News You Can Use – Craig – Feb 2026 – FDA, AI, and the Paris Café We Deserve
Written by Dr Nick on March 9, 2026
This month’s episode of “News You Can Use” on HealthcareNOWRadio features news from the month of February 2026
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 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:
- Doximity ChatGPT
- AI Detection Algorithms
- LLM Use Cases
- Paris Cafe’s
- FDA Changes
If Billy Joel Ran the FDA
February apparently means two things: gray skies and regulatory whiplash. On this week’s show, Dr. Craig and I kicked things off with the FDA’s decision to ease drug approval requirements. Shifting from two rigorous studies to one for certain therapies. And like two aging rockers who remember the B-side better than the hit single, we both blurted out the same word: Thalidomide. Not funny. Not trivial. But deeply instructive. History tightened the rules for a reason. Now we’re loosening them because… vibes? Efficiency? Optimism? Look, there’s no perfect answer in medicine, only trade-offs. But when your shared, reflexive memory is a global drug disaster immortalized by Billy Joel in “We Didn’t Start the Fire,” maybe it’s worth pausing before declaring everything “perfectly cloudy.”
From there, we waded into the AI swamp. Specifically, Doximity’s version of ChatGPT and the broader LLM land grab in healthcare. The pitch is very seductive. Talk into your phone, get a pristine progress note, maybe even some suggested orders. Less typing, more doctoring.
Except…
Hallucinations are still a thing.
Compliance is a thing.
And copying chunks of a legal medical record into a third-party tool without ironclad safeguards is also very much a thing.
That said, when AI summarizes a chart so Doctors can spend more time actually looking at my patient instead of spelunking through 47 progress notes from 2009, that’s not trivial. As Craig pointed out, the real question isn’t
“Is it perfect?”
It’s
“Is it better than the gloriously flawed system we already have?”
Same standard we should be applying to drugs, self-driving cars, and pretty much everything else.
We also poked at AI-powered diagnostic gadgets, like the amped-up stethoscope that promises to detect heart failure and atrial fibrillation but, in at least one study, didn’t exactly set the world on fire. Meanwhile, handheld ultrasound is hovering over the stethoscope like a tech bro at a Blockbuster Video circa 2005.
Less Dashboard, More Doctor
Progress marches on. And yet, I can’t shake the feeling that medicine isn’t just data capture and signal detection. It’s touch. Trust. The absurd privilege of being allowed into someone’s physical and emotional space. Which brings me to Paris, where I watched a café hum along beautifully without customer satisfaction texts, incentive dashboards, or five-star ratings. Just professionals being professional. Maybe healthcare could use a little less algorithmic micromanagement and a little more Paris café energy.
Fewer cosmic pranks. More quiet competence.
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
It. Welcome to the month of February. I’m Dr Nick and I’m Dr Gregg. 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 leaves you wondering if it’s all just a cosmic prank.
Nick van Terheyden
This week, we take a look at Doximity chat, GPT and AI detection algorithms,
Craig Joseph
and we dive into llms and AI implementation.
Nick van Terheyden
But first off, this week, we have some changes at the FDA recently announced, and what we’re being told is that the FDA has updated its approval process, mechanisms, whatever, I think the the summary point that I got was it’s no more two rigorous studies to win approval for a new drug. It’s down to one. What do you think?
Craig Joseph
Well, as we were preparing for this, you we were discussing this at a try not to do the show before the show. But you said, Boy, this, this reminds me of just one word, and I don’t know if you think the same way, and I just looked at you and I said, thalidomide, right?
Nick van Terheyden
And it’s not a laughing matter, to be clear, but dear Lord, that was and that was exactly my mind went, I mean, it was like a rubber band snap. And I thought, maybe that’s just me, because I was in the UK, and I went to school with a kid that had, you know, thalidomide as a consequence, and I saw a fair amount of it, and I thought maybe I was tilted as a result of that, but I deliberately didn’t bias you, or tried not to buy you do, and you just came. It’s not just that’s an n of two. That’s like a whole study right.
