I want to applaud and critique Bobby Samuels' piece on medical benchmarks by telling you how I use medical-grade Pop Rocks.
Graham Walker, MD
@drgrahamwalker.com
— ER doc in SF — @Offcall.com co-founder (Solving physician burnout through transparency!) — MDCalc.com creator — Physicians' Charter for Responsible AI physicianscharter.ai/ (posts are my own and nothing to do with employers)
💋 A quick amuse bouche for my keynote in Melbourne at the Australian Medical Association National Conference 2026 on Friday. Can't wait! Don't try to zoom in and enhance... you've got to attend to see what I'll say! #AMA26
Doctors are losing in 2 very different courts this month: one in JAMA, and the other in Plymouth County. Weirdly, I think they expose the same mistake: We keep judging physicians by the tiny slice of medicine that outsiders can actually see.
I don't want to be too grandiose, but any technology you plan to bring into healthcare can kill people. With chemo or radiation, it's probably obvious. You can assuredly connect some of the dots with AI. blog.mdcalc.com/post/the-tr...
The Trust Layer
Trust is the rocket fuel, not the afterthoughtThe Future of Clinical Decision Support is a new series from MDCalc exploring how AI, evidence, and physician judgment are reshaping medicine. These essays are intended to spark discussion about where technology is taking clinical decision support – and where physicians feel it should go. Every powerful medical technology needed its trust layer before it could scale. I don't care if you're talking about CT scans, statins, or glucometers. You don't ge
blog.mdcalc.com
Sometimes, there is no satisfying why. Nara Smith makes her family toothpaste from scratch on TikTok. Her 2 year-old daughter was diagnosed with cancer. Bryan Johnson spends millions a year measuring and optimizing every marker in his body. He was recently diagnosed with autoimmune gastritis.
"It's a terrible disease, because it's a disease you get when you care for someone. You have to ask communities not to touch someone they love when they are feeling sick." — Anaïs Legand from the WHO I've never heard it said so directly.
Doctors asking themselves "Am I gonna sleep well tonight?" is one of the most powerful ways we do medical decision making. Physicians carry a quiet internal test after hard decisions.
The #1 reason doctors are quitting medicine is that it's too much work... to do work. A new national survey asked physicians who'd left clinical practice early why they walked away. “𝗛𝗮𝘀𝘀𝗹𝗲 𝗳𝗮𝗰𝘁𝗼𝗿.”
Full automation in medicine has one flaw nobody pitches: it 𝗰𝗮𝗻'𝘁 𝗱𝗲𝗰𝗶𝗱𝗲 𝗻𝗼𝘁 𝘁𝗼 𝗮𝗰𝘁. (I know you're not supposed to write a double negative, but hear me out on this one, it matters.)
The engineers building AI coding tools named their "skip the safety checks" command --𝚍𝚊𝚗𝚐𝚎𝚛𝚘𝚞𝚜𝚕𝚢-𝚜𝚔𝚒𝚙-𝚙𝚎𝚛𝚖𝚒𝚜𝚜𝚒𝚘𝚗𝚜. The other one is literally called --𝚢𝚘𝚕𝚘.
𝗡𝗘𝗩𝗘𝗥 𝗟𝗜𝗘 is the prime directive we teach to all trainees across all of medicine, regardless of specialty. The next tenet is one we have to actively teach, because trainees don't arrive believing it: 𝘺𝘰𝘶 𝘩𝘢𝘷𝘦 𝘱𝘦𝘳𝘮𝘪𝘴𝘴𝘪𝘰𝘯 𝘵𝘰 𝘯𝘰𝘵 𝘬𝘯𝘰𝘸.
This activates the same eye roll in me as 'my magic rose quartz that cures all cancer'
Without attempting eye contact, the TSA agent told me “Sir, the computer selected you for enhanced screening" in a tone so flat and robotic that the computer might as well have said it itself. But she didn't surrender authority to the algorithm; her bosses stripped it from her by design.
