Yael Schenker, & Anne Kelly. 👉 Post: bit.ly/GeriPalEp385 😀 Hosts: @alexsmithmd.bsky.social | @ewidera.bsky.social

I took up this question in the latest issue of Notes: open.substack.com/pub/familyme...

They wonder what’s driving hospital investment in ambient AI for charting, as evidence for improved productivity isn’t there. Maybe it’s earnest care for clinician well-being? I have another suggestion: surveillance.

this field biologist does a great job highlighting the insidiousness of AI editing these one-click AI edit buttons are incredibly appealing to many photographers, amateurs and professionals alike, and are framed as innocuous this is worth sharing and educating people about

I didn’t really get how much “health care contact days” is a meaningful patient outcome until I got sick thank you @ishaniganguli.bsky.social @dusetzinas.bsky.social @jamanetworkopen.com

Introducing ambient #AI scribes into a world in which clinicians write notes is very different from the future world in which no one has written notes. familymeetingnotes.substack.com/p/where-the-...

My final installment in a series of essays on medical authority. I worry we won't find a path forward by yelling at each other, but I see hope in a few places. familymeetingnotes.substack.com/p/a-power-gr... #medsky

Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz Exploring medication effects mediated symbolically www.psychiatrymargins.com/p/meaning-me...

This is the 3rd time Google has offered a Gemini trial for college students since May. They're clearly tying trials around the academic calendar. It is no wonder college instructors are hostile toward AI companies pushing free premium AI for college students during finals.

Next up: medical authority and intervention. I approach a controversial case with the hope that this could provide a context for a more productive disagreement. familymeetingnotes.substack.com/p/here-to-he... #medsky

REUTERS: The winner of the 2067 Nobel Prize in Literature has been awarded to Sample #789, the author of “Vaping in the House My Father Built”. Sample, a synthetic brain organoid, lives in Saratoga, NY with their seventeen dogs.

The most important thing to remember about all this fantasy-engineering of the Constitution is Madison's warning: If we suck as a people, no clever constitutional schemes will save us.

In 1582, a papal bull introduced the Gregorian calendar, still used today by most of the world. Because it’s 11 days ahead of the Julian calendar, countries introducing it simply skipped a third of October, and if you scroll back far enough in the iPhone calendar app you can see it change

This will keep you stuck in the past, preventing you from healing. Even worse, your memories of your lost loved one will be polluted and overwritten by your memories of their AI-generated ghost, until you’ve forgotten the person you lost, and instead grieve only their caricature.

As a palliative care doc, I’m constantly navigating questions of the appropriate extent of medical authority. That was also a large part of my previous job as a psychiatrist. How do we figure out where the limits are? familymeetingnotes.substack.com/p/should-you...

Haha yes, YES

Doctor LLMs don't want you to know this one weird trick

The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.

Sikorav Against the World A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy www.psychiatrymargins.com/p/sikorav-ag...

Looking for an easy way to make a difference this fall? Leave your leaves! 🍂 Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves

A challenge to the conventional approach to VSED from Benjamin Frush, Farr Curlin, and Daniel Sulmasy: agsjournals.onlinelibrary.wiley.com/doi/10.1111/... #hapc #medsky

The limits of our personal experience and the value of statistics 🧵 How many people do you know by name? One study found that the average American knows 611. In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent. We can’t see much of the world through our direct experience

I do sometimes have writers block, more commonly known as the time you need to sit or pace or stare out the window and let your thoughts form rather than ask the machine to tell you what you think

It's remarkable some people don't believe deception is harmful, even if the deception isn't discovered. Furthermore, deception harms the deceiver by making the kind of person who deceives.

familymeetingnotes.substack.com/p/a-machine-... Some thoughts on using #AI for surrogate decision-making.

I've never said yes to an interview so quickly as when @ashleybelanger.bsky.social reached out to discuss a topic that – it will surprise no one to learn – I feel pretty strongly about.

From @arstechnica.com: arstechnica.com/features/202... My answer, as a palliative care physician: never.

this was such an informative read. @emilymoin.com is really good at breaking down the problems here

Looking Again at SSRIs in Adolescent Depression and Anxiety “Society gets the type of adolescent that it expects and deserves.” A response of sorts to @ploederl.bsky.social‘s recent blogpost www.psychiatrymargins.com/p/looking-ag...

So maybe 15 years from now none of this will matter (though I'm skeptical) -- but in the meantime, I think I stand by what I told Dhruv in that story, if we (meaning educators) don't figure out how to train the next gen in this environment, we're all screwed.

My biggest concern about this technology in the short (and, well, medium)-term is what is does to US, especially the current generation of doctors in training. Even the difference between my third year and first-year residents is pretty stark in their use of AI tools (especially Open Evidence)