42 yrs of medicine, the last 25 at @EndeavorHlth. The last scrub, the last pacer, the last ablations, the fantastic team, wonderful pts. Lucky indeed. Will miss it.
NEW: Wearables may be healthcare’s most successful consumer tech
83% of wearable owners use them 5+ days per week. 59% wear theirs always or nearly always.
Most use them to track physical activity (35%), sleep (26%), & heart rate (21%)
A 17 year old volleyball player Claire Crawford goes into full cardiac arrest while playing a match . She hits the volleyball then collapses to the floor. CPR was not working but a quick thinking school administrator runs in with a heart defibrillator. This saves her life and Claire makes a full recovery.
Thank God things lined up the way they did . 🙏🏼
Further, I’ve never seen so many people
out on a Sunday night at the Lincoln Memorial to see the reflection. Decline is a choice - as is refusing decline, putting in the work to keep things beautiful and being proud of our capital city/our incredible country. 🇺🇸
Most of the debate about AI in medicine is about a small slice of the planet.
Trainees will deskill. Clinicians will lean on the tool. We will lose something irreplaceable. I hear it constantly. And inside a well-resourced academic hospital with attendings and gold standards to protect, these are fair worries.
Now step outside that building.
Billions of people lack reliable access to a physician. There is no attending to deskill because there was never an attending. There is no gold standard at risk because there was never a standard. The first doctor-level intelligence many of these people will ever see is a model on a phone. One that can reason across tropical diseases, distribution patterns, and first-line treatments. Available in a moment that used to offer nothing.
Tell me how that is worse than no care at all.
This is not a deskilling story. It is a leapfrog. The world skipped landlines and went straight to mobile. Billions are about to skip the entire century of medical infrastructure we built and go straight to AI. For them, this technology is not threatening their system. It is their first system.
And then look at what we are actually defending. Inside our own system, adverse events still hit nearly one in four hospital admissions. An estimated 795,000 Americans a year are killed or permanently disabled by diagnostic error alone. That number has not meaningfully improved in decades. Progress in a few targeted areas, yes. Enough everywhere else, no.
So when a serious critique of medical AI spends its energy on what happens if the tool goes offline for a few hours, something that represents a fraction of a percent of clinical time, and never once mentions the error rate that harms patients every single day, the priorities are upside down. We normalize the baseline harm of the existing system while demanding the new tool justify itself against an imaginary perfect one.
Deskilling is real. Solve it. But solve it against where this technology is going and who it can reach. Not against a wistful picture of medicine as it has been practiced in the best hospitals for the past hundred years.
For most of the world, and for the parts of our own system that keep failing, the comparison is not AI versus the best attending you ever trained with. It is AI versus nothing.
It turned out big academic medical centers could NOT actually be “kingmakers” for startups - but Epic actually could, as we saw with Abridge. What does that tell us about adoption of Health Tech Innovation?
I remember when we first started @SeamlessMD, we made the wrong assumption that brand name academic medical centers could give you a halo effect. That if you could show famous hospital X was a customer, everyone else would follow.
So when we finally got a couple of big brands as adopters, I thought everything would be easy - but I was wrong. No one actually cared. No one bought our product just because some famous brand did. And every year another 100 startups make this mistake (and also some famous hospitals keep perpetuating this myth… but oh well).
What’s interesting is that it turned out there was a way to create a halo effect for Health Tech… but it came from the EHR, NOT health systems themselves.
Folks might remember that Abridge and Nuance/DAX were the only two AI scribe partners in Epic’s Workshop - which meant Epic was co-developing new Technologies together. Which enabled earlier access to new APIs and integrations with Epic.
This allowed Abridge and Nuance to completely dominate the US health system market for AI scribes for a couple of years. I know this mattered because I have many instances of CMIOs/CIOs telling me they only seriously considered Abridge and Nuance for this very reason. Even though other AI scribes had also integrated with Epic, this Epic Workshop designation created a perception that Abridge/Nuance had access to better integrations already or in the future. So of course this gave the impression that Abridge/Nuance were better in some way - why else would only those two be in the Workshop category?
I even remember a CMIO telling me that they had picked a different AI scribe vendor after a structured, multistakeholder evaluation… only to be overruled by the health system Board because Abridge had that halo effect.
This is a perfect example of the old adage “great distribution beats great product”. This is not to say Abridge and Nuance didn’t have the best products (maybe they did), but that doesn’t matter as much as having the best distribution - which the Epic Workshop status certainly helped provide.
However the lesson of this story isn’t that you need to convince Epic to create a new Workshop category to kingmake you - that’s an outlier event.
The bigger lesson is that nearly every great Health Tech innovation also needs great distribution and go-to-market to succeed. And that in the health system IT space, the perception of “who plugs in best to our core platforms like the EHR” often has far more influence on adoption than features, evidence or social proof.
Too often Health Tech innovators focus too much on the product and not enough on distribution - if this is you, consider this your wake up call.
Alexander Zverev is living on needles for the last 25 years...taking Insulin everyday since age 4.
Today at 29, he became a GRAND SLAM CHAMPION. Overcame a life nemisis.
Huge Inspiration to children with diabetes. He runs a foundation for the same 👏
The heroes who stormed the beaches of Normandy to fight against tyranny must never be forgotten.
Generations have enjoyed freedom thanks to those in uniform and all who helped.
On the 82nd anniversary of D-Day, and always, we continue to remember and honor their legacies. 🇺🇸
@elonmusk White exsanguinated hands, defensive wounds, blood stained clothes, blood on the ground, blood on killer’s clothes, Clinical signs of late stage Hemorrhagic Shock.
Everything staring the police in the face but ignored, blinded by racism.
Send the video to everyone you know showing how heinously Nowak was treated by the police in his dying moments and how the police cravenly kowtowed to his murderer.
Legacy mainstream media, same ones who wrote about George Floyd millions of times, are dead silent about Nowak.
A new study links GLP-1 drugs and 30-35% reduced incidence of breast cancer, using matched-pair propensity analysis
https://t.co/AjNYlDM3A3
Confirms other association studies but still no proof
@AmericanAir third flight in a row no wifi. Frankfurt to Dallas. 12 hours. San Diego to Miami 5 hours. Now Miami to Atlanta 2 hours. Taking @Delta the rest of the week now (3 flights). I can’t afford the downtime.
@AmericanAir yes a safe flight is expected. Table stakes. I use flight time to get things done. Ever since you went free wifi my paid subscription hardly works. First a 11 hour flight from Frankfurt to DFW last week ruined productivity and now tonight SAN to MIA. All my productive work capacity vanished. Sigh. Pls fix your wifi.
Today, I officially filed to run for the United States Senate!
Minnesotans are looking for a common-sense leader, not another career politician. I’m running to bring new leadership to Washington and put Minnesota first.
🇺🇸 It once draped the casket of a hero who served.
It is folded 13 times for the 13 colonies.
It is shaped like a triangle for the tricorn hats of the Revolution.
When it’s done, only the blue field and stars show as a reminder of “In God We Trust.”
Over a million Americans died for that flag.
Honor it 🫡🇺🇸
The only thing that stops violent men from raping you and your society are other men who are equally willing to be violent in stopping the rapists. The West has decided that the highest virtue is to quietly comply with the destruction of your civilization because to do otherwise is bigoted toward the rapists. It really is that simple.