Doctor as Designer

"Without data you aren't doing improvement. You're having a nice time together." -Michael Seid @ImproveCareNow

With predictable long term consequences for wealth, health, and happiness. Pediatricians ought to be in the vanguard of tracking this, publicizing it, and intervening.

An unfortunate problem -- and one that I think is going to get much worse. Citation padding (aka "drive-by citation") has been an issue for a LONG time, often tacitly encouraged by reviewers. LLMs are just pouring gasoline on weaknesses of how we do (and reward) scholarship

AI native grads, ones who have overused AI, are even worse than many expected. They are unable to think critically, write without AI, and think without AI. They don't have ideas. Companies are trying to avoid them futurism.com/future-society…

The real-world utility of a chart like this is so high.

Now that looks like an interesting job! linkedin.com/jobs/view/4400…

“ A root cause of a major defect in the health care system is that, while we falsely admire and extol the intellectual powers of highly educated physicians, we do not search for the external aids their minds require.” — Lawrence Weed, MD

"We discussed when he first was alerted to the nonscientific approach clinicians use to make decisions on patients." …-ncbi-nlm-nih-gov.proxy.lib.umich.edu/articles/PMC29… #ehr #hit

My biggest takeaways from Claude Code's Head of Product @_catwu: 1. Anthropic’s product development timelines have gone from six months to one month, sometimes one week, sometimes one day. Part of this acceleration is access to the latest models (i.e. Mythos). Another is shipping new products into “research preview,” making clear it's early, experimental, and might not be supported forever. Another is an evergreen "launch room "where engineers post ready features and marketing turns around announcements the next day. 2. The PM role is shifting from coordinating multi-month roadmaps to enabling teams to ship daily. As Cat puts it, “There should be less emphasis on making sure you are aligning your multi-quarter roadmaps with your partner teams and more emphasis on, OK, how can we figure out the fastest way to get something out the door?” 3. The most efficient shipping unit is an engineer with great product taste. On Cat’s team, many engineers go end-to-end—from seeing user feedback on Twitter to shipping a product by the end of the week—without a PM involved. Also, almost all the PMs on the Claude Code team have either been engineers or ship code themselves, and the designers have been front-end engineers. The roles are merging, and the most valuable skill is product taste, not job title. 4. Build products that are on the edge of working. Claude Code’s code review product failed multiple times because earlier models weren’t accurate enough. But because the prototype was already built, they could swap in Opus 4.5 and 4.6 and immediately test whether the gap was closed. Teams that wait for the model to be ready will always be a cycle behind. 5. The most underrated skill for building AI products is asking the model to introspect on its own mistakes. Cat regularly asks the model why it made an unexpected decision. The model will explain that something in the system prompt was confusing, or that it delegated verification to a subagent that didn’t check its work. This reveals what misled the model so the team can fix the harness. 6. Every model release forces their team to revisit existing products and audit their system prompt to remove features the model no longer needs. Claude Code’s to-do list was a crutch for earlier models that couldn’t track their own work. With Opus 4, the model handles it natively. Features built as scaffolding for weaker models become debt when the model catches up—so the team actively strips them. 7. Anthropic employees build custom internal tools instead of buying SaaS products. A sales team member built a web app that pulls from Salesforce, Gong, and call notes to auto-customize pitch decks—work that used to take 20 to 30 minutes now takes seconds. Their core stack is Claude Code, Cowork, and Slack. No Notion, no Linear, no Figma. 8. People underestimate how much Claude’s personality contributes to its success. As Cat describes it, “When you reflect on everyone you’ve worked with, there’s just some people where you’re like, I really like their energy, their vibe.” Claude is designed to be low-ego, positive, competent, and earnest—qualities that make it feel like a great coworker, not just a tool. This isn’t cosmetic; it’s what makes people want to use Claude for hours every day. The team has a dedicated person, Amanda, who “molds Claude’s character,” and it’s one of the hardest roles at the company because success is so subjective. 9. The future of work is managing fleets of AI agents, not doing the work yourself. Cat sees a clear progression: first, individual tasks become successful. Then people start running multiple tasks at the same time (multi-Clauding). Next, people will run 50 or 100 tasks simultaneously, which will require new infrastructure—remote execution, better interfaces for managing tasks, agents that fully verify their work, and self-improving systems that incorporate feedback. The human role shifts from doing the work to knowing which tasks to look into, verifying outputs, and giving feedback that makes the system better over time. 10. Hire people who lean into chaos and face every challenge with a smile. At Anthropic, there are weeks when a P0 on Sunday becomes a P00 by Monday and a P000 by Monday afternoon. If you get too stressed about any one thing, you’ll burn out. Their team looks for people who can look at a hard challenge and say, “Wow, that’s gonna be hard. But I’m excited to tackle it and I’m gonna do the best that I possibly can.” This mindset—optimism, resilience, and comfort with constant change—is increasingly essential as the pace of AI development accelerates. Don't miss the full conversation: youtube.com/watch?v=Pplmzl…

