A Year-End Tour of Healthcare Absurdity – Broken Flux Capacitors, Robots Flying Planes, and Biff Is Running Healthcare
Written by Dr Nick on January 5, 2026
This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of December 2025
News You Can Use with your Hosts Dr Craig Joseph and Dr Nick van Terheyden
US Healthcare: Now Featuring Robots, Sepsis Confusion, and Spam
The show that gives you a quick insight into the latest news, twists, turns, and debacles going on in healthcare with my friend and co-host Craig Joseph, MD (@CraigJoseph), Chief Medical Officer at Nordic Consulting Partners, and myself, where every diagnosis comes with a side of humor. We hope you stay curious, stay engaged, and keep seeking the truth in healthcare in a world that thrives on information.
Buckle up as we dive into the ER of excitement, the ICU of irrationality, and the waiting room of wacky wisdom in this month’s show that features a review of:
- Predictions
- AI Foundations and Healthcare Use
- Where to Get Your Medical Advice
- Flying Unsupervised
To close out the year, we offer you our discussion on the world’s most expensive absurd drama that is also called US Healthcare, so grab your popcorn and settle in for this month’s edition of News You Can Use.
We kick off our discussion on the AI hype-train currently barreling through healthcare, and look at this post “How to Explain AI in Healthcare” that features a pyramid approach to assessing the technology that describes a hierarchy of AI, from the little “bots” (or “agentic AI“) scurrying around doing admin busywork, up to the lofty and often wrong “predictive AI” that tries to guess if a patient is about to crash. The big punchline? This top-level predictive AI can be about as reliable as weather forecasting (although in fairness, that has gotten better). Unfortunately, it’s often wrong operating as a mysterious “black box”, making doctors feel foolish for listening to it.
AI Can Land a Plane, But Can’t Fix Healthcare (Or LinkedIn)
In an interesting side note to the discussion, we found this story of incapacitated pilots of a Beechcraft King Air B200 at Rocky Mountain Metropolitan Airport in Broomfield, Colorado, that landed itself with a robot voice, sadly so robotic it probably confused the local air traffic controllers. So, yeah, the robots can land a plane, but they still can’t tell us why they think you have sepsis accurately.
We move to the overcrowded space for New Year predictions that come around every year, around this time. Bucking the trend of focus on the AI boom, we share our anticipated challenges centered on legislative action that will force many to lose their health insurance and the inevitable flood to the already-overwhelmed emergency rooms for care they can’t pay for, turning preventative medicine into a luxury item. And Craig saw the healthcare guidance going “Back to the Future” to a 1970s-style free-for-all, where recommendations are a patchwork mess, and the CDC has become a suggestion box. It’s like we’re all in a DeLorean, but the flux capacitor is broken, and Biff is in charge.
Finally, we wrapped up complaining about the true plague of our time: LinkedIn spam. We’re talking AI doom, systemic collapse, and yet the thing that nearly broke us was the mid-show deluge of messages from “startup HR managers” who’ve “carefully reviewed our resumes.” The cherry on top? The sketchy reach-outs from suspiciously attractive profiles that are so obvious, they’re almost insulting. Our advice? Report everyone. But as we confess, sadly, it seems to do absolutely nothing. So, in a year where AI might kill us or save us and the healthcare system is appears to be unraveling, the most persistent enemy is a bot with a stock photo and a bad sales pitch.
Happy New Year, everyone. Try not to get your next career opportunity from “CryptoHealthFanatic23.”
AI Might Save Us, Healthcare Might Collapse, LinkedIn Definitely Will
We hope you enjoy our take on the latest news and developments in healthcare and want to help you keep untangling the web of information, dodging the sensational pitfalls, and emerging victorious, albeit a little dizzy, on the other side. In the end, the stories we uncover, and the discussions we ignite, all shape the narrative of our shared future. We want to hear from you, especially if you have topics covered or questions you’d like answered. You can reach out directly via the contact form on my website, or send a message on LinkedIn to Craig or me.
Until next time keep solving healthcare’s mysteries before they become your emergencies and stay healthy, stay skeptical, and for heaven’s sake—check who’s listed as your emergency contact.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Raw Transcript
Nick van Terheyden
Welcome to the month of December. I’m Dr Nick and I’m Dr Craig. This week, we’ll be dissecting the latest healthcare news, unraveling twists and turns and making sense of some of the debacles.
Craig Joseph
Just remember, life’s a lot like a breaking news story, unpredictable, often absurd, and occasionally just leaves you wondering if it’s all a cosmic prank.
Nick van Terheyden
This week, we’ll take a look at predictions for the coming year and flying unsupervised,
Craig Joseph
and we dive into who to look to for advice, and LinkedIn reach outs.
