Dr. Tom Kelly

The study design caused these results. “AI scribes” /= Abridge, DAX and Ambience. If you study identical products you’ll get disappointing results. All of them are super embedded with no native interfaces outside the EHR, so it’s not a shock they’re demonstrating modest results for the few clinicians that adopt them. We need new interfaces, integrate of course but we can’t be buried in legacy systems. I’ve been dogmatic on this point and it will play out, mark my words. Medicine is no different to engineering, agent-first medicine is coming, it’s just taking everyone longer to figure it out. These products probably won’t exist long enough to build it.

We need some sort of clinical olympics for AI teams. Every 4 months. If I see another tech bro say we beat the USMLEs, I might have to start them. Wdyt @ambossmed @doximity @EvidenceOpen @tryheidi @MedwiseAI anyone can join, medical establishment sets the gauntlet.

@BoWang87 @UHN Agree 👍 working on this at Heidi, we would love to collaborate DM me

Absolutely agree: the future of healthcare AI is on-device intelligence. Small embedded LLMs are getting good enough to bring real medical reasoning directly to the edge — faster, cheaper, more private, and far more scalable. My lab at @UHN has been pushing in this direction too. We recently fine-tuned Qwen3.5 27B, 9B, and 2B on a healthcare benchmark, and found that on-device LLMs can match frontier models on medical diagnosis. That future may arrive sooner than most people think. See more: x.com/BoWang87/statu…

@elonmusk Is it in the base model or with search? We do millions of health queries a week, we’d swap if it’s in the base model. Search optimisation doesn’t count it’s cheating haha.

Current release of Grok is much than beta 1, which beat Opus in this arena. We usually update the model twice a week. Try the current version of Grok Heavy and you will be pleasantly surprised.

@_Timdoyle @omooretweets US founder/vc skill issue terrible takes agree

@omooretweets this definition of paid ads belongs in the hall of fame of dumb VC takes.

Wow, lots of discourse on this one! A few things I want to point out from the original post: 1. I am talking about generational consumer companies. In my mind these are $10 B - $20 B+ outcomes. There are many other AMAZING consumer businesses that have gotten big with paid ads. 2. I’m not saying all growth has to be 100% organic. I’m referring specifically to paid ads which I’ve seen to be nearly always inflationary over time (cost increases at scale). This doesn’t include creator marketing, brand marketing, referral programs, etc. 3. Historically the biggest consumer outcomes are network effects businesses (social apps and marketplaces). In these cases, unless the network is growing itself pretty organically, usually the product value proposition is not strong enough. 4. Note that I say it’s a problem to grow “largely” with paid ads. I have seen companies use ads to kickstart a flywheel that then grows more organically. But if you’re 50%+ paid ads for a significant period of time starting in the early days, I think it’s tougher. This is why a lot of the consumer subscription businesses (physical and digital) that are ad-dependent have grown to be $1 B+ businesses but aren’t the biggest consumer businesses in the world. This could change with AI as the true mainstream user is willing to directly pay for software! And, lots of counter examples that people have pointed out - in my mind TikTok is probably the biggest one. That uniquely required a large content graph to start hooking users.

Starlink Mobile’s next-gen satellites will deliver 5G speeds from space with 100x the data density of the current V1 generation satellites V2 satellites will seamlessly enable streaming, internet browsing, high-speed apps and voice calls, just like being connected to a terrestrial network → starlink.com/mobile

Shopify CEO @tobi on the @theallinpod: “Only founders who subtract in companies.” “We randomly delete all recurring meetings. We’re actually going to do random deletion of slack channels… they will come back if they’re useful.”

This is great. I only want to fly on planes that have Starlink.

@sama Comms advice: Never respond to playful humor with an essay. Just say “damn, they cooked us” or make a joke about them.

@SawyerMerritt @Starlink 💯

I think a lot of people underestimate how many people will switch airlines for great internet (@Starlink). Airlines that don't have great internet will lose customers to airlines that do have great internet.

To the stars! @SpaceX & @xAI are now one company

What's the real reason every airline isn't retrofitting Starlink? Took me 25 min to send this with United wifi

@mamoonha @EvidenceOpen The lowest we will ever be. Also *US only.

Pretty incredible results from a recent survey of 1000 physicians. @EvidenceOpen has really taken over medicine with 44% of surveyed physicians using it. Full report here: 2025-physicians-ai-report.offcall.com

Tesla has been working hard toward shipping Full Self-Driving (Supervised) in Europe for over 12 months now. We have given FSD demos to regulators of almost every EU country. We have requested early access, pilot release programs or exemptions where possible. We have developed & shared detailed safety evidence for FSD, now public in our latest Safety Report. And we have driven over 1 million kilometers safely on EU roads across 17 different countries (internal testing).  Our main path to success is partnering with the Dutch approval authority RDW to gain exemption for the feature. This involves proving compliance with existing regulations (UN-R-171 DCAS) + filing an exemption (EU Article 39) for yet-to-be-regulated behaviors like Level 2 systems off-highway, system-initiated lane changes with hands-off the wheel etc.  Some of these regulations are outdated and rules-based, which makes FSD illegal in its current form. Changing FSD to be compliant with these rules would make it unsafe and unusable in many cases. While we have changed FSD to be maximally compliant where it is logical and reasonable, we won't sacrifice the safety of a proven system or materially deteriorate customer usability.  As a result, we are gathering evidence to get exemptions on a specific rule-by-rule basis. Unfortunately, the real world fleet-proven safety wins alone are considered insufficient.  Currently, RDW has committed to granting Netherlands National approval in February 2026. Please contact them via link below to express your excitement & thank them for making this happen as soon as possible. Upon NL National approval, other EU countries can immediately recognize the exemption and also allow rollout within their country. Then we will bring it to a TCMV vote for official EU-wide approval.  We're excited to bring FSD to our owners in Europe soon! rdw.nl/en/contact/our…

Here's a longer-term chart. The simple story is correct. Capitalism created Poland's miracle, and socialism created Venezuela's catastrophe.