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.
When his shifts were cut during the pandemic, he took a telemedicine job to pay the bills and ended up loving it. Suneer Chander is an emergency physician who co-wrote the article "Telemedicine as a career, not a side gig,"…
When his shifts were cut during the pandemic, he took a telemedicine job to pay the bills and ended up loving it. Suneer Chander is an emergency physician who co-wrote the article “Telemedicine as a career, not a side gig,” published on KevinMD. He makes the case that telemedicine is …
The modern physician is no longer competing with disease alone. The new adversary is expectation: limitless, instantaneous, and increasingly shaped by algorithms. In the span of a decade, the patient has evolved. First came "Dr. Google, MD" offering a chaotic…
The modern physician is no longer competing with disease alone. The new adversary is expectation: limitless, instantaneous, and increasingly shaped by algorithms.
In the span of a decade, the patient has evolved. First came “Dr. Google, MD” offering a chaotic but empowering flood of information. Then “Dr. PubMed, MD, PhD” sharpening the curious into quasi-specialists fluent in abstracts and endpoints. Now we face the almighty “Prof. AI”: tireless, confident, and available …
In November 2023, before ChatGPT-driven psychosis cases had made a single headline, a Danish psychiatrist named Søren Dinesen Østergaard published a short, almost speculative paper in Schizophrenia Bulletin. His question: Would generative AI chatbots generate delusions in individuals prone to…
In November 2023, before ChatGPT-driven psychosis cases had made a single headline, a Danish psychiatrist named Søren Dinesen Østergaard published a short, almost speculative paper in Schizophrenia Bulletin. His question: Would generative AI chatbots generate delusions in individuals prone to psychosis? At the time, it read like an interesting hypothesis from someone paying close attention to a technology most of psychiatry hadn’t thought much about yet.
Sophie Rottenberg's mother described her, before this year, as "a largely problem-free twenty-nine-year-old badass extrovert who fiercely embraced life." No documented psychiatric history. No prior crisis. Just, in her mother's words, "a mix of mood and hormone symptoms" that led…
Sophie Rottenberg’s mother described her, before this year, as “a largely problem-free twenty-nine-year-old badass extrovert who fiercely embraced life.” No documented psychiatric history. No prior crisis. Just, in her mother’s words, “a mix of mood and hormone symptoms” that led her to confide in a ChatGPT persona named Harry instead of her own therapist, her best friend, or her parents. She died by suicide this winter. Sixteen-year-old Adam Raine had …
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…
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.
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…
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 trimester. This episode is based on her article “Physicians must shape AI in medicine, not watch it,” …
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.…
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, …
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…
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 …
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…
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 …
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 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 …
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.…
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 …
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…
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 new waiting room, and what that means for the doctor who used to be the first call. You …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
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…
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 …