Sequoia's thesis that the next $1T company will sell work, not software, is the most important reframe in AI right now. The argument: if you sell a copilot, you're competing with every new model release. But if you sell the outcome — books closed, contracts reviewed, claims handled — every AI improvement makes your margins better, not your product obsolete. The key insight most people miss: for every $1 spent on software, ~$6 is spent on services. The entire SaaS playbook was about capturing the software dollar. The AI playbook is about capturing the services dollar — at software margins. Not "AI for accountants." The AI accounting firm. Not "AI for lawyers." The AI law firm. The companies that figure this out won't look like SaaS companies. They'll look like services firms rebuilt on software infrastructure. That's a fundamentally different company to build, fund, and scale. And most founders are still building copilots.

Tennis players live 9.7 years longer than sedentary people. Not 9.7 months. 9.7 years. Nearly a decade. The Copenhagen City Heart Study tracked 8,577 people for 25 years and ranked every sport by how much life it adds. Badminton: 6.2 years. Soccer: 4.7. Cycling: 3.7. Swimming: 3.4. Jogging: 3.2. Tennis almost triples jogging. A separate study of 80,000 adults found racket sports cut all-cause mortality by 47% and cardiovascular death by 56%. Swimming hit 41%. Aerobics hit 36%. The question is why racket sports destroy everything else. Three mechanisms stack on top of each other. First, the physical demands. A tennis rally requires explosive sprints, lateral cuts, and sustained aerobic output. You're training fast-twitch and slow-twitch muscle fibers simultaneously. Most cardio only trains one system. Second, the cognitive load. You're reading spin, predicting angles, adjusting position, and executing motor patterns in real-time. Your brain is solving spatial puzzles at 80+ mph. That hand-eye coordination and strategic processing builds neural connections that protect against cognitive decline. Third, and this is the one researchers keep coming back to: you literally cannot play alone. Every racket sport requires another person on the other side of the net. That forced social interaction triggers neurochemical benefits that solitary exercise cannot replicate. Strong social connection alone increases your chance of longevity by 50%. Jogging is you and your thoughts. Tennis is you, a strategic opponent, and a community. Dr. Daniel Amen is right. The data is overwhelming. If you want the single highest-ROI activity for a longer life, pick up a racket.

Most tech companies break out product management and product marketing into two separate roles: Product management defines the product and gets it built. Product marketing wires the messaging- the facts you want to communicate to customers- and gets the product sold. But from my experience that's a grievous mistake. Those are, and should aways be, one job. There should be no separation between what the product will be and how it will be explained- the story has to be utterly cohesive from the beginning. Your messaging is your product. The story you're telling shapes the thing you're making. I learned story telling from Steve Jobs. I learned product management from Greg Joswiak. Joz, a fellow Wolverine, Michigander, and overall great person, has been at Apple since he left Ann Arbor in 1986 and has run product marketing for decades. And his superpower- the superpower of every truly great product manager- is empathy. He doesn't just understand the customer. He becomes the customer. So when Joz stepped into the world with his next-gen iPod to test it out, he fiddled with it like a beginner. He set aside all the tech specs- except one: battery life. The numbers were empty without customers, the facts meaningless without context. And, that's why product management has to own the messaging. The spec shows the features, the details of how a product will work, but the messaging predicts people's concerns and finds way to mitigate them. - #BUILD Chapter 5.5 The Point of PMs

this looks very cool

@kentcdodds Teach… curiosity? Or as my university professors used to say. “We are here to teach you to learn, not to know.”

@saranormous Yes

any nontechnical folks want to get more comfortable/powerful in their use of AI and want to be a beta user on something I made?

I'm glad Claude is supporting diagrams and I love Claude (it has revolutionized my approach to software development) but these are nice diagrams and neither cool nor amazing. Nice. Nice job @AnthropicAI on the charts. Not amazing yet but maybe some day.

The new interactive diagrams feature in Claude is seriously amazing. Go make some cool charts!

I can see Bret Victor's Explorable Explanations in every Claude prototype and data story and yet we don't really seem to be celebrating the democratization of the form and instead it seems more like we're scared that we lost the ability to keep these barbarians out.

💯 "If you build it, they will come." :) ~Every business you go to is still so used to giving you instructions over legacy interfaces. They expect you to navigate to web pages, click buttons, they give out instructions for where to click and what to enter here or there. This suddenly feels rude - why are you telling me what to do? Please give me the thing I can copy paste to my agent.

Advice from Dr Kleindorfer: Lift while you climb Give yourself some grace Don’t be on an island @UMich @umichmedicine

At the celebration of women in academic medicine celebrating ⁦@EvaFeldmanMDPhD⁩ and Dawn Kleindorfer @umichmedicine⁩ ⁦@UMich⁩