EPtalk by Dr. Jayne 2/19/26

Clinical Informatics is a broad specialty. But depending on our job roles, we sometimes only get to work in a handful of its domains.

I’ve always enjoyed public health informatics work and being able to identify opportunities where we can make changes that help thousands of patients and families. Pregnancy continues to carry higher risks in the US than in other developed countries. I recently ran across the Baby2Home app that is designed as “a one-stop platform supporting perinatal families through an evidence-based collaborative care model.”

The tool includes mental health screening, access to stress management resources, and connectivity to care managers for support. It also offers the ability to track infant-related parameters such as feeding, sleeping, diaper changes, growth, and vaccinations.

Researchers tested the tool during a multi-year study that ended in 2025, with 642 first-time parents randomized to receive either typical postpartum care or typical care plus the app. Members of the intervention group had improved mental and physical health scores and were more confident in their parenting skills compared to those in the control group. The data was presented at the Society for Maternal-Fetal Medicine meeting on February 11. Although the tool is currently investigational, I found it compelling and will be watching to see what happens next.

Speaking of companies I’m following, I was delighted to see a recent LinkedIn post containing a video from the folks at CognomIQ. The peppy beat perfectly channels their call for organizations to “Drain that stagnant swamp of a 1990s data lake.” The post says, “We’re not mincing words or hiding behind flowery rhetoric.” They weren’t kidding, since they call out several prominent vendors by name.

The snappy chorus of “Healthcare data sucks, you can’t dress it up” had me rolling. So did, “We build the board a house of glass and pray the question’s never asked.” All of us have been there, but few are willing to become a lightning rod by saying it out loud. Props to the team that created this campaign. I’ll see you on the dance floor.

From Captain Incredulous: “Re: LinkedIn. In a moment of weakness, I accepted a LinkedIn request from a friend of a friend. Within 24 hours, my new connection emailed me at my work address. He asked me to introduce him to a well-known CEO in my network and advocate for a partnership meeting. He even went as far as to suggest a draft email for me to use. He has now sent three emails about this issue.”

The reader shared the email thread, and it is certainly presumptuous. Additionally, I found some irony that the reader failed to notice: the draft email included mentions of how the author’s company could help the CEO at his previous employer rather than his current one. Putting myself in the reader’s shoes and knowing the CEO in question, I would definitely mention it to him, if only for a chuckle.

My inbox is bursting with cold email outreach efforts asking to connect at ViVE next week. Colleagues are receiving similar messages from startups that are desperate to meet. Most use words like synergy, partnership, and collaboration. Of those in my inbox, many include the salutation “Hey.” I know ViVE is the hip cool cousin of the conference scene, but it still feels unprofessional to me.

My favorite request just said, “I will be attending VIBE and connecting with people across the healthcare space” without stating the requester’s company or why it might be relevant to me. The misspelling of the conference name captured my attention, but I’m still not going to book a meeting.

From Jimmy the Greek: “Re: AI answers that are obviously incorrect. Check out this thread, where I asked whether I should walk or drive to the car wash.” AI recommended walking if the user didn’t mind exercise and if the weather was decent. It suggested driving if short on time or if the route isn’t pedestrian friendly. It completely missed out on the fact that the car would not be at the car wash if the user walked. It confidently stated that “walking is the more elegant move,” unless the car wash was of a certain configuration. It concluded by asking the user to specify what kind of car wash was involved so it could “pick the smoothest plan.”

The average healthcare IT team consumes a large volume of caffeinated beverages, so this article in the Journal of the American Medical Association caught my eye. The authors investigated whether long-term consumption of coffee and tea is associated with dementia risk and cognitive function. The study was large, with 132,000 participants and up to 43 years of follow up. The findings showed that, “Greater consumption of caffeinated coffee and tea was associated with lower risk of dementia and modestly better cognitive function, with the most pronounced association at moderate intake levels.” No similar association was observed with decaffeinated coffee.

Study participants were healthcare workers. Females were drawn from the Nurses’ Health Study and males from the Health Professionals Follow-up Study. Data was collected every two to four years using a food frequency questionnaire.

As we all know, correlation does not imply causation. One should also be cautious about extrapolating these findings to non-healthcare workers since many of us have other behaviors that might not be typical. A shout-out to all the emergency department workers out there who have disordered eating habits, disrupted sleep, and fond memories of colleagues sneaking out through the ED doors to smoke cigarettes before returning upstairs to counsel patients about smoking cessation.

I’m a stickler for starting meetings on time to be respectful of those who are punctual. I’ve been fortunate to work in organizations that use the 25/55 meeting scheduling paradigm, which gives people five minutes to transition between calls or meetings. I’ve seen how it can help more meetings start on time.

Even without a back-to-back meeting schedule, some people are habitually late. During a recent discussion on meeting management, a colleague shared an article about people who arrive late and the causes. Although some people may be overscheduled or previous meetings might end late, there is also the phenomenon of “time blindness,” in which people are unable to identify how long an activity might take or to understand how much time has passed.

People might also arrive late if they don’t want to engage in pre-meeting banter. I’ll admit that I haven’t thought much about that. Starting on time reduces the available time for small talk, but it’s something to think about the next time I’m on someone else’s meeting and they’re “just waiting a few more minutes for people to arrive.”

How does your organization support on-time meetings? Are agendas and timekeepers a must or something only found on the wish list? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 2/16/26

I met up with some clinical informatics friends over the weekend. Our conversations focused on a few key themes. One was how much time we’ve spent in the field, as we realized that the most junior member of the group just hit the 20-year mark.

None of us set out to specifically look for technology-related roles, but each of us found our way to the field as we identified gaps in what was happening around us and stepped in. The most senior of the group got involved because he had an engineering background and saw what was going on elsewhere in the country with respect to electronic charting. He wanted to see his institution be a leader in the field rather than a follower, and worked with a big tech company to build a clinical repository for the organization.

It initially compiled data from just one hospital, but as more hospitals joined the system through mergers and acquisitions, the repository became more complex. The team that supported it needed clinical expertise to handle issues like normalization of laboratory values and standardization of test orders. He had some great stories about how the repository grew and became integrated with electronic medical records. It lasted for more than two decades before being retired in favor of a half-billion-dollar investment to move everyone to a single platform.

My colleague still refers to the systems clinicians use as EMRs. That led to a discussion of EMR versus EHR. One member admitted that he uses the terms EMR and EHR interchangeably because he keeps getting loaner computers from his IT department and hates having to go into all the different dictionaries to prevent the system from autocorrecting EHR to HER.

That admission led to a discussion about how the Microsoft Office suite and Office 365 applications handle such things, which bafflingly makes the setting device-specific rather than defaulting from the user profile. I’m no expert, but I know that it’s annoying every time I get a new laptop. I usually end up consulting Google because finding it in the application settings isn’t intuitive.

Quite a bit of back and forth ensued around the merits of EMR versus EHR. I was surprised by how passionate some of the people are about one or the other. We all agreed that “health record” is more comprehensive than “medical record.” One of the group felt that the latter sounded more serious since “health” is often linked with “wellness,” which often includes non-evidence-based and consumer-oriented services.

People pulled out their phones to look for articles for and against each term. I was surprised that the first response that popped up in my EMR versus EHR query was that “EMRs are mainly used by clinicians for diagnosis and treatment, while EHRs are designed to be shared and accessed by the patient. EMRs are less susceptible to cybersecurity issues, since they are not being shared with patients, but are securely managed by the practice.”

That got us rolling, since none of us has encountered a cybersecurity issue related to patient use, but we’ve seen plenty of times where trained employees and hospital medical staff fell victim to phishing schemes. An ASTP/ONC blog addresses the topic, but it’s from 2011. Some of its language is identical to what I found in that first response, which leads me to suspect that the vendor had done some copying and paraphrasing from ASTP.

Most of us agreed that now it’s kind of a stylistic thing and we aren’t bothered when vendor folks use the words interchangeably. I’ve worked with vendor organizations whose style guide spells out which term to use when referring to their products, but not everyone has one of those. I remember reaching out to Epic a few years ago to ask if it had an official position one way or the other and was told that it doesn’t. If that has changed, feel free to drop a comment and let me know the current state.

That conversation led us into a whole “words have meaning” discussion. That immediately drew me in because the industry is plagued by people who use words that don’t make sense. Maybe it’s a phrase they learned during a corporate training class, or perhaps they saw it in an article. When they come to me as a CMIO and start spouting words that don’t completely work together, it makes my attention go zinging off elsewhere.

One colleague, who is a doctor of osteopathic medicine, noted that nothing turns him off more than using “MD” as shorthand for “doctor.” Both have the same number of syllables, so it’s not like saying MD is faster or easier. It’s not worth it to use it in a way that alienates a subset of physicians.

One of the group brought up a recent position paper in Annals of Internal Medicine that addresses “The Ethical Significance of Names in Health Care.” It’s an analysis of the physician versus provider debate, referring to the latter term as contributing to “deprofessionalization.” The authors felt that their examination was unique because it looks at the situation from an ethics perspective.

I popped up the article while we were talking and was excited to see a Shakespeare quote in the first screenful of text. The article includes a review of the origins of care-related words, including patient, physician, doctor, and compassion.

One might have expected that the article would recommend simply not lumping physicians in with other kinds of heath care providers, but it went further to suggest that we get rid of the word “provider” entirely: “Language in health care has ethical and practical implications. Physicians should be referred to as physicians, not providers. Also, when describing professionals with varied credentials who care for patients, the terms clinicians or health care professionals, should be used.”

I’ve been a fan of the word clinician for a long time. It’s shorter than the recommended alternative. I plan to stick with it.

Not surprisingly, we stumbled into a discussion of clinical informatics versus medical informatics, and even a debate about informaticist versus informatician. There’s actually a paper from 2024 called “Informaticist or Informatician? A Literary Perspective”  that goes deep into the history of the two. My colleague quickly sent me a link.

It is a fascinating read. The authors close with a clinical informatics spin on a classic Shakespeare quote, which made me smile. They also received a chuckle with their line, “Whether you are an informaticist or an informatician, may you collaborate better than the Montagues and Capulets.”

Even though the conversation was all over the place, it’s always good to catch up with colleagues who have fought the same battles and who have made it through the same topsy-turvy changes within the industry. They are not only knowledgeable, but are generally a fun bunch. I feel privileged to have them on my phone-a-friend list when times get tough.

