Rohan Kotecha

I often think about this "It’s also unique to biology. How would engineering planes be different if I could build millions of planes with different designs and test them all in wind tunnels? In fact, in no other physical medium is this possible." and ask why progress is slow..

The hardest problems thus far have been fabric related. I've learnt everything from friends at Central Saint Martins, and a wonderful tailor in Whitechapel, London's original garment district.

Relying heavily on a narrow set of elite journals (NEJM, JAMA, etc.) is dangerous, not a feature. It misses the true breadth of medical research published across thousands of journals. Researchers choose smaller/specialty journals for faster publication, higher acceptance rates for niche or incremental findings, negative results, regional data, emerging topics, or work that doesn’t fit the broad/high-profile appeal big journals demand. Limiting AI to “prestige” sources creates blind spots in real-world evidence.

Many aspects of American healthcare that patients dislike are downstream of having a third party (insurance) pay for services that should simply be paid in cash or HSA. Probably true for physicians too. Health insurance should be insurance, not some weird group purchasing scheme. You don’t need to submit to the humiliation of 8 pages of paperwork and several frustrating phone calls to buy a haircut and it shouldn’t be true for a primary care visit either. Nor does someone who does a new haircut need to lobby the haircut board to create a haircut billing code like 92133 “ZOOMER BROCCOLI CUT W/ FADE”. We know markets work. Healthcare isn’t some magic part of the economy that defies the laws of physics. E.g. LASIK which is all cash pay has gotten cheaper in real terms and better since the ‘90s. The preciousness of healthcare doesn’t need to blind everyone to common sense and evidence. There is a button and you can just push it.