Digital Exhaust #199

Doctors as commodities and the urinal of things

It’s another edition of Digital Exhaust, my weekly digest of odd stuff from the web and beyond. Thanks for subscribing. And if you’re not part of the tribe, subscribe below. And enjoy the list.

The urinal of things

Diagnostic urinals are apparently a thing in Beijing. You pee. Then the units offer a digital display complete with a built-in payment processing unit that allows users to have their urine tested after eliminating.

Too many issues to discuss here. And it’s apparently only for dudes.

Okay, you're the boss of me

A new AMA survey shows that the share of physicians working in private practice fell by 13% between 2012 and 2022 — from 60.1% to 46.7%,

+ I thought the percentage of docs working outside of private practice was higher at this point than this survey suggests.

‘Let’s see what the CT shows’

In the Journal of the American College of Radiology, this study looked at imaging utilization rates among doctors and advanced practitioners. Physician assistants used imaging at higher rates than physicians, in particular CT at 6.5% of visits compared to 0.7% for MD/DOs.

+ Not super surprising, really. This mirrors what I see in practice. We’ve democratized diagnostics so that those with less training can work the front lines. The rise of point of service testing and advanced technology has allowed APPs to advance their position in modern healthcare.

But the cost savings may be offset by overutilization.

Velcro and dead folks

An interesting history of velcro. And a short history of funeral homes.

Doctors as commodities

Great Substack essay from

Ryan McCormick, M.D.

discussing the devolution of the doctor as a commodity. Despite closing advice on how to avoid commodification, I suspect the horse is out of the barn. The medical profession is on a desperate race to the bottom and they’re not winning.

I’ll add that Ryan is one of the OGs of physician blogging. He penned The Examining Room of Dr. Charles — clean clinical stories with a chilling kind of minimalism. That was way back. Of note, he was anonymous as most physicians were during the early days of Web 2.0.

Fostering a robust AI market in healthcare

As U.S. policymakers face calls for regulation of artificial intelligence in the biotech and healthcare sectors, Andreessen offers up 3 things U.S. regulators should do to prepare for the revolution:

1. Empower the FDA with AI as a tool.

2. Let AI drive dollars to patient care.

3. Enable data to surmount bias.

Interesting read if you’re into this kind of thing.

The Doctor Who Inspired Van Gogh’s Final Paintings

A doctor can be a consoling presence in the life of any troubled human being. Such was Dr. Paul Gachet, the physician, phrenologist, artist, and art collector who became an intimate — or, as van Gogh himself once described him in a letter to his brother, a “ready-made friend and something like a new brother” — at the end of the painter’s life.

Interesting story of the complex relationship shared between doctor and patient. I was trying to understand whether they were intimately connected?

Another TikTok celebrity doc eats humble pie

An Ohio plastic surgeon accused of prioritizing her TikTok account over her practice had her medical license revoked this week. Dr. Katharine Grawe was known for live streaming as @doctorroxy on TikTok as she performed surgeries on patients from 2018–2022.

Grawe said she filmed videos in the operating room “to make people smile in a world that is negative and difficult to navigate.” Standing before the board, however, she said she understands how “many of those silly videos appeared unprofessional.”

You don’t have to click too far to see that this was more about the ego of this individual than the selfless mission to “make people smile.”

+ This is a fundamental law that you can take to the bank: When the focus of a doctor’s public presence is getting attention, they’re likely to wind up somewhere bad.

France to allow police to ‘spy through phones’

LeMonde is reporting that, as part of a justice reform bill, police will be allowed to remotely access citizen phones. No one is sure how they’ll actually pull this off. Scary stuff.

French police should be able to spy on suspects by remotely activating the camera, microphone and GPS of their phones and other devices, lawmakers agreed late on Wednesday, July 5. Part of a wider justice reform bill, the spying provision has been attacked by both the left and rights defenders as an authoritarian snoopers’ charter, though Justice Minister Éric Dupond-Moretti insists it would affect only “dozens of cases a year.”

Covering laptops, cars and other connected objects as well as phones, the measure would allow the geolocation of suspects in crimes punishable by at least five years’ jail. Devices could also be remotely activated to record sound and images of people suspected of terror offenses, as well as delinquency and organized crime.

My next read

Author Micah Cash traveled the southeastern United States visiting and photographing Waffle House restaurants, a project resulting in Wafflehouse Vistas. Here’s an interview with Atlas Obscura.

Journal retraction world record

German anesthesiologist Joachim Boldt has lost 20 more papers since January 2023, earning him the top spot in Retraction Watch’s Hall of Shame, with 184 retractions.

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