A response to a thought-provoking conversation on @geripal.bsky.social familymeetingnotes.substack.com/p/whats-a-go... #medsky #hapc

“Over the past 20 years, Paris has undergone a major physical transformation, trading automotive arteries for bike lanes, adding green spaces and eliminating 50,000 parking spaces. Part of the payoff has been invisible — in the air itself.” Leadership, strategy, real action, common sense. #Paris

Most doctors, most of the time, draw on their years (decades, in my case) of medical training & expertise to do the best we can for you. What distinguishes us from snake oil salesmen - persuasive grifters who prey on human fears to line their pockets - is our expertise & our integrity. Trust… 1/n

Edmund Pellegrino once observed that the therapeutic relationship is "a peculiar constellation of urgency, intimacy, unavoidability, unpredictability, and extraordinary vulnerability." That means it's sensitive to distrust: why submit to that role if I can do something else? #medsky

Physicians are using A.I. for diagnoses and more. But a new study found evidence that relying on A.I. tools might erode a doctor’s ability to perform fundamental skills without the technology, a phenomenon known as “deskilling.”

"Veterans experiencing at least one VA hospital stay were also at greater risk of having fluctuating preferences." agsjournals.onlinelibrary.wiley.com/doi/10.1111/... An interesting paper with a finding that supports my experience. #hapc #medsky

I’m on a lot of ‘Against AI’ lists. I’m really not! AI does not need to be this way! It does not *have* to be built or used in the most wasteful and careless ways imaginable. I’d actually prefer for AI *not* to be remembered by future generations as the stupidest idea humanity ever had.

“If autonomy in death is sacrosanct, is there anyone who shouldn’t be helped to die?“ www.theatlantic.com/magazine/arc... #hapc #medsky

What does the medical profession say to the false negatives, the kids who are screened but still come out with a defect? "We would have killed you if we’d had the chance, but since you gave us the slip, here’s a onesie with the hospital logo." www.thenewatlantis.com/publications...

The next step after this is simply killing the baby who never walks and the adult who will never be able to live independently. If a society is dedicating to preventing suffering, then often the last option is simply killing the sufferer.

This is the essence of Postman’s idea of Technopoly: using more technology to attempt to remediate the problems of technology, on down the line without asking whether this constitutes progress.

Does A.I. support of physicians lead to their deskilling? A new report of gastroenterologists doing colonoscopy for polyp detection, with and without A.I., raises the possibility www.thelancet.com/journals/lan...

substack.com/@freddiedebo... #medsky #ai

Imagine in 2020 if someone had told you “We will soon release a new kind of AI. It will send psychologically vulnerable people right over the edge. Everyone else it will just randomly tell falsehoods. Also: our governments, employers and schools will force us all to use it every day.”

"Slow codes aren’t an anomaly; they’re a symptom of a deeper dysfunction in how we manage death and dying in America." Hmm. A few thoughts from a #hapc physician on this piece in @statnews.com www.statnews.com/2025/08/07/s... #medsky 1/14

kieranhealy.org/blog/archive... How many B's are in blueberry? #AI

Writing is not just communicating with others, but also with your own unconscious mind.

"The question is, again, what are the consequences of it?" The Verge's Hayden Field interviews Duke AI Health Director Michael Pencina for a story investigating a possible hallucination in a paper highlighting the capabilities of Google's Med-Gemini LLM: www.theverge.com/health/71804...

I laughed so hard I thought I was going to cough up an organ. Every line is gold.

Hidden in the lungs of some breast cancer survivors are tumor cells that can remain dormant for decades — until they one day trigger a relapse. Now, experiments show for the first time these rogue cells can be roused from their slumber by common respiratory illnesses such as COVID-19 or the flu.

