Healthcare’s Wildest Hallucinations (And No, We’re Not Talking About AI… Or Are We?)
This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of April 2025
News You Can Use with your Hosts Dr Craig Joseph and Dr Nick van Terheyden
The show that gives you a quick insight into the latest news, twists, turns and debacles going on in healthcare withmy 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 months show that features a review of:
- Hallucinations on the Rise
- The Pitt
- Left Behind after Surgery
- Bending the Rules for ‘alternative’ treatments
- 5 Things You Should Clean now
Welcome to another episode of Healthcare: The Greatest Show on Earth, where we dissect the latest medical absurdities with the precision of a surgeon and the skepticism of a cat watching a magic trick. This month’s lineup? Rogue surgical sponges left behind like tragic party favors, and the rise of AI “hallucinations” (spoiler: they’re not the fun, psychedelic kind). Oh, and apparently, your dishwasher is dirtier than your gym socks. You’re welcome.
Let’s start with AI’s creative side—because nothing says “trustworthy” like a robot making up legal cases 50% of the time. We are thrilled (read: horrified) by OpenAI’s latest trick: confidently inventing facts like a toddler explaining how airplanes work. Meanwhile, our Craig’s AI thinks his Uber driver is German (his name was literally German). So, should we trust AI for medical advice? Only if you enjoy playing Russian Roulette with your diagnosis. Pro tip: If you’re asking ChatGPT for rabies vaccine facts, maybe just… call a doctor.
Next up: The Pitt, the medical drama so brutally accurate it makes Grey’s Anatomy look like Sesame Street. Realistic? Yes. Depressing? Also yes. Between the bureaucratic nightmares and the occasional scalpel left inside a patient (because oops), it’s a miracle anyone survives healthcare. Speaking of oops, did you know “never events” (like forgetting a sponge in someone’s abdomen) still happen? Technology was supposed to fix this, but alas, even robots can’t count.
The Art of Saying “Sure, Why Not” or Maybe Not
Ever had a patient beg for ivermectin to treat COVID? Certain that was happening during the Pandemic. We debate the ethics of bending rules for desperate families (Spoiler: It’s complicated, like a hospital billing department). And in a shocking twist, your dishwasher is a bacterial rave. Clean the filter, folks, unless you enjoy eating with a side of last week’s salmon.
Final takeaway? Healthcare is a mess, AI is a prankster, and your couch is plotting against you. Stay skeptical, stay sanitized, and for the love of everything, don’t trust the robots, whatever they might say their name is.
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 week keep solving healthcare’s mysteries before they become your emergencies
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
Nick, welcome to the month of April. I’m Dr Nick, and I’m Dr Craig. This week, we’ll be dissecting the latest healthcare news, unraveling twists and turns and trying to make some sense of the latest debacles. Just
Craig Joseph
remember, life’s a lot like a breaking news story, unpredictable, often absurd and occasionally leaves you wondering if it’s all just a big cosmic prank,
Nick van Terheyden
which it may be. Let’s be clear this week, we take a look at the scheming of the Medicare Advantage, medical loss ratio, alternative treatments in medicine, and
Craig Joseph
we dive into the pit what’s left inside after surgery. That’ll be a fun one and five things you should clean right now. But
Nick van Terheyden
first off, let’s talk about how hallucinations are on the rise. You getting more hallucinations? Gregg,
Craig Joseph
I am. In fact, you’re floating in front of me right now. But, oh, wait, no, that’s, that’s the computer. That’s, it’s the
Nick van Terheyden
virtual background right there for you. Sorry about that.