Craig Joseph
There. It was professor, Dr Billy Joel, yeah, who, I think, exposed many, many Americans to the concept of thalidomide by mentioning it in we didn’t start the fire, which I will sing if I’m forced to,
Nick van Terheyden
you are you are being forced to because I enjoyed it so much the first time,
Craig Joseph
children of thalidomide. Oh, my God, please. And then there’s more. I actually pulled up the words, if you want me to do the whole thing.
Nick van Terheyden
Oh no, no, no, it’s okay. Karaoke, monkey
Craig Joseph
mafia, hula hoops, Castro Edsel is a no go. I’ll stop it there. I’ll stop it there. But for those, for those who don’t know who professor Dr Billy Joel is, he’s a famous pop singer. Yes, he was and writer and songwriter and, yeah, thalidomide to happen? Well, you could probably tell you were there to kind of on site, but essentially a medication that caused problems for pregnant women, for their fetuses, right? Wasn’t found out. It took, you know, commercially available, right? And and as a consequence of that, US authorities said, Hey, that we don’t want that. And tightened up the requirements for new medication to be even more rigorous in terms of testing.
Nick van Terheyden
And to be clear, this is tightening up the regulations that had already in this particular instance. And I think it was down to an individual at the top of I’m not sure what the organizations were, whether it was the FDA or whatever, but there was immense pressure. I mean, this is worldwide pressure to release this drug to the market. It was, I think, primarily for pregnant women. I tell me if I’m wrong, but it was to stop the nausea that I think that’s exactly right. It was, it was a combination of things that you go, wow, that’s and of course, then it had the catastrophic impact. And what was interesting, as I recall, because I’ve read about this a number of times, was that the individual, I don’t know who it was, was concerned about the safety day in the US, and despite the approvals and this immense pressure, resisted it. But there were a few cases because they allowed for, you know, what still goes on to this day, which is investigational trials where, you know, in. Individual physicians can say, hey, I’m going to test this. It’s not on the on the books for treat, you know, it’s off, off label, I think is, you know, one of the mechanisms of, I don’t want to say bypassing, I mean, there are legitimate use cases. Botox is one of them, albeit, you know, whether you consider that legitimate or not, but I mean, it’s used for other things, and it’s not on the label for and as a result, there were a few, I don’t know, but it was a handful compared to the just immense damage that was caused. And yet, despite the fact that that happened, they wanted to strengthen it further, and that was exactly the regulations that we got and have and have been working to, and now we’re saying, No, everything’s so much better. We can predict this stuff. I’m not convinced. I’m pretty sure you’re not just based on the fact that we both snap back to the same thing, right?
Craig Joseph
This is a, you know, there’s no good answer to this problem. And it’s kind of just like, hey, which problem do you want? Do you do you want good, safe, effective drugs held off the market for many years while we study to make sure and make sure again and make sure a third time? Or do you want the problem of having some drugs that did have a study that seems safe, and then go out in the general market, and then we find out problems when they, when they, you know, get used by a lot more people. There’s, there’s a somewhere in between, is the right answer. And I
Nick van Terheyden
don’t know, an n of two to an n of one is somewhere in between, is my view. I mean, I don’t know, but I think that’s exactly right as always in medicine, it’s gray, not black or white, typically, and there is some balance. But I don’t think that this is found. It’s very worrying. And maybe that’s just history. It’s like my parents, who went through, you know, shortages and war, rationing and everything, and that made them the people that they are. And you know, they looked at the waste from my generation, and I’m not even trotting after some people since. Is it an age related thing? Are we? Are we old timers and sitting in our chairs rocking away.
Craig Joseph
Yeah, you know, again, it relaxing some of these very rigorous requirements, some of the most rigorous in the in the world for certain types of drugs, has
Nick van Terheyden
already been done. Right? That’s exactly right, rare diseases, yeah,
Craig Joseph
rare diseases, or some horrible cancers where untreatable. And exactly, hey, if we don’t do anything, you’re going to die. So we might as well try these meds, and if they have side effects, they have side effects. Everyone’s going in with their eyes open. We’ve done that, and
Nick van Terheyden
we’ve had some pretty bad consequences. I think my recollection from some of those therapies that were tried. They were gene related. There was that awful case of the relatively young guy that died as a consequence. He ended up in complete catastrophic, I can’t even remember the details, but, you know, but no choice, no problem, in some instances, maybe,
Craig Joseph
yeah, I again, you know, you’re getting to the end of one with one patient and and their willingness to to move forward with treatments that are not proven to be effective or safe. And that’s, that’s fine, but yeah, it’s, we’re in on. We’re moving towards less charted territory. I wouldn’t I was about to say Uncharted. I’ll say less charted, yeah, territory of note, though, there are certainly still some medications and therapies that the FDA seems to not apply this to, right?
