<?xml version="1.0" encoding="UTF-8"?><rss xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:atom="http://www.w3.org/2005/Atom" version="2.0" xmlns:itunes="http://www.itunes.com/dtds/podcast-1.0.dtd" xmlns:googleplay="http://www.google.com/schemas/play-podcasts/1.0"><channel><title><![CDATA[Joe Sipher]]></title><description><![CDATA[Helping patients navigate the complex healthcare system armed with their own data and AI.]]></description><link>https://www.joesipher.com</link><image><url>https://substackcdn.com/image/fetch/$s_!5vbZ!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png</url><title>Joe Sipher</title><link>https://www.joesipher.com</link></image><generator>Substack</generator><lastBuildDate>Wed, 21 Oct 2026 02:49:05 GMT</lastBuildDate><atom:link href="https://www.joesipher.com/feed" rel="self" type="application/rss+xml"/><copyright><![CDATA[Joe Sipher]]></copyright><language><![CDATA[en]]></language><webMaster><![CDATA[outsmart@substack.com]]></webMaster><itunes:owner><itunes:email><![CDATA[outsmart@substack.com]]></itunes:email><itunes:name><![CDATA[Joe Sipher]]></itunes:name></itunes:owner><itunes:author><![CDATA[Joe Sipher]]></itunes:author><googleplay:owner><![CDATA[outsmart@substack.com]]></googleplay:owner><googleplay:email><![CDATA[outsmart@substack.com]]></googleplay:email><googleplay:author><![CDATA[Joe Sipher]]></googleplay:author><itunes:block><![CDATA[Yes]]></itunes:block><item><title><![CDATA[Olivia Munn’s Family History Helped Uncover Her Breast Cancer Diagnosis]]></title><description><![CDATA[She had a clean mammogram and tested negative on a genetic panel covering 90 cancer genes, but details about her family history contributed to a 37% lifetime risk of breast cancer.]]></description><link>https://www.joesipher.com/p/olivia-munns-family-history-helped</link><guid isPermaLink="false">https://www.joesipher.com/p/olivia-munns-family-history-helped</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 29 Sep 2026 14:03:13 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!iSfM!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Olivia Munn high-fived her sister over the phone after they tested negative for 90 cancer genes including any mutations in the dreaded BRCA genes. They both also had clean mammograms so felt safe even though breast cancer ran in their family.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://www.instagram.com/p/C4dXfrULDdJ/?utm_source=ig_embed" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!iSfM!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 424w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 848w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 1272w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!iSfM!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png" width="1456" height="1072" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/f41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1072,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:2222712,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://www.instagram.com/p/C4dXfrULDdJ/?utm_source=ig_embed&quot;,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/216468232?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!iSfM!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 424w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 848w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 1272w, https://substackcdn.com/image/fetch/$s_!iSfM!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff41d8b45-b231-43ac-8d32-b7ce4d022642_1646x1212.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Olivia Munn Diagnosis Announcement on Instagram</figcaption></figure></div><p>But Olivia&#8217;s doctor was concerned -- there are many more factors that go into a breast cancer assessment than genetic tests. In fact, less than ten percent of all breast cancer cases can be explained by all inherited mutations combined, BRCA included. The <a href="https://magview.com/ibis-risk-calculator/">Tyrer-Cuzick </a>assessment (also known as the IBIS Breast Cancer Risk Evaluation Tool) looks at a much wider range of contributing factors including childbirth history, age at first menstrual period, and family history of breast and ovarian cancer.   </p><p>When Olivia&#8217;s doctor plugged in all the relevant information including a comprehensive family history, it assessed her <strong>lifetime risk of breast cancer to be 37%</strong>. Anything above 20% counts as high risk. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!0-sA!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!0-sA!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 424w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 848w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 1272w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!0-sA!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png" width="1456" height="509" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:509,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:112061,&quot;alt&quot;:&quot;If your honest answer is \&quot;I don't know\&quot; about your family health history, you could be under estimating your risk&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/216468232?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="If your honest answer is &quot;I don't know&quot; about your family health history, you could be under estimating your risk" title="If your honest answer is &quot;I don't know&quot; about your family health history, you could be under estimating your risk" srcset="https://substackcdn.com/image/fetch/$s_!0-sA!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 424w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 848w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 1272w, https://substackcdn.com/image/fetch/$s_!0-sA!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F71ebc2c6-6194-4688-bb7a-3bfbeb7d6546_2029x710.png 1456w" sizes="100vw"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>With that high of a risk, her doctor recommended Olivia get a breast MRI, which found an aggressive cancer called Luminal B in both her breasts. Within a few months of a clean mammogram, she was on the operating table getting a double mastectomy. </p><p>The rest of her heart-wrenching story is well-documented. The good news is that, as of this writing, she is healthy and enjoying time with her husband, John Mulaney and their two children, Malcolm and M&#233;i.</p><p>But she hasn&#8217;t been quiet.  She&#8217;s become an advocate.</p><p>In every media outlet from her own Instagram to <em>Good Morning America</em> to <a href="http://Preventcancer.org">Preventcancer.org</a>, Olivia bravely tells her story and ends with a clear message: <strong>the assessment tool saved her life</strong>. She recommends every woman use the free <a href="https://magview.com/ibis-risk-calculator/">Tyrer-Cuzick </a>tool themselves, and bring the result to her doctor.</p><h2>Family Health History Is Critical</h2><p>Below is the warning you see before entering the family history section of the Tyrer-Cuzick assessment that Olivia Munn has in the link in her Instagram bio. To get an accurate assessment, you must &#8220;answer all questions in each section as accurately as possible.&#8221;  </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!lEU-!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!lEU-!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 424w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 848w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 1272w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!lEU-!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png" width="1456" height="1211" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1211,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:699628,&quot;alt&quot;:&quot;Tyrer-Cuzick assessment warning&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/216468232?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Tyrer-Cuzick assessment warning" title="Tyrer-Cuzick assessment warning" srcset="https://substackcdn.com/image/fetch/$s_!lEU-!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 424w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 848w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 1272w, https://substackcdn.com/image/fetch/$s_!lEU-!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4e6fdd75-461d-4057-812c-1ccc689092cf_1696x1411.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Answer all questions in each section as accurately as possible.</figcaption></figure></div><p>But the family history section asks about fourteen categories of blood relatives. For your mother and each of your grandmothers, it wants the age at every diagnosis, and current age or age at death. </p><h2>If You Don&#8217;t Know, Maybe Someone Else in Your Family Does</h2><p>Of course, you may not know whether your aunt&#8217;s cancer was breast or ovarian, or what age your grandmother was when hers was found, but someone in your family almost certainly does.</p><p>HealthScout lets your whole family build one shared history together. One person starts it, and relatives add what they know. The conditions and the ages at diagnosis can come from the people who were actually there versus people just trying to remember. </p><p>HealthScout&#8217;s family health history feature covers blood relatives with recorded conditions, the same set of people the assessment asks about. So the result is more medical document than genealogy project. Share or print your Family Health History as a PDF for your doctor, or send it to relatives who don&#8217;t use the app. Family history is free for you and everyone you add.</p><p>Download it before <a href="https://nationaltoday.com/national-family-health-history-day/">National Family Health History Day</a> this Thanksgiving so you can be ready to record everything your relatives know and share the results at the end.</p><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, treatment or assess clinical risk. Always consult with qualified healthcare professionals for medical decisions.</em></p><p><em>HealthScout, including the Family Health History feature, is available now on the <a href="https://apps.apple.com/us/app/healthscout/id6743687046">App Store</a>. Using Family Health History is free for you and everyone you add.</em></p>]]></content:encoded></item><item><title><![CDATA[Chris Hemsworth Knows His Alzheimer's Risk. Do You Know Yours?]]></title><description><![CDATA[Finding out early means you can do something about it while there's still time to act.]]></description><link>https://www.joesipher.com/p/chris-hemsworth-knows-his-alzheimers</link><guid isPermaLink="false">https://www.joesipher.com/p/chris-hemsworth-knows-his-alzheimers</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Mon, 21 Sep 2026 14:01:42 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/d6758748-49c5-41c5-afce-f8a7fe9bd866_1030x882.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>&#8220;This is a photo of a boy and his father in the outback,&#8221; says Chris Hemsworth, welling up as he shows the photo to the camera. &#8220;And the dad&#8217;s looking at his son with a lot of love.&#8221;  </p><p>The boy in the photo is a three or four year-old Hemsworth and the dad is his father Craig, who today has early stages of Alzheimer&#8217;s.  </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://www.youtube.com/watch?v=bJtFW5PQ7NU" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!ein2!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 424w, https://substackcdn.com/image/fetch/$s_!ein2!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 848w, https://substackcdn.com/image/fetch/$s_!ein2!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 1272w, https://substackcdn.com/image/fetch/$s_!ein2!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!ein2!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png" width="1456" height="773" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/df130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:773,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:5281378,&quot;alt&quot;:&quot;Official trailer via National Geographic (now streaming on Disney+ and Hulu).&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://www.youtube.com/watch?v=bJtFW5PQ7NU&quot;,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/215745532?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Official trailer via National Geographic (now streaming on Disney+ and Hulu)." title="Official trailer via National Geographic (now streaming on Disney+ and Hulu)." srcset="https://substackcdn.com/image/fetch/$s_!ein2!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 424w, https://substackcdn.com/image/fetch/$s_!ein2!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 848w, https://substackcdn.com/image/fetch/$s_!ein2!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 1272w, https://substackcdn.com/image/fetch/$s_!ein2!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fdf130d11-a4aa-4537-ab5e-f6354e3acfa6_3954x2098.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Official trailer <em>Chris Hemsworth: A Road Trip to Remember </em>via National Geographic (now streaming on Disney+ and Hulu).</figcaption></figure></div><p><em>Chris Hemsworth: A Road Trip to Remember</em> documents how father and son  explore their past and strengthen their relationship in hopes that these brain stimulating activities slow the decay of Craig&#8217;s memory.</p><p>Later in the documentary we find out Chris Hemsworth himself carries the two APOE4 genes, which increase his risk of getting Alzheimer&#8217;s by 8 to 10 times as compared to the general population.</p><h2>Do You Know <em>Enough</em> Alzheimer&#8217;s Family History?</h2><p>Chris found out he had the APOE4 genes in an unconventional way. He had a comprehensive work up as part of his health-focused National Geographic series <em>Limitless with Chris Hemsworth</em> in 2022. When he found out on camera, his doctor called it a &#8220;blessing&#8221; because most people wouldn&#8217;t take a genetic test until they already had symptoms in their 50s or 60s. But because Chris knew at 39, his doctor contended that &#8220;if we take every step possible, we can reduce your risk to that of anyone else.&#8221; </p><p>Chris lucked into this genetic testing because he&#8217;s a celebrity superhero doing a TV show. But you can do something simpler and more meaningful:  pull together your comprehensive family history of Alzheimer&#8217;s disease.  