Is your company in EMR or EHR mode? What phrases, taglines, or buzzwords make you cringe? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 2/12/26

JAMA Network Open published an interesting Original Investigation last month that set out to answer the question: “Are greater levels of generative artificial intelligence (AI) use by US adults associated with greater levels of depressive symptoms?”

The authors surveyed 20,000 adults. Of those, 10% reported daily use of generative AI tools and 5% said they use it multiple times per day. Higher levels of AI use were linked to increased depressive symptoms, especially in certain age brackets. The authors note that additional research is needed to understand the nature of the association and differences in impact.

AI truly is everywhere, but I was surprised to see it on the new RealFood.gov website that replaced MyPlate.gov. Users who post a question are redirected to the Grok AI tool.

I took advantage of a preloaded sample question that addresses the challenges of eating non-processed foods when the closest food source is a gas station and an individual is on a fixed income. The answer also recommends that users consider food stamps, food pantries, and other community-based options.

Some of our government health leaders are promoting animal fats as healthier options so I decided to poke the AI bear and asked whether animal fats cause heart disease. Grok sided with existing data that suggests that higher consumption of meat, dairy, and eggs is associated with increased risk of cardiovascular disease. Score one for Grok in keeping with established mainstream science.

I asked Grok what happened to MyPlate. I was impressed that it clearly identified those who are responsible for the new approach, none of whom are physicians, nutritionists, or dietitians. Grok noted criticisms of the “return to a pyramid format that was abandoned partly because it was harder for people to interpret compared to the simple plate model.”

It also offered a follow-up question that compared the old guidelines to the new. It also identified critics, including Harvard Nutrition Source, Stanford, and public health groups, and their concerns, such as the scientific process that was employed.

As a family physician with a keen interest in the literature, I’m concerned at how this paradigm minimizes fiber. If flipping the guidelines were a scientific study, I’m not sure it would make it past Institutional Review Board approval. So many of us feel like we’re living in an unregulated science experiment.

I asked Grok its thoughts on the links between red meat, fiber, and colon cancer. It gave me a deep dive into exactly how red meat contributes to colorectal cancer risk and the protective nature of fiber. At least I have some facts in my head for the next patient who comes in asking about their diet, because I won’t be recommending the new guidelines without extensive discussion of context and validation.

Amazon One Medical has introduced a new beta feature to help patients navigate their lab results. The Health Insights functionality, which is included in the One Medical membership, provides commentary on 50 standard blood work results while grouping tests together by health domains such as cardiovascular and immune function. Users complete a questionnaire, then the tool generates a wellness score and offers evidence-based lifestyle recommendations with scientific references. I’m not a subscriber, but I would be interested in hearing from anyone who has had a chance to check it out.

Given the number of health systems and care delivery organizations in the US, it seems like someone is always merging, acquiring, or separating. The M Health Fairview brand will be retired from a subset of hospitals in 2027 as part of a new agreement between the University of Minnesota and Fairview Health Services. The deal, which was approved by the university’ board of regents on January 30, shifts the partnership from a joint clinical enterprise to an academic affiliation.

Healthcare administrative types may be familiar with the nuances of those structures, but I doubt that the majority of patients who live in the communities that the organizations serve will understand what the shift means.

The groups will still work together with regard to the University of Minnesota Medical Center. However, details of the agreements that impact the respective physician groups are not yet public. In short, the university will maintain control of academic and research functions, while Fairview will be responsible for hospital operations.

Relations between the two organizations have been strained for a number of years. The university opposed a merger between Fairview and Sanford Health, after which Fairview opposed the university’s push to merge with Essentia Health. The Minnesota Attorney General became involved, triggering facilitation and mediation efforts. The new agreement will be in force for 10 years compared previous partnership’s 30 years.

Speaking of branding, Texas Health Resources has inked a deal to buy naming rights to Texas Health Mansfield Stadium. It includes “prominent branding throughout the stadium, a refreshed logo and a new digital presence… while also laying the foundation for a wide-ranging collaboration focused on community health initiatives.”

The hospital president and CEO indicated that the facility “will serve as the central wellness hub for the entire Mansfield community.” Given the fact that stadiums are typically closed and locked when teams are not in play, it will be interesting to see how it becomes a wellness hub. 

The article mentioned that Texas Health will be the facility’s “Official Health Partner” and “will collaborate on initiatives designed to promote healthier lifestyles, including community programming and enhanced food and beverage offerings that emphasize more nutritious options.” Hide the jumbo nachos and the foot-long corn dog, y’all.

The ASTP meeting kicked off earlier this week, with a focus on the intersection of health IT and the priorities of the US Department of Health and Human Services. Main stage sessions include titles such as “Health Technology for Transparency and Affordability” and “Making America Healthy Again through Technology + Care.” Breakouts covered standards, data exchange, and of course information blocking.

I’m interested to hear from anyone who attended, and in particular, from people who attended previous meetings. How was the attendee mix compared to the past? Were topics handled similarly? What was the overall mood? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 2/9/26

Most of us have figured out by now that it’s difficult to spend a day without using some kind of AI-powered tool. I was a fairly early adopter of the Amazon Echo devices after receiving one for a gift. I used them until recently to control some of the lighting in my home. (RIP, Wemo smart home devices.)

I mostly use the Alexa assistant to get quick answers to straightforward questions, such as “What is the temperature?” and “What is the forecast?” so I can do a little planning before I drag myself out of bed in the morning. In the kitchen, I primarily use it for timers or to play music while cooking. I haven’t been impressed by the “skills” that it offers, however.

A couple of weeks ago, I started receiving teasers to upgrade my device to new voices and personas. I held out since I didn’t want to be a beta user. Ultimately, I gave in and was pleased to find a somewhat sassy voice that is officially described as “grounded” or “easygoing.” It reminded me of one of my favorite audiobook narrators, so I decided to give it a try.

Over the last few days, I’ve noticed some quirks. I’m not sure if it’s specific to the voice I selected or if something is going on with the cloud services, but Alexa started giving me more information than I was asking for. Instead of simply giving me the current temperature and the forecast high, it added commentary like “it’s going to be a great day” or something similar.

Then I noticed it providing information that seemed disordered. For example, telling me that the current temperature was 38F with a forecast high of 47F, but that it currently feels like 44F, which just doesn’t make sense. It also tells me that tomorrow’s forecast high will be in the 40s when the Weather Channel thinks it will be a dozen degrees higher.

Tonight, I was thinking about some travel plans and asked Alexa what the correct time zone is for Nashville since I can never remember and was multitasking. Alexa confidently told me that “Nashville is in the Central Time Zone,” but went on to offer information that I didn’t ask for and told me the time. Since I’m on Central time, I was surprised that it was wrong.

I was curious to see what Alexa would say if I called out an incorrect answer. It replied, “You’re right, I should have been more specific. Nashville, Tennessee is indeed in the Central Time Zone.” I had to specifically ask the time and it finally answered correctly.

It’s one thing for a system to provide inaccurate information in response to a question, but it’s another to offer incorrect information that wasn’t even asked for.

I’ve seen some positioning for virtual assistants, including Amazon Alexa and Google Assistant, as general purpose tools that can help the elderly age in place and manage daily routines. They are also supposed to be helpful for reducing social isolation and providing voice-activated medication reminders. What happens, however, when those tools don’t do the right thing? What happens when the tools are confused about what time zone they’re in and it leads to a patient taking medications more than once? In that situation, a simple non-AI alarm app might be more reliable and provide greater safety for patients.

Later in the day, I found an email from Amazon listing how “Early Access” customers made Alexa+ better, including such items as being more responsive during chats, a better sense of when you want to engage, and that it “adapts to your vibe” by learning and adjusting to the user’s communication style.

Honestly, I’m not impressed. As soon as I get some free time, I’m going to experiment with some of the other voices to see if they’re as problematic as the one I selected or if the entire system is just not meeting my needs any more.

Meanwhile, I’m starting to make a list of all the grossly inaccurate responses that I receive from AI tools. I recently read a novel that was based on a true story and asked an AI-powered search tool what happened to some of the main characters later in their lives. The answers should have been straightforward, since the characters I asked about were part of a World War II effort to project works from the National Gallery of Art by storing them at the Biltmore Estate in Asheville, North Carolina.

Instead of providing facts, I got some wild speculation about the Gallery’s director, David Finley, which required visits to a couple of primary sources to fact check. As an upside for the next time I need a random nugget of obscure information, I now know that 40 cubic feet of Finley’s personal papers and artifacts now reside in the Gallery archives, including dried flowers, a cigarette case and lighter, and postcards from a honeymoon in Greece.

The Super Bowl is a big deal in the US. A lot of watercooler conversations happened at the end of the week around whether people had plans for the big event and which team they might be supporting. I was one of the people who don’t really have a connection to either team, but was really rooting for the combined squad of US Air Force and US Navy pilots who were slated to perform the pre-game flyover.

I have to say it did not disappoint. The seven-ship formation led by the B-1 was on point. Those of us with aviation geek tendencies knew there was more to come, and the US Navy livestream made our day as the camera panned back to catch the second B-1 approaching in full afterburner.

Having spent my career in medicine, I appreciate the fact that a seemingly short display like this is actually the end result of hundreds of hours of research, planning, and practice. It’s like one of those domino transplant surgeries where all the organs have to make it to the right patients in the right city at the right time with all the associated facilities and staff preparation.

The flyover planes originated in South Dakota and California. They were supported by refueling aircraft from Ohio, with everyone gathering nearby for the final maneuver. Each aircraft is supported by teams of maintainers who are in turn supported by other disciplines. Everyone is essential, much like in a hospital. Thousands of hours of training and education are behind each person’s ability to do their job when called upon. The pilots’ fist bump in the cockpit following the flyover was charming and I can only imagine how excited their families were to see that. (Photo taken from US Navy livestream).

If you partied for the Super Bowl, what was your favorite snack? Did your event include any heart healthy options, or was it all about Buffalo wings and pizza? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 2/5/26

It’s been a couple of years since I’ve written much about digital therapeutics. The number of vendors in the space is small, and the market got quiet after Pear Therapeutics, the one I knew best, declared bankruptcy in 2023.