Nick van Terheyden
That was the that was the other thing. I mean, we’ve vaccines, yes, oh my god, yes. That’s right, modernas and the messenger RNA, that basically saved our bacon. Let’s be clear, yes,
Craig Joseph
but we’re not interested in moving forward, although again, FDA, backtrack, yeah, so it’s, it’s perfectly cloudy. I think that’s what we should come
Nick van Terheyden
to the conclusion. Oh, I’m back in the UK. Perfectly cloudy. Yes, perfectly cloudy. I don’t think I ever heard that on the weather report, but I’m sure if they’d heard it, they would have used it all right, so moving on. Doximity is G chat GPT. So Doximity has their own version of chat GPT. You and I have talked about this before we’ve got that they’re not the only ones. There’s obviously the opportunity to use this, and open evidence has open evidence, and I found that I found both to be useful. Any thoughts on that particular piece that we saw?
Craig Joseph
Well, well, it’s just, it’s, it’s like anything. Most doctors now work for large conglomerations. They control their it, and some of these it, systems like Doximity and like open evidence are saying, hey, you know, let us, we will for free. You can just turn on the microphone on your phone, and we’ll record the conversation in the clinic and create an office, create a progress note for you, and maybe suggest some orders for you, and do some other things. And that’s great, but now you’re running into some compliance and regulatory rules and and so we, you know, there was certainly seen articles where people have said, Well, I I had all this, all these progress notes and all these very complicated surgeries for this patient who I didn’t know very well. And so I copied all of that into, you know, to Doximity or to open evidence. And had it, had the, the large English model, yeah, and summarize it for me. And you know, couple problems, right? One is some of these tools. None of these tools are foolproof, right? And so they absolutely can, even though it’s much better than it was a year ago, they can hallucinate. They can tell you that the patient has this problem that was never identified anywhere. So that can happen, getting better, getting much better, but still can happen. And two, hey, if you’re copying information out of the patient’s legal medical record and putting it into a third party system that hasn’t dotted the I’s and cross the T’s with with respect to security and compliance, you’re running a big risk. And I guess it’s one thing if you’re a small office and those are risks that you’re willing to take, but it’s another thing if you work for some huge multi state organization. And so it’s, yeah, I don’t know what the right answer is. I think what’s going to happen is we’re going to see more and more of these tools be incorporated into the electronic health record, so it’ll all, at least on the from the user’s perspective, it’ll all be right there for you. Yeah, right. Oh, that’s that’s what we need.
Nick van Terheyden
But that’s still not solving the problem of the errors and the fact that they’re highly plausible errors Correct. That’s how they’re designed to be presented. It’s designed to be, yeah, that makes sense. And to be clear, I mean, I don’t think, I don’t think the case is settled, at least not based on the data that I see online in terms of the savings because the review time. I mean, if you talk to folks that use some of these tools, it’s not quite a straightforward cut and dried, oh yeah, this saved me all this time. I’m getting home early because I’m not seeing that, and I’m not hearing that. We do need studies. We just not seeing many of them.
Craig Joseph
Well, they’re, I think they’re happening. And there’s more than just time savings, of course, right? So there’s, there’s,
Nick van Terheyden
right? That’s absolutely yeah.