If it&#8217;s clean and you have no symptoms, you're in the best position you can be in. If you do have a family history, perhaps a genetic test would be the next step. </p><p>If you think you know your complete Alzheimer&#8217;s family history, it&#8217;s trickier than it sounds.</p><h2>Extended Family Makes a Significant Difference</h2><p>The fact that Alzheimer&#8217;s runs in families is not new news. Chris&#8217;s grandfather also had the disease. However, what is only starting to be understood is that more distant relatives with the disease can make a dramatic difference in the risk factor. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!yHYJ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!yHYJ!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 424w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 848w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 1272w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!yHYJ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png" width="1456" height="1550" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1550,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:422871,&quot;alt&quot;:&quot;Study: Extended Family Significantly Contributes to Alzheimer's Risk&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/215745532?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Study: Extended Family Significantly Contributes to Alzheimer's Risk" title="Study: Extended Family Significantly Contributes to Alzheimer's Risk" srcset="https://substackcdn.com/image/fetch/$s_!yHYJ!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 424w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 848w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 1272w, https://substackcdn.com/image/fetch/$s_!yHYJ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F22a498f7-0a1d-4bef-9f31-30ff8faabab7_2160x2299.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>A 2019 study published in the journal <em>Neurology</em> used the Utah Population Database to find approximately 1.3 million individuals with at least 12 of their 14 immediate ancestors also in the data. Using death certificate analysis, they found that having one 1st-degree relative (parent, sibling, or child) plus two 2nd-degree relatives (aunts, uncles, grandparents) with Alzheimer&#8217;s in your family history increases your risk by over 21 times as compared to the general population. <em><strong>This family history was far more risky than having two 1st-degree relatives with the disease. </strong></em></p><p>Of course, many know if their parent, sibling, or child had the disease, but do you know if your mother&#8217;s sister did?  Or your grandparent who died 20 years ago?  I didn&#8217;t. My grandmother died when I was in my 20s and did have some kind of dementia, but I had no idea what kind. My father&#8217;s brother was also demented later in life, but I didn&#8217;t know the details. Using HealthScout, my cousins and I collaborated to conclude that neither was diagnosed with Alzheimer&#8217;s. One remembered that my grandma&#8217;s dementia was likely vascular dementia because it started after a stroke. The other lived through his father&#8217;s diagnosis. That information can now be passed on to my children.</p><h2>Find Out Now So You Can Take Action</h2><p>I am publishing this article on World Alzheimer&#8217;s Day to support the global effort to raise awareness around Alzheimer&#8217;s. Until relatively recently people with a predisposition to Alzheimer&#8217;s had few options to delay or prevent the onset. Raising awareness is even more important now because some real options for high-risk Alzheimer&#8217;s patients are coming to light: </p><ol><li><p><strong>Intensive m<span>ulti-domain lifestyle intervention</span></strong><span> (diet, exercise, cognitive training, social engagement) has proven to improve symptoms in a </span><a href="https://link.springer.com/article/10.1186/s13195-024-01482-z"><span>Preventive Medicine Research Institute study</span></a><span>. The social engagement part was the primary purpose of </span><em><span>Chris Hemsworth: A Roadtrip to Remember</span></em><span>.</span></p></li><li><p><strong><span>Using GLP-1 inhibitors</span></strong><span> to reduce the risk of Alzheimer&#8217;s onset. In a 2024 study, the GLP-1 semaglutide was associated with a 40&#8211;70% reduced risk of first-time Alzheimer&#8217;s diagnosis in over 1 million type 2 diabetes patients across a </span><a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14313"><span>3-year nationwide real-world analysis</span></a><span>.</span></p></li><li><p><strong>Anti-amyloid medicines</strong> are beginning to change what is possible in early Alzheimer disease and are expanding the opportunity to act earlier. This <em><a href="https://www.nature.com/articles/s41582-025-01154-y">Nature Reviews Neurology</a></em><a href="https://www.nature.com/articles/s41582-025-01154-y"> Perspective</a> concludes that these advances make pharmacological prevention of Alzheimer disease a feasible goal that could substantially delay or even prevent cognitive decline.</p></li></ol><p>Of course, each of these options depends on knowing your risk early. That's why I built family health history into HealthScout. So your entire family&#8217;s health history is gathered in one place and saved for the next generation.</p><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><p><em>HealthScout, including the Family Health History feature, is available now on the <a href="https://apps.apple.com/us/app/healthscout/id6743687046">App Store</a>. Using Family Health History is free for you and everyone you add.</em></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p>]]></content:encoded></item><item><title><![CDATA[Doctors Have a Good Reason to Ignore Your Family Health History]]></title><description><![CDATA[The information is decades old and passed down like a game of telephone, but an accurate history could save your life.]]></description><link>https://www.joesipher.com/p/doctors-have-a-good-reason-to-ignore</link><guid isPermaLink="false">https://www.joesipher.com/p/doctors-have-a-good-reason-to-ignore</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 15 Sep 2026 15:02:53 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!23-r!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>I&#8217;ve always had high cholesterol. In my 30s and 40s, I tried following doctor&#8217;s orders by eating low-fat, keeping my weight down, and exercising, but all my work was for naught. My cholesterol numbers just kept getting higher.  </p><p>After hopelessly fighting my body chemistry for a decade, I became a skeptic of the entire eating-fat-leads-to-high-cholesterol-leads-to-heart-attack industrial complex. I read books like <em>The Great Cholesterol Con</em> and followed Gary Taubes&#8217;s anti-establishment medicine blog. Some of those ideas still hold up &#8212; that stress contributes to heart disease and that eating high-cholesterol foods like eggs isn&#8217;t as bad for you as people once believed.</p><p>But there&#8217;s also a tidal wave of evidence (<a href="https://consensus.app/papers/lowdensity-lipoproteins-cause-atherosclerotic-ference-ginsberg/5a88c5d288705f799d1cc14f478ac6bb/">here</a>, <a href="https://consensus.app/papers/lowdensity-lipoprotein-cholesterol-lowering-for-the-vallejo-vaz-robertson/1de6b519f85f5abbb996aa753c53e0c2/">here</a>, and <a href="https://consensus.app/papers/the-importance-of-ldlc-lowering-in-atherosclerotic-mhaimeed-burney/8d98304dfa4f59f88abd8506380feeaf/">here</a>) that people with high LDL-C (the &#8220;bad&#8221; cholesterol) are more likely to have heart events, and that lowering LDL-C reduces the incidence of heart events.</p><p>In hindsight my behavior was a classic case of cognitive dissonance. I was seeking out information that supported a worldview that made me more comfortable with my terrifying lab numbers. </p><p>By the time I was 47, my LDL-C had skyrocketed to <strong>237</strong> mg/dL. This is not my total cholesterol (which is a <a href="https://pubmed.ncbi.nlm.nih.gov/7919426/">misleading metric</a>). My &#8220;good&#8221; cholesterol HDL-C was also high, 72 mg/dL then and as high as 109 over the years. High HDL-C is supposed to be protective, so I continued to ignore my unsafe LDL-C.  </p><h2>My Family History Was Already in My Records</h2><p>On every medical intake form, I dutifully filled out the family history section, reliving it every time: my father had a heart attack at 54, my paternal grandfather had a heart attack at 52, and my maternal grandfather dropped dead of a heart attack at 59. So my family history was definitely in the record.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!23-r!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!23-r!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 424w, https://substackcdn.com/image/fetch/$s_!23-r!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 848w, https://substackcdn.com/image/fetch/$s_!23-r!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 1272w, https://substackcdn.com/image/fetch/$s_!23-r!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!23-r!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg" width="1456" height="1787" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1787,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:788533,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/jpeg&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/214935259?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!23-r!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 424w, https://substackcdn.com/image/fetch/$s_!23-r!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 848w, https://substackcdn.com/image/fetch/$s_!23-r!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 1272w, https://substackcdn.com/image/fetch/$s_!23-r!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7f24d378-dd38-4465-affe-01b20f959b2e_2817x3457.jpeg 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">My father at his wedding flanked by his father (left) and my maternal grandfather (right). All three would have heart attacks in their 50s.</figcaption></figure></div><p>Familial hypercholesterolemia (FH) is a genetic condition that impairs your body&#8217;s ability to clear &#8220;bad&#8221; cholesterol (LDL-C) from your blood. Genetic testing can confirm it, but it is usually diagnosed clinically, from family history combined with lab results, and managed with cholesterol-lowering medication, usually starting with statins. But no doctor ever mentioned familial hypercholesterolemia to me &#8212; I suspect because what we write on those intake forms get skimmed. If only I had a document to hand to my doctors to get them to <em>pay attention</em> to my family health history. I&#8217;ll go deeper on that in a minute.</p><p>While my doctors did suggest I should go on a statin (after preaching diet and exercise), not one said, &#8220;With these labs and your family history of heart disease, you may have a genetic disease called familial hypercholesterolemia. With this diagnosis, diet and exercise simply don&#8217;t work. Standard treatment is to prescribe a statin for people with familial hypercholesterolemia to reduce chances of a cardiac event.&#8221; </p><p>I think my 47-year-old, cognitively dissonant brain might have cracked if a doctor had diagnosed me with a <em>disease</em>. My layman&#8217;s thinking was: if you have a disease, you take medicine; if you have a high lab number, you work through it.  </p><h2>Then I Got a Scare</h2><p>After a decade of stubbornly fighting with my doctors about statins, I made the argument to one: &#8220;High cholesterol isn&#8217;t a disease; the disease is atherosclerosis. Isn&#8217;t there a test I can take to see if my arteries are clogged?&#8221; He answered, &#8220;Yes there is.&#8221;</p><p>A Coronary Artery Calcium (CAC) scan calculates the calcium plaque burden in the coronary arteries. A score of zero means you don&#8217;t have any calcified plaque clogging your arteries. A score greater than zero means you have a disease: coronary artery disease (CAD).</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!WhhT!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!WhhT!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 424w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 848w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 1272w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!WhhT!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png" width="728" height="419" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/a14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:false,&quot;imageSize&quot;:&quot;normal&quot;,&quot;height&quot;:838,&quot;width&quot;:1456,&quot;resizeWidth&quot;:728,&quot;bytes&quot;:406726,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/214935259?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:&quot;center&quot;,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!WhhT!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 424w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 848w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 1272w, https://substackcdn.com/image/fetch/$s_!WhhT!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa14945f9-702f-4395-be4c-118c5a120c12_4714x2714.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>My score was greater than zero, and this shook me enough to start on a statin. As you can see from the chart above, the statin brought my LDL-C down to a safe level and my fears about memory loss and muscle pain side effects did not materialize. I&#8217;ve had no side effects, even as my doctors and I agreed to a more aggressive approach.</p><p>But I&#8217;ll never know the impact of letting my LDL-C ride above 190 mg/dL for a decade.</p><h2>Why Is Family History Often Ignored?</h2><p>I had never heard the term familial hypercholesterolemia until I started building HealthScout. It was <a href="https://apps.apple.com/us/app/healthscout/id6743687046">HealthScout</a> that put the pieces together, telling me to talk to my doctor because my labs and family history were a &#8220;classic case&#8221; of FH.  </p><p>At a recent primary care visit, I asked my doctor to add FH to my record. He said, &#8220;So you have a family history of heart disease?&#8221; To be fair, he was a new doctor and my lab numbers were already in the normal range, but he did have access to records that included my answers on those medical intake forms.  </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!XK3F!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!XK3F!