Large language models are transforming medicine—but the technology comes with side effects. “Surveys have suggested that many people are more confident in A.I. diagnoses than in those rendered by professionals. Meanwhile, in the United States alone, misdiagnosis disables hundreds of thousands of people each year; autopsy studies suggest that it contributes to perhaps one in every ten deaths. [..] One recent study found that OpenAI’s GPT-4 answered open-ended medical questions incorrectly about two-thirds of the time. In another, GPT-3.5 misdiagnosed more than eighty per cent of complex pediatric cases. Meanwhile, leading large language models have become much less likely to … Read More
All posts by Anupam
A research group reviewed each country’s residents’ probability of dying from a non-communicable disease (including, but not limited to cancers; cardiovascular diseases; diabetes; endocrine, blood, and immune disorders; non-infectious respiratory, digestive, and genitourinary diseases; neurological conditions; mental and substance use disorders; congenital anomalies; and sense organ, skin, musculoskeletal, and oral or dental conditions) at 2001, 2010, and 2019. When looking at the probability of dying from a non-communicable disease between birth and age 80 in 2019, here are the top five performers by gender, along with America, Canada and England: For females For males “the poor performance of the USA … Read More
“A report on childhood health from the federal Make America Healthy Again (MAHA) commission released in May 2025 mentions the concept of harm associated with UPF dozens of times, signaling the possible inclusion of this category in the forthcoming Dietary Guidelines for Americans, 2025–2030. The available evidence, however, suggests that a focus in national nutrition policy on reducing UPF consumption won’t make Americans any healthier. The term “ultraprocessed food” [UPF] was adopted as part of a food-classification system that was introduced in a 2009 commentary by Carlos Monteiro and subsequently named “Nova.” Initially including three groups of food, Nova was … Read More
[Farr] One of the big questions I have as someone who also wears an investing hat is how big can cash-pay healthcare get? What’s your answer to that as you look at publicly traded businesses like Hims & Hers? [Blitz] Cash-pay is not going away and will continue to grow a ton. Every year our insurance premiums go up, health insurance companies pay for less of your care, they make it harder for us to get basic care paid for, so patients are just tired of all this. They are looking for affordable solutions that are just easy and don’t … Read More
“the drumbeat of primary care physician exits continues, atop the relative silence of trainee interest in the field, as more than 30% of US adults now lack a usual source of care. In January 2025, 3 advanced primary care management (APCM) codes were introduced to inject additional dollars into primary care (G0556-G0558). Reflecting 3 levels of medical and social complexity, these APCM codes pay a per-patient, per-month fee for advanced primary care services (eg, urgent access, care management, population health management) without requiring time-based documentation. For a low-income beneficiary with 2 or more chronic conditions, the monthly fee is $80 in … Read More
“A French team of investigators studied the question of whether a protocol-driven strategy of progressive reduction of blood pressure lowering drugs would alter a primary outcome of death rates in elderly frail patients who were residing in a nursing home. The authors also measured many relevant secondary endpoints. Just over 1000 patients underwent randomization to either the so-called step-down approach or usual care. The hypothesis was that reducing BP meds, and allowing BP to rise a bit would improve mortality. Inclusion in the trial required patients to be older than 80 years, be on more than one BP-lowering drug and … Read More
“A year before the beaver incident [a patient portal message stating “diffuse metastasis to the lungs” while staring at a giant beaver statue in a Buc-ee’s parking lot], I had undergone magnetic resonance imaging (MRI) of my cervical spine. My doctor read the impression and assured me everything was fine. Yet buried deep in the radiology report, not in the impression, but in the dense paragraph nobody reads, was “multiple thyroid nodules, likely nonmalignant.” This incidental finding was never mentioned in the impression or by my doctor. In fairness, I likely would have glossed over it with a patient too. … Read More
By gatekeeping health data, the AI Action Plan risks hardwiring bias into the future of American medicine. “the Trump administration has purged data from government websites, slashed funding for research on marginalized communities, and pressured government researchers to restrict or retract work that contradicts political ideology. These actions aren’t just symbolic—they shape what gets measured, who gets studied, and which findings get published. Now, those same constraints are moving into the development of AI itself. Under the administration’s policies, developers have a clear incentive to make design choices or pick data sets that won’t provoke political scrutiny. These signals are shaping … Read More
“Patients arriving with researched information is not new. They have long brought newspaper clippings, internet search results, or notes from conversations with family. Potential solutions passed along in WhatsApp threads have at times been an integral part of my clinical conversations. Information seeking outside the health care setting has always been part of the landscape of care. But something about this moment feels different. Generative artificial intelligence (AI), with tools like ChatGPT, offers information in ways that feel uniquely conversational and tailored. Their tone invites dialogue. Their confidence implies competence. Increasingly, patients are bringing AI-generated insights into my clinic and … Read More
“Robust evidence shows that diabetes is preventable through lifestyle modifications aiming at weight loss. A meta-analysis including 19 randomized clinical trials confirmed the long-term beneficial effect of lifestyle interventions, even with modest weight loss. Most of these interventions targeted weight loss through an energy-reduced, healthy low-fat diet combined with increased physical activity. However, no previous trial has assessed the effect of energy reduction in the context of a relatively high-fat diet, such as the Mediterranean diet (MedDiet). The PREDIMED (Prevención con Dieta Mediterránea) trial demonstrated that an ad libitum MedDiet supplemented with either extra-virgin olive oil or mixed nuts reduced diabetes incidence … Read More