Insights
Writing about the things I think about between cases — imaging interpretation, decisions before the OR, workflow bottlenecks, and what thoughtful change in surgery actually looks like. For surgeons, trainees, and the builders working alongside them. Patients are welcome, but this is the working side of practice.
Technology & Innovation
AI scribes can reduce documentation burden, but specialty burnout also comes from fragmented records, slow EHR workflows, imaging delays, and the time it takes to reconstruct the patient story.
March 23, 2026
7 min read
Surgery & Decision-Making
I'm a spine surgeon. I spend most of my time in the OR, in clinic, or thinking about what happens between those two places — the imaging we order, the decisions we make before a single incision, the workflow bottlenecks nobody talks about. I'm not interested in hype. I'm interested in what actually works, what we measure poorly, and what we could do better if we were honest about the gaps. This is writing for surgeons, trainees, and builders. Patients are welcome, but this is the working-out-loud side of practice.
March 15, 2026
12 min read
Surgery & Decision-Making
The gap between a patient's first visit and the operating room may be the most important variable in outcomes we rarely measure. In the rush to schedule, we often overlook the value of deliberation — and the decisions that happen before the OR matter more than most of what happens inside it.
February 28, 2026
8 min read
Workflow & Systems
We treat imaging as a diagnostic event, but it's actually a workflow bottleneck. Who reads it, when they read it, what they compare it to, and how findings get communicated to the patient — each step introduces friction and potential error that has nothing to do with the scan itself.
January 20, 2026
9 min read
Technology & Innovation
Moving past the feature list to ask what really changes outcomes, workflow, and confidence in the OR. The gap between what's marketed and what matters is wide — and closing it requires surgeons who build, not just surgeons who buy.
December 12, 2025
10 min read
Surgery & Decision-Making
Most surgeons believe they practice shared decision-making. Most patients would disagree. The uncomfortable middle ground is where the real work happens — and where training falls short.
November 5, 2025
7 min read
Technology & Innovation
Before asking what AI can do in the operating room, we should ask what problems are worth solving and what evidence we would need to trust a solution. Not interested in hype — interested in what holds up under scrutiny.
October 18, 2025
11 min read
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