Craig Joseph
No, are these? These are not the kind of hallucinations I get. I think these are hallucinations that artificial intelligence is, yeah, so this
Nick van Terheyden
isn’t drug induced, although maybe it is, I don’t know. No, it’s so that. So there is actually an increase based on the latest models. And to be clear, I’m just going to declare my antithesis to hallucinations. This is the anthropomorphizing of artificial intelligence, which, you know, it’s not human it’s not a human activity, but we’ve given it this sort of human behavior to sort of short give you a shortcut to the fact that these models, when they respond, will actually make up things references. I mean, we’ve seen a number of, you know, pretty funny cases in law courts where you know they’ve made up cases that you know for submitting cases and so forth. And with the new open AI models, which I think you’re the rich guy, you pay money for these things, so you can maybe speak to this. But I believe oh three and oh four mini I think is the one. It a staggering I mean, I’m just going to call this staggeringly high rate at about 1/3 and in the mini up to 50% so half the time you’re going to get stuff that’s made I mean, I can go to my three year olds and ask them questions. I could get probably better results than that, or maybe not. Maybe it’s about the same.
Craig Joseph
Yeah. Well, as you said, I’m, I’m wealthy, and pay the $20 a month
Nick van Terheyden
to get the yes from all the money that I pay you for doing these things. Yeah, well,
Craig Joseph
and I’m hoping that I’m gonna get a raise soon. Yeah, you know it’s, you’re absolutely right. There’s no hallucination. And you’re also absolutely right. We anthropomorphize lots of things so that we can understand them, right? So that we
Nick van Terheyden
think that’s the excuse. Okay, I’ll go with it for now. I do. I think, you
Craig Joseph
know, we, we want to know how things work in the world, even though we, most of us, have very little idea, like, how electricity gets in the house. I really be,
Nick van Terheyden
for yourself, there’s a wire. I don’t know. I’m reading all about the Big Bang Theory. So I think I’m way ahead of the game. That’s fair. That’s enjoying it. I’m just gonna say,
Craig Joseph
so, yeah, we all, you know, a large language model works by predicting the next word or the next part of the word, or the next pixel, if it’s drawing a, you know, if it’s making some sort of artwork for you and and so it’s all, it’s all just math, and there’s really no thinking or understanding there. So saying it hallucinates or is also kind of saying that it’s lying or but it’s not really lying because it’s, again, just predicting the next word.
Nick van Terheyden
Oh, pick another word that anthropomorphizes. Yes, that will just
Craig Joseph
trigger me. It’s, it’s, once again, I feel like the line most of today. You know, a eyes is not where I’m gonna go to get facts and and,
Nick van Terheyden
okay, so you’re that one guy. I just don’t, because everybody I see, that’s the first thing that let’s ask chat. GPT, I
Craig Joseph
mean, I like to ask is all like I do that, but it’s, you know, you get what you get. And sometimes it’s very I, you know, I tell you, the worst AI that I’ve seen is on my very expensive iPhone, Apple intelligence. That’s. AI for for Apple, Apple intelligence, and, yeah, by their own admission, it’s really, really bad. But yesterday, I was getting an Uber, and I got a little, you know, pop up summary that my Uber driver was about to arrive and and then I it closed, and then the the on board AI summarizes that that message for me, even though it was pretty, pretty short message, and it said, it said, your German driver is about to arrive. And I was like, This is awesome.
Nick van Terheyden
Oh, my God, I can’t wait. Pulled out Google
Craig Joseph
Translate for my German driver in Boston to to to arrive. And then I clicked on it to actually look at what the message said. And it said, your driver whose first name happened to be the word German. It’s an unusual first name, I get it, but yeah, so he was not German. That was just his name. Okay, that’s there you go. I don’t know if that’s called in a hallucination or just bad AI, but either way, it’s the same thing. It’s giving me information that’s partially true. It’s partially true. Wasn’t fully off, but it implied that this, this gentleman, was from the country of Germany. He was not
Nick van Terheyden
Morgan. Couldn’t talk. Yeah, but Yeah, ready for it. Weren’t you?