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 424w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 848w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 1272w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!XK3F!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png" width="1456" height="555" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/d99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:555,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:92978,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/214935259?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!XK3F!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 424w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 848w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 1272w, https://substackcdn.com/image/fetch/$s_!XK3F!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd99cb2f0-3047-4fb8-b1a6-3f9697c30f41_1862x710.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>I suspect many doctors deprioritize family history as an input because the data is often so unreliable. Of course it is. The information is often decades old and passed down like a game of telephone. I&#8217;ve been working on my own family health history for months now, and I&#8217;m still not 100% sure what my paternal grandmother died of or if she had Type 1 or Type 2 diabetes. </p><p>But if we can make family health history reliable, it belongs on equal footing with risk factors doctors already act on such as smoking status, exercise, and diet. </p><p>My cholesterol story is a microcosm of what happens every day. People&#8217;s family health histories of cancer, diabetes, Alzheimer&#8217;s, and dozens of other heritable conditions are not taken into account in doctor visits all over the world. And if a doctor doesn&#8217;t <em>know</em> a disease runs in your family, <em>they&#8217;ll treat you like it doesn&#8217;t</em>. You won&#8217;t get the early screening for colon cancer or the early mammogram that could save your life, or, in my case, the preventive medicine that could reduce your chances of a serious health event.</p><h2>HealthScout Family Health History</h2><p>HealthScout&#8217;s new Family Health History feature takes a different approach to the sparse, inaccurate information on those intake forms. Instead of an individual trying to remember all the conditions of generations past, the family works on it <em>collaboratively</em>. Everyone on the bloodline can add or edit information on their own profile and on their blood relatives&#8217; profiles. And it makes sense &#8212; maybe you don&#8217;t remember how your grandmother died, but your great-aunt lived through it. Even if she&#8217;s not on HealthScout, you can ask her and add the info for everyone on the bloodline to share.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!igfZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!igfZ!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 424w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 848w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 1272w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!igfZ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png" width="1456" height="544" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/a2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:544,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:145376,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/214935259?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!igfZ!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 424w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 848w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 1272w, https://substackcdn.com/image/fetch/$s_!igfZ!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa2a5d13e-eb6b-4dc6-958d-cc76dceec428_2086x780.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Once your family health history has enough valuable information, you can generate a PDF of blood relatives with heritable conditions that you can share with your doctor. If you personally share a document like this, your doctor will more likely pay closer attention to your family health history.</p><p>One part of the PDF is the Age at Onset heatmap below showing at a glance family history that might be concerning. This family had seven members with heart disease onset in their 50s or younger. Seeing this, your doctor could ask more questions and take more aggressive preventive measures than they might have had they not seen a chart like this.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!GJzU!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!GJzU!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 424w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 848w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 1272w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!GJzU!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png" width="1456" height="714" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:714,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:264514,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/214935259?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!GJzU!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 424w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 848w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 1272w, https://substackcdn.com/image/fetch/$s_!GJzU!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4bf7fd72-38fe-4e77-b1f9-d9cae3719512_3368x1652.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>There&#8217;s much more on how family health history works and how your information stays private at <a href="https://www.healthscout.co/home#familyhealthhistory">www.healthscout.co</a>. In future posts, I&#8217;ll go deeper on the stories of <a href="https://www.healthscout.co/olivia-munn">Olivia Munn</a>, <a href="https://www.healthscout.co/bob-harper">Bob Harper</a>, and <a href="https://www.healthscout.co/taking-action">William Nijjer</a>, who each had heritable conditions and either took life-saving preventive measures because they knew about family health history or wish they&#8217;d had better information sooner.</p><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><p><em>HealthScout, including the Family Health History feature, is available now on the <a href="https://apps.apple.com/us/app/healthscout/id6743687046">App Store</a>. Using Family Health History is free for you and everyone you add.</em></p>]]></content:encoded></item><item><title><![CDATA[It Answers at 11pm]]></title><description><![CDATA[When a brain tumor diagnosis sent Melinda through six months of hospitals, biopsies, and medications she&#8217;d never heard of, HealthScout offered her something doctors couldn&#8217;t: answers at 11pm.]]></description><link>https://www.joesipher.com/p/it-answers-at-11pm</link><guid isPermaLink="false">https://www.joesipher.com/p/it-answers-at-11pm</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 02 Jun 2026 14:31:58 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/92eb0635-1340-4b48-a3cc-f077d93f8354_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. Melinda is a real user. Her name has been changed to protect her privacy.</em></p><div><hr></div><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!-Ype!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!-Ype!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 424w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 848w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 1272w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!-Ype!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png" width="1456" height="841" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:841,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:2064728,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/199915907?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!-Ype!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 424w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 848w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 1272w, https://substackcdn.com/image/fetch/$s_!-Ype!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F08ff0db2-2cf1-4a40-81c0-d28f0d832d84_1736x1003.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><h3>A Child Found Her on the Floor</h3><p>Melinda is a pre-school teacher. One day last fall one of the children came back from recess and found her on the floor, unconscious. The frightened student ran to find another teacher, who called 911. The paramedics recognized she had a seizure and immediately took her to the hospital, where scans found a mass in her brain.</p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Subscribe free for posts about using AI for patient health.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><p>Melinda doesn&#8217;t remember any of it. Her memory picks up in the ambulance, where she told someone her chest hurt. It hurt because her colleagues had been doing chest compressions.</p><p>At the hospital, after more tests, they took her in for a biopsy. She came out of it with her head pounding and her daughter Erin sitting nearby. Melinda&#8217;s first request was for her mouth guard. She thought her jaw was causing the headache. It took a few minutes before anyone explained to her that she&#8217;d just had brain surgery.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!LKST!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!LKST!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 424w, https://substackcdn.com/image/fetch/$s_!LKST!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 848w, https://substackcdn.com/image/fetch/$s_!LKST!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 1272w, https://substackcdn.com/image/fetch/$s_!LKST!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!LKST!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png" width="538" height="323.6868131868132" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:876,&quot;width&quot;:1456,&quot;resizeWidth&quot;:538,&quot;bytes&quot;:156375,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/199915907?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!LKST!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 424w, https://substackcdn.com/image/fetch/$s_!LKST!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 848w, https://substackcdn.com/image/fetch/$s_!LKST!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 1272w, https://substackcdn.com/image/fetch/$s_!LKST!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F7ccd2ccd-4aa6-4850-b17a-bf9dd7737294_1947x1172.png 1456w" sizes="100vw"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>The first biopsy came back inconclusive. She didn&#8217;t have many options except to do a second biopsy, but that couldn&#8217;t be scheduled for months.  Now she had to wallow in that uncertainty. New symptoms appeared that she may have ignored before, but now they made her nervous. She wanted to know if any new symptom was connected to the mass in her brain.</p><h3>Help with Uncertainty</h3><p>About a month later, a friend came to Melinda&#8217;s house to visit and bring dinner. While they were there, the friend picked up Melinda&#8217;s phone and installed HealthScout for her.</p><p>Melinda immediately started asking it questions. She noticed cigarette and metallic smells when nobody around her could. Could that be related to her brain tumor? HealthScout confirmed that phantom smells are a recognized sign of a mild seizure, something none of her doctors had mentioned to her yet.</p><p>Then when Melinda missed a dose of her seizure medication one night, she needed to know whether to take it late, skip it, or double up in the morning. It was not the kind of question you sit with until your doctor&#8217;s office opens. So she opened HealthScout, got an answer specific to her medication and her dosing schedule, and went to sleep.</p><p>Her doctors weren&#8217;t available for a quick consult at 11pm. HealthScout was.</p><p>Before every appointment, she would open HealthScout and ask what questions she should bring to her oncologist, her neurologist, or whoever she was seeing that week. HealthScout helped her bring the version of herself who was prepared, specific, and hard to dismiss.</p><p>&#8220;When I&#8217;m seeing doctors,&#8221; she told me, &#8220;I&#8217;m using it multiple times a day.&#8221;</p><h3>Her Doctor Said She Didn't Need AI. She Disagreed.</h3><p>Melinda had the second biopsy, and they were able to remove 75% of the tumor at the same time. That was when they finally had enough information to make a diagnosis.</p><p>She had a Grade 2 glioma &#8212; a slow-growing, manageable form of brain cancer. Her oncologist told her it was &#8220;the best news I can give anybody.&#8221;</p><p>It was great news, but a new drug and a new reality meant new symptoms and more questions. </p><p>She was out to a Japanese place with friends one night and wanted a little sake. She already suspected what the answer would be, but she asked HealthScout anyway. It told her the alcohol would interfere with her seizure medication. Her friends were telling her the same thing, but she wanted to know from something that actually had her records. </p><p>During one of her appointments, she pulled out her phone to ask HealthScout a question right in front of her doctor. He told her she didn't need ChatGPT because he could answer her questions himself.</p><p>She told him she wasn&#8217;t using ChatGPT. She was using HealthScout, and it had all her medical records. So when HealthScout answered a question, it already knew what medications she was on, what surgeries she&#8217;d had, and what her diagnosis actually was.</p><p>He said, &#8220;Oh, that&#8217;s good.&#8221;</p><p>If you ask ChatGPT about a missed seizure medication dose, it answers for seizure patients generally. HealthScout answered for Melinda specifically, because it already had her records.</p><h3>HealthScout Remembers So You Don't Have To</h3><p>At one point during our conversation, I asked Melinda about the medical term for her diagnosis. She paused. She knew it started with a G. She was pretty sure there was an &#8220;oma&#8221; in there somewhere. So she opened HealthScout and asked.</p><p>&#8220;Grade 2 glioma.&#8221;</p><p>&#8220;I&#8217;ve gone back to do that for other things too,&#8221; she said. &#8220;If I can&#8217;t remember something, I&#8217;ll just ask, what did doctor so-and-so say about this.&#8221;</p><p>Because her records are all in one place, she doesn't have to hold the whole story in her head.  </p><p>She still uses HealthScout every day. She used it the morning of the interview we did for this piece, to prepare questions for an upcoming appointment with her oncologist. </p><p>&#8220;I honestly cannot imagine going through this journey without it.&#8221;</p><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">HealthScout is available free on the App Store</a> and requires no signup or email collection. Upload one record and ask your first question in under a minute.</em></p>]]></content:encoded></item><item><title><![CDATA[You Lie to Your Doctor. Almost Everyone Does.]]></title><description><![CDATA[Are people less likely to lie to their AI health assistant?]]></description><link>https://www.joesipher.com/p/you-lie-to-your-doctor-almost-everyone</link><guid isPermaLink="false">https://www.joesipher.com/p/you-lie-to-your-doctor-almost-everyone</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 26 May 2026 14:31:07 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/daba49d9-0c48-481f-b047-d55956b4e36a_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>There&#8217;s a question your doctor asks at nearly every visit: <em>How many drinks do you have a week?</em></p><p>Most people don&#8217;t answer it honestly. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!mr6g!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!mr6g!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 424w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 848w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 1272w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!mr6g!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png" width="1456" height="760" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:760,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:2189571,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/191215411?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!mr6g!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 424w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 848w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 1272w, https://substackcdn.com/image/fetch/$s_!mr6g!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F8e4a8b6c-33b5-4a8e-ae4d-c6725f8123f0_1736x906.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>They say one or two drinks a night, maybe three on weekends. The real number is often higher. And alcohol consumption is just one of the sensitive topics patients often don&#8217;t answer honestly. How about whether you&#8217;re actually taking your medication, whether you&#8217;ve been exercising, whether you&#8217;ve been following the diet you promised you would, and what&#8217;s happening with your sex life?</p><h3>Why Do Patients Lie To Their Doctors?</h3><p>In 2018, researchers from the University of Utah, Middlesex Community College, the University of Michigan, and the University of Iowa surveyed more than 4,500 Americans across two age groups. They asked people whether they had ever withheld health information from a doctor across seven common scenarios.</p><p>Between 60% and 81% said yes.</p><p>The study, published in <em>JAMA Network Open</em>, found the most common reasons: people didn&#8217;t want to be judged or lectured to. They simply wanted their doctor to think well of them.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!B8qo!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!B8qo!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 424w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 848w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 1272w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!B8qo!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png" width="1211" height="839" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/effa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:839,&quot;width&quot;:1211,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:67721,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/191215411?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!B8qo!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 424w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 848w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 1272w, https://substackcdn.com/image/fetch/$s_!B8qo!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Feffa2a90-2179-49d5-9975-bc12e07fb7ca_1211x839.png 1456w" sizes="100vw"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Source: WebMD survey</figcaption></figure></div><p>&#8220;Most people want their doctor to think highly of them,&#8221; said Angela Fagerlin, senior author of the study and chair of population health sciences at University of Utah Health. &#8220;They&#8217;re worried about being pigeonholed as someone who doesn&#8217;t make good decisions.&#8221;</p><h3>What Is Social Desirability Bias?</h3><p>Psychologists call this social desirability bias. The short version: when another person is watching, we perform the version of ourselves we wish were true.</p><p>It&#8217;s not unique to doctors. People overreport how often they vote, how much they exercise, how much they donate to charity. Wherever there&#8217;s a judgment being made by someone we want to impress, the bias kicks in. The doctor&#8217;s office is just a place where the gap could have serious consequences.</p><h3>Patients Are More Likely To Be Honest with AI</h3><p>A 2025 white paper from UK&#8217;s Aide Health surfaced a different pattern. When patients interacted with AI instead of a human clinician, they disclosed significantly more. The company&#8217;s conversational AI platform found that 26% of asthma patients admitted to not taking their medication as prescribed &#8212; a figure far higher than rates typically reported in face-to-face consultations with a doctor.</p><p>Being more honest with technology than a human has been around since the dawn of computer human interaction. As early as the 1960s, people disclosed surprisingly personal information to the very first AI chatbot, ELIZA, treating it as if it understood them, even though it was only a simple pattern&#8209;matching program. </p><div class="captioned-image-container"><figure><div class="image-link image2" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!yvvH!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 424w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 848w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 1272w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!yvvH!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png" width="1456" height="347" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:347,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:60679,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/191215411?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!yvvH!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 424w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 848w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 1272w, https://substackcdn.com/image/fetch/$s_!yvvH!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F98877292-36cd-4682-99e0-b1004045d0c2_1848x440.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></div></figure></div><h3>What This Means for the Value of Health AI</h3><p>When your doctor asks how many drinks you have per week and you say two, your doctor makes a decision based on two. When you tell a health AI the truth, and it can also read your liver function labs from three different hospitals, it&#8217;s working with something closer to what&#8217;s actually happening in your body.</p><p>Doctors train for a decade, physically examine you, read the room, and catch things no algorithm will catch. But a system that receives honest information and has access to your complete medical record is working with better inputs than a clinician who receives sanitized or truncated versions. </p><p>Better inputs don&#8217;t guarantee better outputs, but incomplete information is one of the most reliable paths to a wrong answer. If giving an AI your honest health story without the fear of being judged feels more comforting than deciding how much you want to tell your doctor while sitting on that loud, crinkly paper, try telling your story to <a href="https://apps.apple.com/us/app/healthscout/id6743687046">HealthScout</a>. It&#8217;s free in the App Store.</p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Subscribe for free to receive new posts about using AI for your health.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><p></p>]]></content:encoded></item><item><title><![CDATA[Medical Intake Forms Suck. HealthScout's New Form Assistant Makes It Better]]></title><description><![CDATA[The consequences of an inaccurate or incomplete medical intake form are worse than you might think.]]></description><link>https://www.joesipher.com/p/medical-intake-forms-suck-healthscouts</link><guid isPermaLink="false">https://www.joesipher.com/p/medical-intake-forms-suck-healthscouts</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 19 May 2026 14:00:47 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/c592b99b-eada-48aa-91bb-7a350d7fd7df_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Last month my new orthopedic specialist&#8217;s assistant handed me the dreaded clipboard with a four-page questionnaire covering most questions I know off the top of my head and many that there&#8217;s no way I remember. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!QinI!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!QinI!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 424w, https://substackcdn.com/image/fetch/$s_!QinI!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 848w, https://substackcdn.com/image/fetch/$s_!QinI!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 1272w, https://substackcdn.com/image/fetch/$s_!QinI!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!QinI!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png" width="1456" height="760" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:760,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:293254,&quot;alt&quot;:&quot;Medical intake form asking for past surgeries and hospitalizations as well as family history&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/197905513?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Medical intake form asking for past surgeries and hospitalizations as well as family history" title="Medical intake form asking for past surgeries and hospitalizations as well as family history" srcset="https://substackcdn.com/image/fetch/$s_!QinI!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 424w, https://substackcdn.com/image/fetch/$s_!QinI!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 848w, https://substackcdn.com/image/fetch/$s_!QinI!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 1272w, https://substackcdn.com/image/fetch/$s_!QinI!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F52844ecf-40be-4de9-a872-bc1ca3900edf_1736x906.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Classic medical intake form. Page 2 of 4.</figcaption></figure></div><p>The form asked for a full surgical history including dates, a comprehensive family history going back to my grandparents, and current medications with exact dosages. Who can conjure all that detail, comprehensively and accurately, from memory? That&#8217;s a rhetorical question. No one can. </p><h2>What Are the Consequences?</h2><p>I used to think skipping or making my best guess wasn&#8217;t important. Many clinicians ask you the same questions in the appointment anyway. </p><p>But a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2855002/">study out of Northwestern</a> found that 85% of medication order errors originated from incorrect or incomplete medication histories. Cardiovascular medications were the most common error (29.1%). If undetected, 52.4% of order errors were rated as potentially <strong>requiring increased monitoring or intervention to preclude harm</strong>. Oh! </p><h4>The Wrong Information Can Propagate</h4><p>HealthScout and any well-designed health AI system depend on the context of your electronic health record (EHR).  AI takes wrong or missing answers as definitive truth. When I first started using HealthScout on my own data, it surfaced incorrect data I wrote on a clipboard 20 years ago. It&#8217;s one of the reasons I built <a href="https://outsmart.substack.com/p/what-your-new-doctor-doesnt-know">My Added Records</a>: to allow users to correct their own records in HealthScout. </p><p>But patients can&#8217;t easily correct their EHR. When your new provider accepts what you wrote, it becomes an official diagnosis. The next provider sees it as established fact and builds on it. </p><h4>Treatment Decisions Change </h4><p>Depending on if a patient forgets a condition or medication or adds one they actually don&#8217;t have (<a href="https://pubmed.ncbi.nlm.nih.gov/26262030/">yes this happens</a>), a doctor might avoid a medication or procedure because of a listed condition, or prescribe something that conflicts with a condition or medication that didn&#8217;t make the list. </p><p>Similarly, a slightly high cholesterol means something completely different for patients whose parents and grandparents lived to a ripe old age versus someone with a parent who died of a heart attack in their 50s. </p><p>In all these cases, life-changing decisions might be made based on incorrect information in the EHR. </p><h2>Form Assistant</h2><p>Besides the accuracy issues we just covered, filling out medical intake forms simply sucks. So today I&#8217;m releasing a new HealthScout feature, Form Assistant.</p><p>Simply photograph a medical intake form or upload the PDF and tap Send. HealthScout reads the form, looks up answers in your health records, and returns them organized to mirror the form&#8217;s own sections: current medications with dosages, documented conditions, surgical history, family history, and even insurance information. If your form is digital, there&#8217;s a copy button on each field to easily paste the answers. If you&#8217;re set up on a modern Mac, you can copy on your iPhone and paste right into a Mac browser window. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!bctp!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!bctp!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 424w, https://substackcdn.com/image/fetch/$s_!bctp!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 848w, https://substackcdn.com/image/fetch/$s_!bctp!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 1272w, https://substackcdn.com/image/fetch/$s_!bctp!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!bctp!