Digital therapeutics require a prescription and are regulated by the FDA. At the end of 2025, the US Food and Drug Administration announced a pilot program to encourage the use of these solutions. The Technology-Enabled Meaningful Patient Outcomes (TEMPO) model began accepting statements of interest in January. Under the model, a subset of medical professionals can prescribe digital therapeutics before they are officially approved by the FDA, with the resulting real-world data being used to potentially support their clearance.

One reason these tools failed to gain traction was the reimbursement landscape, which left developers unable to build a sustainable financial model. Some companies pivoted into the direct-to-consumer space and marketed their tools as wellness apps to avoid regulation.

The TEMPO pilot was developed by the FDA Center for Devices and Radiological Health (CDRH). It is limited to prescribers who participate in the CMS Center for Medicare and Medicaid Innovation model for Advancing Chronic Care with Effective, Scalable Solutions (ACCESS). If you’re a providers who meets the acronym test and is planning to prescribe digital therapeutics, feel free to drop us a note.

A recent article in JAMA Oncology looked at the MyLungHealth tool, which can help identify patients who are eligible for lung cancer screening. The procedure is underused, with about 16% of eligible patients receiving the screening. The trial described in the writeup, which was conducted at the University of Utah and NYU Langone Health, showed how digital tools can help close gaps in care.

Lung cancer remains a leading cause of cancer deaths around the world. Screening is recommended for adults aged 50 to 80 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the previous 15 years. Barriers to screening include inaccurate or missing tobacco use history in patient records, missed opportunities to order screening, and lack of patient awareness.

The tool includes a patient education component with both videos and text-based content. Clinicians are alerted when patients engage. The study had 30,000 participants. Patients who received an intervention using a patient-facing tool integrated with the EHR patient portal completed more screening tests.

The authors noted that the end point of having a study ordered was a limiting factor. They encourage more research to look at strategies to ensure that patients complete the recommended CT scan. Props to them for also noting the need to test this approach in other care delivery settings, such as community-based primary care offices, to make sure that the findings are generalizable and to maximize impact.

They also noted the need to adapt the approach to address the needs of underserved patients, especially since patient portal use was required and rates of such use can be variable across demographic groups.

Most of the healthcare leaders who I talk to are trying to trim their budgets due to declining reimbursement and continued cost pressures. Vizient recently released data on healthcare expenditures and I was surprised to see that pharmacy costs are no longer the fastest growing expense category. Facilities and IT lead again, with IT hardware and software at a 5.66% inflation rate. IT services are close behind at 4.5%, with facilities management at 4.13%.

Other interesting tidbits: with the rise in medication use to treat obesity, bariatric surgery volumes are down 20%. The inflation rate for laboratory services is predicted to be less than 2%, which surprised me given the continued evolution of testing platforms and multi-result panels.

I work with a physician who is vocal about the tools we have for patient care. He is outspoken why AI is causing the downfall of civilization. He collects examples where AI tools have been wrong, specifically in situations where patient harm could have resulted.

His message of the week includes an example of uploading an image to identify a mushroom that a hypothetical patient might have eaten. The tool incorrectly identified it as being safe to consume, when in fact it was quite toxic. I’ve never been a mushroom hunter, but I’ve worked at a poison control center, so I hope that mycophiles and foragers are using multiple sources to confirm edibility before they sample their finds.

I appreciate his point of view and the fact that he provides interesting examples that make us think. But we’re not going to put this particular genie back in the bottle anytime soon.

One of my colleagues who is more accepting of AI told me about something called Moltbot, which apparently underwent a renaming in the time it took me to find time to research it. Now called OpenClaw, it’s an AI agent that goes beyond chatting and starts taking action. The solution is seeing rapid adoption given the fact that it’s free and runs locally. The tool can run using either ChatGPT or Claude models and can be assigned a vibe to embody as it goes about its work, which might involve executing commands or making changes to files.

The writeup in Scientific American had me chuckling as it noted that the tool “follows almost any order like a well-paid mercenary.” I’m curious about its potential, but leery of some of the risks as far as privacy and access. If you’ve given it a try, drop us a line.

One of our local care delivery organizations is looking to rebrand. I’m a little surprised because it has had no significant mergers or acquisitions that would indicate a responsible use of funds or a need to avoid confusion. It seems like more of a vanity project since the organizations have already been linked for decades.

They are apparently doing marketing outreach to local physicians, asking their opinions on logo and color combinations to see which have the most impact or best represent the partnership. I’m not sure if they’re also reaching out to patients for their opinions, but I would be curious to see how those might differ from those of the physician community.

Bottom line, however, is that this makes me a little angry. The organization’s cheapskate tactics have negatively impacted patient care in recent years. I wish they would spend the money on issues that directly impact patient care and improve the health of the community versus trying to look better than their competitors.

Has your organization been through a rebranding effort? Did it deliver the outcomes it promised or was it not worth the cost and effort? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 2/2/26

I’ve been doing a bit more clinical work lately because of how the flu season has played out in my community. Rates of Influenza A have been rising over the last several weeks, but we were cautiously optimistic when we started to see a small decline in flu-like symptoms.

However, the flu season decided to deliver a classic one-two punch, because influenza B is now on the rise. Looking at the statistics, this year’s flu season is one of the worst in the last decade as far as hospitalizations for pediatric patients. Our local hospitals are swamped. Hospitals are boarding patients in the emergency department for a prolonged times because they lack staffed beds elsewhere in the hospital. With float pools exhausted, nurses are being reassigned to units that are outside of their core area of expertise.

Hospitals can be full of overly rigid policies and procedures, so I was surprised to learn that one of my colleagues was hired by a local hospital and fast-tracked through their credentialing process in under two weeks. Although it’s great to see that when there’s a will there’s a way, it raises the question of why hospitals can take up to 120 days to credential providers under normal processes.

Putting on my process improvement hat, I wonder whether the process contains steps that are less critical than assumed, and perhaps those steps are skipped during fast-track credentialing. Alternatively, pieces of the process might be able to be expedited at an additional cost that hospitals are not usually willing to pay.

Either way, I was glad to see her get back into the trenches quickly. Having a physician on the sidelines when they are willing and able to work is a loss to community’s patients.

For those of us that work for multiple care delivery organizations or who work infrequently, a fair amount of anxiety can be created when you decide to pick up a shift. When you’re a PRN or as-needed staffer, you are theoretically supposed to keep up with changes to the organization’s policies and procedures. You are also expected to be aware of any changes that have been made within the electronic health record or other tools.

An organization that I work with makes this easier for clinicians. They have a high level of maturity around their EHR governance processes and it’s rare for them to deliver updates more than once a month unless something has gone wrong. Their documentation is great. I typically store all of their update emails in a folder and read through them before I go back on shift so that the changes are fresh in my mind. I arrived at this process after trying a “read as you go” approach that wasn’t as productive.

Another facility where I’ve worked at makes a hash of this with a far less robust process. Instead of sending a single monthly email with release notes that follow a standard format, every builder who is working on a change creates their own messaging without any overarching review. Sometimes the descriptions of changes and fixes are vague, making it challenging to figure out whether they will affect everyone or if they even apply to your department.

For this facility, I still store everything in a folder and refresh my knowledge before reporting. Regardless of how well I try to read and comprehend, the first hour or two of my shift feels like being in a carnival fun house, with all kinds of surprises popping out at you.

One of my favorite organizations to cover is a direct primary care practice. The practice is not a Covered Entity under HIPAA and doesn’t do any third-party billing, their EHR is remarkably simple, and updates to the system are few and far between. The platform they use is remarkably patient-centric. Documentation is a breeze since you’re focused on documenting the clinical encounter rather than meeting billing and documentation guidelines.

The practice has templated the visit notes to have three areas of focus. The “Short Term” section is like a traditional SOAP note and captures issues that are addressed during the encounter. This might occur in person, by phone, or via video visit. A “Patient Progress” section captures the bigger picture of chronic or recurrent conditions.

I like the patient progress nomenclature. It feels more positive than the traditional problem list even though it’s doing the same thing in capturing whether a given issue is improving, worsening, or remaining stable. That section also includes tools to help visualize and close care gaps, monitor preventive services, and track procedures or orders that are due in the next month, quarter, or year.

I can still go to traditional problem list or past medical history or social history sections in the chart. But it’s nice to have things pulled directly into the note where you can see them and understand how they might connect with today’s issues without having to click around.

The last section is simply called “Horizon.” It’s a bit of a catch-all for everything that doesn’t fit into the other two sections, but it includes information that helps the clinician chart a broad course with the patient.

Rather than just having demographic and family history information, it graphically illustrates the patient’s support system. It includes information on their cultural beliefs and practices as well as their general preferences in care. You can go here to figure out whether the patient is motivated to make lifestyle choices or prefers medications to address issues. It’s also where you can see notes on their living will and healthcare directives as well as the nature of any end-of-life care discussions.

Patient portal messages are blissfully absent in this practice. Patients use a secure texting platform to communicate directly with the physician or their coverage. Those interactions are added to the chart at the end of the conversation.

It’s elegant in its simplicity, but it works, primarily because the physician has a smaller patient panel than most insurance-based practices in the area.

I always get whiplash when I go from covering this practice to working in a setting where I’m incentivized to see as many patients as quickly as possible. Still, it reminds me of what it must have been like to be an old-timey physician who really got to know their patients.

For those of you who work with different care delivery organizations, what are some of the most striking differences you see? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 1/29/26

The Journal of the American Medical Association published a research letter this week that looks at how authors are disclosing their use of AI when preparing submissions to professional journals. The JAMA Network has required such disclosures since August 2023. The authors reviewed the data to better understand how AI is being used and disclosed.

Papers in which AI use was declared increased from 1.7% to 6%. Common uses were creating drafts, searching the literature, editing language, developing statistical models, and evaluating data. AI use was more likely in Viewpoints and Letters to the Editor submissions than in Original Investigations.

The paper concludes that without a standard for confirming AI use, it’s difficult to know if authors are underreporting. They add that the results may show a greater need for journals to confirm how authors are using AI and whether it’s appropriate and accurate.

Clinician burnout continues to be a major focus for care delivery and professional organizations. One of the top symptoms that I hear about from colleagues is their inability to disconnect in the digital age. Physicians feel that they need to check their inboxes for patient results and respond to portal messages during off hours to avoid having them piling up.

