Ben White

Back in 2018, fresh out of training, I was asked, along with some physician finance bloggers, to contribute an answer to an article about early-career financial mistakes (my post about that post is here). That post is now defunct, but my answer at the time:

“The ‘correct’ answer is usually to spend less on a car, not buy a house, put more away for retirement, and get disability insurance. But looking back, my biggest real regret is not being more purposeful with my discretionary time. Time outside of work obligations has both a monetary and nonmonetary value, and I was very free with spending too much of it to ‘maximize’ my income at rates that are trivial to me now. I was worth more on a per-hour basis back then, even if I didn’t realize it.”

// 08.10.26

Medicine is a Loser’s Game

08.06.26 // Medicine

In his 1971 book, Extraordinary Tennis for the Ordinary Player, Dr. Simon Ramo (also known as, of all things, the “father of the intercontinental ballistic missile”) popularized the concept of Loser’s Games and Winner’s Games:

The notion is that professional tennis is a Winner’s Game, where you win through high athletic achievement and hitting incredible shots, whereas amateur tennis is a Loser’s Game, where you win by avoiding unforced errors (i.e. you win by “not losing”).

Medicine, and especially radiology—which is especially prone to post-hoc criticism thanks to the permanent unchangeable nature of the images themselves—is much more the art of avoiding unforced errors than the art of hitting home runs. After all, common things are common. Horses, not zebras, as they say.

This is the purpose of search patterns and good habits: to build and achieve consistency.

It remains to be seen if and how and when AI might change what kind of game medicine is.

The Purpose of Perception

08.03.26 // Reading

From Douglas Hoffman’s “Interface Theory of Perception” as described in 2019’s The Case Against Reality:

The purpose of a desktop interface is not to show you the ‘truth’ of the computer — where ‘truth,’ in this metaphor, refers to circuits, voltages, and layers of software. Rather, the purpose of an interface is to hide the ‘truth’ and to show simple graphics that help you perform useful tasks such as crafting emails and editing photos. If you had to toggle voltages to craft an email, your friends would never hear from you. That is what evolution has done. It has endowed us with senses that hide the truth and display the simple icons we need to survive long enough to raise offspring. Space, as you perceive it when you look around, is just your desktop — a 3D desktop. Apples, snakes, and other physical objects are simply icons in your 3D desktop.

Interesting.

Steven Pinker essentially summed up the argument well back in 1997:

We are organisms, not angels, and our minds are organs, not pipelines to the truth. Our minds evolved by natural selection to solve problems that were life-and-death matters to our ancestors, not to commune with correctness.

As British statistician George E.P. Box once famously said, “All models are wrong, but some are useful.”

Radiology Jobs

08.01.26 // Radiology

I believe in the importance of thriving independent private practices for the field of radiology. True private practice—where doctors control the organization, are responsible to their peers and patients, and earn the full fruits of their labor—is the benchmark that sets the market and provides the anchor against exploitation from unscrupulous employers.

My group, like most groups in this market, is hiring. Here are several more 100%-independent radiologist-owned private practices across the US that are recruiting. If you’re in the market for a new position, consider reaching out with your CV. (Click the triangles for more information.)

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Reno Radiological Associates

(Reno, Nevada)

Serving Northern Nevada since 1947, RRA is a strong, highly subspecialized, democratic, extremely collegial, high-earning group of 25 radiologists working in perhaps the best city in the country for raising a family and enjoying unparalleled access to natural beauty, endless outdoor activities (perhaps the best ski-city in the US), and incredible weather (jokingly referred to as “the cheapest city in California” for its proximity to Lake Tahoe (<30 min), Napa Valley, national parks, and more without the super high cost of living and no state income tax).

Shareholder Track (onsite):

  • 1 year to 75% partner, 2 years to 100%
  • Top 90+% comp nationally, maximally generous benefits
  • 8/9/10+ weeks of vacation
  • Remote shifts + opportunities for extra income, $100 buy-in

Employee Track (remote or onsite):

  • High comp, Maximally generous benefits, opportunities for extra income
  • Onsite preferred, fully remote night (8p-3a PST) or early morning (6a-2p EST) available

Independent Contractor:

  • Flexible shift options, high compensation

Learn more at http://www.renorad.com/
Contact: CEO Anthony Dispenziere at adispenziere@renorad.com

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Vantage Radiology & Diagnostic Services

(Near Seattle, Washington)

~35 subspecialized radiologists practicing near Seattle and enjoying a quality lifestyle focused on work-life balance, located minutes from urban amenities, and with easy access to abundant outdoor activities in the natural beauty of the Pacific Northwest. We’ve provided professional services for two hospitals since 1970 and are co-owners of their affiliated imaging centers.

