As doctors we must understand: asymmetry of power/knowledge in the doctor-patient relationship vulnerability of patients the sacred trust they put in us by sharing their stories, bodies, hopes, fears, pain An x-ray is not just an x-ray. Is someone’s body part #medtwitter

A medical school professor walks into clinic with her 12 year old son. He has 18 specialists. She does not fill out the intake form anymore. She hands the front desk a one-page medical sheet and says, "This is the current state of affairs," because the complexity will not fit in anything a clinic prints. That is Kathleen Muldoon, a med school professor and the parent of a medically complex child. She and co-guest Jonathan Cottor came on the podcast to talk about what pediatric medicine misses when it treats the diagnosis as the whole job. Kathleen is the one teaching your future colleagues what humanistic, whole-person care looks like. She is also the one who gets up in the middle of the night to reposition her son, because he cannot move on his own. Here is what your 15 minute visit does not see. The alarms that go off all night. The cold mornings in Arizona when his whole body tenses and nothing moves the way it should, which changes his mood before you ever lay eyes on him. The communication device she has to fight for so people can finally hear that her son can answer his own questions when he is given the chance. The two siblings absorbing the labor and the mood of a household run on triage. The third grader asked at school whether his brother was going to die. The six months of logistical work it takes to arrange a single weekend away. She has a spider web diagram she shows med students that maps all 18 specialties and how they interact, because none of them talk to each other. The diagram is not a curriculum exercise. It is the operating manual of her actual life. We have built a pediatric system that treats medical complexity as a list of diagnoses to manage. The families managing those diagnoses are running a 24/7 operation with no shift change, no relief team, and a clinic visit that asks about A1c but not about whether anyone in the house has slept. The intake form has a field for allergies. It does not have a field for "the parent across from you has not slept through the night in years." The reframe worth bookmarking: care is not just clinical, it is relational. When you care for the caregiver, you are caring for the whole family. In a 15 minute visit, that is three questions. Do you have respite care. How do you care for yourself. What would make it easier for you to keep doing this safely. Those three questions are the cheapest, highest-leverage intervention in pediatric medicine that almost no chart prompts you to make. They take under a minute. They cost nothing. They tell the family across from you that the person doing the most work in their child's care, the one with no medical license and no shift end, has finally been seen by the system that prescribed it. Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Which of those three questions have you been avoiding asking, because you are afraid of the answer? #ThePodcastbyKevinMD

US nonprofit hospitals spent $7.8 billion on management consultants from 2009 to 2023, but contracts were not associated with meaningful changes in finance, operations, or quality of care. 🧵 ja.ma/4d46zfq

These kids came up with a unique performance for their school Talent Show doing Synchronized “Air Swimming!”

“This new Google experiment is not a matter of cosmetic adjustments — it radically transforms journalists’ words.” 🔗 rsf.org/en/usa-google-claimi…

In healthcare, no amount of personal wellness practices can substitute for appropriate staffing, humane scheduling, efficient clinical workflows, adequate administrative support, or a culture of psychological safety.

If you want to fix healthcare, don’t start with the ED. Start with everything that forces people to come here.

Two studies tested ChatGPT, Gemini, and other AI tools on health-related questions. In one, they got almost half the answers wrong. Companies are improving AI health tools, but experts say they should supplement, not replace, medical professionals. wapo.st/4mKEJt4

🚨New preprint! We find evidence of LLMs enabling people to file lawsuits without lawyers (filing "pro se") at historically unprecedented rates in federal courts.👇 1/n

Four million physician hours are spent on mandatory modules each year. They represent not just clinical time lost but “evenings reclaimed and cognitive load reduced.” Redundant training and low-value modules should be a thing of the past. jamanetwork.com/journals/jam…

In Nara Park, Japan, the deer are so calm you can walk right up and hand feed them under the blooming cherry blossoms 🌸🦌

春の浜名湖は美しい

AI was supposed to save time. Instead, many workers are having to spend time and effort prompting, checking, and fixing flawed output. f-st.co/7Fc8fu4

Curtis Brown (@CWAgencyUK) has voiced concern about editors using ChatGPT to assess confidential manuscripts, as more literary agencies introduce clauses around Artificial Intelligence into contracts 👇

AI can miss mental health crises, and that’s dangerous. This study builds a guardrail that detects psychiatric emergencies in text with ~99% sensitivity, aiming to catch what other systems miss. So, why is this important? Most AI systems optimize for accuracy. This one optimizes for not missing a crisis. nature.com/articles/s41746-0…