Nick van Terheyden
But first off, this week, we’ve got aI foundations, and it really plays to the rest of the discussion around predictions, because that seems to be the effusive AI is going to solve anything. But first off, I wanted to call out a post that I saw that really sort of struck me as thoughtful, delivering something really insightful, and it’s how to explain AI in healthcare, and the four types of AI that every clinical leader needs to understand. And it reminded me of Maslow’s hierarchy, although, quite honestly, that’s just the pyramid and, you know, foundational pieces so but essentially, the founding or building blocks are a genetic AI, which is, you know, little, I’m going to call them bots. It sounds like I’m, you know, the the tiny little, you know, bots moving around, but really it’s just, you know, blocks of code, I guess, that can deliver efficiencies into the clinical process. I think we’ve got a number of those doing pretty well. And then clinical AI assistance that are, you know, taking information and providing some feedback, I guess, summarizing charts and so forth. And then generative, AI, which is, you know, creating the drafts. I’ll call out some of the ambient tools that are in the space. And then predictive, you know, and that’s one that, you know, appeared in a number of the denials spaces, revenue cycle management, where we attempt to say this patient’s going to have sepsis based on the information. It’s one of the I’m going to say it’s one of the most difficult things. It’s a long time since I’ve tried to sort of establish that clinically, I don’t know what’s your recollection when you were practicing? Was that an easy, easy thing to predict, or did people just go off? It’s it’s hard for me to recall. Was it easy to do?
Craig Joseph
Well, it’s not easy to predict the future. Dr, Nick, I’m going to tell you that right now. Are you sitting down
Nick van Terheyden
here on this cheap show? No,
Craig Joseph
if I could predict the future on some island, I’d be on an island for sure, for sure. Well, I think it’s, you know, the problem with we’ve been doing predictive AI for a long time, right? Generative AI came out of nowhere just a few years ago, seemingly out of nowhere for the for most of us, predictive AI we’ve had for a long time, and it, yeah, it’s easy to predict things right as they’re happening. It’s more complicated to predict things further further. You know,
Nick van Terheyden
you mean in the now, that’s I mean, when you
Craig Joseph
I think we, I think with any clinical experience, actually, any experience at all. I think all of us, no matter what we do, whether we’re clinical folks or not, like, if we’re an expert in something, we have this, this, you know, this weird sense that something’s about to go wrong, or that, oh, I don’t like the looks like, oh, I don’t like the sound of that engine, right? I I don’t like the looks of that patient. There’s, there’s something I don’t for sure, right? But, I mean, I think that’s prediction, right? Like, Well, what exactly don’t you like about this patient? What makes you? What exactly makes you? I don’t know. I can’t, and I’m not going to be right all the time, but I’m going to be right more than I’m right those predictions, I think we’re pretty good at but you know, the problem with predictive AI, which is again, at the top of that pyramid, is that it two things. One is it’s often wrong. So hey, this patient’s going to get sepsis. You might want to watch move them to ICU, because they might decompensate pretty quickly. So it’s wrong a lot. So how do you you can’t believe it all the time when it’s wrong a significant chunk of that time, or it doesn’t it’s also off in a black box, much like we are when we say, I don’t like the sound of that engine, we’re off in a black box. We don’t. Know why it wasn’t any one thing that we could put our finger on. The AI also doesn’t, kind of tell us. It doesn’t really often there’s no way to determine exactly why it’s making this prediction, which makes us humans much less likely to accept them. Right? Like some machine said, this patient’s gonna gonna I was going to say decompensate, but Crump is another word that we use, fall apart, not do well in the future. Well, they look great now, and all their labs look great. And I feel like an idiot sending them to the ICU, which is very expensive endeavor, and now you’re taking up an ICU bed for someone who might actually need it. And so there’s a lot of things going on, but I like this pyramid. I like the idea of the agentic AI, the agents, the bots, the little pieces of code that are kind of floating around looking for things to happen. That’s right. I mean, that seems to me like what they really are. They’re just waiting, waiting for a referral to come in, and then they do some magic, and they shoot some stuff off, and then they just go back to waiting for another referral to come in, but, and those are mostly administrative, right? Like there’s, we’re not really talking so much about clinical at this point. That’s at the clinical AI assistance, like you said, chart summary and triaging messages from patients that these five can wait This one’s very important. And then generative, creating progress notes and other things like that, sending explanations or patient instructions and terms that that patient can particularly do well with. And then, of course, predictive, AI, I do. I love it. It’s a good pyramid, and it does remind you of Maslow, because it’s also a pyramid I find Dr Nick that pyramids remind us of other pyramids. I predict that the next time you see a pyramid, you’re going to be like, Oh, it reminds me of this other pyramid.
