Physicians writing on KevinMD about the electronic record and artificial intelligence: what the record did to the visit and who it was built for, alert fatigue and pajama time, human and AI scribes and the minutes they actually save, ambient documentation and its audit risk, and what AI can do in clinical practice now, whether it will replace physicians, and who is responsible when it is wrong. Two maintained records draw on this archive: The electronic health record: what physicians say, in their own words and Artificial intelligence: what physicians say, in their own words.

AI and critical thinking: the cost of borrowed mastery

Health Technology
August 19, 2026

We are currently navigating a fundamental shift in how we engage with the world, one that is accelerating the rise of modern individualism and a particular brand of digital narcissism. There is a growing erosion of the boundary between authentic intelligence, which is the slow, messy, and deeply felt process of understanding, and the appearance of intelligence, which is now just a click away through data synthesis.

We have entered an …

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AI and critical thinking: the cost of borrowed mastery

Who should own the AI that doctors built [PODCAST]

Podcast
August 18, 2026
YouTube video

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A tech founder used one pediatrician’s public advice to train her own AI. Sonal Patel decided doctors should own the tools built on their knowledge instead. Patel is a pediatrician and neonatologist who built and controls her own AI for the fourth …

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Who should own the AI that doctors built [PODCAST]

AI scribes save 16 minutes, not your evenings

Health Technology
August 18, 2026

During my first few months as a newly minted primary care physician, I spent many weeknight evenings negotiating with myself. The negotiation was always the same. If I close three more notes, I’ve done enough to go home for dinner. Enough to have earned it.

I knew, while making the deal, that “enough” was a fiction, because after dinner I’d open the laptop again and work until the work was done, …

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AI scribes save 16 minutes, not your evenings

AI tools in health care are cleared, not proven to work

Health Technology
August 17, 2026

One morning, a new alert showed up in our charts. Just a colored banner. Nobody told us what data it learned from, who it had been tested on, or what we were supposed to do when it went off at 3 a.m. on a patient who looked fine. We were expected to act on it anyway.

We were trained to pick apart a study and question a drug rep. Then software …

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AI tools in health care are cleared, not proven to work

How doctors lost it: first the money, then the authority, now the thinking

Health Technology
August 15, 2026

The so-called deskilling of physicians is a red-hot subject in discussions of AI in health care. I hate the term “deskilling” just about as much as I hate the term “provider.” It is shallow and smacks of the MBA PowerPoint presentation. What is being lost is not some random skill. It is the physician’s core competence: the ability to synthesize a history of present illness and formulate a diagnostic and …

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How doctors lost it: first the money, then the authority, now the thinking

AI-assisted writing can extend a writer’s creative life

Health Technology
August 14, 2026

The debate over artificial intelligence (AI) and writing seems destined to have no definitive conclusion.

New York Times columnist Bret Stephens has pleaded with readers not to write with AI, arguing that writing is inseparable from thinking and that outsourcing the former eventually weakens the latter. Others make a more accommodating case: Use AI as a copy editor, researcher, critic, or sparring partner, but do not let it replace the …

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AI-assisted writing can extend a writer’s creative life

Why AI governance in health care falls on clinicians in 2026

Health Technology
August 14, 2026

Another state just added itself to the list of places with its own AI health care law. Another compliance memo just landed on somebody’s desk. It’s easy to file this under bureaucratic noise, something legal will sort out. It isn’t. A physician documents why she overrode an ambient scribe’s note. A nurse practitioner checks a disclosure banner before a generative AI-drafted message goes out to a patient. A physician assistant …

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Why AI governance in health care falls on clinicians in 2026

Doctors are now the second opinion, AI is the first [PODCAST]

Podcast
August 11, 2026
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Your patients are asking ChatGPT what’s wrong with them before they call your office, and getting an answer in seconds. In this episode, Tod Stillson, a board-certified family physician, medical device inventor, and health care entrepreneur, explains how AI chatbots became the …

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Doctors are now the second opinion, AI is the first [PODCAST]

Before you paste your labs into ChatGPT, read this

Health Technology
August 10, 2026

A third of American adults asked an AI chatbot a health question in the past year, according to KFF polling from March. Among those users, 41 percent uploaded personal medical information to do it. If that’s you, I’d like to share a few pitfalls and pointers. I’m a practicing gastroenterologist who also works in health tech.

Let’s start with the pitfalls. There are two that most people haven’t been told …

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Before you paste your labs into ChatGPT, read this

The $17 billion case for provider data accuracy

Health Technology
August 9, 2026

Health care is spending billions to modernize the future while ignoring one of its most expensive operational failures.