Craig Joseph
So if I’m, if I feel better about the time that I’m spending, and it feels less like monkey, you know, monkey work, and more like actual spending time with the patient, because the system has summarized a bunch of points to me, and now I can go to the patient and say, okay, so it looks like these things happened. Is this, is this your understanding? And let’s dig in deeper. And that’s that’s just higher quality time for me to spend than me doing the actual searching through the record and trying to find that one progress note. You know, if the patient, patient says I had brain surgery, but I can’t find it, that’s a waste, yeah,
Nick van Terheyden
but I actually thought you were going somewhere else. And I, you know, I agree even, even if it is costing you time and you’ve got to check it, and, you know, I think that validation your process, I’d say you should patent it, but I’m being flippant here. But I mean, I think you’re right. Is doing it in in conjunction, because there’s no better validation than the patient, because they tend to know. I know that’s not always true, at least in my experience, they don’t always know. But, you know, they’re a good validator, because they didn’t create the note and so forth. But the fact that you’re focusing on them as opposed to the technology, I think, is that’s, you know, it’s hard to quantify that, because that is huge value, at least for the patients, and I think for the physicians as well. So you know, point well taken,
Craig Joseph
yeah, and let me just say again, it’s only fair to compare when we’re doing these studies that you’re asking for and which are being done. It’s not fair to compare to perfection. It’s best to compare to what we would have gotten right. Standard way, right? So the standard way is you’re sick in a hospital bed, and I’m asking you a ton of questions about what happened 15 years ago, potentially, and and then your answers I’m recording is kind of doctrine, because that’s what you told me.
Nick van Terheyden
Can I just ask you to apply that to drug trials as well? So we should be comparing the latest release drug against the one that’s currently in use that works really effectively, as opposed to going against no therapy or therapy that is so old that, you know, we’ve gotten a lot. I’m just saying that’s good general advice.
Craig Joseph
I could not agree more. But this is part of the problem. We’ve talked about this before. Other shows you know where you’re looking at a car that drives itself and and comparing it to perfection, yes, versus comparing it to the average driver,
Nick van Terheyden
which is a better there is no such thing. Everybody is above average. We know this based on survey.
Craig Joseph
It depends on what state you live in, but I Yeah, yeah. So I think that’s fair. You just got to again, compare to what the patient was going to tell me, or what I was going to find by looking through this chart. Compare that. So if I’m going to there’s a chance I could make a mistake. There’s a chance the patient can make a mistake. There’s a chance that the LLM can make a mistake, right?
Nick van Terheyden
All right. So moving on, still in the same zone, I thought this AI detection study was interesting, albeit, didn’t come out with what I would call good news, the echo stethoscope, which just for the purposes of everybody you know, declaring. So I did receive one of these. I enjoyed using it to validate it. I shared it with colleagues, friends. Essentially, this was a study out of the UK, randomized. I wasn’t too excited about the randomization. I think it was difficult to sort of get into the detail, but it basically showed and this device amplifies, which I got to say, that was a huge positive for me, because I’ve always had trouble hearing with those damn stethoscopes. And you know, that was when my hearing was, I think, better. But it also tied together so you can it will give you a EKG readout, and it can tie to your phone and does an analysis. It can do an audio and EKG analysis, and they were testing to see if it improved detection rates for heart failure, atrial fibrillation, even valvular heart disease. And ultimately, what they showed was it didn’t it. They couldn’t demonstrate a decent validation of this as a value proposition. And what they saw, and I’ve got to say this was my experience as I shared the device, because I did was a dropping off of the use and in their particular instance, this was one of my criticisms of the study. I think this was a shared device. And I’m just going to say, not great. I don’t know that each individual physician got one. So it wasn’t necessarily, but there’s also a whole process, because you’ve got to then, you know, it’s got to be tight. You don’t just slap it on and listen. So they saw the decline. So not quite the value proposition that you know. Quite honestly, you can see, if you go listen and anybody that’s not a cardiologist, and maybe for even a few of those, it can detect things that we maybe might miss, because it’s got improved capabilities, but I think disappointing for them, but the jury’s still out, I think because there was another study that seem to demonstrate otherwise? Any thoughts?
Craig Joseph
Well, I’m looking at the study, and this was done between October of 2023, and May of 2024, so 500 years ago, this was done, relatively speaking, in terms of the tech advancement. Yeah, I, you know, as I’m, as I’m, you know, reading through, I’ve never used one of these things. It seems to me, it’s kind of going along the lines of the of the physical exam, which, which is also, I’m ready to go there. Why are we so here?
Nick van Terheyden
Why are we still doing it? Oh, my God. Why are we sacrilege?
Craig Joseph
Why are we talking about heart sounds? Dr, Nick, when we could be just sticking a ultrasound probe on your chest, squishing it around for 30 seconds.