A new article in the Journal of Medical Systems describes a randomized controlled trial around Reducing Work-Related Screen-Time in Healthcare Workers During Leisure Time (REDUCE SCREEN). Researchers used a straightforward intervention to examine whether a link exists between clinician wellbeing and the use of work-related apps on personal devices. A cohort of 800 physicians, residents, and nurses was divided into a control group and one whose members were instructed to take specific steps to reduce after-hours work, such as using out-of-office notifications and removing work apps from personal devices.

They found that after a scheduled weekend off, those in the intervention group had double the reported reduction in stress compared to those who weren’t instructed to make changes in device use. The intervention group also had an overall reduction in screen time compared to the control group. The study was limited by the fact that one-third of participants failed to complete the post-weekend assessment.

The authors plan additional research to look at interventions that force disengagement from work during non-scheduled hours to see if they are linked not only to less stress, but to improved productivity during working hours.

From Home Care: “Re: AI solutions. My daughter’s college is working on AI solutions that could help individuals with cognitive decline live independently longer. This seems like a much better use of AI than some of the options currently out there.”

The article covers a project that brought computer scientists together with occupational therapists to create an AI assistant to help solve this problem. The team captured videos of patients with and without cognitive decline performing a specific task, then created models to identify cognitive sequencing errors during task completion. The system is cheekily named CHEF (Cognitive Human Error Detection Framework) as it looked at the executive functions needed to prepare oatmeal on a stove.

While a camera captured the subject’s movements, occupational therapy students also provided cues about safety concerns or other errors. The system’s vision-language model integrates videos along with text and images to identify both obvious errors and those that are difficult to detect. The team states, “This is an excellent example of applying the cutting-edge AI to a vital health problem with tremendous public health impact.”

As a family physician who has had many difficult conversations about aging patients who are struggling to remain independent, this is some of the most exciting AI-related work that I’ve seen in recent memory. I hope these types of solutions are a reality by the time I might need them.

HIMSS has announced that the keynote speaker for the upcoming meeting will be actor Jeremy Renner. The announcement promises “a thoughtful look at the intersection of determination, care, and innovation and the impact they can have when people come together in moments that matter most.” Those who register before Friday, January 30 have a chance to win an opportunity to meet him personally.

I did something that I haven’t done in a very long time today. I wrote a paper check to pay for a medical bill. The entire process was frustrating. I received a patient portal message that told me that I had a bill, but I wasn’t able to log in. I thought it was an expired password, but I could access the portal from a different link.

It turns out that the practice operates as two separate entities. They use the same EHR, but each practice has its own patient portal. Going back to the portal that I could access, I saw the billing statement with the header for the other entity.

Clicking the payment link took me to a “page not found” error, so I typed the link manually, with the same outcome. I repeated this process the next day, thinking that maybe it was a site outage, and had the same result. 

I called the number on the bill. They told me that they can’t take payments over the phone, so I was off to find the checkbook. If providers want to be paid in a timely manner, they need to make sure that their systems are working to make it easy for patients to pay.

I received two separate mailings from that practice today. The first was a check, which I assume was mailed by their billing service, that refunded me for an overage for the patient co-insurance portion of a procedure that I had last month. The second was a letter from the practice of the physician who performed the procedure featuring red “Second Notice” stickers to remind me that I was overdue to have the procedure and that they would make no further attempts to schedule it. This right here is US healthcare at its finest.

The American Academy of Pediatrics released its own childhood vaccination schedule this week, breaking with the Centers for Disease Control and Prevention on vaccine guidance. States are also issuing their own guidance or joining coalitions to discuss common recommendations.

The EHR where I practice most often continues to display legacy recommendations, and I haven’t heard of any plans to update them. I’m not sure if that’s because the work to do so wasn’t slotted into the IT build budget or if facility leadership is making a statement. Some days it’s refreshing to be outside the circle of decision- making, after having done it for so long.

How is your organization approaching the task of updating vaccine recommendations in your EHR? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 1/26/26

Significant portions of the US are experiencing arctic temperatures and significant snowfall this weekend. As the storm approached my area, I touched base with nursing staff at several hospitals to see how they were ensuring adequate staffing despite deteriorating road conditions.

They generally offered options for staff to sleep on campus, but approached the situation in drastically different ways. One hospital enticed nurses to sleep on campus to guarantee attendance, paid a retention bonus for the time between shifts, and provided meals Another sent a text message that was less than welcoming, treating those who planned to stay at the hospital as a burden by telling them to bring their own bed linens and towels. I’m betting that employee satisfaction differs between those facilities.

Speaking of things that didn’t resonate well during the storm, the marketing folks at Starbucks should reconsider their tactics during winter storms. While the National Weather Service was issuing advisories and our city and state public safety officials were urging people to stay off the roads, Starbucks was blowing up my phone with discount drink offers.

It seems like it would be easy to suppress those promotions in area codes where people shouldn’t be on the roads, whether they’re customers or employees. People who have storm-belt area codes might live elsewhere in the US, but I would guess that they are in the minority. Better yet, come up with a promo code that people can enable that becomes active in three or four days, when they start to tunnel out and are looking for a treat. My city is still focusing on clearing interstates and critical roads, so I will be staying put for a while.

We became skilled at pivoting to virtual meetings during the COVID pandemic, so I was surprised to see some meetings cancel off of my schedule even though they could have been held as web meetings or even as old-school conference calls. I could understand this for small organizations that might have let their virtual meeting subscriptions lapse, but these cancellations involve larger organizations that routinely have at least one or two people on video due to travel constraints.

Childcare issues could be at play due to school closures, but one of the only bright spots of the pandemic was getting to virtually meet the families and pets of my co-workers.

In last week’s Healthcare AI News, Mr. H mentioned the growing concerns that we are on the cusp of seeing AI-related malpractice lawsuits. Frankly, I’m surprised that we’re not already there, given how I see some of my colleagues using AI tools.

Quite a few knowledgeable clinicians, including clinical informaticists and AI researchers, understand the limits of AI. But large numbers of people are overly trusting of the content they see coming out of LLMs.

I’ve seen people cut and paste content containing obvious errors directly from a non-clinical AI tool into the EHR. I’ve also seen people operate wildly outside their scope of practice based on the ability to quickly access information that may or may not be accurate. Unfortunately, these are the situations where people don’t know what they don’t know, and LLMs can be extremely convincing even when they are wrong.

As an example, I recently saw a patient who was accompanied by a physician family member. The family member had a predetermined outcome that they wanted to achieve during the visit. They apparently thought that paying an $80 co-pay entitled them to see a physician who would suspend their professional knowledge and judgment and do the electronic equivalent of whipping out a prescription pad and ordering what they wanted.

I explained the clinical situation, the evidence-based recommendations, what I saw on the patient’s exam, what I had gathered from their history, and why I believed that the requested medication wasn’t appropriate in that scenario. The family member began arguing with me and was showing me his phone with his previous searches on the topic as a way to prove his point. Especially given that his specialty training wasn’t even close to the body system in question, he wasn’t aware that the articles being cited were only tangentially related to the diagnosis.

Fortunately, I’ve spent the last couple of decades working with patients who bring their internet research to the visit. I’m pretty good at educating while arriving at a plan of care that is mutually acceptable. However, I don’t have a lot of experience arguing with a peer who is putting blind trust in the output of a generative AI tool, so it was new territory.

I used my emergency department-mandated de-escalation training, so we managed to make it through the visit once one of the other family members in the room made the physician family member leave. With situations like this on the daily, it’s no wonder that clinicians have lost the joy in medicine. Having to argue with AI-generated errors when a patient’s health is at stake is something that none of us signed up for.

Mr. H also mentioned ECRI’s annual list of technology hazards, and I was gratified to see one of my soapbox issues in the number two position. “Unpreparedness for a ‘Digital Darkness’ Event” is a fancy way to say that an organization isn’t ready for an unplanned downtime. Maybe making it sound more exciting will convince people that they need to do something to get ready.

We should all know that cyberattacks are a “when” situation rather than an “if” these days, and that network or vendor outages are entirely possible. For clinicians who have always been dependent on the tools and safeguards that are built into the EHR, having to work without those can be frightening. It’s one thing to not have calculators or references at your disposal, but not being able to see the overall picture of what’s going on in the intensive care unit at full capacity is something else entirely.

Those of us who practiced in the olden days remember the large paper ICU progress notes that were the size of a poster board, but could fold up to fit in a standard medical chart. With just a glance, we could quickly figure out what was going on with a patient and formulate the best questions to ask during shift change.

The availability of electronic dashboards and monitoring suites has rewired those parts of my brain, but I bet that mental model is still in there somewhere and I could access it in a pinch. We need to remember that soon there will be more clinicians who have never seen that kind of paper documentation than those who have, and adjust our downtime preparations accordingly.

Are you prepared for a digital darkness event? Have you experienced any outages due to snowmageddon? Is your hospital treating staff who have to stay overnight in the facility like a blessing or a burden? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 1/22/26

The American Board of Preventive Medicine is notifying candidates that they have successfully passed the Clinical Informatics board certification exam. The certifications are retroactive to January 1, 2026. Congratulations to all the new Diplomates, and welcome to yet another continuing certification process that will have you asking yourself why you decided to become double-boarded.

From Straight A Student: “Re: online registration form for a training course that I completed recently. Prompts were in a ‘are there any’ format that asked about mobility restrictions or food allergies. A dropdown choice list appeared to be pre-populated with ‘none.’ My answer was ‘none’ for all of them, so I tried to just submit the form, which popped me back to the top with no feedback. The course vendor responded to my help desk ticket to say that the dropdown requires choosing ‘none’ and people miss that all the time.”

These sorts of Process Improvement 101 issues drive end users batty. The time wasted by users and the help desk adds up.

I wonder if user acceptance testing was done, since it should have been caught. Sometimes teams give the users detailed testing instructions outside of the application, such as “click here, then choose that,” which makes it impossible to determine how they will interact with the workflow. I also wonder if they are analyzing call volume to to identify ongoing issues. Then, has the help desk team reported the issue to development and asked for an update?

It feels like it would be more efficient to change the default to “please select from the list” or “choose a response.” Or, to add a page instruction telling users what to do.

