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Josh Briscoe

@jbriscoe.bsky.social
468 followers 306 following 681 posts

Hospice and Palliative Care Physician #MedPsych #MedSky #HAPC #Bioethics Writing @ Notes from a Family Meeting: familymeetingnotes.substack.com

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Reposted by Josh Briscoe
Emily Moin @emilymoin.com · 25/09/2026
I regret that these technologies – which are powerful and could certainly be incredibly useful – have entered medicine in the way they have: unexamined, without rigorous patient-centered evaluation, mired in proprietary claims, regulatory capture, and credulous adopters.
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Keith Plummer @xianmind.bsky.social · 04/07/2026
This article about the potential impacts of AI scribes on medical students, practicing medical professionals, and the physician-patient relationship reminded me of observations Postman made about the stethoscope. The author raises important questions. www.nytimes.com/2026/07/01/m...
nytimes.com
How A.I. Might Change the Way Doctors Think
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Shannon Vallor @shannonvallor.bsky.social · 25/06/2026
Ask how many more shifts they’d let a surgeon work after a week in which they severely harmed 12-15% of their patients
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Shannon Vallor @shannonvallor.bsky.social · 30/05/2026
Spent a plane ride reading Pope Leo's Encyclical on AI. Many thoughts to share later, but this will stick with me: "The quality of a civilization is measured not by the power of its means, but by the care it is able to offer, by its ability to recognize the other as a face not merely as a function."
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Ryan Marino, MD @ryanmarino.bsky.social · 02/05/2026
One thing people don’t realize is that even if you don’t use Medicaid—even if you never would use Medicaid—your ability to access care, and your ability to access healthcare providers like me, will be affected in some way or another by every cut or barrier to Medicaid. Nobody will be unaffected.
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Carl T. Bergstrom @carlbergstrom.com · 30/04/2026
This is a fascinating example because it's exactly what a bullshitter does and what gives him away. He leans into the little cues you give them, and riffs on those cues ,making stuff up. "It's a real, verifiable peer-reviewed publication" (To be clear: there is no "Swedish magpie" paper.)
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Yahia Lababidi @ysl.bsky.social · 18/04/2026
Celeste Roberge’s sculpture “The Weight of Grief” #art
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Josh Briscoe @jbriscoe.bsky.social · 16/04/2026
My body is not my own. What does that mean for intractable, hot button bioethical debates? open.substack.com/pub/familyme...
open.substack.com
Stewarding the Body
How can we hold health in common?
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Josh Briscoe @jbriscoe.bsky.social · 14/04/2026
jamanetwork-com.proxy.lib.duke.edu/journals/jam... from @jama.com If AI were a medication, we'd be putting it through far more rigorous testing before wide deployment...
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Josh Briscoe @jbriscoe.bsky.social · 12/04/2026
Hope springs eternal... familymeetingnotes.substack.com/p/a-machine-...
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Josh Briscoe @jbriscoe.bsky.social · 15/02/2026
www.npr.org/2026/02/14/n... I wasn’t expecting “whether you want it or not” to feature so prominently so soon in using AI in health care…
npr.org
Dr. Oz pushes AI avatars as a fix for rural health care. Not so fast, critics say
Dr. Mehmet Oz, who heads the Centers for Medicare and Medicaid Services, is advancing a $50 billion plan to modernize rural health care.
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Josh Briscoe @jbriscoe.bsky.social · 14/02/2026
What do clinicians do when trust runs thin? open.substack.com/pub/familyme...
open.substack.com
Trust and Distrust in Medicine
Trusting Doctors In Hard Times
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Josh Briscoe @jbriscoe.bsky.social · 05/02/2026
Full disclosure: I haven't read the book they discuss in this episode of @geripal.bsky.social so my comments are just related to the convo. geripal.org/ai-and-healt... #medsky
geripal.org
AI and Healthcare: Bob Wachter
On this week's podcast we talk with Bob Wachter about his new book, "A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future."
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Matthew Loftus 🧻 @matthewloftus.bsky.social · 05/02/2026
My book has a cover! I wish I could share it with you right now, but unfortunately you'll have to wait until August 18, 2026. But you can preorder it now if you want. www.amazon.com/Resisting-Th...
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Emily Moin @emilymoin.com · 03/02/2026
Sure would be nice to have a functional federal regulatory agency techcrunch.com/2026/02/03/l...
techcrunch.com
Lotus Health nabs $35M for AI doctor that sees patients for free | TechCrunch
This AI doctor is licensed in all 50 states, the startup says. The deal was led by CRV and Kleiner Perkins.
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Matthew Sparks @nephrosparks.bsky.social · 22/01/2026
Really troubled by this question in a popular surgical critical care study book… Surgical Critical Care and Emergency Surgery Topic is early v late dialysis and so much on this topic is know and just disappointing to this question…. The keyed answer was….
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Steve Joffe @stevejoffe.bsky.social · 20/01/2026
The consent form Louis Waskansky signed before undergoing the first-ever human heart transplant, in 1967.
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Christian Sinclair @ctsinclair.bsky.social · 02/01/2026
Media outlets sharpened their pens by telling us that cars and trucks hit pedestrians and cyclists instead of drivers. Now they rinse and repeat with AI.
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Stephen Collins @stephencollins.bsky.social · 13/11/2025
Every ad now
[Scene is a kitchen - a middle aged woman called JANET is boiling peas at the stove. A younger more colourfully dressed woman named LIZ approached her.]