  • Competitive salary ($370-570k) with a signing bonus for a 4-day work week and 8 weeks of vacation.
  • Benefits include a CME allowance, memberships to professional societies, profit-sharing, malpractice and disability insurance, 401K contributions, and a commitment to associate mentorship.
  • All partners and partner-track associates share in general call responsibilities (many from a practice-provided remote home workstation). Overnight call is covered by our internal nighthawk team.

Openings:

Swing:
  • 4PM – 1AM PST from Monday to Friday.
  • 2PM – Midnight on Saturdays and Sundays.
  • Practice is open to flexible staffing solutions or a combination of above shifts
  • Additional compensation as desired via internal moonlighting or reading OP cases as swing shift case volumes permit
  • Concurrent staffing with at least one other radiologist.
  • Caseload volume is approximately 60-65 wRVU per weekday and 70 wRVU for the weekend.
  • Salary for 7 days is approximately $25,000.
  • May be 1099 or W2.
  • Benefits are available at cost as desired.
Breast:
  • Approximately 75% breast imaging and 25% general radiology or 100% breast (full-time or 3/4 time).
  • Qualified candidates must be skilled in all breast imaging studies and procedures including screening and diagnostic mammography, ultrasound, MRI, and needle/Savi Scout localization and biopsy.
  • Participation in weekly breast tumor conference.
  • No IR requirements
Neuroradiology:
  • Full-time or 3/4-time partnership-track hybrid position
  • Neuroradiology daytime shifts. Typical general ER/inpatient evening and weekend call shifts from home.
  • No breast or IR requirements
Body:
  • Full-time or 3/4-time partnership-track hybrid position
  • Abdominal daytime shifts with body MRI, multiphase CT, and general radiology. Typical general ER/inpatient evening and weekend call shifts from home.
  • No breast or IR requirements
IR:
  • Full-time partnership track position for fellowship-trained IR
  • Caseload consists of venous access, biopsies, dialysis access, interventional oncology, TIPS/BRTO, central and peripheral venous therapies, pelvic congestion and UFE, and emergent angiography interventions, as well as general radiology (no breast required).
  • In the past several years, we have developed new service lines and are looking for future growth leaders. Daily work is supported by 2 IR PAs and clinic staff.
  • Competitive salary + signing bonus, with additional incentive-based pay opportunities

Learn more at https://www.vrads.com/
Contact: recruiting@vrads.com

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South Texas Radiology Group

(San Antonio, Texas)

STRG is a well-established, expanding, independent subspecialty practice of 70+ radiologists serving 15 hospitals, multiple freestanding ED facilities, and a large outpatient imaging practice (STRIC). Both onsite and remote positions are available.

STRG is a forward-thinking practice with a strong and cohesive culture. Multiple AI projects are in place and in progress to improve efficiency and quality. Internal moonlighting opportunities are available.

Shareholder Track:

  • Flexible associate period as short as 18-months.
  • Leads to full partnership with board of directors membership.
  • Equity ownership within a large expanding outpatient imaging practice (STRIC)
  • Competitive salary with up to $800K starting salary for experienced applicants. Up to $600K starting salary for inexperienced applicants.
  • Excellent benefits package
  • Onsite and work-from-home options for daily work and call
  • Hiring across all specialties, with a current emphasis on Body Imaging and Cardiothoracic/Body

Emergency Radiology Track:

  • 1 week on/1 week off (7/7) and 1 week on/2 weeks off (7/14) positions available
  • Competitive salary with excellent benefits package available.
  • Fully remote and onsite options available.

Employee Mammography Position (Onsite):

  • Competitive base salary with excellent benefits package
  • No call. No nights or weekends.
  • Remote opportunities available for general radiology or body imaging work if interested.