I have been in countless conversations about the safety of healthcare AI solutions. I’m always interested in how the risks and benefits are portrayed to patients and other non-clinical, non-tech individuals. Mr. H mentioned a preliminary report by the VA Office of Inspector General that found that the Veterans Health Administration had some gaps in AI chatbot oversight. The story was also picked up by military-focused Task & Purpose, which ran its own version. 

Risks that were highlighted for the general audience included “producing misinformation, privacy violations, and bias, and that the systems had been put in place without review by the VA’s own patient safety experts.” I didn’t see mention of concerns that were noted by other publications, such as whether lags exist in providing current information for the LLMs to use.

An article commenter shared their physician assistant’s thoughts that “the AI is egregiously wrong 90% of the time, so he doesn’t bother with it.” Based on my own experiences with clinical-focused and consumer-focused AI solutions, that’s probably a significant exaggeration. I wonder if the user would benefit from additional education on prompt construction or effective use of AI tools.

The VA providers who I’ve talked to locally are happy with the AI solutions that are available to them. They are looking forward to continued expansion of their capabilities, such as helping craft more readable medical information for patients. If you’re a VA user, feel free to chime in. We can keep your comments anonymous.

I’m still in my New Year’s inbox cleanup extravaganza, and found an article about Hackensack Meridian Health’s canine-powered cancer detection program. The health system partnered with startup SpotitEarly for a clinical trial that examines the ability of trained dogs to detect cancer via patients’ breath samples. The goal is to validate the technique as a noninvasive cancer detection approach that might be more attractive to patients who are unwilling or unable to complete traditional screening recommendations.

The test is conducted by having patients breathe into a mask-like device for several minutes, followed by the dogs sniffing the devices. The dogs are trained to recognize odor signatures in the exhaled volatile organic compounds that can be associated with cancer. The dogs indicate detection by sitting next to a sample.

We know AI has to be involved somehow, and indeed it is. The company is using AI tools to document and analyze the behaviors of the dogs based on behavioral and physiological data.

SpotitEarly has been in the US market since May 2025, although it was founded in 2020. Previous studies of the technique found that the test was 94% accurate for detecting lung, colorectal, breast, and prostate cancers. If any readers are involved in the study, I’d love to hear about the “best boys” and “good girls” that are doing the sniffing and whether they prefer belly scratches or having their ears rubbed. My medical school had some public-facing research animals and they were the most amazing companions when they retired, resulting in a years-long waitlist for adoption opportunities.

Based on some of the other email traffic in my inbox, quite a few physicians made a New Year’s resolution to look for different employment. Several of them seem to think that informatics is something that you can just jump into because you are “techy” without any formal training or experience.

Some startups will hire clinicians in this situation, but I always encourage people to consider formal coursework to better understand the informatics landscape. I’m a big fan of the courses offered by the American Medical Informatics Association. The virtual courses are convenient, and the in-person ones are great for networking with colleagues working in the field.

A number of highly qualified clinical informatics physicians have recently been displaced from EHR vendors and health systems, so it seems that as long as mergers continue, the job market will remain challenging.

Are you looking to make a career change in 2026, and if so, how are you approaching it? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 1/19/26

Based on the contents of my inbox, it feels like everyone is talking about recent research from Michigan Medicine on emoji use in the electronic health record. The research letter was published in JAMA Network Open last week. It examined 218 million notes belonging to 1.6 million patients. Researchers found that emoji use was higher than previous studies that looked at clinical texting tools. 

The authors identified 372 emojis within 4,162 notes that were created during the last five years. Of those, 35% were patient portal messages to patients, followed by telephone messages at 28%, encounter summaries at 15%, progress notes at 14%, and patient instructions at 6%. The University of Michigan patient portal doesn’t support patients adding emojis to communications.

The smiling face with smiling eyes was used 1,772 times, with communications emojis such as the telephone receiver and calendar appearing 544 and 429 times, respectively.

The article contains an illustration of the 50 most commonly used emojis along with their official names. Just skimming through them, I’m not sure that I would come up with names or descriptions that matched their official titles.

Take the “briefcase,” for example. Could people be using it because it looks like an old-timey doctor’s bag? I can’t remember the last time I saw someone carrying a briefcase that looked like the emoji. Even looking at the most used one, the smiling face with smiling eyes, I would describe that one more as blushing than having smiling eyes. I also would not have correctly described “beaming face with smiling eyes.”

Some of them were new to me, including “busts in silhouette” and “bar of soap.” The latter got me thinking about how many people actually see or use bar soap these days, given the popularity of liquid soap and body wash products. Similarly, how long will it be before people no longer identify a “telephone receiver” as such?

I wondered about the context for some of the emojis that were used, such as the “P button,” the “small blue diamond,” and the “round pushpin,” and how they might be used in medical communications. The most concerning to me was actually the least used, the “police car light.”

Researchers note the risk of confusion in using emoji to communicate, especially in older patients. While most emoji use occurred among tweens and teens, patients in their 70s had the second highest usage. The authors call for organizations to develop guidelines to promote clear communication and professionalism in clinical communications. I once encountered someone who used a particular emoji extensively before discovering that it wasn’t a Hershey’s Kiss, so I agree with the concern.

The authors go on to note that measuring emoji use is just the beginning, and that future investigation should look at how emoji “might affect patient understanding, trust, and outcomes – and explore whether these playful digital symbols offer new opportunities or pose unintended challenges in electronic health record communication.”

One of my close physician friends sent me a link to a Facebook post about the article. It had some pretty funny comments about which commonly used emojis were missing from the study, along with those questioning whether the AI tools clinicians are using to write messages were responsible for the addition of emojis. A couple of commenters thought the research was frivolous, but those sentiments were countered by others who were clearly concerned with the potential impact on patients.

Another colleague with ties to Michigan Medicine said that emoji use in the medical record was prohibited, although he wasn’t able to find the specific policy. He said that he remembered a conversation with risk management where it was discussed, however, and that there were significant concerns about the meaning of symbols within the context of the legal medical record. Although the policy could have been changed, I’m wondering whether some clinicians still haven’t fully internalized that the patient portal is part of the legal medical record.

He said he’s not opposed to their use, especially with pediatric or teen patients with whom clinicians are trying to build rapport. Still, he advises residents that if deleting the emoji changes the meaning of the message, either the emoji shouldn’t be used, or it should be supplemented by actual words.

I was curious about the previous research that looked at clinical text messages. In 2023, clinicians from Indiana University School of Medicine looked at the content of messages that were sent by hospitalists who used a secure messaging platform during 2020 and 2021. Messages with emojis were identified, as well as those with more old-school emoticons.

The authors found that the majority of the emojis and emoticons “functioned emotively, that is, conveyed the internal state of the sender” where others “served to open, maintain, or close communication.” The authors also noted that “no evidence was identified that they caused confusion or were seen as inappropriate.” They concluded that “these results suggest that concerns about the professionalism of emoji and emoticon use may be unwarranted.”

I believe that differences exist in how clinicians communicate with each other compared to how we communicate with patients. In the former, we are more likely to use medical abbreviations or jargon. With the latter, we should be using terms that are more clearly understood by patients. In my experience with peer review, communications with patients are typically held to a higher standard.

It will be interesting to see what kinds of guidelines or policies organizations come up with as far as regulating the use of emojis in patient communications and charting. I reached out to medical staff leadership at the facilities where I’m affiliated, and none of them recalled this topic coming previously.

I found citations for a half dozen other articles that looked at the content of clinical text messages among hospitalists and other members of the clinical team, as well as norms for emoji use. I didn’t have time to go down that particular rabbit hole this weekend, but I would be interested to hear from readers that have strong opinions on emoji use or those who have been involved in this type of research.

Do you use emojis in patient-facing communications? If so, how do you use them? If not, what do you think about the practice? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 1/15/26

Plenty of people have been asking me for my thoughts about last week’s announcement of OpenAI for Healthcare.

Models that are tuned to physician needs and that have been through robust clinical testing certainly offer advantages. The incorporation of the organization’s internal documents via SharePoint and other platforms is also attractive.

I recently chatted with a friend who is both a physician and an attorney about the impacts of such integrated solutions on the medicolegal landscape.

In the current state, with many physicians playing the “bring your own AI” game and using various solutions on their phones, no connection exists between those queries and the legal medical record. However, an enterprise platform that ties it all together and specifically encourages the use of patient data and PHI adds an additional layer of complexity to medicolegal investigations.

It won’t just be about the EHR and its audit log. It will involve all the potentially related queries that may have been entered and acted upon by the care team. We’re starting to see some legal activity around physicians who based their decisions on inappropriate AI-generated information. This is an area to watch.

I also wonder about the ability for hospital policies to negatively influence access to information by clinicians. For example, if you work in a hospital that restricts certain procedures or medications for religious reasons, how will those limitations shape the responses when those prohibited treatments might be the right answer for a patient?

This could evolve to include a bedside component for patients. They could ask questions about their care plan while hospitalized. However, they might learn that their care is limited by their choice of facility.

My conference BFF Craig Joseph, MD recently wrote that healthcare is betting on the wrong AI instead of looking at solutions that actually improve clinical outcomes. He cites a study from the University of Southern California that found that physical robots outperformed chatbots in reducing psychiatric distress. He goes on to talk about how the brain perceives interactions when there is a physical presence compared to a virtual one and about the benefits of emotional experience in delivering care.

It made me think of my own experiences with physical therapy. It’s an advantage having your friendly (or not so friendly) physical therapist right there urging you to push yourself compared to a therapy bot at home that is less perceptive when you’re slacking off.

The robots used in the study looked fairly low-tech and had crochet covers, reminding me a bit of the cats in Disney’s “Lady and the Tramp.” For a tech industry that focuses on flashy products, these wouldn’t even be on the radar. I agree with Dr. Joseph that sometimes low tech is best. Maybe we’ll have to make that the focus of our next conference booth crawl.

Speaking of low tech, I was talking with a couple of physician friends recently about the Oura ring as a potential adjunct to addressing sleep issues. One colleague swears by his, although the actions that he has taken based on the ring’s sleep data are the things that every family physician recommends for sleep issues: consistent routine around and time for sleep, adjusting environmental conditions, appropriate timing of meals, and keeping a basic sleep diary to identify triggers.