Nick van Terheyden
Hold on the earth just shook there. Yeah. Are you sitting down?
Craig Joseph
I hope our audience is sitting down. I predict that next time you see a triangle. It will remind you of other triangles. That’s why people tune in.
Nick van Terheyden
Absolutely. I’m trying to think of the name of those little robots that were in the Stargate Universe that sort of wandered around. That’s what I envisage with agentic AI. And probably, you know, completely off, off base there. I think what I liked the most about that piece was it talked about specifically, the the challenge of oversight and why governance specifically. And I know a number of folks that you and I both know pretty well. You know, from the physician it world, talk about this a lot that you know, you can’t there’s no point in delivering solutions without the without the appropriate governance. It can’t just be generic. It’s got to be appropriately focused on the different sort of capabilities, because otherwise all this stuff just fails. And as this particular post points out, it tends to fail silently in many cases, and we don’t get to learn from it. And you know, so I liked it. I am going to call out something that I think, is really intriguing to me about AI, and it happened the last few days. It was the auto land of a private plane. It wasn’t a big plane. It was a Cessna, I think of some description that was having problems. And this was, I think, in the Rocky Mountains somewhere. It was a, oh, it was a Beechcraft. That was a Beechcraft King Air so twin engine plane, and the pilots became incapacitated, and they hit a button that is now available in some planes. It’s been around since 2024 and this is the first time I’ve seen anything of this. And I watched the, I’m going to say, animation that sort of covered the the activity. What was most interesting was listening to ATC air traffic control, and this automated system, despite the fact that it did something really difficult and complex, which was they pushed a button and said, We’re incapacitated. Obviously they weren’t completely but they couldn’t land the plane, and it actioned an auto land which says, let me find the closest runway Can I land there? And then, importantly, communicate that. And I think the most disappointing
Speaker 1
thing was the automated voice that came through on this is
Nick van Terheyden
beach crowd, you know. And instead of putting it, I know we could do better with voices. We’re good at that. But no, that’s what came. Him out. But, you know, essentially ATC cleared the airspace, closed the airport, and this thing landed. It was, I want to say, 20 minutes. That’s truly astounding. So this stuff is working. That’s a, you know, the top of that hierarchy. So we’ve got potential. That’s a very difficult task, but it was successful. So I’m excited that we can apply some of this. But I really worry about healthcare, because, much like that, this, this is about people’s lives. This isn’t just, you know, hey, oh no, that’s not sepsis. And you’re going, yeah, it is, yeah.
Craig Joseph
Well, there are certain points and I there have been people smarter than me. Physicians actually smarter than me, who have kind of talked about, well, when a when, not if, seemingly when AI, gets smarter than humans at certain things. Is it ethical to even have a human kind of in that loop?
Nick van Terheyden
So just medical driving, right there? Driving? Yeah, well,
Craig Joseph
exactly, exactly, right, exactly. So it doesn’t make sense to even have a human in the loop, because
Nick van Terheyden
50% of drivers think they’re the best drivers on the planet.
Craig Joseph
Yeah, my wife has said she doesn’t listen to this. So I can say this. My wife has said she would never get into a moving away mode, she will never get into a way Mo. And when I throw at her, like, oh my god, like, their percentages of accidents are so egregiously lower than any human, it’s almost not, it’s almost crazy that we, you know, still allow humans to drive. But then, of course, just a few, a few days ago, San Francisco had a big power outage. It did, and what happened to the way most Do you know? What happened to the way most I do
Nick van Terheyden
made for good video, they are stopped, yeah, blocked intersections. Oh, my God, the power’s off, stopped.
Craig Joseph
They didn’t know what to do, and they just stopped wherever they were, which, you know, again, from a safety standpoint, sure, but from a traffic standpoint, yeah, actually, that’s a good point. From a safety standpoint, it’s probably best to get off the side of the road somewhere, then stop,
Nick van Terheyden
especially in San Francisco, where the trams are still going, or maybe they weren’t, with the power out, possibly, I don’t know, but
Craig Joseph
yeah, yeah. So we’ve still got a little bit of a waste.
Nick van Terheyden
There’s still some room for improvement, let’s be clear. So fair enough. All right, well, so we’re at the end of the year. It’s certainly been an interesting year, I guess. What are your predictions? Any predictions I know, I sort of called out the disaster that’s unfolding as a result of some of the legislative actions that is just going to overwhelm our emergency departments that are already overwhelmed with patients that shouldn’t be there. More burnout, more whatever, more people uninsured. That to me, I think is going to be the biggest story next year, not the technology but, and I’m a technology guy, but I can’t see technology fixing that problem. Can you?
