Practicing in the Age of AI: Essays on Medicine, Meaning, and Machines

Description

AI is already in the exam room. Are you ready?

Artificial intelligence has entered clinical practice — quietly, rapidly, and with consequences no physician fully anticipated. It sits behind the documentation tools that auto-populate your notes, the imaging algorithms flagging findings before you do, the insurance decision engines that approve or deny your orders. Medicine has changed. The question is whether physicians will shape that change — or simply adapt to it.

In Practicing in the Age of AI: Essays on Medicine, Meaning, and Machines, physician leader and essayist Arthur Lazarus, MD, MBA, CPE, DFAAPL, takes readers inside the transformation — not as a technologist, futurist, or alarmist, but as a clinician who has watched AI reshape the very fabric of medical practice.

This isn't a guide to the best AI tools. It's a framework for thinking about what AI means for the physicians who use them — their clinical reasoning, their documentation, their professional identity, and their accountability to patients.

Across 36 essays organized into four sections, Lazarus examines:

• How AI is transforming medical writing, documentation, and clinical language — and what gets lost in translation.
• Why physicians risk becoming editors of machine-generated work they didn't create and aren't sure they should sign.
• Where AI promises efficiency but delivers automation bias, hallucinated documentation, and algorithmic inequity.
• What physician leaders must demand from AI governance, FDA oversight, prior authorization systems, and health system design.
• How to preserve clinical judgment, moral responsibility, and the human core of medicine in a machine-assisted world.

With intellectual range, narrative skill, and the balanced skepticism of a seasoned clinician, Lazarus occupies the nuanced middle ground: neither dismissing AI's promise nor surrendering to its hype. His essays give physicians the language and conceptual tools to participate in AI conversations with precision, lead institutional decision-making with confidence, and protect what patients need most — a physician who still thinks, judges, and cares.

Whether you are a practicing clinician encountering AI in daily workflow, a physician executive navigating technology adoption, or a medical educator preparing the next generation, this book offers the reflective framework today's physicians need.

About the Author

Arthur Lazarus, MD, MBA, CPE, DFAAPL

Arthur Lazarus, MD, MBA, CPE, DFAAPL, is a physician leader, writer, and editor with extensive experience in psychiatry, healthcare administration, and medical publishing. He is a distinguished life fellow of the American Psychiatric Association and a distinguished fellow of the American Association for Physician Leadership. Lazarus has contributed widely to peer-reviewed journals, trade publications, and books on physician leadership, clinical practice, and healthcare policy. He brings to this work both the clinical perspective of a practicing physician and the analytical lens of a physician executive who has witnessed AI's arrival at the front lines of care.

Table of Contents

Note to Readers

Introduction

Section I: The Writing Mind Meets the Machine

• Essay 1. What Does the "A" in AI Stand For — Artificial or Augmented? The Case of Medical Writing
• Essay 2. Tools, Applications, and Ethical Considerations in AI-Assisted Medical and Scientific Writing
• Essay 3. The Promise and Peril of AI Scribes
• Essay 4. When AI Writes the Therapy Note, the Patient's Story Can Disappear
• Essay 5. Why the Silence? Reflections on the Vanishing Physician Commentariat
• Essay 6. When Is a Joke Not a Joke? Medicine, Social Media, and the Return of the Physician Commentariat
• Essay 7. The Compression of Language by AI

Section II: Workflow, Practice, and the Clinician's Role

• Essay 8. The Algorithm in the Interview: When AI Becomes the Recruiter
• Essay 9. Where Are the Guardrails?
• Essay 10. Breaking Up Isn't Hard to Do: Implications of the Anthropic-Pentagon Dispute for Medical Practice
• Essay 11. The AI Health Arms Race Has Begun. What Comes After Copilot Health?
• Essay 12. Stop Looking for the Best AI Tool
• Essay 13. Physicians' Adoption and Use of AI: From Curiosity to Clinical Practice
• Essay 14. Garbage In, Garbage Out: How to Feed the Machine
• Essay 15. When Conversation Becomes Workflow
• Essay 16. The Physician as AI Editor
• Essay 17. Dr. Seuss, AI, and Portents for Medical Learning
• Essay 18. Can AI Really Shorten Medical School?

Section III: Trust, Authority, and the Human Stakes

• Essay 19. AI Can Read the Chart Nobody Wants to Touch
• Essay 20. What's Leadership Got to Do with It?
• Essay 21. When Warmth Becomes a Template
• Essay 22. Creativity in the Age of Medical AI
• Essay 23. When the Manuscript Has a Chatbot in the Background
• Essay 24. A Chatbot Is Not a Therapist
• Essay 25. At Silicon Valley Speed: The FDA's AI Gamble and the Future of Clinical Judgment
• Essay 26. What Medicine Can Learn from Waymo: A Case for Boring, Accountable AI
• Essay 27. When Algorithms Decide: AI and the Future of Prior Authorization
• Essay 28. Pseudologia Algorithmica: When AI Hallucinates and Humans Stop Checking
• Essay 29. When the Doctor on Your Screen Isn't Real: Deepfakes, Fraud, and the Erosion of Medical Trust
• Essay 30. Cover Me: Medicine's New Hiring Crisis
• Essay 31. Grand Rounds on Replacing Physicians: A Satire of Doctors, Chatbots, and the Fight for Natural Intelligence

Section IV: Systems, Policy, and the Future of Medicine

• Essay 32. Is AI Failing Healthcare, or Is Healthcare Failing AI?
• Essay 33. Can AI Fix a Broken Healthcare System?
• Essay 34. Autoland Is Not a Diagnosis: Rethinking the Aviation Metaphor for AI in Medicine
• Essay 35. When the Machine Enters the Nursing Station: AI, Invisible Labor, and the Future of Doctor–Nurse Collaboration
• Essay 36. AI: Past, Present, and Future

Afterword