Craig Joseph
I was, I would know, I
Nick van Terheyden
just have to ask one question, because you did cite Apple intelligence. Is that an oxymoron, or is that it
Craig Joseph
is now my right now it is really, is I it’s really, really bad. So I’m hoping that they’re gonna, I know they’ve made a bunch of changes. So
Nick van Terheyden
good news, it’s getting worse, so we can have even more fun next month. Yeah. But
Craig Joseph
anyway, and getting back to, you know, if you use tool improperly, then is it the tool’s fault? And if you’re asking to me, if you’re asking, like, fact based questions of an AI, right now, I’m not saying ever, it’s, you know, and then taking it as I guess that’s the next step, and then taking it as gospel. I actually,
Nick van Terheyden
I’m not so sure I agree with you, because I found a lot of the because what seems to happen, I’m assuming that I’m getting this because I’ll use Google sometimes, yeah. And I think I get an AI response to some of the things, the questions i Yes, yes. And I think some of those are pretty good. I mean, I got they are surprising. One they are so I’m going to ask you if I was to say to you rabies vaccines and where were they typically administered? What would you say in
Craig Joseph
what country or what part of the body? Historically,
Nick van Terheyden
when we used to give rabies vaccines, I mean,
Craig Joseph
again, in in what country, or how did we administer them on a human, on a human? I’m sorry, my understanding, I’ve never done it was around the bite. That’s what I that’s what I thought that one day.
Nick van Terheyden
So the prevailing I’ve never done it though, well, no, neither have I, but it was something that we all seem to know and learn. Maybe this was a cultural thing. They were administered into the abdomen, extraordinarily painful. And oh, it was. And it was 28 day course, and whatever. And when I was searching for this, it was because it was featured in one of these historical dramas that I’m watching 1920 something or the other they were doing this. And I’m thought, why is it that we do that? And then I went, I looked it up. Apparently it’s a bunch of BS. There’s no reason. Yeah, well, no, that we never did. There was some a little bit of history when it first happened, but no, it was always administered just somewhere. Yeah, anyway, well, well,
Craig Joseph
I, you know, hey, we, there’s a, there’s, I think what’s becoming a popular AI chat bot for for health care, which is open evidence.com, I don’t think we’ve ever discussed. We haven’t. We should put that on the list, open evidence.com, and it’s right now. It’s only available to physicians. You have to have a practitioner ID number to get a login. But it’s and it’s trained, so we can just talk about it at a high level. It’s trained only on journal articles and guidelines from you know, mainstream, you know, America
Nick van Terheyden
isn’t necessarily help to be clear, because, oh no,
Craig Joseph
no, it’s not trained on the internet, and so at least the evidence that it’s been trained on is accurate. I think physicians are starting to use it. I know I’m I’m playing around with it. My point is this, I can evaluate some of these claims to say, like, Oh, that makes sense. Yes, that’s what I was thinking. Or that seems like way out there and and one of the things that it does is it gives you, it’ll give you references to where it’s getting some of these, some of its. Acts from. And so if, if, for instance, for your your rabies vaccine, if it said, Well, this is how it’s been, this is how it’s best administered, it will give you a link to a authoritative, theoretically authoritative article or reference that you can look up and make sure that that is exactly what it says. And so that’s, that’s my point. That’s at least how I today deal with an AI, if it’s if it’s something important, which it often is not, but if it’s something important, then I want to go and double check it
Nick van Terheyden
all right. Well, so long topic. I was surprised. I don’t think we were expecting that, but there you go. So the pit, and we’re not talking about just general pits. This is the TV series The Pit, featuring Noah, who was in the original er which maybe inspired some people didn’t, whatever, but it was certainly one of the premier TV series medical dramas that tried to make it more realistic. You’ve seen one episode. I’ve seen a few more than that. Just to be clear, for an enemy listening, we are not going to feature any spoilers. I’m going to try very hard if I do, it’s, it’s, it’s your fault. Yes, of course it is. You always say that. So we Yeah,
Craig Joseph
well, I haven’t. I’ve only seen the first episode, so I can’t, right?