Employee Position – All Subspecialties (Onsite, Hybrid, or Remote ):

  • Competitive base salary with excellent benefits package
  • 5.5 weekends (day shift) per year. No evening or overnight call.

Learn more at https://stric.com/.
Contact: Waynea Finley at wfinley@strg-pa.com

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Kettering Network Radiologists

(Dayton, Ohio)

Kettering Network Radiologists, Inc. (KNRI) is a physician-owned, independent private practice serving Kettering Health’s extensive network. Our team consists of 56 radiologists, 8 physician assistants, and 8 radiology residents, providing high-quality imaging services across  8 hospitals (115-500 beds), 20 outpatient centers, 11 emergency departments, and 2 trauma centers (one Level II, one Level III).

Overnight:
  • 1 week on / 2 weeks off rotation (3 night radiologists are working every night shift)
  • Scheduled shifts (EST):
    • 9 PM – 6 AM, 6 PM – 3 AM, and 7 PM – 4 AM
  • Productivity bonus for those working overnight shifts. Additional individual shifts are available for extra pay but are not required.
Swing Shift:
  • Monday – Friday schedule, contracted for 5 days per week with the radiologist choosing between 10-17 weeks of vacation.
  • Includes 5-weekend shifts per year, with the radiologist selecting their preferred weekends.
  • Scheduled shifts (EST):
    • 12 PM – 9 PM, 2 PM – 11 PM, 3 PM – 12 AM
  • Weekend shifts include:
    • 6 AM – 3 PM, 9 AM – 6 PM, 11 AM – 8 PM, 12 PM – 9 PM, 2 PM – 11 PM, 3 PM – 12 AM
Daytime Neuro:
  • Partnership Track on-site/hybrid role
  • Standard 4- or 5-day workweek with 5 weekends per year.
5-on/9-off Neuro:
  • 5 days on (Thursday – Monday) followed by 9 days off (Tuesday – following Wednesday).
  • This schedule amounts to ~130 shifts per year with each work cycle being 5 consecutive days.

When working ER or night shifts, you are never alone—always part of a team. We are a stable, well-compensated group, enjoying flexible scheduling with very comprehensive benefits.

Contact: Dr. Rachel Shikhman at rachel.shikhman@gmail.com

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RAPA

(Central Arkansas [Little Rock, Conway, Searcy, and Pine Bluff] & Northwest Arkansas)

40+ radiologists covering 20+ sites (hospitals + clinics) with a multi-subspecialty mix of inpatient, outpatient, and ED imaging.

Robust reading room assistants and IT presence to promote peak efficiency. Unified Clario reading list, Inteleviewer PACS, Powerscribe dictation (no switching stations or PACS to read other sites). RadAI automated impressions to improve efficiency.

Partnership track – Central Arkansas (Little Rock, Conway, Searcy, and Pine Bluff) and Northwest Arkansas:
  • 1 year to partnership
  • 10 weeks vacation + 1/2 day off per week on average for partners
  • Highly competitive compensation combined with low cost of living
  • Internal moonlighting options to boost income
  • Robust CME allowance, signing and moving bonuses, full benefits
  • Many work-from-home shift options
  • Minimal after-hours requirements – overnight shifts are fully staffed with telerads
100% Remote Nighthawk, partnership track:
  • 7 on/14 off, 10 pm-7:45 am CST
  • 1 year to partnership
  • Competitive compensation, robust CME allowance, signing bonus, full benefits
Daytime Teleradiology:
  • 100% remote.
  • Subspecialty work available with up to 50/50 split with general radiology
  • Option for employed or partner track. Partner track includes call weekend shifts, approximately 1 in 5 weekends.
Employee track:
  • General radiology, mammography, and other options available
  • Fully remote, hybrid, or on-site options available
  • Flexible scheduling including daytime teleradiology, 7 on/14 off. General radiology, but any subspecialty is a plus.
  • Competitive salaries
  • Robust CME allowance, signing and moving bonuses, full benefits

Greatest needs are IR, mammography, body imaging, MSK, and nuclear medicine, but all subspecialties and general radiologists are welcome.