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png" width="870" height="390" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/be9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:390,&quot;width&quot;:870,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:54130,&quot;alt&quot;:&quot;Form Assistant Results page showing protected insurance information&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/197905513?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Form Assistant Results page showing protected insurance information" title="Form Assistant Results page showing protected insurance information" srcset="https://substackcdn.com/image/fetch/$s_!bctp!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 424w, https://substackcdn.com/image/fetch/$s_!bctp!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 848w, https://substackcdn.com/image/fetch/$s_!bctp!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 1272w, https://substackcdn.com/image/fetch/$s_!bctp!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fbe9ed29d-d57a-44d2-9c39-9864efa49ab6_870x390.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Form Assistant results include a copy button to paste the answers</figcaption></figure></div><p>The first time you use Form Assistant, your answers are saved to a profile called Saved Info. Every intake form after that starts with your Saved Info, and if something&#8217;s wrong, you can correct it right there for next time.</p><h4>Why HealthScout Answers Are Better</h4><p>When HealthScout fills a field from your health records, the answers reflect what your providers actually documented. The dosage is the one in the prescription on file. The diagnosis name is the specific one, not your recollection of what a doctor mentioned at an appointment two years ago.  And if your EHR is wrong, Form Assistant prioritizes your My Added Records correction entries so all the most up-to-date information is provided.  </p><h4>What Happens to Your Form Photos</h4><p>Form Assistant follows the same privacy architecture as everything else in HealthScout. Your health data is never stored on HealthScout&#8217;s servers. The form photos you submit are processed to generate answers and then discarded.</p><h4>Where to Find It</h4><p>Form Assistant is included in the generous free tier of HealthScout. If you don&#8217;t have HealthScout yet, download it free on the App Store.</p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/us/app/healthscout/id6743687046" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!l5P7!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 424w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 848w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 1272w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!l5P7!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png" width="438" height="183.20192307692307" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:609,&quot;width&quot;:1456,&quot;resizeWidth&quot;:438,&quot;bytes&quot;:121959,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/us/app/healthscout/id6743687046&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/197905513?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!l5P7!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 424w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 848w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 1272w, https://substackcdn.com/image/fetch/$s_!l5P7!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9411d604-d9b6-4f4b-b3ef-ff705009eae8_2100x879.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><p>If you&#8217;re already a user, be sure to update and look for the new clipboard icon on HealthScout&#8217;s home screen.</p><div><hr></div><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free to stay up to date on using AI safely for health.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><p></p>]]></content:encoded></item><item><title><![CDATA[Perplexity Health Had My Records But Forgot to Use Them]]></title><description><![CDATA[Why purpose-built health AI works better than bolting health onto a generic model.]]></description><link>https://www.joesipher.com/p/perplexity-health-had-my-records</link><guid isPermaLink="false">https://www.joesipher.com/p/perplexity-health-had-my-records</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 05 May 2026 14:02:26 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/c80f0efb-d020-4f9e-aa64-a1fd156521ca_2400x1206.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system.</em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><p>In earlier posts, I made the case that generic AI is a poor tool for personal health questions. It <a href="https://www.joesipher.com/p/asking-chatgpt-without-your-full">doesn&#8217;t know your health history</a>, it <a href="https://www.joesipher.com/p/generic-ai-recommended-a-drug-i-cant">doesn&#8217;t ask clarifying questions,</a> and it is <a href="https://www.joesipher.com/p/before-sharing-health-data-with-chatgpt">weak on privacy protections</a> for health data.</p><p>The obvious response is: that&#8217;s why companies are building health-specific AI. ChatGPT Health, Copilot Health, and Perplexity Health all let you connect your health records. Problem solved.</p><p>I tested that assumption with Perplexity Health. It did not go well.</p><h2>I Asked About My Knees</h2><p>I have bilateral knee osteoarthritis with prior meniscal injuries in both knees. I&#8217;ve had cortisone injections, X-rays, and platelet-rich plasma (PRP) treatments. I&#8217;ve been seeing a regenerative medicine orthopedic specialist for over a year. All of this is documented in my health records.</p><p>I connected records from four providers to Perplexity Health. Then I asked: &#8220;What should I do about my knees?&#8221;</p><p>Perplexity Health gave me a long, organized response . . .  about rucking.</p><p>It recommended I drop my ruck weight, use flat routes, never run with a ruck, and do wall squats and calf raises. </p><p>None of that was drawn from my health records. It was drawn from previous conversations I&#8217;d had with regular Perplexity about rucking and exercise. Perplexity Health borrowed context from those unrelated chats and used it to answer a health question, while ignoring the actual medical records I had connected.</p><h2>&#8220;Can&#8217;t You See My Knee Related Health Records?&#8221;</h2><p>That&#8217;s what I typed next. Verbatim.</p><p>Perplexity Health&#8217;s tone changed immediately. &#8220;Yes, there is quite a bit of knee-related information visible in your records, and it meaningfully changes the advice.&#8221;</p><p>Suddenly it could see much of the info: my bilateral primary osteoarthritis, old meniscus injuries in both knees, cortisone injections from 2024, and knee X-rays. It acknowledged that my situation was &#8220;not just generic runner&#8217;s knee&#8221; but &#8220;structural, bilateral knee osteoarthritis with prior meniscal damage that has already required injections and imaging.&#8221;</p><p>All of that was there the first time I asked. Perplexity Health just didn&#8217;t look.</p><h2>Even After Looking, Half Was Missing</h2><p>Perplexity Health connects to providers through a service called b.well. One of my connected providers is San Diego Orthobiologics, the regenerative medicine practice where I&#8217;ve had the PRP injections.</p><p>Perplexity Health&#8217;s connection to that provider showed my name and basic information. But nothing substantive came through: not the PRP records, not the shockwave therapy notes, not the clinical notes from those visits.</p><p>To be fair, Perplexity Health does let you upload lab results manually. So I tried. I uploaded the clinical note from my January 2025 PRP treatment at San Diego Orthobiologics. It&#8217;s a PDF of what looks like a mimeograph from 1975 with handwritten checkmarks, notes, lab values, procedure details, and the treatment plan.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!r52K!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!r52K!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 424w, https://substackcdn.com/image/fetch/$s_!r52K!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 848w, https://substackcdn.com/image/fetch/$s_!r52K!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 1272w, https://substackcdn.com/image/fetch/$s_!r52K!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!r52K!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png" width="1456" height="1897" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1897,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:606446,&quot;alt&quot;:&quot;Mimeographed Health Form with handwritten text and boxes checked&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/191789625?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Mimeographed Health Form with handwritten text and boxes checked" title="Mimeographed Health Form with handwritten text and boxes checked" srcset="https://substackcdn.com/image/fetch/$s_!r52K!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 424w, https://substackcdn.com/image/fetch/$s_!r52K!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 848w, https://substackcdn.com/image/fetch/$s_!r52K!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 1272w, https://substackcdn.com/image/fetch/$s_!r52K!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F147ef93a-cc30-4442-a4aa-646f16701353_1500x1954.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Perplexity Health didn't know what to do with this. HealthScout turned it into a medical record.</figcaption></figure></div><p>Perplexity Health could not ingest this document. When I asked whether it knew about my PRP treatment in January 2025, the response was clear: &#8220;No PRP treatment appears in the connected records for January 2025 or any other date.&#8221;</p><p>I uploaded that same document to HealthScout through My Added Records. HealthScout read the handwriting, identified the procedure (PRP injection to bilateral knee joints and left shoulder), extracted the lab values (platelet counts of 1,535 and 1,592 in the PRP concentrates), noted  my elevated BP (I was nervous!), and organized everything into a structured record it could reference in future answers.</p><p>The documents were identical. One app couldn&#8217;t read it. The other turned it into usable medical data.</p><h2>What HealthScout Did With the Same Question</h2><p>I asked HealthScout the same question: &#8220;What should I do about my knees?&#8221;</p><p>The first response was one sentence of acknowledgment and a question: &#8220;You have a detailed history of knee issues and treatments. To help me provide the most relevant guidance for your knees right now, could you tell me what you&#8217;re hoping to achieve or what your biggest concern is?&#8221;</p><p>Then it gave me five numbered options: 1. manage current pain, 2. explore long-term treatments like regenerative therapies, 3. exercise guidance, 4. understand my diagnoses, or 5. share more records for a more complete picture.</p><p>I typed &#8220;2&#8221; for the long-term treatment options.</p><p>HealthScout came back with a response grounded in my actual records. It referenced my PRP injections from January 2025, the improvement I&#8217;d seen, and my consultation with a new doctor for stem cell injections. It noted my CKD (Chronic Kidney Disease) and why regenerative therapies were particularly relevant given that I can&#8217;t take NSAIDs.</p><p>Every sentence referenced something from my records, not because I prompted it, but because that's how the app is built.</p><p>Yes, HealthScout had a more complete picture than Perplexity Health did. I had uploaded documents from providers whose records didn&#8217;t flow through automatically, including the treatment notes and consent forms from my regenerative medicine specialist. HealthScout actually gives you a way to close the gaps, and it reads nearly anything you throw at it. </p><h2>Health AI:  Purpose-Built or Additions to Generic AI?</h2><p>The promise of health AI is that connecting your records changes the experience, and that AI will use your medical history to give you better answers than generic AI can.</p><p>But Perplexity is a search and answer engine first. Because the health feature is bolted on, it reached for an old rucking conversation instead of my medical records. Perplexity&#8217;s purview is so wide, it had to guess at the context, and it guessed wrong. That&#8217;s a hard problem to solve, especially without asking a clarifying question.</p><p>HealthScout doesn&#8217;t have a non-health mode. Every answer starts from your health records, because that&#8217;s the only context it has. If it doesn&#8217;t have enough context, it asks a question first. </p><p>For your health, purpose-built wins over generic AI.</p><div><hr></div><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">HealthScout is available now on the App Store</a> and requires no signup or email collection. Upload one record and ask your first question in under a minute.</em></p>]]></content:encoded></item><item><title><![CDATA[ChatGPT Answers What You Ask. That's the Problem.]]></title><description><![CDATA[Generic AI answers your questions. HealthScout surfaces the ones you didn't know to ask.]]></description><link>https://www.joesipher.com/p/ai-answers-what-you-ask-thats-the</link><guid isPermaLink="false">https://www.joesipher.com/p/ai-answers-what-you-ask-thats-the</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 28 Apr 2026 14:02:33 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/e5479b03-bc3d-4ec9-89d7-72e711687943_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the fifth in a series on using AI for personal health.</em></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. </em></p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free to receive new posts and support my work.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><div><hr></div><p>When I asked my orthopedic specialist about a new knee treatment called Arthrosamid, he hadn&#8217;t heard of it. A month earlier, neither had I.</p><p>I have knee osteoarthritis. So, I&#8217;d done the research, knew the options, and chose a regenerative medicine specialist for PRP (platelet-rich plasma) injections because that seemed like the next logical step. Most people have never heard of PRP, but I&#8217;m a proactive patient and had researched it along with stem cell therapy.</p><p>That&#8217;s where my research ended.</p><h3>I Had No Idea What I Did Not Know</h3><p>At least a million new research articles are added to PubMed every year. Your doctor keeps up as best they can by reading the literature and attending conferences, but no physician can track every development across every condition affecting every patient in their practice.