Rethinking the Medical Record

The Diagnosis Crisis

In this episode I’m joined by Alexandra Sifferlin of The New York Times, author of The Elusive Body. We talk about the hidden crisis of misdiagnosis, why we still struggle with uncertainty despite our technology, and what patients get wrong about how diagnosis actually works. This is a big conversation about the limits of medicine, the mythology of the doctor, and what may remain stubbornly human as AI moves into the clinic. * Subscribe to the LiminalMD newsletter. [https://liminalmd.substack.com] * Alexandra Sifferlin's website [https://www.alexandrasifferlin.com]. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Rethinking the Medical Record

Every physician knows the feeling of opening the electronic health record and finding a note that's beautifully structured with every box checked but somehow says almost nothing about what's actually wrong with the patient. This is not an accident. It's the result of decades of design choices, most of them not made by doctors but rather billing departments and compliance offices. In this episode I talk with Dr. Craig Joseph, an informaticist and consultant at Nordic Global Consulting, about the chart — what it was supposed to be, what it became, and whether the arrival of ambient AI gives us a genuine second chance to finally make the clinical note right. Relevant links: * Dr. Joseph's LinkedIn essay. [https://www.linkedin.com/posts/craigjoseph_larry-weed-didnt-want-your-impression-of-activity-7443697572008845312-PyGd?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAFYal8BSgZ1KxkNiPm9fXlFLtkTJDY1W1E] * Designing for Health [https://podcasts.apple.com/us/podcast/designing-for-health/id1663272427], Dr. Joseph's podcast. * Nordic Global Consulting [https://nordicglobal.com]. * Subscribe [https://liminalmd.substack.com] to the Liminal MD newsletter. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

The Lost Aura of the Physician

What happens to the physician's authority when artificial intelligence can do what only doctors once could? Bioethicist and pediatrician John Lantos has written one of the more provocative pieces in recent medical literature — a JAMA editorial arguing that AI isn't the beginning of medicine's identity crisis. It's the culmination of one that started two centuries ago. Drawing on philosopher Walter Benjamin's concept of "aura," Lantos traces how medicine's mystique has been quietly eroding since Foucault described the clinical gaze, through the rise of hospital medicine, evidence-based practice, and the electronic health record. By the time AI arrived, he argues, we had already trained physicians to think like machines. In this episode of Liminal MD, I sit down with Dr. Lantos to unpack that argument — and push on it. We talk about what the physician's aura actually was, whether it was ever fully earned or partly manufactured, and what forces have accelerated its dissolution: the transactionalization of care, the fragmentation of the therapeutic relationship, the democratization of medical information, and the transparency movement that put complication rates on public dashboards. But the more interesting question is what comes next. If the old aura was built on monopoly, mystique, and distance, what replaces it? And who bears the responsibility for that reinvention — the profession, institutions, or individual physicians? This is a conversation about identity, technology, and what it means to be a physician when the things that made the role singular are becoming reproducible at scale. * Dr. Lantos' JAMA editorial [https://jamanetwork.com/journals/jama/article-abstract/2845756] * Subscribe [https://liminalmd.substack.com] to the Liminal MD newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Is Medicine Better Without Physicians?

In this episode, I’m joined by Dr. Charlotte Blease, an informaticist and philosopher and the author of Dr. Bot: Why Doctors Can Fail Us and How AI Could Save Lives. The book has generated sharp reaction within medicine by advancing a simple, uncomfortable claim: that in some cases, continuing to rely on human clinicians may be ethically inferior to turning decisions over to machines. We discuss physician authority, resistance to technology, and the danger of empathy in clinical care. This conversation examines a future in which judgment, accountability, and moral responsibility may no longer reside primarily with the physician. Resistance to this idea is part of what we examine. You can learn more about Dr. Blease here [https://www.charlotteblease.com]. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Bhargav Patel on the Future of AI Scribes

In this short take episode, Dr. Bhargav Patel, Medical Director of Sully AI, joins Freerange MD to talk about the rapidly evolving world of AI in healthcare. With more than 120 companies in the AI scribe space, the market is crowded—but not sustainable. Dr. Patel shares his perspective on what’s coming next, how Sully AI is approaching the challenge, and why clinical efficiency is only the beginning of what’s possible. This focused conversation offers a sharp look at the shifting landscape of ambient AI and what it means for clinicians, companies, and the future of care. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]