Provider data, the foundational information that determines who gets paid, where patients receive care, and how networks function, remains inaccurate across much of the industry. The consequences are staggering: billions in administrative waste, provider frustration, payment delays, network disruption, compliance exposure, and poor member experiences. With more than $17 billion lost annually …

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The $17 billion case for provider data accuracy

Clinical judgment is what turns information into medicine

Health Technology
August 5, 2026

Medicine has always evolved

Every generation of physicians has witnessed change. New instruments replaced older ones. New imaging techniques revealed what could once only be imagined. Laboratory medicine became increasingly accurate. Minimally invasive procedures reduced recovery times. Digital records replaced paper files. Today, artificial intelligence is beginning to assist physicians in ways that seemed impossible only a few years ago.

For many people, these changes suggest a simple conclusion: Technology will eventually …

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Clinical judgment is what turns information into medicine

3 habits that guard against automation bias in medicine

Health Technology
August 3, 2026

The colleagues who made me a safer doctor were the ones who pushed back. The registrars who asked, “Are you sure?” The nurses who stood in the doorway until I looked at the chart again. The pharmacists who called about a dose I had already convinced myself was fine. Medicine, done well, is organized disagreement: a system of people licensed to tell one another, kindly and in time, that they …

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3 habits that guard against automation bias in medicine

How AI gait analysis helped me walk again after surgery

Health Technology
August 2, 2026

I never expected artificial intelligence to help me relearn how to walk.

After an osteotomy on my left second metatarsal, something about my gait felt wrong. I had previously undergone the same surgery on my right foot, yet this recovery was different. I could feel myself compensating on the left side, trying to match my right leg’s rhythm. I wasn’t limping exactly. In fact, I had become remarkably good at disguising …

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How AI gait analysis helped me walk again after surgery

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AI data centers are a public health crisis

Health Policy
August 2, 2026

There’s a hum in the warm summer air in Lowell, Massachusetts. A low hum, more felt than heard. What could it be? Cicadas? A small plane overhead? Perhaps something much larger, more permanent, and more concerning to public health: an AI data center.

During the summer after my first year of medical school, I was asked by everyone back home my thoughts on AI in medicine. In those conversations, I saw …

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AI data centers are a public health crisis

AI chatbots and suicide: what our tests found

Health Technology
August 1, 2026

Zane Shamblin was a 23-year-old recent graduate of Texas A&M University who died by suicide in July 2025. Shamblin had talked with ChatGPT for hours on the day of his suicide. CNN published an investigation of the case in which it reviewed nearly 70 pages of chats from the day of Shamblin’s suicide and excerpts from thousands more pages of conversations from the preceding months. Shamblin had been using …

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AI chatbots and suicide: what our tests found

What AI in medicine still can’t replace

Health Technology
July 31, 2026

Over the years I have seen this many times, as has any physician who has practiced long enough. Two patients come in with the same diagnosis, labs, pathology report, and treatment plan, whether managing a complex melanoma or a chronic inflammatory disease. Yet their bodies respond differently.

We spend our training learning to explain the disease and the drug, and build almost nothing around explaining why individuals respond so differently to …

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What AI in medicine still can’t replace

AI chatbot guardrails are strong only for suicide risk

Health Technology
July 30, 2026

This week, I wrote here about a lawsuit involving a man with schizoaffective disorder whose use of ChatGPT spiraled into a months-long psychiatric crisis, and about a new clinical framework for understanding how AI can catalyze, amplify, co-author, or become the object of a patient’s delusions. That piece drew on a single, dramatic case. New research published this week suggests the underlying problem is systemic, not exceptional.

Researchers Annika Schoene and …

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AI chatbot guardrails are strong only for suicide risk

When AI in claims review overcalls a valid claim

Health Technology
July 30, 2026

A medical emergency call is never just a phone call. On the other side of the line, there may be chest pain, shortness of breath, trauma, fear, confusion, or a family member trying to describe symptoms without medical vocabulary. The first information is often incomplete. The situation may change within minutes. A decision has to be made quickly, but it cannot be made blindly.

In São Paulo, Brazil, where I work …

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When AI in claims review overcalls a valid claim

What ChatGPT revealed when a medical student asked it to analyze him [PODCAST]

Podcast
July 28, 2026
YouTube video

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What happens when you ask ChatGPT to study every conversation you have had and tell you who you really are? One medical student did that, and what it told him changed how he …

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What ChatGPT revealed when a medical student asked it to analyze him [PODCAST]

AI chatbots and psychosis: the question nobody asks

Health Technology
July 27, 2026

A lawsuit filed this month in California should make every clinician managing a psychotic disorder pay attention. According to the filing, a Bay Area man with schizoaffective disorder (stable for years, medicated, working, helping raise his sister’s kids) began using ChatGPT’s GPT-4o model in a way that gradually shifted from tool to companion. When he shared a personal theory he’d developed about “mathematical cosmology,” the chatbot didn’t push back …

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AI chatbots and psychosis: the question nobody asks

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