Craig Joseph
I cannot. And I think just for the sake of those listening who don’t aren’t really aware, a lot of people are about to lose access to reasonably priced health care, right? And so your prediction, which I think is shared by a large number of people, is that, hey, if your health care premiums that you have to pay every month for health care insurance double or triple, your chances are you’re not going to keep that insurance. You just won’t be able to pay for it, and there’s not an alternative where you can get something that’s more reasonably and so then you don’t have insurance. And so then what do you do? Well, for anything that can’t wait, you go to the emergency department. That’s what you do, which is not the right place for you. And for other things where they’re for prevention, forget about that. Like you don’t have money for that, which means that if there’s going to be a cancer or there’s going to be a serious infection, it’s, it’s, it’s just going to happen. And then, of course, we all know that your outcomes are not as good, and it costs a lot more to treat than does to prevent or to treat at the very beginning, as opposed to once, everything is kind of spread or shut down. So I think that’s a pretty safe a pretty safe, safe prediction, safe and pessimistic. And to continue, along with the safe and pessimistic, my prediction is Back to the Future. That’s what I’m calling. It Back to the Future we’ve seen over the last year, a big change in the way the federal government does health care. I’m going to talk about the CDC and FDA and those kinds of groups and and so they’ve they’ve made kind of writ large. Some changes to recommendations. And those there are recommendations, they’re not. None of them say, Hey, you have to get this shot before you go to school. States say that, but the federal government doesn’t have the power to say that, but they have a bully pulpit. They the CDC is always, this isn’t always, since I’ve been practicing, has always been in a position to say, like, this is what we think this is the consensus. And those were, that was a consensus with the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians and internal medicine, right? Those, those groups have kind of been all together and said, Okay, well, we think it should be tweaked a little bit, but we’re not going to argue. If you guys are fine, we’re fine. We’re just going to go going to go with this one big recommendation. And that’s often what insurance companies looked at and states looked at to see what they should do. Well, those have, in my opinion, and this is just simply my opinion, I think we’ve made a reversal from kind of fact based, science based recommendations. And a lot of the recommendations now coming out, it either they’re, they’re different than they were, based on no new science, or there just are no more recommendations. Hey, we’re getting out of the recommending game. You should talk to your doctor. You know, those kinds of things, as opposed to these are the, these are the things that you should do for your health. And so my prediction Back to the Future is the kind of the way it was in the 70s and 80s. 1970s and 80s, where there were, you didn’t really have the government, federal government, coordinating these recommendations. It was every state kind of just was its own little fiefdom. And the American Academy of Pediatrics and the American, I think it’s the Academy of Family Physicians would would put out slightly different recommendations, like 90% overlapping, but 10% slightly different, probably not even meaningfully different, but, you know, slightly different. We think it should be four weeks. We should think it should be five weeks, like those kinds of things. That’s where we’re going back to now. So I think, as a pediatrician, I’m looking to the American Academy of Pediatrics for recommendations, not the CDC, and that’s the way it used to be. I’m not sure that was better that way. I don’t think it was, but that’s that was my prediction, that you’re going to see less and less of the federal government being an authoritative source of information, and more of that authoritative source being the states or regions of the states. So several states banding together and saying, we’re making these recommendations and and the groups of physicians and scientists who have always been there, traditionally have participated with the federal government, but kind of distancing themselves. Now that’s my sad and pessimistic prediction.
Nick van Terheyden
Well, I got to say that, you know, I was humming Back to the Future in my back of my mind, because one of my favorite. I it was a great, great theme song. Had some interesting background. I don’t know whether you knew this, but it actually, when they approached Huey Lewis to do it, he wasn’t interested, and, you know, declined. And then I think he read the script or got the outline or something, and wrote it over the weekend or something. I mean, that was, you know, that’s the story behind it, and it’s just so anyway, you can’t listen to that without sort of thinking about it. I think what’s really striking to me, and of course, this is because I’m not from this country and didn’t grow up in this healthcare system, and whatever is the fact that that was the case before that I would never have imagined that. That’s where it started. But of course, this whole federated states that sit below the federal government, and this interaction, you know, that is all foundational to the way that things work here, it’s just, it’s shocking to me that that was the case and that, you know, we stepped forward, but now we, I’ve got to say, it sounds like Back to the Future, not in a good way, like the movies, because they were, they were lot of fun, although Biff was a bit, you know, not, not Excited about his behavior. But we did overcome him. Eventually we did. So I look, I mean, it’s a struggle for me, because obviously I get asked by folks, and I try and sort of navigate this without, you know, pushing a narrative, you know, recognizing that you it’s very difficult to change people’s minds. I understand that. We learned that a lot through covid, right? And our ability to change people’s minds doesn’t start with you’re wrong. No, although i There are occasions that I feel like saying that, but that’s not the way. But. Um, oh, hold on. I just got a LinkedIn message. I’ve got a new job. It’s coming in right now.