My other colleague proposed a decidedly low-tech approach: sleeping with a stuffed animal. He pulled out his phone to share a Wirecutter blog from last year that addressed the tactic. It cites several scholars and their comments on the practice, including notes on how it might help adults shift from a state of cognitive arousal to the more relaxed mindset required for sleep.

The blog notes the lack of literature on adults sleeping with stuffed animals, but I bet if we threw some AI into the mix, people would be eager to study it. Maybe those crochet cats can work the night shift as well as having a day job.

From Night Nurse: “Re: my annual refresher training. Passing pre-tests exempted us from that section. This was one of the questions. What kind of world are we in where this is considered an appropriate question?”

I have unfortunately seen some bad behavior from healthcare providers during my career, so I agree that we should be screening for people who have thoughts like this. I don’t think a bold annual training question is the way to pick them up. Even in a written survey, I would probably recommend a more subtle approach to identify those who have such sentiments. I’ve done a fair amount of work writing test questions and I wonder what the hospital’s item writers were thinking with this one.

From Tech Traveler: “Re: swearing. I’m a medical device representative and read your blog to keep up with healthcare tech topics so I can commiserate with the physicians I call on. I’m in and out of operating rooms and physician lounges all day and notice that there’s a certain amount of swearing that goes on among physicians, but it seems to vary by specialty and age as well as by topic. I’ve joked about doing a research project to explain the phenomenon, but it looks like researchers beat me to the punch.”

The article notes that although swearing is “often dismissed as socially inappropriate,” it has been linked to increased physical performance through state disinhibition. That is a psychological state in which individuals are less likely to restrain their behavior. The authors propose that this leads to flow, confidence, and focus, with those who swear being able to perform better on strength and endurance tasks than those who used neutral words.

They note that “these effects have potential implications for athletic performance, rehabilitation, and contexts requiring courage or assertiveness. As such, swearing may represent a low-cost, widely accessible psychological intervention to help individuals “not hold back” when peak performance is needed.”

Another one of the practices where I receive care has finally given in to the private equity company that has been pursuing it for the past couple of years. The physician mentioned this at a recent visit and shared the behind-the-scenes story. She has been struggling since she opened a second location, but has been keeping her head above water through the availability of same-day dermatology appointments, which turned local primary care doctors into a loyal referral base.

We’ve all been impressed by her ability to fit people in. Who doesn’t love being able to have a patient’s suspicious lesion removed in a timely fashion? Before she opened, patients often waited months for appointments.

Although she offers some cosmetic dermatology services, the practice is heavily skewed towards medical dermatology. She shared that automatic payer downcoding has been financially devastating. Her attempts to promote the more lucrative cosmetic treatments, which are typically cash pay, couldn’t compete with local med spas that run coupon specials. She decided to give in with five years to retirement. We’ll see how well that same-day availability holds up with private equity operations leaders at the helm.

If your care providers have been acquired by private equity, what changes have you noticed? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 1/12/26

The New York Times ran a piece this week about “The Tech That Will Invade Our Lives in 2026.” The author aims to sort out which innovations will be impactful and which are fads that can be ignored.

Item number one on the list is, “We’ll finally be talking to our computers.” It’s more focused on having AI chatbots represent themselves with humanlike voices than on having them be able to better interpret conversational prompts, unfortunately. If we can get to the place where AI assistants act more like the computer in “Star Trek” and less like a recalcitrant middle schooler, I’ll be pleased.

Another item on the list refers to the search for “a successor to the smartphone” and offers smart glasses as an option. I don’t necessarily need a successor to the smartphone, but what I’d like to see is the ability to broadly operate smartphone apps on my laptop.

As an example, many of the hotels I frequent have begun providing menus of services via a QR code in the room. That’s great, but I would rather not read those documents on my phone when I have a perfectly good laptop right there on the desk. My workaround is to scan the code and send the link to myself so I can open it on the laptop, but that’s a nuisance.

I don’t know why the hotel can’t display that information from a link on its website. That would be ideal not only to enable guests to use their devices of choice, but also to allow travelers to get the information they need before they reach the hotel room.

I have my own personal list of tech I wish would invade the workplace.

• Let’s start with the ability to ask Microsoft Windows to find a setting for you that used to be easy to find prior to Windows 11 and now is in some obscure place with an obscure name.
• I would also like to be able to ask an AI assistant to do things like, “Find me that email that was sent by a member of the training team within the last three weeks that was talking about some weirdness with one of the clinical alert popups” when I accidentally file something in the wrong folder and can’t remember who sent it.
• Maybe we can get the ability to set up an automatic reply to emails where people ask you about meeting at a specific time and neglect to mention which time zone is in play.
• Just as a nice-to-have, I’d like a rule to highlight meetings in a particular color based on whether there are external attendees on the invite list rather than having to do it manually as meetings come in or as a retrospective exercise.
• Last but not least, at the top of my wish list are upgrades that don’t break user workflows. I know that’s a lot to ask for, but a girl can dream.

What are others looking for in an AI tool? I did some casual investigation and found strong sentiment for pushing AI to handle mundane or data-heavy tasks rather than creative pursuits. “I want AI to balance my checkbook and categorize all my expenses, finding the problem when things don’t match up. That will give me more time for my hobby of photography. I don’t want AI making pictures for me.”

One person I spoke with wanted to be able to adjust the AI behind social media algorithms. She wants to stop seeing things that she doesn’t want to see and see more of those she is missing. That led to a conversation about why algorithms work the way they do.

I was surprised by this person’s lack of understanding of how social media platforms make money. It made me wonder how many other people out there have the same knowledge gaps. 

One person I spoke to was excited about self-driving cars, especially for individuals as compared to the taxi-style use case. “I was in Europe earlier this year and made good use of their robust rail infrastructure. Now that I’m back in the US, I realize how pathetic the long-distance options are if you’re not on the east coast. We have several major cities in my state that are all about 90 miles apart, but there is no easy way to get to them other than driving your own car.”

One of my snarkier colleagues commented, “If it’s so easy to use AI to write code, why can’t Microsoft figure out how to get feature parity between new and classic Outlook, or between either of the desktop versions and the web version?”

Another noted that he wasn’t against AI innovation, but felt that advancements were coming so quickly that there wasn’t enough time to process how they might be useful in the workplace or at home. He said he was reluctant to get excited about anything because once you do, it’s already been surpassed and you have to adjust to something new. That’s a valid point.

I was surprised at the response from one of my junior colleagues who said he felt that he was late to the game for actually caring about or using AI, and that, “It’s getting added into everything but not necessarily for good reason.” He uses it to help summarize documents, write letters of recommendation, and build patient education content for his niche specialty. He hasn’t found many other good uses for it.

One of my IT colleagues said that he wishes it was better at manipulating data, along the lines of “Find the data in spreadsheet A that corresponds to spreadsheet B, and append spreadsheet A with the values for X, Y, and Z.” He also had me chuckling with his request for calendar management tools that will automatically reject meetings that are sent without agendas.

One of my foodie friends had an item on her wish list. “I’d like AI to keep track of everything that’s in my pantry, refrigerator, and freezer and cross index it with my recipe files and a list of what I’ve cooked recently so I can ask questions like ‘I’m in the mood for pasta, what can I make with ingredients that are on hand that isn’t similar to anything I’ve made in the last 30 days?’” In addition to helping people reduce waste with outdated ingredients, it might contribute to the household harmony where staring at each other and asking what to have for dinner is the norm.

I’m sure we have all heard that adage that today’s AI is the worst it’s ever going to be. Although blips exist, it will continue to evolve.

What do you wish AI would do for your workplace or in your personal life? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 1/8/26

Mr. H’s mention of a recent article caught my attention. It says that 40 million people are using ChatGPT for health-related questions every day.

I agree with the article’s statement that people are “turning to AI tools to navigate the notoriously complex and opaque US healthcare system.” They mention patients using it to decipher billing statements, appeal insurance denials, and answer clinical questions “when access to doctors is limited.”

Another statistic that caught my attention: more than 5% of ChatGPT questions are about healthcare, and 1.6 million questions per week are asked about health insurance.

Clinicians certainly can’t fault patients for using AI tools when they are doing the same. I see physicians every day using AI to write insurance appeals and create patient-facing communications, not to mention all the AI-powered documentation. The risk of hallucinations remains a major concern. Some care delivery organizations have applied their “we can’t control it so we’ll just ignore it” philosophy. 

I would instead encourage organizations to make better use of their existing tools in providing accurate and vetted information to patients. Those institutions that offer robust patient education and engagement solutions should feature that information prominently on their websites and within their patient portals. Patients would be able to self-serve with reputable information.

Clinicians need to look at patient education less as a check-the-box exercise and more as a key part of patient care. In my experience, educated patients who have access to resources that they can consult down the road are less likely to send patient portal messages or call the office with basic questions. They feel more confident about their care and their ability to manage at home.

Another juicy tidbit from the report: 70% of health-related ChatGPT queries occur outside of normal medical office hours. Most medical offices are open for about eight hours per day, usually overlapping the same work hours as people who also work traditional schedules. It’s difficult for many patients and caregivers to get the information they need during the hours that they are available. Patient portals and secure messaging have helped this issue somewhat, but gaps still exist.

In addition to making sure that patients know how to access trustworthy patient education materials, care delivery organizations should do a better job promoting other patient-facing resources, such as after-hours nurse triage lines or on-call services. Organizations that are actively managing risk do a better job with this, because they are incentivized to keep patients from going to the emergency department.

It would be interesting to compare after-hours use of generative AI solutions by patients who have access to after-hours services and those who don’t. Anyone up for some research?

From Midwest Gal: “Re: portal messages. You mentioned waiting for test results, received a patient portal notification that you had a message from the physician, and it turned out it was a general message about holiday hours. The same thing happened to me right before the Christmas holiday. Instead of getting my mammogram results, it was a reminder that the office would be closed.” I reached out to some folks who are experts in the EHR that the reader’s site uses. They said that using the patient portal in this manner is not a best practice. For the love of all things, if you’re on a patient portal team, please work with the operations teams that are sending these messages to help them understand the anxiety that they are causing.

