Essays on AI, medicine, and how it actually works.
Longer-form pieces originally published on LinkedIn — on clinical AI, healthcare policy, and practicing emergency medicine.
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I Don’t Miss the Skills I’ve Lost, but Maybe That’s the Problem
With fond memory I still recall the ability to squeeze my Honda Fit into the tiniest of San Francisco parking spaces, becoming one with my car for a moment. I could use my mirrors and automotive proprioception to judge distances down to the centimeter. I’d thought that the skill…
The Bias Isn't the Problem. The Bias Is the Symptom.
If you ask me how I feel about large language models in medicine I'll give you a couple words: tense. Uneasy. "Mixed." *Not*dismissive — if you follow me, I'm practically Dr. GenAI Hype-Man, discussing their tremendous potential every day, and I often review research highlights…
Agentic AI and the Reality Gap in Medicine Part 2
## Google's AMIE and the World That Guidelines Imagine There is quiet, unglamorous work in medicine that will never make it on The Pitt. It saves way more lives. It is the work of often primary care but specialists do it too: keeping patients from falling through the cracks.…
Agentic AI and the Reality Gap in Medicine, Part 1
## MIRA and the Wrong Question My biggest problem with this clinical AI paper is that I wish they'd kept the humans out of it. This week brought another [big agentic AI paper — MIRA](https://www.nature.com/articles/s41586-026-10675-5) (Medical Intelligence for Reasoning and…
The Dangerous Practitioner: on miscalibrated confidence in medicine
It's generally unprofessional for attending physicians to talk about residents behind their back. But there is one reason we all will: when we consider that resident **dangerous.** *Dangerous *is a loaded term, so let me give you its precise meaning. A dangerous resident has a…
Medicine Has Always Made Sourdough. AI Wants to Make Wonder Bread.
As a baker and San Franciscan, I feel it necessary to teach you about sourdough if you want to know anything about medicine and AI, because medicine has been running a sourdough bakery continuously for the last 100 years. Sourdough — if you somehow never had that phase during…
The ER has three prime directives. Diagnosis isn't one of them.
I say this with all the love in my heart: **Your ER doctor probably doesn't care about your exact diagnosis** — and this is one of the many ways that media is failing in its reporting of [the new paper in Science](https://www.science.org/doi/10.1126/science.adz4433) this week.…
The Future of Medicine Is Not More Testing. It’s Better Judgment at Scale.
Eric Topol's *Super Agers* was not the first time I'd heard an argument for more testing in medicine. Versions of that idea are all over the internet, usually attached to someone trying to sell you a full-body MRI, a boutique blood panel, or a biologically impossible explanation…
What's the Fee-For, If AI Does the -Service?
AI is coming for everything broken in healthcare. Not just the inefficiencies and the middlemen — although I’d love those to be first. It’s coming for perverse incentives, and outdated payment structures, and bureaucracy and paperwork and administrator meetings. *Hallelujah. *…
Healthcare AI Predictions for 2026 — The Year the Politeness Ends
For years now, healthcare AI has been graded on potential. Participation trophies for showing up. Gold stars for “promising early results.” In 2026, that era ends. Not because the technology suddenly matures into something magical — it won’t — but because AI finally collides…
The Age of Specificity-First Screening
If all treatments were benign and side-effect free, I wouldn’t need to be telling you about sensitivity, specificity, and the [Apple Watch’s new hypertension feature](https://support.apple.com/en-us/117296). If resources were infinite, we could just test everything, all the…
Joseph Lister, Medical Progress, and the Arrogance of Hindsight
When you enter Edinburgh's Surgeons' Hall Museum, you're encouraged to climb the narrow steps of a small surgical anatomy theatre, and take a seat to look down upon a pale, wooden figure in the general shape of a human below you. An actor in old-timey surgical garb reminds you…
If AI Is the Crutch. Will Medicine Forget How to Walk?
## Part 2: Real-World Risks and the Confidence Spiral In [Part 1](https://www.linkedin.com/pulse/ai-crutch-medicine-forget-how-walk-graham-walker-md-oobtc/), we explored how generative AI reshapes the way we think and learn. We looked at studies showing how confidence in AI can…
If AI is a Crutch, Will Medicine Forget How to Walk?
