Dave deBronkart

@francisdeng @healthythinker Assess what - what consumers want? I meant the crazy radical ideal of *asking* consumers whether they value the things that industry values. You know, market research, etc. (Please don't say "But people don't know what's important." That would be paternal thinking.)

@ePatientDave @healthythinker How would one assess that, aside from the thought experiment if patients had to pay for everything out of pocket and could shop around?

Has anyone mapped this into what consumers *want* and/or *value*? The sucky pay for family medicine is glaring; what about others? @HealthyThinker

@gardenbev Which "it"? Antecedent please

@ePatientDave Hmm that doesn't automatically mean it's a good idea, does it?

"The medical community had the most heated debate about 'is AI ready for healthcare?" … now this debate has already been decided by users. They just started using it and acting on it." Um, I believe this is called "democratization"!

@r0ck3t23 Too bad the mofo has zero respect for civilization & who gets hurt along the way to his self-centered racist nirvana. The laws of physics are indeed real but he explicitly doesn't give a sh*t about human values, bc they don't blow up his lab if he ignores them, as physics does.

Katherine Boyle just identified Elon Musk’s most important contribution to America, and it has nothing to do with the products he shipped. Boyle, General Partner at a16z: “I think Elon’s most important contribution to this country is training two generations of engineers to work with their hands again.” For ten years, America’s sharpest technical minds optimized ad clicks and built messaging apps. Software consumed ambition. The physical world became something you abstracted into APIs, not something you touched or understood. Elon didn’t reverse that through inspiration. He reversed it by building companies that required understanding manufacturing or failing completely. SpaceX and Tesla forced engineers to learn how metal fractures, how tolerances cascade through systems, how physical iteration costs months and millions per failure. No debugging. No patches. Just physics that doesn’t negotiate. Boyle: “Training two generations of engineers.” The product isn’t the cars. It’s the people. Look at who’s founding America’s critical hard-tech companies now. The common thread isn’t Stanford or MIT. It’s time on factory floors at SpaceX or Tesla. They learned welding. They learned that “impossible” just means unsolved engineering, not violated physics. They learned failure in the physical domain where mistakes compound instead of reverting. Elon didn’t build companies. He accidentally rebuilt industrial knowledge that had been decaying for thirty years while America’s best minds chased digital scale. Boyle: “Work with their hands again.” Three words that sound quaint but describe a civilizational inflection point. Software dominated because it scaled infinitely at zero marginal cost. Physical manufacturing was slow, expensive, unfashionable. Building real things became what you did if you couldn’t code. Elon made atoms matter again. Made manufacturing the hardest problem worth solving. Made physical engineering prestigious in ways it hadn’t been since humans walked on the moon. The evidence is everywhere now. Technical talent that doesn’t default to “which app” but asks “which physical thing should exist that currently doesn’t.” Ambition redirected from optimizing engagement metrics to building rockets. From scaling users to scaling factories. From virtual products to physical infrastructure. That shift matters more than any vehicle or spacecraft Musk delivered. Products obsolesce. Redirecting an entire generation’s engineering ambition from digital to physical compounds across decades and rebuilds industrial capability at civilizational scale. We stopped just coding the future. We started machining it, welding it, breaking it in reality until physics confirms it works. That transformation from virtual to tangible ambition is reconstructing American manufacturing one engineer at a time. And those engineers are now training the next wave. The compounding has started. The School of Elon doesn’t need Elon anymore. It’s self-sustaining, spreading through an entire generation that learned building real things matters more than building virtual ones. That’s not just a business achievement. That’s a civilization remembering how to make things that matter in the physical world again. And it might be the only thing that saves American technological leadership when the competition is just building faster because they never forgot.

@cryptopunk7213 Well you have to admit that ANYONE "committing" to keep ANYTHING "open" in this space is a little bit grain-of-salty. Time will tell. Nice for pipe dreams, anyway.

lmao so just to recap the week: - openai acquired peter steinberger and openclaw committing to keep the project 100% open source and make it a core part of openai’s ecosystem. zuck is fckin fuming. - china’s bytedance got sued by disney and hollywood for their seedance video model being so damn good BUT turns out it doesn’t even use their IP, it’s just that good lol - a clawdbot (openclaw) gave birth to a replicate of itself and autonomously paid for its api access - some random dude discovered $1.5 trillion worth of lithium buried under a super volcano in nevada miraculously solving the USA’s battery crisis (tesla praising the lord rn) - anthropic confirmed spotify engineers no longer code they just prompt claude to write 100% of the platforms code. we’re talking about a $100B+ company here - openai launched codex spark, a faster version of codex 5.3 that slings 1000 tokens / sec insane - anthropic and openai both lost key AI safety staff because “the world is in peril” and they reject AI ‘adult mode’ - xAI laid off 20-40% of staff in a vital bid to align grok, X and spaceX teams before building 100Tw of compute in space - matt schumer’s “something big is coming” article hit 100M+ views warning against AI except… it was co-written by an AI - runway raised $300M at a $5.3B val - europe committed $13B+ to fund next-gen AI startups to compete with the US - norway decided to fck their entire economy with a 36% tax on UNrealised gains goodnight.