</p><p>Generic AI doesn&#8217;t have that constraint. It can process every article ever published. What it can&#8217;t do is connect any of them to you, because it has no idea about your health history. Ask it about your knee pain, and it will give you a thorough answer, but only to what you asked. </p><p>It won&#8217;t tell you about a treatment you&#8217;ve never heard of.</p><p>HealthScout works differently. Because it read my health records, it knew about my knee osteoarthritis without me typing a word. Every few days, HealthScout sent a new &#8220;Treatment Discovery Alert&#8221; with a research finding matched to my condition. The first few covered PRP and stem cell therapies, which gave me confidence the system was pulling relevant material.</p><p>Then it started finding things I had never heard of: genicular nerve radiofrequency ablation, low-intensity pulsed ultrasound (LIPUS), and Arthrosamid injections. Each of these is an evidence-based treatment being used clinically, but none had surfaced in my own research because I hadn&#8217;t known to look for them.</p><p>I brought HealthScout&#8217;s &#8220;Treatment Discovery Alert&#8221; knee treatment list to my orthopedic specialist. Some he dismissed, &#8220;I wouldn&#8217;t do that.&#8221; But when we got to Arthrosamid, he paused. He found the idea interesting enough to look into. Arthrosamid is only approved in Europe and Canada, so an American specialist having never heard of it makes sense. I&#8217;m still deciding whether to pursue it, but I wouldn&#8217;t have known it existed without HealthScout.  </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!kJJ-!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!kJJ-!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 424w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 848w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 1272w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!kJJ-!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png" width="1088" height="1047" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1047,&quot;width&quot;:1088,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:170488,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189929564?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!kJJ-!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 424w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 848w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 1272w, https://substackcdn.com/image/fetch/$s_!kJJ-!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F07628ab6-d063-4fe0-9ac9-acf9e7169d85_1088x1047.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Example Treatment Discovery Alert</figcaption></figure></div><p>The same problem plays out in every appointment.</p><p>Doctors consistently report that patients who come in prepared have better appointments. A patient who asks &#8220;My A1C went from 5.1 to 5.6 in three years. Is it OK as long as I don&#8217;t get into the pre-diabetes range?&#8221; gets a different conversation than one who asks &#8220;is everything okay?&#8221;</p><h3>The Questions You Didn&#8217;t Know to Ask</h3><p>Most people don&#8217;t know what questions to ask. They get their lab results back, see everything marked normal, and assume nothing needs discussing. But lab numbers tell a story across time, across multiple tests, in the context of medications and conditions, and that story isn&#8217;t visible without something to connect the dots.</p><p>HealthScout&#8217;s Smart Question Cards do that work. Before you type anything, HealthScout analyzes your complete health picture and generates questions drawn directly from your records: your labs, your trends, your medications, your conditions.</p><p>One HealthScout user&#8217;s vitamin D came back at a &#8220;normal&#8221; 27 ng/mL. But HealthScout noticed it was at the low end of the range and generated a Smart Question Card: &#8220;Could my Vitamin D level of 27 ng/mL be affecting my energy?&#8221; She&#8217;d been feeling tired for months and hadn&#8217;t connected it to anything. She brought the question to her doctor, who agreed with the assessment and started her on supplements. Her energy came back. She wouldn&#8217;t have known to ask about vitamin D without HealthScout.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!PRbl!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!PRbl!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!PRbl!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png" width="1456" height="832" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:832,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:480638,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189929564?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!PRbl!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!PRbl!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F104df43b-0efb-4294-9636-e51f906b8d13_1922x1098.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption"><em>Relevant questions generated automatically from your health records</em></figcaption></figure></div><p>Generic AI waits for you to ask the right question. HealthScout surfaces what you should be asking based on your health records, whether or not you knew to look.</p><div><hr></div><p><em>HealthScout is available now on the App Store. No email required, no account. Connect your providers or upload one record and see what your health data surfaces.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download HealthScout Free</a></em></p>]]></content:encoded></item><item><title><![CDATA[Your Health Records Are Wrong]]></title><description><![CDATA[Your doctors only know what made it into the record. A lot didn't.]]></description><link>https://www.joesipher.com/p/what-your-new-doctor-doesnt-know</link><guid isPermaLink="false">https://www.joesipher.com/p/what-your-new-doctor-doesnt-know</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 14 Apr 2026 14:01:52 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/630aefe9-c4d8-47a6-a8b6-b455625b88ea_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the fourth in a series on using AI for personal health.</em></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. </em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><div><hr></div><p>"Are you still on Vicodin?" asks an intake nurse for the umpteenth time. No, I&#8217;m not &#8220;on&#8221; Vicodin. It was prescribed after my gallbladder was removed in 2005. Why are they still asking about it 20 years later, and what does it mean for health AI?</p><h4>Wrong Records Produce Wrong Answers</h4><p>The healthcare industry has been working for decades on something called &#8220;the longitudinal record,&#8221; an initiative to provide access to all your health records from all your providers to you, the patient and (with your permission) your doctors. Real progress has been made, but what I found developing HealthScout is that most people&#8217;s health records are a mess: medications never marked as inactive, diagnoses that are now resolved, and typos. At some point someone typed in Rosuvastatin 5mg when in fact I&#8217;m on 40mg.</p><div class="captioned-image-container"><figure><div class="image-link image2" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!t523!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 424w, https://substackcdn.com/image/fetch/$s_!t523!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 848w, https://substackcdn.com/image/fetch/$s_!t523!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 1272w, https://substackcdn.com/image/fetch/$s_!t523!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!t523!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png" width="1456" height="310" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/a1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:310,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:40371,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189931264?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!t523!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 424w, https://substackcdn.com/image/fetch/$s_!t523!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 848w, https://substackcdn.com/image/fetch/$s_!t523!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 1272w, https://substackcdn.com/image/fetch/$s_!t523!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa1cf1562-f61a-4e39-b3a1-4c2927d32467_1848x394.png 1456w" sizes="100vw" fetchpriority="high"></picture><div></div></div></div></figure></div><p>If you feed wrong information into an AI, it&#8217;s going to try to make the best sense of the information it has.  So when I ask it for the history of my cholesterol numbers as compared to my statin medications, it struggles to make sense of a sudden &#8220;drop&#8221; in Rosuvastatin dosage.</p><p>Is that the AI hallucinating or just bad data?</p><h4>What If You Could Just Fix the Record Yourself?</h4><p>So HealthScout includes a feature called &#8220;My Added Records&#8221; that enables <em>you</em> to correct your health record. Now you can note when you stopped a medication or mark when a condition was resolved. Your correction takes priority over the healthcare provider records, so every answer HealthScout gives from that point forward reflects what&#8217;s true about your health today, not what was documented years ago.</p><h4>No Health App Covers Every Provider. HealthScout Fixed That.</h4><p>I have six healthcare providers. One of them, a specialist I see regularly, isn&#8217;t in the Apple Health network. For most health apps, that provider doesn&#8217;t exist. </p><p>This isn&#8217;t unusual. Smaller practices, independent specialists, and physical therapists often don&#8217;t participate in electronic health record networks. If any one of your providers falls into that category, a significant piece of your health story is missing.</p><p>With My Added Records, you can close that gap yourself. Securely upload whatever that provider has given you: a lab result they emailed, clinical notes from your visit, or an imaging report that came in the mail. You can even photograph a printed document or take a picture of a report on your computer screen. HealthScout reads it, incorporates it, and treats it the same as anything pulled from a connected provider.</p><h4>The Stuff That Never Made It Into Any Record</h4><p>Even if your healthcare provider records were complete and accurate, they would still be missing information never reported to your doctor.</p><p>Think about the last year. When did you come down with that terrible flu, January or February? When did you start taking fish oil supplements? </p><p>All those notes could be important, but none are documented in any medical record. They felt too minor to bring up to your doctor. Yet undocumented information like this can be critical if something serious pops up later.</p><div class="captioned-image-container"><figure><div class="image-link image2" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!wEU8!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 424w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 848w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 1272w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!wEU8!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png" width="1456" height="310" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/a5366495-497e-4437-ac56-ff135768cd48_1848x394.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:310,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:48467,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189931264?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!wEU8!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 424w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 848w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 1272w, https://substackcdn.com/image/fetch/$s_!wEU8!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa5366495-497e-4437-ac56-ff135768cd48_1848x394.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></div></figure></div><p>Your doctors make decisions about your health based on the information they have. They take laborious histories to try and catch everything, but they can&#8217;t.  Without a complete picture, medical professionals can&#8217;t make the best decisions. And if you ask an AI to analyze your incomplete records, it will miss things too.</p><p>But you know all of it. You lived it.</p><p>My Added Records is how you give that context to the AI. Log the gastrointestinal issue you had, your new supplements, or the exercise routine you started. </p><p>Every one of those entries becomes part of the picture HealthScout uses when you ask questions.</p><h4>Patients Should Control Their Health Records</h4><p>The healthcare industry is working on the serious problem of getting health records to move between systems. But if the original records are out-of-date or just plain wrong, then all these systems are synchronizing inaccurate records. </p><p>HealthScout is the only place where you can manage one complete health record that you own.  And who cares more about your health than you?</p><div><hr></div><p><em>HealthScout is available now on the App Store. No email required, no account. Start with one record to see how it works, or securely link your healthcare providers to get a complete picture.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download HealthScout Free</a></em></p>]]></content:encoded></item><item><title><![CDATA[ChatGPT Health Watches. OpenAI's Fine Print Explains How.]]></title><description><![CDATA[OpenAI Is Misleading People about ChatGPT Health's Privacy Protections]]></description><link>https://www.joesipher.com/p/before-sharing-health-data-with-chatgpt</link><guid isPermaLink="false">https://www.joesipher.com/p/before-sharing-health-data-with-chatgpt</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 07 Apr 2026 14:01:24 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/7d18486b-9af3-4a94-b054-4270a8008932_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the third in a series on using AI for personal health.</em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. </em></p><div><hr></div><p>I was reading OpenAI&#8217;s Health Privacy Notice to find out if a court ordered OpenAI to hand over user health data, could they comply? If they could, that would confirm health data is technically accessible to employees.</p><p>I never got to that question. Something stopped me on the way there.