## Part 1: Thinking Less, Learning Less **Quick: **what's 17 x 19? While I'd imagine most of you could work this out, you probably reached for your phone. It's less brain work, it's faster, and you're likely more confident in its answer than your own mental math under pressure.…
Dr. Uché Blackstock's Legacy: Medicine's Blind Spots Through a Clearer Lens
You know that sensation when a word is stuck on the tip of your tongue, or when you’re *about* to have déjà vu? It's the feeling of something being familiar and foreign at the time. That’s what I felt reading [Uché Blackstock, MD](/in/uche-blackstock-md/)'s book…
Patients at the Bottom, Power at the Top: The Healthcare Control Funnel
We all have a role in the healthcare system. Whether we’re shaping policies, providing care, creating drugs, or simply seeking treatment, we each contribute to how the system works — or fails to work. I'd originally called this *The Healthcare Blame Game*, but a better word is…
The Food Policy Paradox: Why Freedom Won't Fix the American Diet or Make America Healthy Again
If you zoom in enough, you can actually find some overlap in the RFK Jr. ↔️ Graham Walker Venn diagram. It’s just a tiny sliver, but it’s there. It reads: **the American diet**. We all want a healthier America: Healthier food choices, healthier food options, fewer fresh food…
Blind Spots Gets It Half Right: Why Medicine's Problems Run Deeper Than We Think
Medicine is *an art* for good reason: it's practiced by imperfect, subjective humans prone to bias and error (also known as doctors). Yet despite these human constraints, medicine strives to uncover biological truths that can reduce suffering and treat disease. In his latest…
My Sunglasses Hallucinate JCPenney: My Meta AI Smart Glasses Review
🕶️ I absolutely love my Ray-Ban Meta Wayfarers (that’s a mouthful): the form factor, the sound, the image quality—but ironically, the worst part? *The AI integration.* Meta’s AI feels more like a gimmicky afterthought than a killer feature. At one point, it hilariously informed…
Progress in Business vs Medicine: How Incremental Gains are Overloading Healthcare
The guy sitting next to me at the conference runs IT for a car insurance company. He leans over and says, “Yeah, this software makes our sales guys like 3% better, and that translates into *hundreds of millions of dollars* a year for us.” We hear about incremental gains in…
🧭The Compass is Broken: How current MedLLM benchmarks worsen AI in healthcare
They’re called *models* in AI because they’re trying to *represent* something else. Just like you might build a *model train*, the whole point is it’s *representing the full-sized one*. One of the things you do when you see a model train is compare it to the real thing: look at…
Healthcare: No Room at the Inn
✈️ You run an airline. The plane’s flying no matter what, so you want every seat occupied. ✅ 🏨 You run a hotel. The pool has to be cleaned and the lights have to stay on, so you want every room booked. ✅ 🏥 You run a hospital. You have to pay the nurses and doctors, so you want…
RuPaul Runs an Amazing Meeting
It’s a well-known fact that if you’re good at one thing, you’re good at *everything*. **Adele** is incredible at finding the best plane ticket deals. **Meryl Streep **does incredible marketing analyses. And **Steve Kerr** is well-known for his effortless 3-pointers. (Hi,…
Medical Alchemy and Rory Sutherland
Last month generated a lot of buzz surrounding [VC firm General Catalyst buying a hospital](https://www.forbes.com/sites/katiejennings/2024/01/17/vc-firm-general-catalyst-plans-to-buy-ohio-based-hospital-summa-health/?sh=56acba0f482e), but I’d be way more excited if advertising…
Part 3 of My Review: Attia’s Magnum Outlive Opus
As we conclude my review of "Outlive," we delve into two often-neglected wellness aspects: quality sleep and robust emotional health. ([Part 1](https://www.linkedin.com/pulse/skeptics-review-peter-attias-outlive-graham-walker-md-z6rsc/), [Part…
Part 2: More Meat, More Potatoes, and More Skepticism about Peter Attia's Outlive
You may have not asked for it, but I’m back anyway with Part 2 of my review of Dr. Peter Attia’s Outlive. (You can find Part 1, which is mostly an overview of *Outlive*'s themes,…
A Skeptic’s Review of Peter Attia’s “Outlive”
Going into this, I’d only heard of Dr. Peter Attia in passing. I had a loose association in my mind between him and keto diets and nutrition-in-quotes podcasts, and I’m generally extremely skeptical of any physician in this space. There’s *so much snake oil* and it’s *so easy to…
Graham Walker's 2024 Predictions for Healthcare and AI
[Thursday](https://www.linkedin.com/pulse/what-do-7-llms-think-ai-healthcare-2024-graham-walker-md-b5mwc) we asked ChatGPT, Claude, Bard, and others what they thought we'll see in 2024. Today, I'll give my own predictions as an ER doctor, healthcare tech leader, and daily user…
What Do 7 LLMs Think About AI in Healthcare in 2024?
On December 30, I'll publish** my lowly human doctor** predictions for AI in healthcare in 2024 (and name an AI winner), so I thought it might be fun to ask the LLMs what *they *think. I've included responses from the "best" LLMs: - [ChatGPT4](https://chat.openai.com/), [Claude…
“We’re from the C-Suite, and We’re Here to Help”
### Or: Aligning Leadership Decisions with Personal Impact > Sure, the drug has numerous risks including death, requires followup and on-going monitoring, and is not a medicine that they’d ever prescribe, but why don’t we just have the ER doctor write the prescription since…
Part 3: Even Today’s Doctors Want Out*
In hushed, quiet tones, in group chats and Facebook message boards, and in the few remaining physician lounges the conversations from the doctors are all the same: *What are you doing to get out of clinical medicine?* My LinkedIn series ([Part…
Part 2: Excitement and Promise for Gen Z in Healthcare
Well it’s always darkest before the dawn, so let’s pivot from my doomsday [Part 1](https://www.linkedin.com/pulse/hope-hesitation-next-generation-healthcare-graham-walker-md-wlw1c/) to the exciting prospects of the next generation of healthcare professionals. ###…
Hope and Hesitation for the Next Generation of Healthcare
Instead of starting out like I usually do with a patient story highlighting my optimism and fear for the future of medical care, I’m just going to have smart, driven medical student [Jonathan Wakim](/in/jonathanwakim/) tell you his story: > Entering medical school, I was driven…
Why Amazon’s Trying Primary Care for $9 a Month
You’ve probably heard that 20% of patients generate 80% of the costs in healthcare. Amazon’s just targeting the inverse of that: the 80% of people that only require 20% of the cost. Here’s why I suspect they’re now offering $9/mo “primary care” — and ultimately why it’s a…
How Easier AI Access Could Decimate the Healthcare System
No, the sky is not falling — but it’s worth considering an enormous problem surrounding access to medical care, AI, accurate diagnosis, and why AI may need to be not just *equivalent *to physicians — but orders of magnitude better. I was recently reading [Eric Topol,…