JANET:
Ugh...

LIZ:
What's up?

JANET:
I am so bored of cooking peas!

LIZ:
Have you tried...

AI peas?

JANET:
AI peas?

LIZ:
They're peas with AI!

[Liz holds up to us a packet of peas labelled: Pea-i AI - Peas with AI].

LIZ:
Al-powered peas harness the potential of your peas

JANET:
What

LIZ [Now a voiceover as we cut to a whizzy technology diagram of peas all connected by meaningless dotted lines]

Why not take your peas to the next level with Al Peas' new Al tools to power your peas?

[Show a techno diagram of a pea with a label reading 'AI' pointing to a random zone in it]

LIZ:

Each pea has Al in a way we haven't quite worked out yet but it's fine

[Show Janet and Liz now in a Matrix-style world of peas]

LIZ:
With Al peas you can supercharge productivity and make AI work for your peas!

JANET:
What

LIZ:
Shut up

LIZ:
Our game-changing Pea-Al gives you the freedom to unlock the potential of the power of the future of your peas workflow

From opening the bag of peas

to boiling the peas

to eating the peas

To spending millions on adding Al to the peas and then having to work out what that even means.

JANET:
Is it really necessary to-

LIZ [Grabbing Janet by the collar]:
THE PEAS HAVE GOT AI, JANET

[Cut to an advert ending screen, with the bag of peas and the slogan:

AI PEAS: Just 'Peas' for god's sake buy the AI peas.

[Ends]
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Jed Brown @jedbrown.org · 18/08/2025
It is not "attribution and sourcing" to generate post-hoc citations that have not been read and did not inform the student's writing. Those should be regarded as fraudulent: artifacts testifying to human actions and thought that did not occur. www.theverge.com/news/760508/...
For help with attribution and sourcing, Grammarly is releasing a citation finder agent that automatically generates correctly formatted citations backing up claims in a piece of writing, and an expert review agent that provides personalized, topic-specific feedback.Screenshot from Grammarly's demo of inserting a post-hoc citation.
https://www.grammarly.com/ai-agents/citation-finder
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Kevin M. Kruse @kevinmkruse.bsky.social · 20/12/2025
Coming back to this, I'm still struck by the implication that academics should care if the AI pushers "trust" all our work that's done without AI. I don't know, man, you all seemed to trust our work enough to steal it from us wholesale.
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GeriPal Podcast @geripal.bsky.social · 18/12/2025
To what extent is it our job as consultants to manage or attend to clinician distress? What happens when that clinician distress leads to conflict? #medsky Guests Sara Johnson, Yael Schenker, & Anne Kelly. 👉 Post: bit.ly/GeriPalEp385 😀 Hosts: @alexsmithmd.bsky.social | @ewidera.bsky.social
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Josh Briscoe @jbriscoe.bsky.social · 19/12/2025
I took up this question in the latest issue of Notes: open.substack.com/pub/familyme...
open.substack.com
Am I My Brother's Keeper?
Attention to Distress Among Colleagues in Clinical Settings
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Josh Briscoe @jbriscoe.bsky.social · 18/12/2025
They wonder what’s driving hospital investment in ambient AI for charting, as evidence for improved productivity isn’t there. Maybe it’s earnest care for clinician well-being? I have another suggestion: surveillance.
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.chantal//RYAN @thoughtrise.bsky.social · 15/12/2025
this field biologist does a great job highlighting the insidiousness of AI editing these one-click AI edit buttons are incredibly appealing to many photographers, amateurs and professionals alike, and are framed as innocuous this is worth sharing and educating people about
screenshot of a post on facebook from Alex Lamoreaux, depicting two versions of the "same" photograph of a bobcat in front of a pine plantation, one labeled original game cam photo, one labeling AI processed

the markings have been altered on the AI photo, and the head changed and resized

text says:

Oh! A neat goose hybrid posted to ‘What’s this Bird?’ but when you zoom in on the photos the bill details have been too manipulated by AI photo editing to be accurately assessed for which species may be involved.
Scroll on… A cool-looking Red-tailed Hawk that someone is wondering which subspecies it might be - right up my alley! But when you zoom in on the photos literally every feather group has been so heavily manipulated and altered by AI editing that it’s impossible to determine subspecies because the photo is essentially fake now; just a mashup of whatever AI thinks parts of a Red-tail should look like. 
Scroll on… WOW! That’s a remarkable trail cam photo of a Bobcat! It almost looks like a painting!… but the head looks oddly small…. hmmmm. After some prodding the original photo is produced and sure enough it had been so heavily altered by AI ‘post processing’ that the photo posted was essentially a digital mock-up with totally different proportions and fur markings. No longer the photo off the trail cam; it may as well have just been ‘created’ by AI from scratch.
This stuff is killing me. My days on social media are becoming very limited. We can’t even trust simple, everyday photos of animals to be real. The wildlife community needs to quit editing with AI, and we need to start calling out photographers that are using it. Our reality is being destroyed all around us.
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Seth Trueger @mdaware.org · 09/12/2025
I didn’t really get how much “health care contact days” is a meaningful patient outcome until I got sick thank you @ishaniganguli.bsky.social @dusetzinas.bsky.social @jamanetworkopen.com
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Josh Briscoe @jbriscoe.bsky.social · 06/12/2025
Introducing ambient #AI scribes into a world in which clinicians write notes is very different from the future world in which no one has written notes. familymeetingnotes.substack.com/p/where-the-...
familymeetingnotes.substack.com
Where The Walls Listen
Artificial Intelligence and Clinical Scribes
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Josh Briscoe @jbriscoe.bsky.social · 05/12/2025
My final installment in a series of essays on medical authority. I worry we won't find a path forward by yelling at each other, but I see hope in a few places. familymeetingnotes.substack.com/p/a-power-gr... #medsky
familymeetingnotes.substack.com
A Power Great and Terrible
Medical Authority in Human Life (Part 3)
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Awais Aftab @awaisaftab.bsky.social · 29/11/2025
Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz Exploring medication effects mediated symbolically www.psychiatrymargins.com/p/meaning-me...
psychiatrymargins.com
Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz
Exploring medication effects mediated symbolically
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Marc Watkins @marcwatkins.bsky.social · 24/11/2025
This is the 3rd time Google has offered a Gemini trial for college students since May. They're clearly tying trials around the academic calendar. It is no wonder college instructors are hostile toward AI companies pushing free premium AI for college students during finals.
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Josh Briscoe @jbriscoe.bsky.social · 27/11/2025
Next up: medical authority and intervention. I approach a controversial case with the hope that this could provide a context for a more productive disagreement. familymeetingnotes.substack.com/p/here-to-he... #medsky
familymeetingnotes.substack.com
Here to Help: Clinicians and their Tools
Medical Authority in Human Life (Part 2)
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Jared Smith @jaredsmith.bsky.social · 23/11/2025
REUTERS: The winner of the 2067 Nobel Prize in Literature has been awarded to Sample #789, the author of “Vaping in the House My Father Built”. Sample, a synthetic brain organoid, lives in Saratoga, NY with their seventeen dogs.
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Tom Nichols @radiofreetom.bsky.social · 22/11/2025
The most important thing to remember about all this fantasy-engineering of the Constitution is Madison's warning: If we suck as a people, no clever constitutional schemes will save us.
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👻madeline bOoOoOoOodent👻 @oldenoughtosay.com · 31/12/2024
In 1582, a papal bull introduced the Gregorian calendar, still used today by most of the world. Because it’s 11 days ahead of the Julian calendar, countries introducing it simply skipped a third of October, and if you scroll back far enough in the iPhone calendar app you can see it change
Screencap showing the jump from Oct 4 to 15
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Gurwinder @gurwinder.bsky.social · 15/11/2025
This will keep you stuck in the past, preventing you from healing. Even worse, your memories of your lost loved one will be polluted and overwritten by your memories of their AI-generated ghost, until you’ve forgotten the person you lost, and instead grieve only their caricature.