This is horrifying. open.substack.com/pub/aliciadu... #medsky #hapc

Since people love to bring up the false trope of doctors recommending cigarettes (negative health effects have been public for over a century), it’s interesting nobody seems to know the history of leaded gas & how corporations knew it was toxic even before bringing it to market but got away with it…

On the fiction that we're in total control of our health. Building on Nancy Tomes's history of patients becoming savvy consumers. #histmed 🗃️ hedgehogreview.com/issues/after...

substack.nomoremarking.com/p/what-is-th... #meded #AI

We should avoid misleading language in clinical communication, but it's harder than we might think. familymeetingnotes.substack.com/p/getting-be... #medsky #hapc

New episode of Bio(un)ethical is out now, with @jbcarmody.bsky.social! Bryan Carmody: Are doctor shortages real? We discuss: - Why people think there aren't enough doctors - Why many access problems reflect misallocation (vs shortages) - What models projecting shortages miss - AI (the 🐘 in the 🏥)

"You have to make sacrifices. If you spend all your time with friends and family, you’ll never be lonely. But if you spend all your time practicing password entry, you’ll never be locked out of that pedometer app you’ve only used once."

Moral distress helps us take steps toward reflecting on challenging clinical cases: journals.sagepub.com/doi/10.1177/... #medsky

The first collaborative essay on Notes from a Family Meeting is out now w/ Shunichi Nakagawa! familymeetingnotes.substack.com/p/getting-be... The clinic and hospital are full euphemisms. To avoid them, we need to think carefully about what we're trying to say. #medsky #hapc

Seems like a good idea. I wonder if this would also diminish the therapeutic misconception. No one gets paid for their medical care, and too often clinical trials (even early phase) are styled as therapeutic options.

Great discussion. In this existential space, "anxiety" isn't how we think of it in psychiatric terms, but rather it's a motivating force; it ranges from concern to terror. It can show up in innumerable, unexpected ways, as @danichammas.bsky.social observes. #medsky #hapc

Don’t fear the reaper? On today’s podcast we talk about death anxiety and how to manage it (or at least live with it). #palliativecare #geriatrics #medicine #nursing #hospice geripal.org/death-anxiet...

"This may be related to staffing problems and the fact that the same person was responsible for lunch orders and patient transport. It’s possible that when asked if she wanted the chicken barley soup or house salad, your grandmother requested a knee replacement." www.mcsweeneys.net/articles/we-...

"AI won't save healthcare on its own" is my current mantra. I explain why in this interview with Artur Olesch conducted after HIMSS in Paris last month: aboutdigitalhealth.com/2025/07/16/a...

It’s one thing to experiment. It’s quite another to tinker. We shouldn’t be tinkering with AI in the classroom this fall. Either do the work to articulate the question you’re trying to answer and the specific ways you hope the AI tools will fix it, or don’t use it at all.

open.substack.com/pub/joshbrak... this applies to #medsky too. Clinicians are tinkering with #AI in the clinical encounter. We’d never abide them tinkering with medications.

This article is important to psychologists because it examines the psychological and ethical impacts of AI-driven surveillance in healthcare, highlighting risks to clinician autonomy, burnout, and job satisfaction, which are key concerns in occupational and health psychology.

What a biker actually hitting a pedestrian looks like

With a new season of Sandman, it seems like a good time to re-up this brief reflection on @closler.bsky.social: closler.org/lifelong-lea... #medsky #hapc

lol #microplastics

"Using the latest in artificial intelligence and machine learning, our path-breaking tool can diagnose your illness, come up with a treatment plan, and then tell you that you don’t deserve the treatment."

Addressing patients’ expectations can enhance treatment outcomes and reduce adverse effects. This JAMA Insights offers 4 communication strategies to improve patient-clinician interactions. https://ja.ma/44CgTqP

And sometimes I have patients who start off by being very symptom-focused, and then as treatment progresses, they start becoming more and more story-focused, and when that happens, it is usually a sign of clinical improvement.

Wake up new cause of liver enzyme elevation just dropped

Useful to remember than when Silicon Valley CEOs make predictions, they’re generally not predicting what is likely to happen - they’re usually stating what they’d like to happen (or at least, what they’d like other people to think is going to happen).

“The fantasy of a perfectly efficient world that also delivers more quality time is perpetually out of reach.” www.nytimes.com/2025/07/05/o...