Learn more at http://rapaxray.com/
Contact: recruitment@rapaxray.com and Dr. Brandon Kelly at bkelly@rapaxray.com

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Eastern Radiologists

(Greenville & Coastal North Carolina)

Eastern Radiologists is a private practice in Eastern North Carolina that is physician-owned and operated and seeking to hire multiple radiologists due to growth and retirement. The well-established private practice serves a large geographic region through 14 area hospitals and several state-of-the-art imaging centers. Support is provided by nearly 70 subspecialty radiologists.

Currently seeking candidates in all subspecialties.

Details:

  • Positions are available in Greenville and other coastal communities in Eastern North Carolina.
  • Most are partnership track positions which include evening and weekend call responsibilities, but other employment options can be considered. Employment positions can be customized to fit desired schedule/income. Internal moonlighting is available for extra income.
  • Most specialties can work nearly 100% in their desired field of interest.
  • Great benefits, competitive salary including profit sharing and bonus, generous vacation and paid family leave, and business/educational discretionary account.
  • Sign-on bonus

Learn more at https://www.easternrad.com.
Contact: Erica Askew at easkew@easternrad.com

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Radiology and Imaging Specialists

(Central Florida: Lakeland/Winter Haven, SW Orlando, Bradenton)

Independent and long-standing group covering a diverse mix of financially sound hospital partners, outpatient imaging centers, an ASC/OBL, clinics, and a multi-specialty group. 50+ radiologists and 10+ midlevel providers. In-house and experienced IT, Credentialing, HR, and Admin team including dedicated Radiology Liaison support 24/7/365.

Recruiting for Body, Breast, Cardiac, Neuro, IR, and General.

Partnership Track:

  • 1-year track for diagnostic radiologists, 2-year track for interventional radiologists
  • 10 weeks of vacation
  • Sign-on bonus for diagnostic radiologists
  • Call compensation for interventional radiologists
  • Internal moonlighting available but not required
  • Full benefits including CME allocation

Employee or Contractor:

  • Flexible scheduling: Hospital (ED/IP) or outpatient coverage options available
  • Fully remote, hybrid, or on-site depending on location(s) and coverage schedule desired
  • Competitive compensation models (including benefits if employed/full-time)

Learn more at http://risimaging.com.
Contact: Alice Varnadore, Executive Assistant at avarnadore@risimaging.com

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Midwest Radiology

(Minneapolis – St. Paul, Minnesota)

Large 175+ subspecialized practice with 17 weeks of vacation. Two-year shareholder track for new graduates and a one-year track with experience.

Positions (On-site):

Body (100% Body) – Regions Hospital
  • Mix of shifts worked on-site
  • Mixture of hospital, outpatient, and remote
  • Interpret MRI, CT, U/S, and radiographs
  • After-hours coverage provided internally by the emergency radiology section
  • No neuro or MSK
Body/Mammo – Western Wisconsin
  • 45-minute drive from the Twin Cities.
  • No overnights, evenings, or weekends required.
  • Interpreting CT, US, body MRI, plain film and mammography studies.
  • Onsite procedures include general fluoroscopy, minor ultrasound, paracentesis, and thoracentesis.
  • No neuro or MSK.
General Body/Mammo
  • Regional hospital sites north and west of the Minneapolis/St. Paul area.
  • Interpreting CT, US, body MRI, plain film and mammography studies.
  • Onsite procedures include general fluoroscopy, minor ultrasound, paracentesis and thoracentesis.
  • No neuro or MSK.
Pediatric Radiologist (100% Peds if desired)
  • General pediatric imaging including fluoroscopy, CT and ultrasound.
  • Experience in MR is optional.
  • Hospital-based.
  • 100% pediatrics if desired (may split time between pediatrics and an additional section).
Neuroradiologist (100% Neuro)
  • Daytime, on-site neuroradiologist.
  • All evenings and 95% of weekend call shifts are off-site.
  • Hybrid weekday (2-3 remote daytime shifts/week).
  • Onsite procedures include lumbar punctures, myelograms, and swallow studies.
  • Functional MRI a plus but not required.
  • Subspecialty CAQ required.
  • No body or MSK.

