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AI scribes help doctor to better focus and interact with patients

Columns

DEAR DR. ROACH: In your recent column, a reader complained about a doctor using AI to write after-visit summaries. I think my doctor has begun using AI for this purpose, but I like it. The reason why I think she is using AI is because she has begun looking at me while we discuss my health, rather than looking at her computer while she types the report. This feels much more personal, and the after-visit summary seems to be just as accurate. — G.U. ANSWER: I appreciate your writing. This is one good outcome from the use of AI scribes. It does often feel like we physicians are too busy ...

The cascade

Columns

I’ve been thinking about the cascade a lot. It could be because of the weather, the politics, the umpteenth “living through history” Millennial Moment, or any of a variety of other whims or nuances — but regardless of the reason, it’s been on my brain. What is the cascade? The cascade is a concept which has existed long before the phrase — a sprawling, ominous cloud that relates most closely to the collapse of everything. However, that concept was succinctly summarized — and perhaps bolstered against — by James S. A. Corey, a pen name used by a pair of ...

Efforts to increase sodium level in woman lead to frustration

Columns

DEAR DR. ROACH: I’m a 71-year-old female. I weigh about 96 pounds, and I’m 4 feet, 9 inches tall. My blood pressure has always been good. When I was 25 years old, I donated a kidney. I was told by doctors and nurses to drink lots of fluid to take care of my one remaining kidney. After watching what happened to my brother and the many patients in dialysis, I made sure to drink at least 16 cups of fluid a day, including coffee, tea and water. As far back as I can remember, my sodium levels have been between 126-129 mEq/mL. I have no symptoms, and my kidney function is good. I live ...

Moral metrics: Are corporate algorithms becoming our new moral authorities?

Columns

You check your credit score before applying for an apartment. Your fitness watch tells you whether you slept well enough. A workplace dashboard measures your productivity. Parents can buy devices that track their baby’s breathing and heart rate while they sleep. Increasingly, numbers tell us how we are doing. These systems promise something appealing: clear feedback about whether we are behaving well. They appear objective, neutral and data-driven. But they also signal a deeper cultural shift, as algorithms define what counts as virtuous behavior. In other words, we are living in ...

Dear Annie: Biting my tongue over husband’s bad habit

Columns

Dear Annie: My otherwise extremely well-mannered husband, “Ted,” has developed an unspeakably disgusting habit, and I need help addressing it. The backstory: About a year ago, there was an accident involving Ted, his brother and a couple of our nephews, which resulted in Ted losing five visible teeth. Our dentist removed the broken teeth and installed partial dentures. Ted has a very low pain tolerance and has had a difficult time adjusting to them. As a longtime denture wearer, I’ve told him that it takes time and that he needs to ask the dentist to adjust the partials if ...

Dear Annie: Kids’ privilege has distorted their perspectives

Columns

Dear Annie: My spouse and I chose to raise our kids in a neighborhood with excellent schools and a strong sense of community. The downside is that it’s also a very affluent area, and many of the families around us are far wealthier than we are. We work hard and live comfortably enough, but we can’t provide the kinds of luxuries that some of our children’s friends take for granted — brand-name clothes, international vacations, new cars at 16 and the latest electronics. Lately, our kids have started acting embarrassed about what we can’t afford. They complain that their friends ...