Gastroenterologist. Co-founder @OshiHealth

Los Angeles, CA
Joined June 2009
Sameer K Berry, MD, MBA retweeted
AI will not automate radiologists like you think We have been talking for years now about AI automating jobs. Radiology has been a prime target, with Geoff Hinton once claiming, “people should stop training radiologists now, it’s just completely obvious that within five years, deep learning is going to do better than radiologists”, which is funny since he said that in 2016. There is now more demand for radiologists than ever, so clearly things did not turn out the way many thought. Here I will make a prediction that while radiology will change in the coming decade, radiologists will not be automated away any time soon. I will use radiology as an example but I think these principles will broadly apply to any field where demand can be elastic and quality can scale with increased intelligence. First of all, we have seen in the short history of language models that there is a “jagged edge of intelligence”, where AI excels at verifiable tasks with a lot of data but is underwhelming on less common tasks. One thing most AI researchers underestimate about radiology is that it is actually extremely multi-task. There are at least a hundred conditions that can be diagnosed from x-rays alone, and thousands using CT and MRI. AI will first master common and easy-to-see conditions and it will not be as good as experts at less-common diseases just because there is less data for that. This jagged edge will certainly improve over time but this means that AI will certainly be used as a triage tool at first, rather than full automation in one go. I would guess that this process from solid triage tool to full automation would take 3-5 years in the best case scenario, because training AI to get all the edge cases right will be bottlenecked by data collection of rare diseases, and also because radiology isn’t currently a focus for frontier labs. Second, there will be elastic demand for radiology as it gets cheaper per unit. I think elastic demand (“Jevons paradox”) is the most underrated phenomenon when people think about AI automation. In software, it is obvious that I have way more demand than before because Claude Code makes it so easy. These days I ask Claude Code to build a custom three-thousand line html viewer to help me visualize every little RL run that I do. The same thing will happen in radiology. If there is essentially no cost or latency of interpreting an MRI, a physician can order many scans preemptively to better diagnose a case. So with AI tools, a radiologist might have to read only 20% of inbound scans, but there might be 5x more scans inbound. Many developing countries have fewer than one radiologist per million people and they will also want to send a lot of radiology to be interpreted. Longer term, cheap and fast radiology interpretation will also drive incentives to build cheaper radiology scanners. If an MRI had essentially no latency for interpretation, medical devices companies will want to build much cheaper MRI machines that can be used more frequently, perhaps even in the middle of a surgery. AI will accelerate the development of scanning technology, too. If a full body MRI was only $100 dollars I would totally want to get one every month instead of every two years. I can imagine a world where people get 10 or 100x the number of scans they do today, largely for preventative care, if radiology were 10-100x cheaper. Third, even if we did have a model that could outperform the world’s best radiologists today, that would not be the end of all work on radiology. Medicine is a field of change. We may develop new treatment protocols that require reading radiology images in a way that radiologists currently aren’t used to. New scanners may reveal diseases that we cannot currently diagnose today with radiology alone. Some radiologists will change their work from reading scans to doing frontier research to advance our understanding of radiology and translate new knowledge into updated models. Moreover, I am sure that we will ask for more out of our AI models than ever before. With a good flywheel, we may one day train AI models that can use radiology images to predict disease probabilities far into the future. With good prediction algorithms, cancer may be detected months earlier than we can detect it now. Society will invest a lot into this research and this will contribute even more to increased demand for radiology and the best AI around it. On top of all of this, the medical system is typically slower to adopt new technology and has more regulation compared to technology companies. There is legacy infrastructure and medical centers need to constantly support patients which makes it hard to integrate new technology. This is even more true in developing countries. Moreover data access tends to be limited due to HIPAA, deidentification, IRBs, etc. So I think radiologists will be in demand for a while. While some worry about radiology being totally automated, I think there is a more exciting future for radiology than ever before—one where there is more demand and we ask for more predictive power from our intelligence. This is similar to how many of us feel that programming will thrive more than ever before despite drastic change in the field. More generally, any domain where demand can be elastic and quality can scale with increased intelligence will, like radiology, similarly flourish with the development of AI. This is certainly a more exciting and nuanced future than what Hinton described in 2016! (Finally, to be fair to Hinton, he did acknowledge in a recent podcast that he was wrong and also agrees with the elastic demand argument.) Thanks @JayRothschild and @engyziedan for feedback on this post.
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Sameer K Berry, MD, MBA retweeted
We built an all-synthetic simulation of a hospital that can be shared publicly without any issues. Our data quality is so high, physicians cannot tell the difference between real/synthetic patients. The data is fully verified -- perfect for RL.
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Sameer K Berry, MD, MBA retweeted
My cancer case is n=1. I'm not holding it up as a model, because most of what I did is not specifically replicable or scaleable. But it is a proof of concept that fully personalized medicine, built around one patient's own biology, is viable in ways it simply wasn't a few years ago. I have lived a version of the future of cancer care that I think is worth aspiring to more broadly. Many of the tools that made this future possible for me are getting better, faster, cheaper, and more accessible every year. I think what we need next is the infrastructure to deploy these tools, and the community willing to build this infrastructure, one patient at a time. I want to help that future arrive faster. I wrote an article in The Cancer Letter cancerletter.com/guest-edito… for the physicians and researchers closest to the patients who could benefit most from this approach, who also believe in this future. If you are working towards building the systems and practices that will make personalized medicine operationally real, we want to collaborate with you too.