Nick van Terheyden
But I think the interesting thing is, I’ve heard a lot about it. I love it. I think it’s as close to the reality of what goes on both in a bad and in a good way, to sort of detail. You know, with even the, I’m going to call the administrative side of things. You know, the negativity and, you know, the oversight that comes into play, you know, is featured in the way that it impacts. There’s, you know, the medical details. I extraordinarily accurate. I think, as usual, with Hollywood, it’s all on fast forward. So the idea that you would see the things that you do absolutely, I mean, that was true with er, for you know, one hour episode, holy smokes, that would have been a, a, busy and B, bloody. What are your what do you say? I mean, I recommend it. I think everybody should see it, because I think it’s a good expose on, dear God, this is what’s going on. Yeah,
Craig Joseph
you know, I’ve seen a lot of emergency physicians say very positive things about it, like, it’s incredibly accurate. I I don’t know there were some, there were some aspects of it, at least the first episode, which is why I didn’t, haven’t gone on yet to see the second episode that I thought were not like, there was a lot of infighting and backstabbing among the of the especially the residents and medical students. And I have to say, like, I that was not my experience, no, it wasn’t mine. That’s true. Yep, you know, we were kind of all. There were people I didn’t like, for sure, but we, we were kind of all thrown into this ugly mess of a training thing. Mostly, we tried to work together. And unless you were really pathologic, it was the
Nick van Terheyden
Hollywood spin, because that allows them to create drama where,
Craig Joseph
yeah, and I found that. So that was kind of, I have to say, I was a little turned off by that. However, absolutely there are, if people don’t understand how our medical system, and I’m putting system in air quotes, works, then this will be an eye opener of Yeah, people who come to the emergency room because they don’t have anywhere else to go, or they can’t get into their primary care doctor, or they have social problems that are not cannot be addressed by healthcare. Yeah, it’s good.
Nick van Terheyden
So I think it’s two thumbs up from the docs, right? That at least certainly one thumbs up
Craig Joseph
medically. Medically. It’s two thumbs up. Okay? Clinically accurate. Clinically
Nick van Terheyden
accurate. I would say definite Thumbs up for watching. Moving on, I think this was a shocker for me. Latest News, or at least recent coverage, was, I think it was in the San Francisco times. I mean, it’s not laughing because, I mean, this used to happen. We left stuff behind impatience. I mean, there’s innumerable cases that you know would always get featured, certainly potentially, in Eminem. And you know, sometimes beyond that, and it’s still going on at an incredible rate. I mean, I read this and I go, gosh, if I have serious, you know, medical procedure and I’m under under anesthesia, the first thing I’m going to ask when I wake up, did you get everything out?
Yeah, well, I don’t know that it helps,
Nick van Terheyden
but lots of
Craig Joseph
different things. I think most commonly, it’s sponges, which are just kind of almost like little rags that are used to kind of soak up,
Nick van Terheyden
also bacteria, you know, absorbing pieces of,
Craig Joseph
yeah, well, not good. I mean, you can even leave a scalpel inside someone or, yeah, it’s, it’s bad and, and to your point, we’ve, this is not new, and it’s, it’s uncommon, but it’s, it still happens. And we’ve put in place all sorts of of workflows to try to prevent it, and we’ve now started adding technology to try and prevent it. For instance, the sponge count is something not helping. How many do we put in? How many do we see? I don’t think it is
Nick van Terheyden
please. Let please somebody tell us that that’s not true. And this is just, you know, headline grabbing eye. Eyeball grabbing headline rather,
Craig Joseph
yeah, these are never events, which means they are never supposed to happen, right? No, there’s no reason for it. Yet they’re still happening. And so will technology help or will technology hinder? Right? Sometimes we over engineer a technological solution and expecting the computer or some sort of technology to take responsibility and do a much better job than we pay less attention
Nick van Terheyden
so and and hallucinate and say, yeah, no, that one was, No,