Positions (Remote):

Daytime Body
  • Fellowship-trained 100% body position
  • Fully remote, daytime, Monday through Friday position with no evenings, weekends, or nights required.
Overnight Body/MSK (Partnership)
  • 1 year to shareholder for experienced radiologists, shareholders work 121 shifts per year (17.3 weeks)
  • Shifts are 10pm to 7am
  • At least two years post-fellowship experience required
  • Multiple other overnight radiologists (Body, MSK, and Neuro) will be working the same shifts allowing for collaboration.
  • 24/7 IT, transcription/editing, and clerical/QA staff assistance.

Learn more at www.midwestradiology.com.
Contact: Barry.Lindo@MidwestRadiology.com

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Radiology of Huntsville

(Huntsville, Alabama)

ROH is 60+ physician, high-volume, private practice with a 2-year partnership track and nominal buy-in. Hiring for a remote partnership-eligible overnight position as well as onsite/remote openings in most subspecialites. Huntsville is a tremendously livable, high-tech, and growing mid-sized city (a #1 Best Place to Live in the U.S. by U.S. News and World Report).

Pediatric Radiologist – Shareholder Track
  • Consistent annual shareholder compensation exceeding $1MM++
  • Shareholder (Partnership) opportunity after two years with nominal buy-in
  • Average 205 clinical shifts annually
  • Shared 1:6 general radiology weekend call
  • Dedicated overnight radiology team — no routine overnight call responsibilities
  • Flexible scheduling options, including daytime-focused practice
  • Join our collegial team of FOUR pediatric radiologists with a dedicated Women’s and Children’s Hospital, comprehensive pediatric imaging including high-volume pediatric MRI, CT, ultrasound, fluoroscopy, neonatal, emergency, and outpatient imaging, as well as light image-guided procedures.
  • Additional voluntary internal locum opportunities compensated per RVU
Onsite and Remote, Daytime and Second Shift opportunities
  • Abdominal / Body
  • Emergency
  • General Radiology
  • MSK
  • Neuroradiology
  • Nuclear Medicine
  • Pediatric
  • Light Interventional

Learn more at www.radiologyofhuntsville.com.
Contact: Brandy McCown at bmccown@radhunt.com or call 256.713.0621.

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Radiology Imaging Associates

(Denver, Colorado)

RIA is the largest private radiology practice in Colorado with over 120+ radiologists. Our group is dedicated to providing high-quality subspecialty imaging and interventional services as well as excellence in patient care. We currently have over 125 radiologists and cover over 35 hospitals and 15 imaging centers in multiple healthcare systems in Colorado, Kansas, and Hawaii.

Our practice:

  • 12 weeks of vacation for associates and 14 weeks for partners.
  • 2 year partnership track.
  • Compensation ranges from $ 500 to $ 1,000,000 with unlimited internal moonlighting opportunities.
  • Generous benefits package including health and dental insurance with premiums covered by the group. Benefits also include an ample CME/business expense account, 401k plan, credentialing assistance, and relocation allowance.

On-site/hybrid (partnership track):

  • IR
  • Abdominal/Thoracic imaging
  • Breast imaging (traditional as well as 100%-breast options)
  • Neuroradiology
  • MSK imaging
  • Nuclear Medicine/PET
  • Pediatrics

Remote (partnership track):

  • Nighthawk – General/Body
  • 7 on / 7 off General/Body Swing

Contract positions are also available for those needing flexible work requirements.

Learn more at https://www.riaco.com/
Contact: radrecruiting@riaco.com

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Inland Imaging

(Washington, Oregon, Montana)

Inland Imaging is a 120+ radiologist-owned private practice proudly serving multiple outpatient, clinic, and hospital sites throughout the Inland Northwest region. We own and operate one of the first outpatient interventional labs in the West in addition to 7 outpatient imaging centers.