As a San Francisco ER doctor, I spend a lot of time around both ends of this debate. I see Waymos every day in traffic, at intersections, outside the hospital. And I see what human driving does to human bodies.
Met @emollick.bsky.social yesterday. One of the best AI explainers alive gave me a lot of existential dread — and he didn't mean to. He was funny, generous, talked about the power and promise of AI exactly the way I like to talk about it.
I'd forgive you if you missed this NEJM paper on Andes virus "super-spreaders," since it was published in December 2020 when most of us were focused on getting COVID vaccines into arms.
I WAS going to write about this wearable table as a beautiful demonstration of how nonspecific wearable data really is. Then Google's marketing torched the seriousness of its own researchers, and now I'm writing about that instead.
For Pete’s sake, can a health system collab with Google Research/Google DeepMind already and run some real end-to-end studies already? They are consistently putting out some of the highest quality, most insightful, clinically sound research on GenAI and care delivery.
RFK Jr. has now officially stated that he will dismantle the United States Preventive ServicesTask Force (USPSTF). This is an independent body of expert scientists who volunteer their time to review data and provide guidance to Americans on important things like cancer screenings.
Exclusive | RFK Jr. to Oust Advisory Panel on Cancer Screenings, HIV Prevention Drugs
The task force determines which preventive services insurers must cover at no cost to patients.
wsj.com
I’m thinking physicians could still prescribe this off label, right? But obviously just sows more vaccine doubt.
jamelle@jamellebouie.net · last yr.“you should have a choice” means “we get to choose for you”
www.medicaleconomics.com/view/mark-cu... Thank you again @mcuban.bsky.social !
Mark Cuban: Health care is a battle of good against bad, and doctors are the good guys
In a recent podcast appearance, the billionaire former member of “Shark Tank” ripped into insurance companies and defended physicians.
medicaleconomics.com
Most people tune out when doctors rage about prior auth, opaque pricing, or middlemen sucking value out of the system. Except @mcuban.bsky.social. Where we all see complexity, he sees opportunity. And he trusts doctors. Full episode: www.offcall.com/learn/podcas...
"The relationship between doctors and insurance companies has become an abusive one." — Dr. Elisabeth Potter who went viral after posting about United Healthcare's prior auth practices online Our full conversation here: www.offcall.com/learn/podcas...
This feels like a Parkland shooting moment. If Americans don't care about dead kids we aren't gonna get gun control. If they don't care about their OWN DEAD KIDS then I'm not sure how you fight back against that
Ilan Schwartz@germhuntermd.bsky.social · last yr.How firm is the hold of antivax beliefs? From the parents of the 6 year old unvaccinated child who died of measles: “Don’t do the shots,” the girl’s mother said. Measles, she added, is “not as bad as they’re making it out to be.” She noted that her four other children all recovered…
We've massively lost the ability to perform critical thinking We've massively lost the ability to spot incorrect and misinformation And we have so much information at our fingertips yet lack the ability to know if said information actually answers the question we have
Saikat for Congress@saikatforcongress.bsky.social · last yr.We still aren’t taking the effect of phones and social media seriously. We should be focusing on it the way we focused on cigarettes in the 80s or lead in gasoline before that.
Other countries socialize their medical problems. America medicalizes its social problems.
I love it when @joho.bsky.social calls out @ucsfhealth.bsky.social docs lamenting Trump's attacks on NIH and CDC, like @anilmakam.bsky.social , @ewidera.bsky.social, and Monica Gandhi, after having amplified the misinformation that got us here. sciencebasedmedicine.org/ucsfapathy/
Welcome to the Resistance UCSF Doctors
The many doctors who are just now realizing that misinformation wasn't "COVID hysteria nonsense" have a lot of catching up to do to understand how the forces they've legitimized the led to this moment
sciencebasedmedicine.org