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“Last month in JAMA, bioethicist Ezekiel Emanuel and colleagues argued that AI is already superior to physicians at five cognitive tasks, including eliciting the patient’s story, and that keeping doctors in the loop with AI actually degrades care. The piece flooded my LinkedIn feed: doctors horrified, AI evangelists applauding. The evidence they cite is impressive. But nearly all of the data rests on methods that sidestep real life: in most studies, the LLM was handed a curated case vignette and asked to spit out a diagnosis. The studies behind the history-taking claim barely had AI talk to a patient—two of … Read More

From the article’s Discussion section: “In this cohort study of 13 423 adults aged 65 years or older, higher objectively measured physical fitness was associated with progressively lower all-cause mortality across multiple domains, with balance and agility showing the lowest risks, followed by lower-body strength and cardiorespiratory fitness. These findings are consistent with the conceptual distinction between disease burden and functional reserve. While previous studies have relied on comorbidity counts or deficit-accumulation indices to estimate risk, our results suggest that objective measures of functional capacity may offer prognostic information beyond traditional comorbidity-based metrics. The inverse gradients observed—even after adjusting for comorbidities—suggest … Read More

“A decent society should do all it reasonably can to reduce human suffering. It should not, however, do so by extinguishing the lives of those who suffer or the lives of those whom we believe might suffer in the future. [..] It is understandable and deeply human to want to bring all aspects of our health as much into our control as possible. Terminally ill patients often face horrifying levels of pain. We should try to treat that pain as best we can. Vulnerability is terrifying, but it is also inescapable. In our quest for health and fitness, we are … Read More

To survive a heating planet, humans need shade—lots of it. “Every year, heat takes more lives than floods, hurricanes, and tornadoes combined. The fatalities can sometimes go unnoticed, perhaps because the danger is invisible: There’s no twister that uproots a neighborhood and no flood that sucks it underwater, nor billions of dollars in property damage. Instead, heat’s imprint is seen in empty streets, work slowdowns, cognitive decline, and hospital bills. When autumn arrives and temperatures relent, heat leaves no discernable trace. The Earth is getting hotter. In many places on the planet, summer is already two to three weeks longer than … Read More

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Adam Grant interviewed Harvard psychologist Dan Gilbert. An excerpt: “[Grant] here’s so many demonstrations of these affective forecasting failures. If you were to choose your top three, what are your favorites? [Gilbert] [..] Certainly one of the mistakes that’s caught my attention the most is our inability to imagine adaptation. My friend Danny Kahneman used to say, when you ask somebody how they would feel if they were blind, they imagine going blind. But the day you lose your eyesight, probably a very, very bad day. But it’s not like all the hundreds and thousands of days that will follow, … Read More

“At some point, it is what many of us experience in our lives as the physician-child paradox. You hold out hope for the best possible outcome, but when the data and your parent are staring you in the face, it is hard to deny the odds and experience. [..] At the end of the day, the look of defeat remained on his face. He had been a good sport, but the outcome was not going to change. Either he or fate had decided it. I could not tell. “I love you,” he said. “I love you, too, Dad,” I replied. … Read More

“Recently, the U.S. Preventive Services Task Force (USPSTF) changed its recommendation for the starting age for mammography screening from 50 to 40 years. Previously, the Task Force deemed screening in 40-to-50-year-old women a personal choice. Because USPSTF recommendations are so influential, mammography screening for women in their 40s will probably become a health care performance measure; if so, it will effectively become a public health imperative with which primary care practitioners must comply. Such a change will affect more than 20 million U.S. women, and it raises some important questions. First, is there new evidence that mortality from breast cancer … Read More

“Mr. Ellsberg, who died on Friday at 92, copied the military’s secret 7,000-page history of the Vietnam War and gave it to The New York Times and The Washington Post in 1971. The government sued to stop publication, but the Supreme Court defended the First Amendment right of a free press against prior restraint. [..] [New York Times] The number of people with the security clearances to view classified material has expanded, perhaps exponentially, since the leak of the Pentagon Papers, and I wonder, aside from a few people like Edward Snowden and Chelsea Manning, why haven’t there been more … Read More

“Discussions of [health care system] reform here in the United States seem to focus on two options: Either we maintain the status quo of what we consider a “private” system, or we move toward a single-payer system like Canada’s. That’s always been an odd choice to me because true single-payer systems like that one are relatively rare in the world, and Canada performs almost as poorly as we do in many international rankings. [..] Universal coverage matters, not how we get there. [..] We have spent the last several decades fighting about health insurance coverage. [..] The only thing we … Read More