</p><p>The ChatGPT Health launch page says: </p><blockquote><p>&#8220;Conversations in Health are not used to train our foundation models.&#8221;</p></blockquote><p>But the actual legal document, the Health Privacy Notice, reads: </p><blockquote><p><strong>&#8220;By default</strong>, we do not use data in Health content to improve our foundational models.&#8221;</p></blockquote><p>Then again, a few paragraphs later: &#8220;<strong>By default</strong>, we do not use content in Health to improve our foundational models.&#8221;</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!DGHG!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!DGHG!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!DGHG!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png" width="1456" height="832" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:832,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:466247,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189494143?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="https://substackcdn.com/image/fetch/$s_!DGHG!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!DGHG!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4b9c719e-e21b-4689-a515-979bf7c5610e_1922x1098.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><h3>&#8220;By Default&#8221; = There&#8217;s a Hole in their Privacy Architecture</h3><p>Saying &#8220;Conversations in Health are not used to train our foundation models&#8221; is a <em><strong>commitment</strong></em>. &#8220;By default, we do not use content in Health&#8221; is a <em><strong>policy</strong></em>, one that can be changed. Policies get updated all the time, often announced with an email that no one will read. </p><p>The difference between <em>we don&#8217;t do this</em> and <em>we haven&#8217;t chosen to do this yet</em> is everything when the data involved is your mental health history, your ED meds, or your colonoscopy results. </p><p>The privacy notice also confirms that even under current policy, &#8220;a limited number of authorized OpenAI personnel and trusted service providers might access Health content to improve model safety.&#8221;</p><p><strong>This means people </strong><em><strong>can</strong></em><strong> reach ChatGPT Health data, already.</strong> </p><p>Therefore, using your data for training is not the only privacy risk. If employees can reach your health data, so can someone who phishes their way in, or an insider who decides their access is worth selling. And of course, the answer to my original question about a court order?  Yes, OpenAI would be legally compelled to comply and share your health records. </p><h2>Good Intentions Don&#8217;t Protect Your Data</h2><p>To be fair, I think OpenAI is genuinely trying to build something useful. ChatGPT Health looks impressive, and the intent seems real.</p><p>But intentions don&#8217;t protect your data. Architecture does.</p><p>The difference is between &#8220;we&#8217;ve decided not to look at your data&#8221; and &#8220;we've built a system where we have nothing to hand over<em>.&#8221; </em>It&#8217;s privacy by policy versus privacy by design.</p><p>When we built HealthScout, we made privacy by design an architectural choice from day one, knowing it would constrain the business in some ways. HealthScout stores your health data encrypted using Apple&#8217;s highest-level encryption standard, Advanced Data Protection (ADP) Complete, where the keys are locked on your device behind hardware-based Face ID or Touch ID encryption. Apple doesn&#8217;t even have them. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!v7sU!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!v7sU!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 424w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 848w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 1272w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!v7sU!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg" width="980" height="551" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:551,&quot;width&quot;:980,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;The Apple privacy logo is shown against a black screen.&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="The Apple privacy logo is shown against a black screen." title="The Apple privacy logo is shown against a black screen." srcset="https://substackcdn.com/image/fetch/$s_!v7sU!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 424w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 848w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 1272w, https://substackcdn.com/image/fetch/$s_!v7sU!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1274a5fe-1843-4f7d-9466-4aa4631eaae0_980x551.jpeg 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">HealthScout protects patient data using Apple&#8217;s highest level of security Advanced Data Protection Complete</figcaption></figure></div><p>In fact, the UK government demanded Apple create a backdoor to this data, and Apple&#8217;s response was to <a href="https://www.bbc.com/news/articles/cgj54eq4vejo">pull the feature from the UK entirely</a> rather than comply. That&#8217;s the standard HealthScout is built on.</p><p>When you ask a question on HealthScout, a portion of your health data is encrypted, transmitted to our AI partners and deleted. Our AI partners are <em>contractually</em> prohibited from using any content from those queries. That&#8217;s a legal obligation between two companies that can be enforced in a court of law versus a policy that can flip with a privacy update email to unsuspecting users. </p><p>HealthScout also does not collect personally identifying information (PII). No email collection. No account creation. We can&#8217;t identify our users even if we wanted to. If HealthScout ever received a court order demanding user health data, we&#8217;d have no ability to hand anything over because we don&#8217;t have it.</p><p>Before you connect your medical records to any AI system, it&#8217;s worth asking one question: is this company <em>choosing</em> not to use my data, or have they built a system where they simply don&#8217;t have it?</p><p>One of those is a promise. The other is a fact.</p><div><hr></div><p><em>If you want AI that protects your health records and doesn&#8217;t watch what you ask, HealthScout is on the App Store now. No email. No account. We can&#8217;t see what you ask. </em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download it free.</a></em></p><p></p><p></p>]]></content:encoded></item><item><title><![CDATA[Asking ChatGPT without Your Full Health History Is Guessing]]></title><description><![CDATA[If AI doesn't have your health history, it answers anyway. That's dangerous.]]></description><link>https://www.joesipher.com/p/asking-chatgpt-without-your-full</link><guid isPermaLink="false">https://www.joesipher.com/p/asking-chatgpt-without-your-full</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 31 Mar 2026 16:31:05 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/f21d518a-f9bb-4da2-a784-ba24eed3bf1a_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the second in a series on using AI for personal health.</em></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. </em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><div><hr></div><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!KvFr!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!KvFr!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 424w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 848w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 1272w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!KvFr!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png" width="430" height="430" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1200,&quot;width&quot;:1200,&quot;resizeWidth&quot;:430,&quot;bytes&quot;:81111,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189927612?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!KvFr!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 424w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 848w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 1272w, https://substackcdn.com/image/fetch/$s_!KvFr!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F560a1ab1-a329-48b8-add5-f13c221b3e6f_1200x1200.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>In an Oxford AI health study, only 35% of the people asking health questions got the right answer. Not great.</p><p>In the same study, when the AI model was given clean, structured cases, it scored 95%. The main difference was context.</p><p>Much of the press generated from the study took the angle that AI doesn&#8217;t work for health. But that 60-point accuracy drop wasn&#8217;t because the AI didn&#8217;t work. The AI models were identical. </p><p>What changed was what the AI had to work with. Researchers gave the AI complete, organized information. Real patients couldn&#8217;t do that. They didn&#8217;t know what was relevant, and they didn&#8217;t have their health records handy.</p><h3>My Labs Looked Normal. They Weren&#8217;t.</h3><p>I saw the Oxford study's findings about health context play out in my own life before the study was even published.</p><p>During an annual physical, I complained to my doctor about my &#8220;old man pains&#8221; (knee, back, shoulder) that increasingly affected my ability to be active. The doctor recommended I try an over-the-counter NSAID (non-steroidal anti-inflammatory drug) called naproxen. </p><p>It was magical. After a few days taking it twice a day (as he suggested), I felt amazing. It worked so well that I eventually switched to a prescription NSAID called celecoxib, which studies show is easier on the stomach. I thought I'd done my homework.</p><p>A year later, at my next wellness check, my eGFR came back at 69.</p><div class="captioned-image-container"><figure><div class="image-link image2" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!wEIi!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 424w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 848w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1272w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png" width="1456" height="270" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/aca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:270,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:&quot;My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal&quot;,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal" title="My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal" srcset="https://substackcdn.com/image/fetch/$s_!wEIi!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 424w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 848w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1272w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></div><figcaption class="image-caption">On the lower end of normal is normal, right?</figcaption></figure></div><p>My doctor scanned the results, saw nothing flagged as &#8220;High,&#8221; and moved on. I did too. With 30 minutes for a wellness check, you cover a lot of ground quickly.</p><p>Four months later, I started building HealthScout. My own health records were the only data I had to test with. As soon as a working version was running, I started asking it questions. One of my early test questions was:</p><p><em>&#8220;Do you see any trends that show a relationship between my medications and my lab results?&#8221;</em></p><p>To my surprise, HealthScout suggested that my &#8220;recent kidney function decline&#8221; could have something to do with my regular use of NSAIDs.</p><p><strong>What recent kidney function decline?</strong> I had no idea what it was talking about.</p><p>As it turns out, my primary care doctor only had records from One Medical. HealthScout had records from three providers spanning over a decade.</p><p>With that full history, it could see that my steady-state eGFR was around 90. A drop to 69 in seven months isn&#8217;t &#8220;low-normal.&#8221; It&#8217;s a 30% decline, which with full context is at least a yellow flag. HealthScout also knew that while most primary care physicians use the standard eGFR threshold of 60 as the cutoff for concern, nephrologists use a more granular classification system where 69 is already approaching moderate kidney disease.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!0_UW!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!0_UW!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 424w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 848w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1272w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png" width="1456" height="971" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:971,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:null,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:null,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!0_UW!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 424w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 848w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1272w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">Nephrologists use a more granular classification than standard labs.</figcaption></figure></div><p>No single provider would have seen any of this. Each one only had their own slice of my history.</p><p>My eGFR dropped all the way to 50 on my next test, low enough that I was diagnosed with Chronic Kidney Disease Stage 3a. A biopsy confirmed the finding: the NSAIDs had caused the decline. The good news: I&#8217;m off them now, and my kidneys are slowly recovering.</p><h3>The Context Gap Is Structural</h3><p>My doctor is a good guy who was put into a difficult situation &#8212; not enough data and not enough time. The Oxford study confirmed what I experienced firsthand: more context produced better answers. Less of it produced dangerous ones.</p><p>HealthScout connects to over 10,000 healthcare systems through Apple Health, including Labcorp and Quest Diagnostics, where most Americans get their blood drawn. It also accepts uploaded documents: photos of lab printouts, PDFs of clinical notes, or even pictures of reports snapped from your computer screen. The AI works from your complete history, across providers, going back as far as your records exist.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!G44d!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!G44d!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 424w, https://substackcdn.com/image/fetch/$s_!G44d!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 848w, https://substackcdn.com/image/fetch/$s_!G44d!