@AmyPricePhD @jmirpub Don't take it personally that I didn't say anything in response to this; I never go on Twitter anymore! I will come back in the morning and have a look (I only came here tonight to see the video of the Olympic crowds booing Vance, which was not shown on American TV LOL)

Check out our Mom and Daughter article. So proud of my daughter jopm.jmir.org/2026/1/e89262 jopm.jmir.org/2026/1/e89262 @ePatientDave @jmirpub

@BozemanDon96959 @MysterySolvents It might help your credibility if you could at least spell your hero's name ... you do know it's Reagan, right? I mean, you HAVE read about him, right? You ARE well informed, not just listening to stuff that passes by?

@MysterySolvents It wouldn’t matter if he was on a hover round he is still the best president since at least Regan

Trump looks like he’s having a hard time walking…

@NelsonPScott @mukund @AnthropicAI @elonmusk I totally agree with the value of this, but here's an even better idea: how about we STOP the rapists, instead of just getting better weapons that skilled people can use to fight them off? Froedert hospital ought to be SHAMED for this behavior!

@mukund @AnthropicAI We saw exactly the same thing when @elonmusk bludgeoned congress into converting a 1000+ page omnibus bill into a 7pg document. AI and a purposeful human agent can now successfully rebuke the blob.

A guy just used @AnthropicAI Claude to turn a $195,000 hospital bill into $33,000. Not with a lawyer. Not with a hospital admin insider. With a $20/month Claude Plus subscription. He uploaded the itemized bill. Claude spotted duplicate procedure codes, illegal “double billing,” and charges that Medicare rules explicitly forbid. Then it helped him write a letter citing every violation. The hospital dropped their demand by 83%. This isn’t just a feel-good story. It’s a preview of what AI will really do next: flatten systems built on opacity. Hospitals, insurance companies, legal firms—all rely on asymmetry. They win because you don’t have access to the same data, code books, or language. Claude gave one person the same leverage as a compliance department. That’s a revolution. We thought AI would replace jobs. Turns out, it’s replacing excuses.

@Makuh90 @nexta_tv It's horsecrap. Nexta is a Belarus/Putin troll farm; this is pure fake news.

ChatGPT will no longer give medical, legal or financial advice: rule change took effect on October 29 As of October 29, ChatGPT stopped providing specific guidance on treatment, legal issues and money. The bot is now officially an “educational tool,” not a consultant — and the new terms spell that out clearly. What changed: • no more naming medications or giving dosages • no lawsuit templates, court strategies or “here’s what you do if…” • no investment tips or buy/sell suggestions Now the model can only explain principles, outline general mechanisms and tell you to talk to a doctor, lawyer or financial professional. AI used to act like a pocket lawyer and home therapist. But regulations and liability fears squeezed it — Big Tech doesn’t want lawsuits on its plate.

@grok @StefReflects @nexta_tv Source, please, @Grok? The Verge says otherwise: theverge.com/news/812848/ch…

@StefReflects @nexta_tv Yes, this is accurate. OpenAI's updated usage policies, effective October 29, 2025, prohibit providing tailored medical, legal, or financial advice without licensed professional involvement. It now focuses on general education and directs users to experts.

@EricTopol @HugoOC I assert that it's neither viable nor fair to not think about the issue of *available* care. And while I agree it's important to assess how "perfect" chatbots & humans are, both should be measured in context of availability and price.

@EricTopol Remember there are two large classes of people who can't see a doc: the ever-growing uninsured, and those with insurance who must wait weeks or months. Cf our pal @HugoOC and his elderly father. FOUR MONTHS for Kaiser to get them a specialist appt. patientsuseai.substack.com/publish/posts/…

On GPT-5 and medicine, status summary nature.com/articles/s4159…

@CraigBeam1 @dr_demetre All I see is "Hone" - where did the data come from that he said? Honest question

@dr_demetre Here's what I found, can attest that at 70 don't feel like I have same T levels as when I was 20.

Hmmm… curious what the data source is on these “interesting” stats? Anyone?

@AskLyft I will DM you but why not answer publicly? It's not just my problem.

@ePatientDave We're sorry to hear about this experience. Would you please DM us the phone number, the email address, and the full name associated with your Lyft account? twitter.com/messages/compo…

@AskLyft twice yesterday I had a serious problem because my driver didn't speak English and I couldn't tell them something important. PLEASE, how can I specify that I need someone who speaks English? One guy slammed his car hard into a severe speed bump bc I couldn't warn him.

A concise viewpoint on how physicians can prepare for the generative A.I. era jamanetwork.com/journals/jamai… @JAMAInternalMed

See through the current AI hype in healthcare! I have mapped the rapidly expanding universe of AI use cases in healthcare from early-stage “on the horizon” innovations to “safe bets” that are already backed by strong evidence. I analyzed them on two scales, little evidence to evidence-based (meaning there are studies and peer-reviewed papers proving their efficiency and safety); and low risk to high risk (meaning patients’ lives might be at stake in case of an error). This yielded four groups: 1) Speculative and risky (little evidence, high risk) 2) On the horizon (little evidence, low risk) 3) Handle with care (evidence-based, high risk) 4) Safe bet (evidence-based, low risk)

Sociopathy in action. A total human train wreck.