A practicing psychiatrist Googled her own name and was the 452nd result. The first seven clinics that came up were not hers. The clinic ranked first had no clinical staff she had ever met. This is vertical integration in U.S. health care, observed at the consumer-facing search bar. Three structural notes. One. Vertical integration in U.S. health care now stacks payor, pharmacy benefit manager, bulk-purchase group, drug distributor, mail-order pharmacy, retail pharmacy, and clinic ownership inside single corporate structures. One parent company owns every step of the chain that connects a patient to a medication. When a market is vertically integrated end to end, the price-setting power and the patient-routing power both consolidate at the top of the stack. Two. The consumer-facing consequence is search-result routing. Owned-and-operated clinics rank first not because their clinical reputation is stronger but because the search architecture is shaped by the parent company's commercial relationships, paid placements, and directory contracts. The patient typing a doctor's name into a search engine in 2026 is not finding the best clinical match. The patient is finding the result the largest parent company wants found. Three. The independent practicing physician, the one with the two-location practice, the established patient panel, the clinical track record built over ten years, is now ranked 452. Not because the clinical care is worse. Because the ownership structure is smaller. The historical antitrust frame applies cleanly. A "trust" was a group holding assets across an industry, and that asset-holding became illegal when it began to harm consumers on price and access. The vertically integrated structures now operating in U.S. health care satisfy that test. The unresolved question is whether existing authority will be applied to them. The car-industry version of this structure would be one company that owns the factory, the dealership, the bank that finances the loan, the auto body shop, and the parts supplier. That structure was made illegal in cars a century ago. The same structure is currently legal in U.S. health care because corporate ownership is layered behind shell companies, and tracing who owns which clinic, which pharmacy benefit manager, and which clinic-chain back to a single parent is genuinely hard. If you are searching for a physician right now, the doctor you find first is the doctor the corporate parent wants you to find first. The doctor with the best clinical match for your condition may be 451 results down the page. Stephanie Waggel, MD, psychiatrist in Northern Virginia, explains how the search result became an ownership question on The Podcast by KevinMD. Link in the replies. What is the single antitrust action that would most directly disrupt vertical integration in U.S. health care today? #VerticalIntegration #ThePodcastbyKevinMD

the pope and anthropic's co-founder just stood together at the vatican to release "magnifica humanitas," the first ever catholic teaching on AI yes, you read that right. the full ceremony was 2 hours. here's the most interesting things for you to know: 1. this is the biggest religious response to AI in history. popes only put out a handful of these huge official letters in their entire time as pope. the fact that one of them is about AI tells you how seriously the church is taking what's coming. 2. small detail with massive meaning: this pope picked the name "leo XIV" on purpose. the last pope named leo was leo XIII back in 1891, and his most famous act was writing the church's response to the industrial revolution. picking the same name is a deliberate signal. this pope sees AI as the new industrial revolution. 3. the catholic church does this every time a major technology reshapes humanity. they wrote "rerum novarum" in 1891 to respond to the industrial revolution. when nuclear weapons threatened the world in the 1960s, they wrote "pacem in terris." climate change and runaway tech got "laudato si" in 2015. now AI gets "magnifica humanitas." they don't issue these often. 4. the pope's main line: "AI needs to be disarmed." he literally compared AI to nuclear weapons. he said the church spent decades pushing for nuclear disarmament because the technology was too dangerous to leave in the hands of a few. he says AI is now in that same category. 5. anthropic co-founder christopher olah told the pope, on stage at the vatican, that anthropic's own research team keeps finding things inside their AI models that "mirror joy, satisfaction, fear, grief, and unease." 6. olah's reframe of what AI actually is: these things are grown. they're trained on a structure roughly modeled after the human brain and fed everything humans have ever written. in his own words: "they are made from us, from our words." he said even the people building them don't fully understand what's happening inside. 7. olah publicly admitted that every AI lab, including his own, faces pressure that can conflict with doing the right thing. commercial pressure to keep shipping, competitive pressure from other labs, plus the older pressures of pride and ambition. his solution: we desperately need outside critics with no skin in the game who will tell the labs when they're failing. 8. olah says there are 3 giant questions the AI labs cannot answer alone and the world needs religion and philosophy to step in on: > how do we make sure poor countries actually benefit from AI? > what does human flourishing even look like in this new world? > and what are these things we're actually building? 9. one of the sharpest lines in the whole encyclical: "the promise of automatic general prosperity often proves illusory." translation: the idea that AI will just make everyone rich on its own is a fantasy. someone has to actually design the system so the benefits get shared. 10. the pope also pulled out a 100-year-old quote: "contemporary man has not been trained to use power well." said by a theologian back in the 1920s. the whole encyclical is basically a long argument that we need to learn how to use this kind of power before it uses us. 11. the pope kept stressing that he doesn't have the technical answers. but he says the church has thousands of years of wisdom on what it means to be human, and that wisdom is exactly what's missing from how we're building AI right now. his closing line: this technology should serve "human flourishing and human dignity, not control consciences."

This is absolutely the vital test for LLMs

Browsing history, I just ran across this observation. VERY true, and it's why if you want change, a big consulting firm is not the one to ask. AmIRight?

