Christopher A. Longhurst, MD

@Gabe__MD Why are humans still in the loop with advancing AI capabilities? bmjdigitalhealth.bmj.com/content/2/1/e0…

A study published today in Science may be the most important AI paper in clinical medicine this year. And it happened to land on the same day I submitted a letter to JAMA arguing that AI can already deliver clinically adequate care for defined tasks. Researchers at Harvard Medical School and Beth Israel Deaconess Medical Center ran six experiments pitting OpenAI's o1 reasoning model against hundreds of physicians across the full spectrum of clinical reasoning: differential diagnosis, management planning, probabilistic reasoning, and clinical documentation. Then they did something most AI studies don't. They tested it on 76 real, unstructured emergency department cases pulled directly from the medical record at a major academic medical center. The results across all six experiments: the AI outperformed physicians. On the real ER cases — the messiest, most clinically relevant test — the AI identified the correct or very close diagnosis in 67.1% of cases at initial triage, 72.4% at ER physician evaluation, and 81.6% at hospital admission. The two attending physicians scored 55.3% and 50.0% at triage, 61.8% and 52.6% at ER evaluation, and 78.9% and 69.7% at admission. The gap was widest at initial triage. On management reasoning using expert-scored clinical vignettes, the AI scored a median of 89%. Physicians with conventional resources scored 34%. That is not a typo. The physician evaluators were blinded and could not distinguish AI-generated differentials from human ones. One evaluator guessed correctly 15% of the time. The other guessed correctly 3% of the time. I'm an emergency physician. I work in a rural Texas ED. These are my cases. These are my decision points. And I can tell you that the triage finding is the one that matters most. Triage is where the least information meets the highest stakes — where the wrong call means a patient sits in the waiting room while their sepsis progresses or their STEMI evolves. The AI was 12 to 17 percentage points better than experienced attendings at exactly that moment. The authors are careful to note this is text-based reasoning only; the AI doesn't see the patient's distress, doesn't hear breath sounds, doesn't read the room. Those are real limitations today. But the cognitive reasoning component of emergency medicine — pattern recognition under uncertainty with incomplete data — is precisely what this model is demonstrating it can do. This was published in Science. Not a preprint. Not a company blog post. Peer-reviewed, in one of the two most prestigious scientific journals in the world. The profession needs to stop debating whether AI will be good enough. It needs to start planning for the fact that, for an expanding set of clinical reasoning tasks, it already is. And yes, this was written with AI. Sorry!!

Read Seattle Children's statement here: seattlechildrens.org/media/press-re…

Seattle Children’s performs more congenital diaphragmatic hernia (CDH) repairs than any other hospital in the Washington, Alaska, Montana, and Idaho region. Our high-volume experience means better care for your baby. We are proud to be a leader in CDH surgery. bit.ly/3L7weHu

Thank you @RepKimSchrier and @RepJohnJoyce for introducing bipartisan legislation to expand childhood vaccine access through the Vaccines for Children Program ⤵️

Honored to be part of the world class team at @seattlechildren! Thank you to the entire organization for a terrific first 100 days - here’s to the future of providing hope, care and cures to help every child live the healthiest and most fulfilling life possible

Welcome to Seattle and the @seattlestorm! 🏀

What if we started thinking of mRNA-CRISPR gene editing as molecular surgery, not as a pharmaceutical product? Excellent @nytimes guest essay ⤵️ nytimes.com/2026/04/09/opi…

Earthset. The Artemis II crew captured this view of an Earthset on April 6, 2026, as they flew around the Moon. The image is reminiscent of the iconic Earthrise image taken by astronaut Bill Anders 58 years earlier as the Apollo 8 crew flew around the Moon.

“You can see the surface of the Moon…we just went sci-fi.” On flight day seven, images from our @NASAArtemis II crew amazed, turning science fiction to reality. From the lunar far side to a solar eclipse from the Moon, the views are EVERYTHING. No pressure to pick a favorite.

Making new friends & giving back 🩵 It's always a wonderful time hanging out with the kiddos at @seattlechildren! Thank you for letting us swing by while we were back in town!

Teens are turning to AI for connection. Yolanda Evans, MD, of Seattle Children's, shares with KOMO News what families should know. bit.ly/3PEZH09

We are aware of the latest news reports regarding potential federal immigration activity at airports. We are communicating with federal partners and monitoring the situation. For now, we expect operations at SEA to continue as normal. Thanks to TSA and frontline staff.

“GuardDog Telehealth admitted it accessed patients' medical records under false pretenses to feed the information to law firms.” 🤯 GuardDog admitted that "since it began operating as a company in 2024, "it focused on requesting, reviewing and summarizing medical records, and providing those medical records to law firms," and that it gained access to those medical records through the Carequality Framework by falsely asserting a treatment purpose for those records. Thank you @HeyEpic for exposing the truth epic.com/content/stipul… washingtonpost.com/health/2026/03… beckershospitalreview.com/healthcare-inf… fiercehealthcare.com/health-tech/gu…

Insight of the day ⤵️

Full story at fox13seattle.com/news/seattle-n…

Erin Martin, a nurse care manager at @seattlechildren, is representing @TeamUSA in the 2026 Winter Paralympics! 🎿 👏

@Bob_Wachter “In the end, I suspect that AI will have a central role in radiology, and that we’ll ultimately need fewer radiologists than we do now (or perhaps the same number to interpret far more imaging studies).” ☑️

My latest Substack: Why predictions that radiologists will be replaced by AI (including, famously, by genAI founding father and Nobel laureate Geoffrey Hinton) have been wildly off base, and what that teaches us about job replacement for doctors. robertwachter.substack.com/p/why-do-you-s…

⏰ Daylight Saving Time is almost here — is your family ready? The one‑hour shift can feel a lot like jet lag for kids, especially younger ones who may wake earlier or get sleepy sooner as their internal clocks adjust. Seattle Children’s sleep expert Dr. Maida Lynn Chen reminds us that these transitions can temporarily disrupt sleep as our social and biological clocks realign. Tip: Start adjusting bedtime gradually, keep routines consistent, and be patient as your child adapts. A few small changes can make a big difference in keeping everyone well‑rested. Learn more here: bit.ly/4st4BLX

More evidence that the global decline in test scores that began after 2012 is linked to the proliferation of smartphones and computers in class: The slide was bigger in countries where students began spending more time on devices (for leisure) generationtechblog.com/p/phones-at-sc…