Speaking of anxiety, the clinical trial in which I am a participant published some of its results recently. However, it didn’t bother to notify patients that this would be happening. Those of us that are clinicians saw it in the journals first, which was bad enough. To make things worse, the research team released new recommendations to patients several days later, some of which provided guidance that is counter to the standard of care. That was accompanied by no explanation.

This occurred the week of December 18, when many people are frazzled by year-end work responsibilities or holiday preparations. I can’t imagine a worse time to release that kind of information.

I reached out to the study coordinator with my questions. I didn’t receive a reply within the published service level, so I reached out again via a different method. Guess what? They were experiencing a high volume of calls and were short staffed due to the holidays. The local physician who had referred me to the study wasn’t aware of either the published article or the communication to patients. You really cannot make this stuff up.

From Burned Out CMIO: “Re: help desk. My large health system outsourced its help desk functions at the beginning of December with the assurance that we would see no degradation in service levels. I had complaints from my ED physicians, who said that their tickets had been closed due to lack of customer response. Help desk staff were emailing the physicians about their tickets, then closing them as unresponsive if they didn’t hear back within a few hours. We’ve been having some serious conversations with the vendor about how that’s not how it’s supposed to work, especially for shift-based physicians who might not be able to respond quickly and then might not be working the next day. Ambulatory physicians ran into issues during Christmas week when offices were closed some days, then came back on Monday to find their tickets closed due to ‘no response from customer.’ Everything blew up over the New Year’s holiday, when tickets were closed in bulk on the 31st to meet meet end-of-year service level metrics. I feel awful because people who I had worked with for years were laid off in favor of the allegedly cheaper outsource firm.”

In situations like this, you can’t put a price on the knowledge of former help desk staffers who understood user and office work schedules around the holidays. I wonder if this outsource firm has any healthcare experience. This falls into the category of “you get what you paid for.”

I hope that a robust review of service level expectations happens again and that ticket closure goals are moved out a bit to accommodate the behaviors of real users in the healthcare setting. I can just imagine people trying to slam tickets shut to meet the metrics, not realizing that users have valid reasons for not responding quickly.

What’s the most foolish outsource maneuver your organization has made? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 1/5/26

People embrace many traditions to ring in the New Year. My extended family enjoys Hoppin’ John, but my personal ritual is to skip straight to dessert.

I started at midnight by toasting 2026 with an assortment of delightful tarts. I then kept my energy up on New Year’s Day with Fluffy Frosted Orange Rolls, a delightful alternative to cinnamon rolls. Fortunately, the sugar boost helped because I was working clinically later that day.

Nearly every patient I treated had influenza. If the “flu-pocalypse” has not made it to your area yet, chances are it is on the way. If you are at high risk for influenza complications or simply want to avoid forced downtime, I recommend masking up in crowded places.

I had the opportunity over the weekend to chat with several physician executive colleagues. Each shared ideas about what to expect in the coming year.

• Hospitals will focus on cost control, especially those that have high numbers of Medicaid and uninsured patients. For organizations that have not outsourced functions such as food service or human resources, doing so may look more attractive. One local hospital has dramatically cut non-patient food service, making it difficult for night-shift workers to get a hot meal. Overnight options are limited to self-service, with only a couple of microwaves available in the cafeteria. Since the hospital is already outsourcing, may I suggest a third-party food truck? Staff would love it, although the food service vendor might not.
• Hospitals will continue to scrutinize pricing for everything from software to patient care supplies to landscape maintenance. Organizations that are not already doing this need to start. One health system is trying to trim several million dollars from its technology budget and is taking steps it would normally avoid, such as asking vendors for discounts mid-contract. Its EHR teams have not attended conferences or user group meetings for the past three years due to budget constraints, and they do not expect that to change. As an interesting side note, leadership teams are also skipping these events, so at least they are showing solidarity.
• Primary care physicians are extremely worried about patients who have let their insurance coverage lapse due to rising costs. A major concern is that those patients, along with those who still have insurance but now face high deductibles, will avoid seeking care. That avoidance could lead to poorer outcomes and higher costs overall. The old adage about an ounce of prevention being worth a pound of cure does not resonate with people who cannot afford preventive services. A gastroenterologist in the group noted that a cash-pay colonoscopy costs $2,200 at her surgery center, which limits demand. Some patients instead choose cheaper screening tests that may not be appropriate for their individual risk profiles.
• Many suspect that mergers and acquisitions will increase as organizations try to scale for contracting leverage with vendors and payers. Smaller community hospitals will face greater challenges, particularly if they lack natural partners. The group universally agreed that more practices will sell to private equity firms.
• Medicare Advantage plans will continue their efforts to grow market share. One group I know is expanding into new markets that are not traditional retiree destinations, such as Wisconsin and Missouri. Physicians are intrigued by promises of employment and robust care team models, but they should perform due diligence. Speaking with former colleagues who had poor experiences could be particularly informative.
• Organizations will keep adopting AI solutions, especially for ambient documentation and revenue cycle management. Leaders still express concern about AI use in research and treatment planning, which is driving tougher questions about hallucination risk and patient safety. One leader whose organization has gone all-in on AI-based revenue cycle tools said the results are no better than human performance, but the tools are far cheaper than even offshore labor.
• Regarding the EHR market, the group agreed that Oracle Health / Cerner will continue to struggle and will lose customers to Epic. Sentiment was cautiously optimistic that smaller platforms, such as Meditech and Altera, will hold their ground. Informatics leaders wonder when consolidation will begin in the ambient documentation space, given that a few clear leaders have emerged.
• One leader is especially excited about 2026. He oversees a relatively new primary care residency program that has been approved to expand its class size in the next match cycle. The program is based at a community hospital rather than a major academic center, and competition for the July start slots was intense. He expects applications to rise further as the program builds a reputation for training strong community-based generalists rather than subspecialists. Kudos to him and his team. I look forward to seeing how the next year unfolds.

During the discussion, I learned a new term: job hugging. It describes people who dislike their current roles but stay put because they fear that moving elsewhere could be worse. At least two participants admitted to this mindset. They worry that other environments may be just as toxic, if not more so, and that mid-career physician leadership roles are increasingly vulnerable to downsizing.

One person noted, “If I’m at risk for a layoff, I would rather stay where I have been for 15 years so I might receive a severance. If I start somewhere new and similar cuts occur, recent hires will not get anything.” Another said he would consider consulting but is too concerned about the cost of health insurance to make the leap.

How did you ring in the New Year, and what are your predictions for 2026? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 12/29/25

As we approach the end of the year, many of us are reflecting on our accomplishments for the year. Maybe we’re proud of the work that we’ve done, or perhaps we are forced to reflect because of end-of-year performance reviews. I enjoy thinking through how I spent my time and how it might have impacted patients.

I asked some of my CMIO colleagues what they are most proud of this year. Many of the projects were predictable, but at least one was surprising.

The first CMIO who weighed in was a little embarrassed about his accomplishment. Apparently his organization never got the memo about the benefits of having proximity cards or other non-password technology to help reduce the burden of multiple logins for its clinicians. Mandatory EHR upgrades or replacing a solution that was about to be sunset always took precedence. A couple of recent cybersecurity events had also consumed a good chunk of the budget and pushed other needs and wants aside. I certainly understand having to spend money on that.

Regardless, the clinicians are happier not having log in while going back and forth to the workstations in patient rooms, so that’s a win for the year.

The next physician leader was passionate about expanding virtual physician services in the emergency department. His organization’s busiest hospitals put a physician assistant in the triage bay. They worked closely with nursing staff to perform workups on patients who were still in the waiting room. The PA examined the patient and entered orders. 

When wait times were at their worst due to bed shortages elsewhere in the hospital, some patients were actually discharged from the waiting room without ever making it to a regular emergency department bed.

The twist this year was using virtual technology to expand that to hospitals that didn’t have the volumes to support the provider-in-triage concept. He felt that it was a win all around. Patients were happier to get their care started more quickly, emergency department staff members were happier because they had fewer patient complaints, and emergency providers were happier because they could opt in to the remote shifts for a break from the ED’s physical grind.

This is a great strategy. I am surprised to see so few facilities creating programs like this. It improves key metrics like the door-to-doctor time, addresses bed turnover issues, improves satisfaction, and provides options to keep physicians in the game when they might be ready to retire. The physician workforce crisis isn’t going away anytime soon, and anything that we can do to maintain those folks and their expertise is good.

I know of another system that has implemented this paradigm. Remote shifts are staffed by people who might otherwise be on medical leave due to orthopedic issues or pregnancy complications, or who need to travel to another part of the country to support family members.

It’s inexpensive since the major investment is a workstation and cameras. Even if you have to do a little rearranging to accommodate a gurney in the triage area, it’s cheaper than building more emergency beds. Another significant factor is probably that hospitals can make a lot of money billing the provider portion of the visit rather than having patients leave without being seen.

Multiple CMIOs said that ambient documentation was the best solution that they implemented all year. Most of them had pilot cohorts that tested the technology first, and at least a couple of them went through a bake-off process where they trialed solutions from different vendors before making their final selection.

One CMIO said, “This is one of two things that I’ve ever implemented that my physicians thanked me for.” Most of them are implementing the technology in ambulatory environments. Only one who I spoke with had a significant project for inpatient wards, and that is in a facility that has 100% private rooms for its patients.

I loved the idea that one correspondent shared about how her facility trained the ambient documentation tools. They created a curriculum called “Caring Out Loud” that addressed how physicians needed to change their history-taking and examination skills for the best outcomes with the technology. Some physicians felt like “talking to themselves” made them seem less professional, but only two of them chose to go back to traditional documentation.

Virtual nursing was also a big win for one CMIO who responded. In a plot twist, this CMIO is a nurse practitioner. Although I’ve seen people in similar roles elsewhere in the industry, she’s the first non-physician CMIO who I’ve gotten to know personally.

Her facility has been able to move approximately half of the steps involved in the nursing admissions process into a virtual workflow, which has been helpful as they continue to have staffing challenges. At their facility, all nurses work at least one virtual shift per month so that everyone is cross-trained. All of the virtual nursing work happens on site, which is different than other models where virtual nursing is used to retain staff that otherwise might be ready to leave bedside nursing.

One respondent’s biggest project was a deterioration prevention system that identifies patients who might be heading towards a crisis. I was surprised to learn that one of the major challenges in that effort was the change management piece. It was not designed to bypass human intervention, but people felt that its use might discourage them from raising an alarm if they suspected that patients were having issues.

