I’m doing my last week of night call next week. Im covering Christmas week for my group since they all have young kids. If you’re near The Woodlands, Texas and your kid swallows an ornament, give me a ring. It’s a big deal because I’ve been taking night call since the early 1990s. I feel like I need to have some kind of ceremony. But that might be weird.
This will be my last letter of the year — The end December tends to be an information black hole. But if something brilliant strikes me that I can’t contain I’ll send it along. I want to thank all of you for trusting me enough to jump back in. I have some fun stuff planned for 2023.
Here’s some stuff I found this week:
Telehealth visits unlikely to need immediate follow up
Epic Research examined more than 35 million telehealth visits to determine the overall rates of telehealth visits by specialty and to identify how often these visits require in-person follow-up within the same specialty. It’s an interesting figure to ponder — some of these are expected, others not. The study supports the idea of virtual visits as “alternative, rather than duplicative” means of care.
Interesting: Mental health and psychiatry, which had the highest volume of telehealth utilization, had the lowest rates of required in-person follow-up.

These Epic research studies are amazing because of the size of their reach. 35 million visits!
The next big thing in health
Susannah Fox was a guest on The Next Big Thing in Health podcast. Dig into her experience as a caregiver and how/why she has come to reference herself as an Archangel. If you are a caregiver this is a must listen — Susannah is a seer. From her post:To be successful in the pursuit of health and a better health care system in the next few years, you will need to tap into the patient-led revolution. Smart organizations are going to go beyond patient engagement and instead partner with patients and caregivers to create new products, services, research protocols, and treatments.
Virtual potty mouth
This JAMA study sought to understand if electronic health record in basket message characteristics (like volume, length, and sentiment) were associated with physician burnout. I was surprised by the reported number of messages containing expletives and threats of violence. I have never seen this level of abuse on MyChart despite getting tons of messages. Odd that threats of violence aren’t found to contribute to physician burnout..
How individuals with disabilities use Apple products
I found this video dramatic and wonderful. Wait for the baby at the end ‘crying silently.’
Big Tech lobbies to continue exploiting children
A trade group (NetChoice) representing Amazon, Google, Meta and TikTok is suing the State of California for trying to pass a law that protects children from tech's craven exploitation of children. TikTok’s recommendation algorithm, for example, pushes self-harm and eating disorder content to teenagers within minutes of them expressing interest in the topics.
This, from the trade group, is rich:
Such over-moderation,” the group suggests, “will restrict the availability of information for users of all ages and stifle important resources, particularly for vulnerable youth who rely on the internet for lifesaving information.
Using Chat GPT-3 to counter insurance denials
This rheumatologist demonstrates how he used ChatGPT-3 to counter an insurance claim denial. I’m not sure this is the answer to all of our problems, but I’m largely bullish on generative AI in healthcare.
Amwell CEO’s Telehealth predictions for 2023
Among other things, the CEO of Amwell predicts “digital care will continue to shift from transactional to transformational.” I have no idea what this means but the rest of this short article had a few nuggets.
+ While I’m promoting link bait lists, Here are Three reasons why NLP will go mainstream in healthcare in 2023.
Do unvaccinated people need to drive slower?
This week brought a wacky study suggesting that unvaccinated people cause more auto accidents. As you might imagine, the mainstream media fell for the title and ran with it. Professor
unmercifully eviscerates the study and tells us why it’s nonsense.Digital Exhaust
Eight rules to combat medical misinformation.
A 20 year old woman in Turkey works for a year as a doctor despite having never studied medicine.
Luddite teens who use flip phones.
Throwback: The U.S. Naval Observatory still sponsors a telephone number that will tell you the time and temperature when you call. Dial 202-762-1401 and you will get a recording of the time from the "Master Clock." I tried it and its works. | Via BoingBoing
Thank you again for being a subscriber. I want to wish you all the best for a wonderful holiday season and a happy, healthy 2023.