themantalope

I’m a physician in the US. In my experience main cost drivers are administration (documentation is part of it but the way billing works is you basically do the job, document what you did, then submit to the payer. This process can take 6+ months and they often just don’t pay for parts of it).

And then ICU/end of life. Way too many Americans don’t ever talk about what will happen when they die and what they do or don’t want at the end of life. Then they become incapacitated, family pursues all advanced therapies because they don’t know what to do and they spend a long time in the ICU getting things done for an unclear goal

Not to mention shoulder MRs can be hard to read. Findings can be subtle and have to be interpreted in context with the exam, symptoms etc.

lol yea I wasn’t going to put in a full dictation on the internet but clearly a lot of misinterpretations from the AI

That’s a good question.

My understanding is that medical images are part of a patients record (so they must be available for the patient or other docs at the request of the patient) but whoever has collected the images does have some form of ownership. I’m not a lawyer and I have a cursory understanding of this. I believe it would be possible for an AI company to lease or get access to the data through a transaction but I suspect that it hasn’t happened (or happened publicly) due to fear of backlash.

For example I know that some companies like Tempus had access to imaging that corresponded to tumors which had been biopsies for sequencing and they were developing models in house.

Somewhat. During residency I developed models for detecting liver tumors in MRI imaging. Like you said, highly specialized and a lot of manual work developing the dataset.

There are now open source open weight “foundation models” coming out of labs that are transformer or mamba based architectures. These will accelerate development.

I mostly do interventional radiology, which is more similar to a surgical specialty than a diagnostic radiology practice. We do a lot of procedures , see patients in our clinic, have a service that rounds on and follows up on patients etc. I don’t think AI will affect my job much in the next 10-20 years. Advancements in AI and robotics could potentially offload some of our work, but most of what’s out there is underwhelming, but we all know that can change fast.

Even for diagnostic, I’m not totally convinced AI is going to cause a lot of issues. From a medical-legal perspective I doubt AI companies are willing to take on the risk of misdiagnosis . When that happens, human rads will start to get phased out.

In the interim, I think the next 10 years could be a golden period for diagnostic rads. Rads will still be the ones doing the work and signing reports, but people who learn how to use the right combination of tools will become very productive and can make a great living. Eventually payers will re-align but early adopters who figure it out will have a leg up.

Radiologist. I don’t read MR shoulder exams in my day to day practice, but from the few pictures shown , I can’t conclusively disagree with the original report.

These models are generally terrible at reading medical images. The amount of public training data on the internet compared to the number of scans a radiologist reads in training is minuscule. There’s obviously a ton of medical images in general but very few, and even fewer along with a report are available on the internet publicly for download.

There are vision language models coming out of research labs that are excellent in describing and localizing findings. Still at the level of a 1st or 2nd year radiology resident, but as we all say - this is the worst the models will ever be.

Not sure. Image reconstruction/generation is a computationally intensive process, and in recent years DL based methods for improve image reconstruction have advanced fields like musculoskeletal MRI imaging. The physics behind this idea are interesting, but will have to wait to see if they produce images with high anatomic detail.

MRI uses EM radiation in the radiowave frequency band. This is using sound.

If you could obtain volumetric/3D ultrasound data that was not operator dependent, that would be great.

US is a good diagnostic tool, but it can be challenging to read because obtaining good images is very operator dependent. You need to have a good sonographer that can get the right views, knows how to adjust the imaging parameters to produce high quality images. It's not like CT or MR where the tech just sets a few basic scanning parameters and let the machine do its job.

However, see my other comment, the example images they provide on the page do not look great, very limited organ detail.

edit: clarification

Other than the shapes of the tissues in the images, there is no anatomic detail. Wouldn't be useful for diagnostics. It's substantially worse than conventional ultrasound.

radiologist here - example images don't look great

I’ve switched to open code and openrouter.

I only did the $20/month subscription since 9/2025

It was great for about 5 months, amazing in fact. I under utilized it.

For the past month, it’s basically unusable, both Claude code and just Claude chat. 1-2 prompts and I’m out. Last week I prob sent a total of 15 messages to Claude and was out of daily and weekly usage each day.

I get that the $20/month subscription isn’t a money maker for them, and they probably lose money. But the experience of using Claude has been ruined

There is a lot in this comment I agree with, however I think may universities have backed themselves into a corner with the degree of tuition inflation that has taken place over the last 20+ years.

I graduated from a SUNY school in 2012. At the time, you could still actually go to school and work part time and get through it. Not saying it was easy by any stretch but it was possible. Tuition + living expenses were about $17/year on campus , less expensive housing was available off campus.

Now, even state schools have tuition which is only affordable through family wealth or loans. Going to university is no longer a low stakes choice - if you flunk you’re stuck with that debt forever. Not to say students aren’t responsible for understanding that when signing up, but the stakes are just a lot higher than what it used to be.

Interesting but how would this prevent against “off-chain” collusion? A fraudulent seller captures brokers on the buy and sell side? Seller backs out of the deal unless they know who the brokers are?

I think this kind of behavior in principle would be detectable but in principle with enough concentration in the market, a fraudulent seller could in practice get brokers and jurors to collude with them.