The hospital held listening sessions so that staff understood what the system was designed to do, and what it was not. They were made aware that they needed to still rely on their internal “Spidey sense” if they felt that a patient was at risk.

I was surprised that AI projects, other than ambient documentation, were far down the list for many of the people I spoke with. That could be an artifact of budgeting processes, where priorities for 2025 may have been set in the summer of 2024. Or, perhaps skepticism remains around AI and how it should fit into the bigger picture of patient care.

I also think that many facilities are playing catch-up around operational and quality debt and therefore have less time to spend on shiny new things. I’m glad to see those institutions focusing on the basics, because if you don’t have a good foundation, everything else is just window dressing.

What are you most proud about in your work during 2025? Do you have a focus you’re excited about for 2026? Leave a comment or email me.

Email Dr. Jayne.

Curbside Consult with Dr. Jayne 12/22/25

I’ve been on LinkedIn almost since its creation. When I joined, it seemed like a great way to keep track of people I met in the course of my work.

Over the past couple of years, I feel like it has lost its usefulness. My main feed seems to be full of vendor ads, punctuated by individual posts that are annoyingly self-promoting and contain way too many emoji. I feel like I have to weed through all of that to find things that are genuine or feel like something more than just an attention grab. When I look at the messages features, it seems that most of the people reaching out are trying to sell me something.

Looking through the last couple of months of messages (which I rarely check, ignoring the notifications that come into my inbox as well) I saw a half dozen solicitations from financial advisors. Based on the content of those messages, they are clearly targeting physicians. In particular, those who are on the downhill slope towards retirement.

A couple were looking for people to invest in various new ventures. At least for me, if you have something like “turning income into legacy” as your headline, your message is guaranteed to go straight to the trash. You’re also going to be ignored if your outreach looks like multilevel marketing.

I also tend to get quite a few messages from people trying to sell services to physician offices. Things like revenue cycle management, bad debt management, collections, phone services, call centers, and the like. If they read my profile for more than two seconds, they would see that I haven’t been in traditional practice in a long time and don’t need any of their services. Their messages are also routed to the discard zone. 

You’re also likely to wind up in that place if you include a personalized message that’s addressed to someone other than me, as the person did this week who started his message with “Dear Correen, It was great to meet you last week.”

Then there are the entrepreneurs who are trying to connect with “like-minded individuals” and who are “interested to hear your opinions” or something similar. One said he was “having conversations with several of my colleagues and would love to hear how you’re navigating the current landscape.”

Based on reading this person’s profile, I can’t even begin to figure out what specific landscape he might be thinking about, let alone how I might contribute. In the past, when I’ve seen messages like this, they have felt like someone who is just trying to get some free consulting.

I got an entertaining spam message this week for a free brow waxing session at a business that plans to open in 2026. It is trying to generate Instagram likes by contacting random people on LinkedIn and requesting that they follow him and/or his business on that platform. The message was from someone listed as a “verified recruiter” with a corporate license. For entertainment, I clicked on his profile, and found that in addition to owning the waxing business, he also owns a burrito restaurant, a carpet cleaning company, and a hair salon. Needless to say, that was a quick delete as well. 

I also get a kick out of seeing the reports of how many people viewed my profile. Quite a few recruiters made the list. Normally if a recruiter reaches out and asks to connect, I will accept the request just to see if they have interesting roles available. Not that I’m looking, but I have plenty of friends and colleagues who are, and I’m happy to help them out if I see something that’s a good fit.

Most of the time, there is some brief back and forth. I let them know that I’ll be sharing their opportunities with others, and then that’s the end of it. This week, however, I had a plot twist with a recruiter that I hadn’t seen before.

I accepted the recruiter’s connection request, so they could see my email information. They apparently used that, as well as the information in my profile, to enter me into their organization’s “Talent Community” as if I were job hunting. They also created referral links for several specific jobs and invited me to apply, as if we had discussed those jobs and I had voiced interest.

I know from my own experiences in large organizations that usually if you’re trying to score a bonus by referring someone, you have to at least attest to the fact that they were aware you’re referring them and agreed to it, so it felt a little odd. Maybe this particular organization plays fast and loose with their referral process.

The roles for which they created referral links were highly specific. It was clear that they had read my profile in detail and were targeting particular skills and certifications that I list.

I know that this particular organization is going through an EHR change. Several of the roles were related to that project, although one role was for a position with a title that was identical to my current role.

This is certainly the first time I’ve experienced this kind of recruiting flow. I’m wondering if it is unusual, or if this is a new way that organizations are trying to source people. Since it’s the end of the year, maybe it’s just someone trying to hit a quota, but who knows. If you’re in the human resources or recruiting realms, I’d be interested to hear what you think of this approach and if it’s common or more of an outlier.

I’m glad Mr. H mentioned celebrating Yalda, which marks the passing of the longest night of the year and the return of light as days gradually grow longer. For the last couple of years, I’ve noticed that the shortening days have played havoc on my sleep schedule, to the point where I’ve tried to spend as much time in more southern latitudes as my work allows, and it’s been helpful.

This year, I was invited to a celebration. Although I wasn’t able to stay until dawn, I really enjoyed the opportunity. Although I do like a good New Year’s Eve party, Yalda Night was more cozy than blingy and felt like a better way to reset in preparation for the new year.

This year has been a tough one for me personally so I’m all about celebrating hope and renewal as we head towards 2026. Given the way the US health system works, however, I’m not looking forward to the resetting of my health insurance deductible, but there’s not much I can do about that.

What is your favorite way to mark the passing of the years? Leave a comment or email me.

Email Dr. Jayne.

EPtalk by Dr. Jayne 12/18/25

I interact with medical students and residents from different institutions. I have learned that the education that they receive about AI and its role in healthcare is highly variable.

The American Medical Association is taking a run at addressing this problem. I’m glad to see someone calling it out, but unfortunately, AI tools are already deeply ingrained in user workflows. Like anything in life, it’s difficult to undo bad habits, especially when they are perceived as creating value. 

A resolution was introduced at the AMA Interim Meeting to create a policy that supports the development of “model AI learning objectives and curricular toolkits.” These would be aligned not only with AMA policies, but also the principles of the Association of American Medical Colleges. The AMA also plans to work with medical organizations to identify AI literacy elements, support CME offerings on the topic, and advocate for funding and resources to promote AI training initiatives.

From Jimmy the Greek: “Re: the holiday gift that keeps on giving. My employer just dropped its new in-office requirements for those who live within a certain radius of one of our locations – four days per week, eight hours per day in the same office. People leaders must be on site for at least one week per month, meaning that our boss will travel 12 hours to the mother ship. It’s going to be a huge waste of money. They are trying to sell it by promising contests and celebrations. It also appears that part of their ‘enhanced office experience’ includes setting the paper towel dispensers in the restrooms to give you about three inches of paper towel per wave with an eight-second timeout. How about letting me enhance my workday by allowing me to effectively wash and dry my hands during cold and flu season?”

I theorize that this organization is trying to lose people through attrition by tightening its control over work locations. I’ve seen companies use this strategy when they’re trying to unload late-career remote employees who don’t want to do the travel and who are likely to be higher on the pay scale than others.

The talk of expanded benefits to being in the office seems like a standard corporate attempt to justify imposing a policy that doesn’t make sense for everyone. I’ve worked in-person, hybrid, and fully remote. All of them have pros and cons depending on the company’s structure. For teams that work closely together, physical proximity can be an advantage. However, making someone go to an office four days a week when none of their team members work there is just silly, as is policing the restroom supplies.

A colleague clued me in to a New York Times article about a writer who tried to spend 48 hours without using any AI technologies. He was surprised at the breadth of AI’s penetration into daily activities, including weather forecasting, environmental monitoring, and supply chain management. It must be noted that the definition of AI used in the experiment included both generative technologies and machine learning.

In addition to forgoing social media, the author also avoided podcasts (due to the potential for AI editing) and most news outlets as well as email services. The article jumped the shark a bit, however, when it discussed not using electricity or municipal water sources because they use AI demand prediction or monitoring. The author instead planned to drink collected rainwater.

Other out-of-bounds services included municipal trash service, because it uses robotic sorting machines and machine learning that streamlines collection routes. Cars were out, as were many modes of public transportation.

I chuckled at his description of trying to get to a meeting using a bicycle and a paper map, then foraging a meal in Central Park to avoid the influence of AI on the food chain. He also reverted to a landline telephone for communications and typed the article on a manual typewriter before discovering that the ribbon was dry and switching to pencil and paper.

The author admits that early on in his experiment, he ranked tools and services from 1 to 10 to represent how much AI was present. He then went forward with using low-ranked tools. I think we can all agree that asking ChatGPT to create random graphics for entertainment is different from using a municipal trash service, but the space in between is grounds for conversation about the impact of AI on daily life.

I don’t follow as much global news as I would like, so I was delayed in learning that Australia has instituted a social media ban for children under age 16. The effort is hailed as a way of putting control in the hands of families rather than with social media tech companies, although as expected, young people are trying to figure out how to get around the ban.

Social media platforms can be fined $30 million if they don’t remove the accounts of children. They are also required to describe how they implemented the restriction. Australia’s ESafety Commissioner will report publicly how well things are working before the end of the month.

Regulators know that savvy youth will use VPNs to make it appear that they are outside of Australia. However, one of them noted that the platforms have the power to identify those who skirt the rules by analyzing their posts.

I ran across another article that addresses the under-16 point of view. It featured comments from a teen who lives in the Outback, who worries about how he will stay connected with his friends who live far away.

I would hazard a guess that young people who are smart enough to set up international VPNs are also smart enough to solve the problem by embracing older technology with a twist. Radio was used in the Outback for years as a way for students to attend school, and amateur radio has become much fancier in the last few years with digital, text and data modes. Where there’s a will, there’s a way. I’ll have to ask my favorite ham radio operators if they are seeing an uptick in activity in the land down under.

The law is being challenged by teens who claim that they have a right to freedom of political communication, so we’ll have to see what happens next.

What do you think of social media bans for young people? Will they result in greater health and safety for that segment of the population? Leave a comment or email me.

Email Dr. Jayne.