Our practice:

  • Sub-specialty interpretations available across all locations.
  • All studies are accessible on a common PACS system, one common voice recognition system, and one common worklist
  • Internal Nighthawk System providing final interpretations on all ER, STAT, and Inpatient Exams. 24/7 Neuroradiology Coverage and IR Call Coverage.
  • 2-year Partnership Track.
  • Full-Time Radiologist Average Time Off = 15 weeks
  • Average after-hours obligations = 9 weekends per year and 22 evening/swing Shifts.
  • Associate: $503,415–$566,342+ | Shareholder: $629,269+
  • Compensation ranges above reflect base; additional earning potential available through extra shifts and increased productivity
  • Full Benefit Package including health, vision, dental, disability, and life; 401k match, profit-sharing contribution, and cash balance plan.
  • Flexible scheduling arrangements accommodated across all positions, with a rich case mix across multiple outpatient, clinic, and hospital settings
  • Hybrid Work Options

Current Openings:

  • Remote overnight ER
  • Neuroradiology (Spokane, Seattle, Walla Walla, Tri-Cities, Missoula, or remote)
  • Body Imaging (Spokane, Seattle, Walla Walla, Tri-Cities, Missoula, or remote)
  • Washington
    • Tri-Cities ($75K signing bonus) — Breast, Neuro, MSK, Body
    • Spokane — Pediatrics, Breast, MSK
    • Moses Lake — General/Breast ($90K signing bonus, $20K relocation, annual retention bonus)
    • Colville — General/Breast
  • Montana
    • Missoula – IR
  • Oregon
    • Pendleton – General/Breast

Learn more at physicians.inlandimaging.com
Contact: Spencer Piper at spiper@inlandimaging.com

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If you’re a group looking to advertise, get in touch. The monthly post here is limited to just a handful of groups at a time, but last year, I launched Independent Radiology as a resource for the broader community, a dedicated private practice radiology job board featuring ~160 groups. If you’re in the market, please also check it out for your job-hunting needs.

The ROI of Narrow Vision

07.31.26 // Radiology

An attempt to model the ROI of using narrow AI tools like PE and brain bleed detection, from “Efficiency and Financial Gains From Artificial Intelligence Algorithm Implementation” in JACR:

The pulmonary embolism triage algorithm also reduced interpretation time, but the magnitude of savings was insufficient to offset AI-related costs. The observed time savings of 0.83 min per case produced a negative contribution margin change from 6.0% to −10.1% and a negative return on invested capital of −76.6% (Table 2). In sensitivity analysis, the algorithm would require a total reduction in interpretation time of approximately 3.55 min per case, or a decrease in annual AI cost from $200,000 to approximately $47,000, to become financially favorable relative to baseline. These results highlight that even measurable efficiency gains may not be sufficient when algorithm costs are high, case volumes are limited or baseline interpretation times are already relatively efficient.

The actual modeling the authors used contains many assumptions that may or may not generalize, but the broader point they make is that we should be able to measure whether any tool is worth it. Both in and out of medicine, many AI projects are outright failures. (The brain bleed tool they tested was worth it, in their analysis.)

A generally insufficiently addressed question for all AI-makes-you-more-efficient discussions is what is the leakage of time saved? What fraction of that expensive deep breath gets applied to the next case? Is the increase in productivity really just taking that time and cranking the hamster wheel perfectly to add in the exact amount of work to fill that gap? If so, does that scale as more and more tools are added? Is that effect durable over time, or do we partially revert after the Hawthorne effect wears off? Do we enjoy our tool-assisted work more or less, and how will that change over time?

A broader financial question for these types of narrow, mission-critical tasks is what parts of the task/job are expensive and/or inefficient? Doing the work or verifying the work or both? AI might help you avoid some mistakes as a second reader, but that’s not the economic model anyone is interested in.

AI Mania

07.29.26 // Miscellany

Three separate quotes from different parts of Nikhil Suresh’s “AI Mania Is Eviscerating Global Decision-Making” that work together:

But the broader reality is so much worse: people who have no background in the technology at all actually believe what they are saying. As a general rule you should avoid getting into business with a liar, but if you must, you can at least reason with them even if only in private. A true believer is much more threatening because they are impervious to even inducement by self-interest.

[…]

This is to say that we’re facing a coordination problem around executives being honest around the AI gains they’ve witnessed – if they co-operate, they keep their jobs. If they defect, they will possibly be fired by their embarrassed peers (who have now been implicitly called liars, cowards, or incompetents) and then replaced with someone that will toe the line anyway. If they could all admit the truth at once there might be some hope, but there is no way to coordinate that event.

