Josh Mandel, MD

The fix is small: require the feed to fire on the resources that actually signal enrollment (Patient, Encounter, ServiceRequest, MedicationRequest, Appointment), and a whole swath of provider apps could finally run on FHIR alone. A glorious future awaits.

Everyone is writing about agent loops right now. Including us at Cursor, because they're so powerful. But here's a prediction: a year from now, nobody will be talking about them. Not because they weren't useful. Because they'll work right out of the box. Batteries included. No instructions necessary. Feels a lot like prompt engineering two years ago. It was incredibly important. People wrote courses on it. Now you just talk to your agent like a normal person. That's the strange thing about AI right now. You learn something critical, get huge gains, and before long it's the new normal and something else is the bottleneck. So the alpha isn't what you know. It's how fast you learn it, and how easily you can let it go.

You'll see a lot of doctors come out "against" this kind of broad screening system. They can even get quite agitated about it. This resistance stems from a well-established clinical consensus: traditional population-level imaging fails to improve health outcomes because false positives and invasive follow-ups do more harm than good. But this view suffers from an obvious blind spot. Existing studies rely on static data and completely ignore time-series imaging. And time-series is ignored because we haven't been able to afford to do high frequency imaging at population scale. Clearly, time series is going to be immensely more valuable than a single image. If you drop costs, value can go from 0 -> 1. On a more fundamental level, the argument against screening rests on an obviously false precept "More information is bad" -- just clearly untrue. More information better, you just have to interpret it correctly.

Its a consistent theory-of-mind failure in models that are otherwise suprisingly good at theory-of-mind