Cook Political moved Trump from Lean Antichrist to Solid Antichrist.

Generative AI (in the form or large language models) will act as the ultimate interface between healthcare professionals and a range of AI-based and other digital tools. Here is another proof of my prediction. Cleveland Clinic is the first health system to pilot "Chart Chat for Nursing", the first EHR-integrated AI conversational tool for inpatient nurses. "𝑇ℎ𝑒 𝑡𝑜𝑜𝑙 𝑝𝑢𝑙𝑙𝑠 𝑓𝑟𝑜𝑚 𝑡ℎ𝑒 𝐸𝐻𝑅 𝑡𝑜 𝑎𝑙𝑙𝑜𝑤 𝑛𝑢𝑟𝑠𝑒𝑠 𝑡𝑜 𝑎𝑠𝑘 𝑞𝑢𝑒𝑠𝑡𝑖𝑜𝑛𝑠 𝑜𝑛 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠’ 𝑐ℎ𝑎𝑟𝑡𝑠, 𝑤𝑖𝑡ℎ 𝑒𝑎𝑐ℎ 𝑟𝑒𝑠𝑝𝑜𝑛𝑠𝑒 𝑝𝑎𝑖𝑟𝑒𝑑 𝑤𝑖𝑡ℎ 𝑓𝑢𝑙𝑙 𝑐𝑖𝑡𝑎𝑡𝑖𝑜𝑛𝑠, 𝑡ℎ𝑒 𝑐𝑜𝑚𝑝𝑎𝑛𝑦 𝑠𝑎𝑖𝑑 𝑖𝑛 𝑎 𝑝𝑟𝑒𝑠𝑠 𝑟𝑒𝑙𝑒𝑎𝑠𝑒. 𝑁𝑢𝑟𝑠𝑒𝑠 𝑐𝑎𝑛 𝑎𝑠𝑘 𝑝𝑙𝑎𝑖𝑛-𝑙𝑎𝑛𝑔𝑢𝑎𝑔𝑒 𝑞𝑢𝑒𝑠𝑡𝑖𝑜𝑛𝑠, 𝑝𝑢𝑙𝑙𝑖𝑛𝑔 𝑓𝑟𝑜𝑚 𝑝ℎ𝑦𝑠𝑖𝑐𝑖𝑎𝑛 𝑝𝑟𝑜𝑔𝑟𝑒𝑠𝑠 𝑛𝑜𝑡𝑒𝑠, ℎ𝑜𝑠𝑝𝑖𝑡𝑎𝑙 𝑝𝑜𝑙𝑖𝑐𝑦, 𝑑𝑜𝑐𝑢𝑚𝑒𝑛𝑡𝑎𝑡𝑖𝑜𝑛, 𝑜𝑟𝑑𝑒𝑟𝑠 𝑎𝑛𝑑 𝑟𝑒𝑐𝑒𝑛𝑡 𝑙𝑎𝑏𝑠 𝑖𝑛 𝑠𝑒𝑐𝑜𝑛𝑑𝑠." It seems healthcare professionals are about to "chat" with the EHR systems across specialties and disciplines, just like what patients do at home. Source: fiercehealthcare.com/provide…

I'm reposting this (a week later!) just to remind everyone not to believe a single word out of TACO DJT's mouth. His whole MO is to mislead, head-fake, and keep people off balance.

Has anyone mapped this into what consumers *want* and/or *value*? The sucky pay for family medicine is glaring; what about others? @HealthyThinker

"The medical community had the most heated debate about 'is AI ready for healthcare?" … now this debate has already been decided by users. They just started using it and acting on it." Um, I believe this is called "democratization"!

A concise viewpoint on how physicians can prepare for the generative A.I. era jamanetwork.com/journals/jam… @JAMAInternalMed

See through the current AI hype in healthcare! I have mapped the rapidly expanding universe of AI use cases in healthcare from early-stage “on the horizon” innovations to “safe bets” that are already backed by strong evidence. I analyzed them on two scales, little evidence to evidence-based (meaning there are studies and peer-reviewed papers proving their efficiency and safety); and low risk to high risk (meaning patients’ lives might be at stake in case of an error). This yielded four groups: 1) Speculative and risky (little evidence, high risk) 2) On the horizon (little evidence, low risk) 3) Handle with care (evidence-based, high risk) 4) Safe bet (evidence-based, low risk)

Sociopathy in action. A total human train wreck.

This is a very good observation essay by Kim Bellard - mostly about the "GenZ stare" but it has strong ties to changes in trust in healthcare.

Little update on @MissionToPsyche.

@ePatientDave Hallo, you can read it here: threadreaderapp.com/thread/1… Share this if you think it's interesting. 🤖

Fact Check: Republicans not only voted against funding for ATCs (which Buttigieg asked for), but they also voted to defund the FAA. meidasnews.com/news/180-repu…

Positively thrilled to have been chosen by Peter Lee for episode 3 of his podcast series "The AI Revolution in Medicine, Revisited" - the episode about how #genAI empowers #PatientsUseAI!

Tried using AI and didn’t get the result you wanted? You’re not alone. But that doesn’t mean AI “doesn’t work.” 🧵 How to get better at using AI—and why it’s worth it.