Craig Joseph
Are you making fun? I feel like you’re making which brings me to making me You’re making fun of me as
Nick van Terheyden
I’m not, because I get them the same as you do and I’m I read Dr Jane’s piece, and, you know, I think the only thing that struck me about her commentary about this was very similar, although I think you know different collection of folks that we get depending on our profile online. But what she didn’t mention was what I get, and I’m sure you do, which is all the reach outs from young women with fashion status photos that you know are reaching out for something or the other, and they’re so obvious because of The pictures, primarily, and I, actually, I wondered if she did get the opposite with handsome young men like you,
Craig Joseph
it’s mostly me.
Nick van Terheyden
And she said, No, not a one. And, you know, she said, there’s, there’s no women that is foolish enough to do that. I thought, yeah, that’s probably right.
Craig Joseph
I send her a lot of of messages. I brought this up to you because
Nick van Terheyden
as we were you literally did get a message while
Craig Joseph
as we were going on the air, as we were going on the air, I said, Oh, wait, hang on my my phone is buzzing and and it is a message from LinkedIn, our favorite social media startup. It’s not really a startup, and it said, Hello, I’m the and, you know, I only get a little blurb, right? I only get like, three lines. I can’t really see the rest of the message without opening up the the app, which I haven’t done. But this is just on my on my phone. It says, Hello, I’m the human resources manager of a startup company. Exclamation mark, which I thought, wow, okay, we’re excited. And then the next sense was, After carefully reviewing your resume, and that’s where it stopped. Dr, Nick, I don’t know there’s more.
Nick van Terheyden
Well, you were ready to quit the show you. You had moved to your island, that’s
Craig Joseph
i i so i did hang up on you, which I apologize for, and and you called me back and and you said, so what does it say? The rest of it? And I’m, I’m just too excited to even read it right now. I haven’t gotten past that After carefully reviewing your resume.
Nick van Terheyden
There’s something more, well, I think I’m going to say that the most shocking thing to me is the fact that you have those alerts coming to your phone from LinkedIn. Because not only do I get those on LinkedIn when I go and check in and whatever, but I also get text messages, and I would say, on average, one a day, at least text messages direct to my phone with some variant of this tripe that is, you know, and some very clever ones I will, you know, I’ll confess the occasional one that actually gets my name correct. I’m wondering if that’s random, or they’ve actually, you know, tied things together. Mostly it’s very bland or generic and but there were, I actually got a lot over Thanksgiving. Did you get a bunch in thanksgiving that it’s been happy Thanksgiving, which is, you know, that’s a good start.
Craig Joseph
Yeah, yeah, no, I’d say it’s been constant for me. And I did apologize for sending a lot of those to you. But I really thought it was a good opportunity, and I wanted to, I did want, I wanted my number the bargain basement opportunity, because this thing’s really going to hit and all you have to do is say, No, you don’t have to go on on a podcast or radio station and make a big deal out of it and publicly shame me like that.
Nick van Terheyden
So Well, look, all I’m going to ask, I’m going to plead with folks, although I don’t know, is it making any difference, but in all these instances, please, please, please report them. So I do that on LinkedIn, I take the, you know, obvious, whatever, and I the first thing I do is report to LinkedIn as I think typically, I select not a real person or something, and then I block it. And I do the same where I get the opportunity. I don’t always get the opportunity on the text messages, but if I do, I report them all, it hasn’t stopped or even decreased the flow. In fact, they seem to increase. So maybe I’m just wasting my time and I should just delete. I don’t know.
Craig Joseph
I don’t know. I on on my iPhone. I do click that, you know, for text, I do click the Report and. A spam or something. But so you do? I do that, but I don’t know that it does anything.
Nick van Terheyden
No, I think it probably doesn’t. Oh, well, that’s the end of our show for the year. What a way to end spam messages on social media?
Craig Joseph
Predictions of the future,
Nick van Terheyden
predictions of the future. Well as as we do each and every month, we find ourselves at the end of another episode exploring Healthcare’s mysteries before they become your emergencies or your fraud until next time and until next year, I’m Dr Nick,
Craig Joseph
and I until next year, am Dr Craig, and
Nick van Terheyden
next year, You’ll be something else, won’t you?
Craig Joseph
I will.