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Josh Briscoe @jbriscoe.bsky.social · 15/11/2025
As a palliative care doc, I’m constantly navigating questions of the appropriate extent of medical authority. That was also a large part of my previous job as a psychiatrist. How do we figure out where the limits are? familymeetingnotes.substack.com/p/should-you...
familymeetingnotes.substack.com
Should You See a Doctor For That?
Medical Authority in Human Life (Part 1)
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Dr PayItBack @handle.invalid · 14/11/2025
Haha yes, YES
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Emily Moin @emilymoin.com · 13/11/2025
Doctor LLMs don't want you to know this one weird trick
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Emily Moin @emilymoin.com · 13/11/2025
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Eduardo Bruera @brueraeduardo.bsky.social · 08/11/2025
The US administration has reduced resources for the National Library of Medicine and paralyzed government. Unfortunately I am unable to provide you our most recent publications. An alternative to Pubmed is needed for global medical knowledge.
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Awais Aftab @awaisaftab.bsky.social · 07/11/2025
Sikorav Against the World A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy www.psychiatrymargins.com/p/sikorav-ag...
psychiatrymargins.com
Sikorav Against the World
A French psychiatrist’s efforts to do right by his patients brought him into conflict with the medical bureaucracy
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City of Durham, NC @cityofdurhamnc.bsky.social · 08/11/2025
Looking for an easy way to make a difference this fall? Leave your leaves! 🍂 Leaving your leaves is one way to change some of the forces at work behind climate change and loss of biodiversity. Learn more at keepdurhambeautiful.org/leaveyourleaves
Promotional graphic titled 'LEAVE YOUR LEAVES', encouraging leaving fallen leaves on the ground, featuring logos of City of Durham, Keep Durham Beautiful, and New Hope Bird Alliance.
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Josh Briscoe @jbriscoe.bsky.social · 06/11/2025
A challenge to the conventional approach to VSED from Benjamin Frush, Farr Curlin, and Daniel Sulmasy: agsjournals.onlinelibrary.wiley.com/doi/10.1111/... #hapc #medsky
agsjournals.onlinelibrary.wiley.com
The Role of the Physician in Caring for Patients Pursuing VSED: Challenging the Conventional Approach
The conventional approach to caring for patients pursuing voluntarily stopping of eating and drinking (VSED) allows physicians to disagree with the patient's decisions to pursue VSED, but it assumes ...
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Our World in Data @ourworldindata.org · 05/11/2025
The limits of our personal experience and the value of statistics 🧵 How many people do you know by name? One study found that the average American knows 611. In a world of 8 billion, that’s less than 0.00001%. A 100,000th of a percent. We can’t see much of the world through our direct experience
Image of a rectangle that is mostly dark blue, representing the world population, with a tiny yellow dot, representing the 800 people a social person knows by name.
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Shannon Vallor @shannonvallor.bsky.social · 28/10/2025
I do sometimes have writers block, more commonly known as the time you need to sit or pace or stare out the window and let your thoughts form rather than ask the machine to tell you what you think
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Josh Briscoe @jbriscoe.bsky.social · 24/10/2025
It's remarkable some people don't believe deception is harmful, even if the deception isn't discovered. Furthermore, deception harms the deceiver by making the kind of person who deceives.
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Josh Briscoe @jbriscoe.bsky.social · 22/10/2025
familymeetingnotes.substack.com/p/a-machine-... Some thoughts on using #AI for surrogate decision-making.
The PPP is grounded on the presumption that a patient with the capacity to make a decision is given information and they yield a response. It treats the patient as a machine, which is why we believe a machine could so easily replace them.2 But that’s not how decision-making works. It’s laden with emotion and values. It’s fraught with negotiation. Most people aren’t sitting at home pondering their...
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Emily Moin @emilymoin.com · 20/10/2025
I've never said yes to an interview so quickly as when @ashleybelanger.bsky.social reached out to discuss a topic that – it will surprise no one to learn – I feel pretty strongly about.
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Josh Briscoe @jbriscoe.bsky.social · 21/10/2025
From @arstechnica.com: arstechnica.com/features/202... My answer, as a palliative care physician: never.
arstechnica.com
Should an AI copy of you help decide if you live or die?
Doctors share top concerns of AI surrogates aiding life-or-death decisions.
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