Screening Strikes Back

Screening Strikes Back

Last episode, we sat down with Dr. TR Levin — the gastroenterologist who built one of the most effective colon cancer screening programs in the country — and worked through why screening is so much harder to understand than it looks. Some tests find things that would never have hurt you. A simple test sent to your home may work better as a screening program than a more invasive procedure, mostly because people actually do it. And we talked about how knowing more is not always better, and sometimes no test is the best test. A lot of you came back with the same question: fine, but what am I supposed to actually do? In this follow-up, we talk about how to think more clearly about screening: what questions to ask, how to think about your own risk, and how to tell the difference between a test that is worth your time and one that is mostly worth someone else’s money.

Should You Get That Cancer Test?

Cancer screening saves lives, and it has been thoughtfully constructed to do so. But the version of cancer screening that some of us experience is one where nobody explains the odds, nobody mentions the alternatives, and a positive result sends you into a cascade of procedures that may or may not have been necessary. That version feels stupid. And there’s another version of screening, where someone in a 60 second video sells you the idea that the medical establishment is playing it safe and you need to take care of your own health by purchasing these additional tests…that just happen to have celebrity endorsements. That can also be stupid—with a price tag. In this episode, we sit down with Dr. TR Levin [https://www.linkedin.com/in/theodore-levin-06528312], the gastroenterologist who built one of the most effective cancer screening programs in the world. He’s the person who figured out that the best screening test isn’t the most invasive one — it’s the one people will actually do. He helps us understand how screening fits into the world of medical testing, and how we can do it better. Links: US Preventive Services Task Force [https://www.uspreventiveservicestaskforce.org/uspstf/]

Should AI Replace Your Doctor?

“Will AI replace doctors?” makes for a great headline, a great dinner party argument, and a great way to stress out a podcast co-host. It’s also, unfortunately, the wrong question. In a follow up to our last episode, we respond to our listeners’ feedback. We put co-host and radiologist Jonathan Mates on the spot and use radiology as our test case — the specialty that’s been at the center of this conversation longer than any other, partly because the job looks simple from the outside. You look at pictures. AI looks at pictures. What’s the problem? It turns out there are a lot of problems. We get into what radiology actually involves, why AI can be impressive and still not replace humans, and some other factors we need to consider when answering this (wrong) question. Links: Geoff Hinton on radiology [https://youtu.be/2HMPRXstSvQ]

How should you and your doctor use AI?

One in four ChatGPT users — roughly 200 million people a week — use it for health questions. About a third of them end up changing their medications or requesting referrals based on what it tells them. Is that brilliant, terrifying, or both? In this episode, we dig into the question everyone is asking themselves, whether they want to or not: How should my doctor be using AI? And how should I? We bring in Rachel Lomasky [https://www.linkedin.com/in/rlomasky?utm_source=share_via&utm_content=profile&utm_medium=member_ios] — an AI scientist and expert — to help us give both the patient perspective and a realistic view of what AI is capable of. Links: Large Language Model Performance and Clinical Reasoning Tasks [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847679?utm_source=openevidence&utm_medium=referral] Are AI Tools Ready to Answer Patients’ Questions About Their Medical Care?  [https://jamanetwork.com/journals/jama/fullarticle/2846269?utm_source=openevidence&utm_medium=referral] AMERICA’S LARGEST CITY HOSPITAL SYSTEM READY TO START REPLACING RADIOLOGISTS WITH AI, ITS CEO SAYS [https://futurism.com/artificial-intelligence/hospital-ceo-ai-radiology]

When Your Results Go Viral

People are sharing medical results from their online portals, just like they do with college acceptances and baby gender reveals. How did we get to this point? And what are the real effects on how patients understand their medical records and how doctors document them? In this episode, we explore how technology and regulatory changes have shaped our relationship to healthcare from the inside and out. Links: Why am I Watching People Get Their Medical Results? [https://www.nytimes.com/2026/04/07/magazine/medical-records-reveal-videos.html] Why Reading Your Doctor’s Notes Can Be Painful [https://nautil.us/why-reading-your-doctors-notes-can-be-painful-257796]