Craig Joseph
we don’t hallucinate, but we don’t count the sponges. If you think you put 12 in, but you actually put 13 in, then it’s not so, it’s not so when you have 12 out account,
Nick van Terheyden
and, I mean, it was, it was a big deal then. And we tried, really, I just, I don’t know, maybe somebody can tell us why that’s still occurring. So, all right, so related to this, was a New York Times article that sort of talked about it was, I think it was titled, bending the rules. It was written by a physician, and it was really about alternative therapies. And, you know, patients coming in, and let’s pick one. I know I could get some hate mail. I certainly had a bunch of it during COVID over my sort of stand against ivermectin, which does not treat COVID 19. It had some positive notes in the laboratory, but never translated anyway. It would be like a patient coming with COVID 19, you know, and asking, Hey, I’d like you to give them ivermectin. And you know, especially if they’re not doing well for a variety of reasons, whatever those might be, you might, as a physician, say, gosh, you know, it’s not going to do any harm potentially. I don’t think you know, there’s not a lot of side effects, risk with this particular one, there was, where were some of the others, but, and, you know, I thought it was very thoughtful piece that talked about this and how they they wanted to, I think in the end, they did. But the question was, did that open the flood gates? And now you’re saying yes to this. Where does it stop? I mean, I imagine you’ve probably had, although, I will say from my practice, which was a while ago. I don’t remember any of this. I don’t remember people going, but I lived in, you know, this was the East End of London where, oh, yeah. Doc, whatever. What have you say? Doc, yeah, right, right on. Doc, jump off this bridge. I’ll do that right now, yeah, I didn’t have those patients. Oh, yeah, no, it was all over. It was, it was lovely. That was so nice. Sorry. Go on.
Craig Joseph
Well, I, you know, again, I’m a I’m a pediatrician. I think the biggest thing I had, and this was, as you mentioned several decades ago, for both of us, but yeah, I certainly had some parents who didn’t want either didn’t want any vaccines or didn’t want vaccines on the schedule that we would recommend, and it’s and this was actually brought up in that article in The New York Times about, well, what to do about that? And there’s no really great answer. So you can either say, No, I’m not going to do that, because that’s not in my I don’t believe that’s going to help. And certainly there are unintended consequences that we have. You get allergic reaction to a medicine that I didn’t even want to prescribe in the first place, and and you do more poorly. However, it also in this case was they were talking about a patient who was critically ill and was most very likely going to die, and the children wanted either some sort of supplement that they wanted to be put in through the G tube, and the doctor ultimately did it. They ultimately did it, and the patient died anyway, of course, right? But she thought, well, I’ve healed a little bit the family to help them think that they’ve done everything that they could. And and she also, the author, said something along the lines of, we doctors do this too, sometimes, sometimes we i. Hey, I don’t really think this antibiotic is going to help, but I want to do everything I can to help save this patient. And so we sometimes do things too that probably we wouldn’t normally do. So acknowledging that it’s a it’s complicated. There’s no right or wrong answer, but I think under under any circumstances, transparency is the most important thing, which is to say, Hey, I’m telling you that there’s no evidence that this, that this helps, but you want to, but if, under these circumstances, I will give it a try. But again, you know, this is, there isn’t a little bit of risk
Nick van Terheyden
there that it actually, you know, much like a rain dance that’s all about timing. You know, if you give it and it works and they were on, if you give it, right,
Craig Joseph
yeah, yeah, you’re, you’re right. But that’s a good problem. That’s a problem I wouldn’t mind having. Yeah,
Nick van Terheyden