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Sameer K Berry, MD, MBA retweeted
"Why are doctors burned out?" Because we may be cross-examined for a comma in our notes years after we write something in the middle of a busy clinic day. I always used to tell my junior residents: "Write your notes as if they're being read out loud in front of a judge."
𝗗𝗼𝗰𝘂𝗺𝗲𝗻𝘁𝗮𝘁𝗶𝗼𝗻 𝗶𝘀 𝗞𝗘𝗬: Every Psychiatry resident and attending needs to watch this exchange. Defense attorney Kevin Reddington’s cross-examination of psychiatrist Dr. Jennifer Tufts is a masterclass in why CLINICAL DOCUMENTATION MATTERS. Everyone with an iota of clinical sense understands what she meant, that the patient did not have pressured speech. But a small error in the note gave the defense an opening, and Reddington relentlessly exploited it. You may know exactly what you meant. Your colleagues may know exactly what you meant. But, years later, sitting on a witness stand, the only thing that may matter is what you actually wrote. DOCUMENTATION IS KEY. Words matter. Details matter. Never forget it. #LindsayClancy #MedTwitter
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Sameer K Berry, MD, MBA retweeted
.@satyanadella just put the whole "water" debate to rest. Datacenters run on a closed loop cooling system, the water usage of a datacenter for an entire year is roughly equivalent to a usage of 1 restaurant!
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Sameer K Berry, MD, MBA retweeted
In the latest Gut Talk #podcast: hosts @sameerkberry and @umfoodoc talk with @AmericanTelemed CEO, @KyleZebley, about the importance of #telemedicine in national and global #HealthPolicy. Listen now: vist.ly/4ysu8
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Sameer K Berry, MD, MBA retweeted
If you ever wonder whether we have a utilization problem or price problem in US healthcare This chart should help Here are four procedures by rates and prices, in the US, Australia, Switzerland and Germany We don't use more healthcare We just pay much higher prices
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Sameer K Berry, MD, MBA retweeted
For Dr. @sameerkberry, “#gastroenterology is a family endeavor,” but today’s GI looks nothing like his father’s era. 📉Workforce shortages 😮‍💨Crushing demand 🔥#Burnout baked into the system See why “we urgently need a new model for #GIcare delivery”⬇️ vist.ly/4mrvj
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We had a great discussion with the CMO @ExactSciences, Paul Limburg, on the phenomenal work being done to expand cancer screening. Today’s announcement of a $21b acquisition of Exact by Abbott will hopefully continue this important work. on.wsj.com/4oOQPS9
In the latest Gut Talk #podcast: @ExactSciences’ @limburg_paul talks with hosts @sameerkberry and @umfoodoc about the factors contributing to his decision to pivot from a career in #AcademicResearch to #Industry. #GICareers  Listen now: healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
A review of interactions between the gut microbiome, brain and sleep disorders genomicpress.kglmeridian.com…
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Sameer K Berry, MD, MBA retweeted
Dr @sameerkberry: • Poor performance of breath test in diagnosing #SIBO • Inaccuracy even more pronounced when used for #IBS patients • No correlation between H₂ gas production and #IBS severity #Gastroenterology #MedTwitter #GI #Microbiome #ACG2025 @AmCollegeGastro
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Sameer K Berry, MD, MBA retweeted
Live from #ACG2025: Patients enrolled in a virtual, multidisciplinary GI clinic reported 👇 🏥 Fewer ED visits 🩹 Fewer surgeries 💰 Lower costs This isn’t telehealth 🆚 in-person care, says Dr. @sameerkberry, but how the combo can improve outcomes. bit.ly/3JiRDzp
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Sameer K Berry, MD, MBA retweeted
What progress has been made toward addressing #GenderInequities in #GI? @sameerkberry and @umfoodoc speak with @AmCollegeGastro president @AmyOxentenkoMD about factors contributing to the growth of women going into gastroenterology. Listen now: healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
Why aren’t #medicalhome models a #standardofcare for patients with #IBD? @sameerkberry and @umfoodoc talk to @ClevelandClinic’s @MiguelRegueiroMD about challenges to access and other health care providers for patients with complex #GIdisease. Listen now: healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
Replying to @HealioGastro
Enjoy this month’s Gut Talk podcast: Living the American Dream with Maria Abreu, MD healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
Our next episode of Gut Talk just dropped: Evolving the relationship between the AGA and GI with Tom Serena, CEO. Thanks to Tom for sharing 30 years of lived experience in GI! ⁦@HealioGastro⁩ ⁦@AmerGastroAssn⁩ healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
NEW EPISODE of Gut Talk! Hosts @sameerkberry and @umfoodoc talk with @AmCollegeGastro’s @BradleyStillman about challenges facing #gastropractices and adapting #GIscreenings for the future to prevent burnout. #GITwitter Listen now: healio.com/news/gastroentero…
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Sameer K Berry, MD, MBA retweeted
How can organizations meet the rising needs of their #patients and #clinicians? @sameerkberry and @umfoodoc speak with @AmCollegeGastro’s @BradleyStillman about the discussions surrounding #workforceissues and finding solutions. #GITwitter Listen now: healio.com/news/gastroentero…
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