Nick van Terheyden
Oh, says the heavy. Mission, right there, having, I mean, we’re not there, we’re not there, but, you know, we are pretty much close
Craig Joseph
to the thing, kind of telling you, much like, for those of us who have done, you know, face ID with with our phone and it says, move it to the left, move your face to the right, up, down. Okay. You know you can imagine. You don’t have to imagine it happens now, putting a probe with someone with very little training, move it up, move it right, move it on. Yeah, all right. And then it and then it’s interpreting for you, you know, the ejection fraction and everything else and the it’s kind of quaint to think about the heart sounds. Now, again, I’m pushing the body. I don’t need any no one, no cardiologists need to attack me. Clear.
Nick van Terheyden
Dr Topol, who is a cardiologist, is not because he has said that the day of the stethoscope is dead, I think. And I know a few young physicians who would be 100% in agreement, especially if they could carry around a butterfly for themselves, because they use it exactly as you describe. And I’m so envious, because if I had one of those things, I would be doing that all over the place. I mean, I’d be doing it on the animals in my house the whole bit. I mean,
Craig Joseph
on yourself. Yeah, absolutely, yeah, yeah. So that it’s a, yeah. So I think a, it’s, you know, it’s from a few years ago, and B, the tech, not the, you know, the future is not the stethoscope, the future is the ultrasound probe that I can just push around. And again, it’s weird. I don’t need the high quality of a real echocardiogram, right? That sure I would have better technology with trained experts who know what they’re doing. But I just need to know, hey, you’re just here, and instead of me trying to figure out what that systolic sounds means, if I can get some technologies to tell me that’d be better faster.
Nick van Terheyden
Yeah, no, I It’s fair comment, I guess I’m I’m bristling, because I got to say it’s one of the privileges. I’ll be frank, it’s a privilege to be allowed to touch and be that, you know, close to a patient. It’s a level of trust and and, you know, it delivers something more than just the diagnosis. It’s that connection, you know, holding a hand of a patient. It’s, you know, and I feel like that might all disappear with this, but, oh well, all right, so running out of time, I did want to get to Paris because, you know, that was important. It’s, I happened to stop into a cafe and observed. I mean, this started out because I noticed. I mean, it was around tipping originally, but it really sort of struck me that, you know, this Paris cafe was running just delightfully with none of the incentives. And, you know, I, my sense of this was, why can’t we have medicine more like that? Paris cafe, none of this incentive. I mean, I can’t tell you I am fed up of text messages, post everything. I go and C, medical or otherwise. Oh, could you give us a ranking? This is all about. It just seems like we’ve gone completely overboard on this.
Craig Joseph
Well, I’m certainly not going to disagree. I think one of your points was that, you know, when you treat professionals as if they’re high school students, then they’re going to start acting like high school students, right? I mean that in the in the best way. And so
Nick van Terheyden
no, you don’t.
Craig Joseph
You get, you get what you pay for. Dr Nick and your your ideas are, make, make a lot of sense. Again, back when I started, even when I started practice, not that long ago, all right? It was long ago, but not 150 years ago. Most, most residents who are leaving practice, we’re going to go open up their own office, right, or join with one or two other doctors, yeah, and now that’s almost unheard of, and this is part of the problem that we we have corporate overlords. I understand. I work for a big company as well, and they have to make rules, and some of the rules make sense and some of the rules don’t make sense, but they are. They’re all enforced equally.
Nick van Terheyden
Yeah, it’s, for me, it boils down to the fact, or at least I think partially boils down to the fact that there is always a bad app. There just always seems to be people that will push the boat out, you know, try and squeeze some and based on that, there’s a reaction, and it tends. Be an overreaction, and then you get this ping pong effect, and we have the same thing, you know, so we go chasing after people that are absolutely ripping off the system on both sides of this equation, and, you know, we all pay for that with all of this overhead. That just really frustrates me. But, well, yeah, anyway, wow. But Paris was nice, by the way. It was super warm, even though it was like in the 40s, but that was because of where I was coming from, so it was all good. But unfortunately, we find ourselves at the end of yet another episode exploring Healthcare’s mysteries before they become your emergencies. Until next time I’m Dr Nick
Craig Joseph
and I’m Dr Craig. You.