no, that’s true. That’s true. All right, so we got a little bit of time left this, you know, it’s a little bit healthcare related. But to be clear, it was an article. I feel like it was a little clickbaity. It was one of these, you know, five things you should probably go clean now. And I’m Hmm, I wonder what’s in that list was, of course, my thinking. So I did click on it. I did send it to you. I asked you if you would predict anything. I don’t know. I think I probably would have gotten a couple of them, but I have to say, it certainly made me clean too out of those things that I was definitely worried about that I thought, hmm, yeah. And I was a bit surprised, and I’ll declare them, you know, one was the water bottle, because I use a water bottle almost every day, and I take it to the gym and, you know, I drink my water versus the chlorinated that they have in the fountains. And the other was the dishwasher, which I just didn’t think would be, because, I mean, that’s run at a super hot heat. Well, at least based on when I open it, when it’s, you know, just finished, I can’t touch the plate, so I can’t believe that anything would survive. But I have to say, my surprise having run the, you know, I It wasn’t an autoclave option, but it was close to it. And I ran that with whatever was in there, and then decided to take, and there was, there was a bunch of stuff, and I’m going,
Craig Joseph
Yeah, well, I wouldn’t have predicted the dishwasher toothbrush was on there. I would have predicted that,
Nick van Terheyden
yeah, that whole the toilet flush thing is just, I think people don’t realize, but if you’ve ever seen the video of it, you flush the toilet with the lid up, which you know, seems to be the norm. Dear God, the spread of,
Craig Joseph
yeah, I think that’s accurate. I don’t know how to spell, but
Nick van Terheyden
don’t worry, we’ll see what the trans the transcript shows. Actually, I’m gonna check that. That’s gonna be really interesting. What does the transcript say to the
Craig Joseph
Yeah, I think that’ll be fun. The with the dishwasher, the main recommendation was cleaning the I’m looking for the word the filter. That’s the word I was looking for, clearing, cleaning the filter at the bottom. If you do that regularly, you’re in much better you’re much better luck. So right, which I do? I do that. I do. Do that. I do. I am shocked. Yeah, I have always just because I if I see food down there. I’m like, No, that needs to get that needs to be scooped up immediately.
Nick van Terheyden
Wow. But you see, hold on a second, there’s i, if there was food down there, I’d scoop it up. But that’s the thing. In mine, there’s a big, deep well, and you pull that up, I can see it, no, no, not in mine. So, I mean, there wasn’t a lot to be clear. Mostly it it gets pushed out. I think the surprising one to me was the couch armrest, which I never would have guessed that. No, definitely, and I didn’t go rushing off to that because, quite honestly, I’m cleaning that most of the time because my damn cat sits on it, and I have to get all the hair off. Yeah.
Craig Joseph
And how do you like? How do you clean that if?
Nick van Terheyden
Oh, well, I have a special huge medufa thing, a huge medufu, a huge medufa, a huge, okay, huge medufa,
Craig Joseph
yeah, yeah, that’s another one. We’ll need to check the spelling, yeah.
Nick van Terheyden
We definitely have to see what the transcript says for that a huge medufa That essentially is a, you know how those sticky rolls used to be the thing that you got hair off thing? Yeah, so much superior to this. And it’s reusable, and it gets it unbelievable, I don’t I,
Craig Joseph
but that’s not, that’s not getting rid of bacteria.
Nick van Terheyden
Virus rubs it enough. It rubs it in. It’ll kill it somehow.
Craig Joseph
Okay? That’s, that’s great. That’s, that’s exactly how it works. It’ll somehow rub it rub off the bacteria, yeah. Well, listen, I think the the moral of the story is, don’t have a couch. Just stand, oh
Nick van Terheyden
absolutely Gosh. Just stand that learning point in there. Yeah, definitely feature that in the five bullet, five things you learned from
Craig Joseph
this is not a medical recommendation.
Nick van Terheyden
Don’t have cat actually, it’s not a bad one, because you could be standing a lot more, and then you Yeah,
yeah, she’ll
Nick van Terheyden
be happier, right? For sure, all right. Well, unfortunately, as usual, we find ourselves at the end of yet another episode that we explored health care’s mysteries and a few things beyond that, to be clear, before they became your emergencies, including the dishwasher getting too dirty. Until next time, I’m Dr Nick
Craig Joseph
and I’m Dr Craig. You.