[…]

The net result of this is that almost every large organisation that I am aware of is no longer able to focus on anything important, unless they are one of the (very) few organisations where AI happens to address their highest priorities. They cannot buy sensible software, hire competent talent, communicate honestly with executives about the state of projects, or undertake any sort of sensible initiative.

The whole thing is very much worth reading. (Those of you who read too many articles on the internet may remember his 2024 gem, “I Will !$%!!$% Piledrive You If You Mention AI Again”)

At least the cryptomania BS a few years ago was unintuitive enough that it was ignored by most businesses despite the desperate pivots and grifting. Adding a useless AI chat feature or calling your platform “AI native” is an easier sales pitch and management obsession than “It’s the same thing…but on the blockchain.”

Most leaders barely understand their own business, let alone the real impact of AI in recent years on their industry, the current contours of AI abilities, or the likelihood of purchased solutions and implementations maturing gracefully in a rapidly changing field. Most people don’t even know if the hard part of the job is generating the answer or verifying it. AI is magical, and yet we’re still firmly in the everyone-is-lying part of the hype cycle.

He writes a cogent summary in the middle of the article:
“Please dear God, do not let it be on earth as it is on LinkedIn.”

A Necessary Friction

07.27.26 // Medicine

In “The People Who Will Thrive in the AI Age,” David Brooks argues that the tolerance/desire for mental effort is the distinguishing characteristic amongst people.

One group:

The Reluctant Optimizers. People with a medium need for cognition will understand that AI might hollow them out. That prospect will really bother them. They will resolve, earnestly and with good intentions, to not let themselves fall victim. But in the crowded and stressful rush of everyday life, they will get sucked in. Their resolve will fail and they’ll become overreliant on the bots.

It seems to me that modern medicine has essentially primed basically everyone involved in healthcare to fall into this camp.

Later:

The crucial task before us is to cultivate people’s desire to seek out cognitive complexity. Not to go all Joseph Campbell on you, but the essential challenge is: How do we train people to see their life as a hero’s journey in which they take on difficult missions that they may fail at and that will certainly involve pain and suffering? How do we form people so they have an explorer’s heart, a willingness to endure, an ability to struggle on, even when their body and mind are telling them to give up, to reach new destinations and figure stuff out?

…

Many of our schools do a decent job of crushing students’ desire for mental effort. Every minute that a kid sits bored in a classroom crushes their desire. Extrinsic rewards, such as grades, do so because extrinsic desires tend to crowd out intrinsic ones. Grade inflation crushes desire by making everything too easy. Many of our systems have been created by rationalists to focus on the declarative level of the mind, the part that learns facts and considers arguments; they are often oblivious to the damage they are doing in the dark forests, the deeper levels of the mind where motivations emerge.

Fortunately, schools and organizations can also inflame desire. The most straightforward theory of motivation is known as self-determination theory, founded by Edward Deci and Richard Ryan. People feel motivated when they are put in situations that give them autonomy (I’m in control of my choices), competence (I’m developing my skills), and relatedness (people here care about me). In my experience, motivation increases with admiration, such as when students are confronted with great people or great works of art. Motivation also increases with apprenticeships, such as when a mentor not only teaches a person how to engineer, but also how to be the kind of person who loves engineering.

It also seems to me that human relationships and a truly forged identity are the only way most people will have any chance of embracing that helpful, crucial friction and combating the siren call of easy mediocrity.

David Epstein, author of Range, writing about Herbert Simon’s notion of “satisficing” in the NYT as part of his promotional blog tour for his new book, Inside the Box:

Maximizers tend to be less satisfied with their decisions and their lives. They are typically less happy, more prone to regret and more likely to compare themselves endlessly with others. Satisficers don’t necessarily have low standards. Their standard is “good enough for me” rather than “the best out there,” and that makes it possible to feel satisfied with their choices, instead of haunted by the ones they didn’t make.

The psychologist Mihaly Csikszentmihalyi, who first used the term “flow” to describe states of complete absorption in an activity, put it well. By making up one’s mind to invest in a choice, regardless of more attractive options that may come along later, “a great deal of energy gets freed up for living, instead of being spent on wondering about how to live.”

Delightful. Both feet fully in as opposed to one foot out. Assuredly hard to always employ in a world where social media functions as “an infinite comparison engine,” but delightful.

 

// 07.23.26