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 1272w, https://substackcdn.com/image/fetch/$s_!G44d!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!G44d!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png" width="1456" height="534" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:534,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:80634,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189927612?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!G44d!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 424w, https://substackcdn.com/image/fetch/$s_!G44d!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 848w, https://substackcdn.com/image/fetch/$s_!G44d!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 1272w, https://substackcdn.com/image/fetch/$s_!G44d!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F39d27bd2-2484-4290-b7c9-d4ab04879084_1848x678.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Your actual health history exists. It's just in multiple systems that don't talk to each other. Do yourself a favor and put it all in one place.</p><div><hr></div><p><em>HealthScout is available now on the App Store. No email required, no account needed. Connect your providers, upload a record, and ask your first question in under a minute.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download HealthScout Free</a></em></p>]]></content:encoded></item><item><title><![CDATA[Generic AI Recommended a Drug I Can't Take]]></title><description><![CDATA[Ask ChatGPT About Your Headache. Count the Paragraphs.]]></description><link>https://www.joesipher.com/p/generic-ai-recommended-a-drug-i-cant</link><guid isPermaLink="false">https://www.joesipher.com/p/generic-ai-recommended-a-drug-i-cant</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 24 Mar 2026 14:02:24 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/3703f9f6-af75-4d3f-b6fd-7df523e50f01_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the first in a series on using AI for personal health.</em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system. </em></p><div><hr></div><p>I typed the same question into two AI apps: &#8220;I woke up with a headache. What should I do?&#8221;</p><p>ChatGPT went straight to a comprehensive six-step response. Drink water. Eat something light. Take a pain reliever. Stretch your neck. Get some fresh air. Try coffee.</p><p>HealthScout presented nine numbered scenarios and asked me to pick the ones that fit.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!mgXm!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!mgXm!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 424w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 848w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 1272w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!mgXm!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png" width="1456" height="4115" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:4115,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:690653,&quot;alt&quot;:&quot;A comparison of HealthScout and ChatGPT answers to the question \&quot;I woke up with a headache. What should I do.\&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189929241?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="A comparison of HealthScout and ChatGPT answers to the question &quot;I woke up with a headache. What should I do.&quot;" title="A comparison of HealthScout and ChatGPT answers to the question &quot;I woke up with a headache. What should I do.&quot;" srcset="https://substackcdn.com/image/fetch/$s_!mgXm!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 424w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 848w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 1272w, https://substackcdn.com/image/fetch/$s_!mgXm!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F93b663d5-c70e-4ff9-95e2-81c00f7e541f_1477x4174.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a><figcaption class="image-caption">HealthScout and ChatGPT responses to the same question </figcaption></figure></div><h3>ChatGPT Suggested Taking a Drug That Would Hurt Me</h3><p>ChatGPT&#8217;s third recommendation, right under &#8220;Take a Pain Reliever (if needed),&#8221; is ibuprofen.</p><p>I have chronic kidney disease. Ibuprofen accelerates kidney damage. It&#8217;s one of the first things a nephrologist tells you to avoid.</p><p>ChatGPT didn&#8217;t know I had CKD. It didn&#8217;t ask. So it handed me advice a doctor familiar with my history would never give.</p><p>This isn&#8217;t rare. The person asking about a headache might be on blood thinners, might be pregnant, or might be taking a medication that interacts badly with what&#8217;s being recommended. Generic AI can&#8217;t know any of that, because it doesn&#8217;t ask, and it doesn&#8217;t have your records.</p><h3>What HealthScout Did Instead</h3><p>Before answering anything, HealthScout gave me nine numbered scenarios and asked me to pick the ones that fit.</p><p>Each option covered a different angle: severity, context, medication status, specific health concern. I typed &#8220;1 and 8&#8221;, and it had what it needed.</p><p>Look at what option 8 actually said: <em>&#8220;I&#8217;m concerned about what pain relief I can take because of my chronic kidney disease.&#8221;</em></p><p>HealthScout already knew I had CKD. It surfaced that scenario specifically because it was in my records. I didn&#8217;t explain my history. I just confirmed it.</p><h3>Why Numbered Options Matter</h3><p>Describing your headache in words takes effort, and most people don&#8217;t do it well. You leave things out. You don&#8217;t know what&#8217;s relevant.</p><p>Numbered scenarios covering distinct angles are faster and more accurate. You pick one or several, and the app has what it needs to give you something useful.</p><p>ChatGPT does eventually ask for clarification. If you scroll past the six steps, past the warning signs, past the &#8220;quick routine,&#8221; there&#8217;s a section at the very bottom: &#8220;if you want, tell me where the headache is and how strong it is.&#8221;</p><p>After the laundry list of advice. After the ibuprofen recommendation.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!9Q57!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!9Q57!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 424w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 848w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 1272w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!9Q57!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png" width="1456" height="534" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/f522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:534,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:73485,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/189929241?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!9Q57!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 424w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 848w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 1272w, https://substackcdn.com/image/fetch/$s_!9Q57!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Ff522dbd0-edeb-4fc4-84c4-3ea67867cb09_1848x678.png 1456w" sizes="100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><h3>Then HealthScout Answered About <em>Me</em></h3><p>Once I replied with &#8220;1 and 8,&#8221; HealthScout pulled from what it already knew: my CKD diagnosis, my current medications, and my history. The response was about my headache, filtered through my health picture.</p><p>For a lot of questions, a wall of text is exactly what you want. For research or planning questions, a broad answer is fine. For health questions, it isn&#8217;t.</p><p>That&#8217;s what purpose-built means in practice. A system designed to understand your situation before drawing a conclusion, because the right answer for most people may be the wrong answer for you.</p><div><hr></div><p><em>HealthScout is available now on the App Store. No email required, no account. Upload one record and ask your first question in under a minute.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download HealthScout Free</a></em></p>]]></content:encoded></item><item><title><![CDATA[Why You Shouldn’t Just Paste Your Labs Into ChatGPT]]></title><description><![CDATA[Generic AI doesn&#8217;t know your health history, doesn&#8217;t find out what matters, and doesn&#8217;t protect your data. A six-part series.]]></description><link>https://www.joesipher.com/p/why-you-shouldnt-just-paste-your</link><guid isPermaLink="false">https://www.joesipher.com/p/why-you-shouldnt-just-paste-your</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 17 Mar 2026 14:02:47 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/adeb7237-7f4d-4647-b830-d67cc4fcf566_1200x603.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p><em>This is the introduction to a five-part series on using AI for personal health. Subscribe to catch them all.</em></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p><p><em>Full Disclosure: I built HealthScout, an app to help patients navigate our complex healthcare system.</em></p><div><hr></div><p>The most common thing I hear when I tell people about HealthScout is some version of: &#8220;Why can&#8217;t I just paste my lab results into ChatGPT and get the same thing?&#8221;</p><p>It&#8217;s a fair question. ChatGPT is free, it&#8217;s fast, and if you paste in a PDF of your blood work, it will give you a detailed interpretation that sounds authoritative. For a single set of lab results, it might even be useful.</p><p>But the approach has a problem most people don&#8217;t think about: you&#8217;re deciding what&#8217;s relevant before you know the answer.  You&#8217;re &#8220;pre-filtering&#8221; what the AI sees.</p><p>When you paste a lab result into ChatGPT, you&#8217;ve already made a choice. You included your CBC but not your metabolic panel from three months ago. You pasted today&#8217;s results but not last year&#8217;s, so there&#8217;s no trend to analyze. You mentioned your current medication but forgot the one you stopped in January.</p><p>A doctor reviewing your chart doesn&#8217;t ask you to decide which pages matter. They look at everything and make connections you wouldn&#8217;t think to flag.</p><p>That&#8217;s exactly what gets lost in the paste-it-in approach. You can&#8217;t include everything that&#8217;s relevant because you simply can&#8217;t know. How would you know the pattern between a medication one doctor prescribed and a lab result another doctor ordered? How might you know about a slow trend across years of results from two different providers?</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!32cl!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!32cl!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 424w, https://substackcdn.com/image/fetch/$s_!32cl!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 848w, https://substackcdn.com/image/fetch/$s_!32cl!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 1272w, https://substackcdn.com/image/fetch/$s_!32cl!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!32cl!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png" width="1456" height="421" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:421,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:63346,&quot;alt&quot;:&quot;ChatGPT doesn't know your health history. It answers anyway.&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/190773005?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="ChatGPT doesn't know your health history. It answers anyway." title="ChatGPT doesn't know your health history. It answers anyway." srcset="https://substackcdn.com/image/fetch/$s_!32cl!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 424w, https://substackcdn.com/image/fetch/$s_!32cl!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 848w, https://substackcdn.com/image/fetch/$s_!32cl!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 1272w, https://substackcdn.com/image/fetch/$s_!32cl!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6304b3a8-257a-437c-97ae-05c8107396ea_1848x534.png 1456w" sizes="100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>ChatGPT&#8217;s memory feature might recall that you mentioned a kidney problem last month. But it won&#8217;t maintain your actual eGFR values, medication dosages, or lab trends over time. Remembering fragments from past conversations isn&#8217;t the same as holding your health record.</p><p>The pre-filtering problem is just one reason generic AI falls short for personal health questions. I spent over a year building HealthScout, an app designed specifically for this job, and in the process I found five more reasons using generic AI is unsafe for personal health. </p><p>Each one matters more than you&#8217;d expect.</p><h2>1. Generic AI Recommended a Drug I Can&#8217;t Take.</h2><p>I typed &#8220;I woke up with a headache. What should I do?&#8221; into both ChatGPT and HealthScout.</p><p>ChatGPT gave me six steps immediately. Drink water, eat something, take ibuprofen, stretch, get fresh air, try coffee. Confident and organized. Looks like good advice.</p><p>HealthScout didn&#8217;t answer. Instead it presented eight numbered scenarios that <em>narrowed down</em> the possible root causes of my headache before giving any information. All I had to do was type in the numbers that matched my situation to get to a relevant answer tailored to my specific health context.</p><p>That difference matters more than it seems. </p><p>ChatGPT&#8217;s third recommendation was ibuprofen. I have chronic kidney disease. Taking ibuprofen would accelerate damage to my kidneys. ChatGPT didn&#8217;t know that, because it didn&#8217;t ask.</p><p>The full article details why the difference between a purpose-built health AI and a generic AI is the difference between helpful advice and a recommendation your doctor would immediately shut down.</p><p><em>Full article coming March 24: Generic AI Recommended a Drug I Can&#8217;t Take</em></p><h2>2. AI Without Your Health History Is Guessing</h2><p>Forty percent of American adults have used AI for health questions. Most of them type something into a blank text box with zero context about who they are.</p><p>Think about that from the AI&#8217;s perspective. It has no idea whether you&#8217;re pregnant, whether you&#8217;re on blood thinners, whether you have a family history of heart disease, or whether the medication it&#8217;s about to recommend interacts with something you already take. It answers anyway, because that&#8217;s what it&#8217;s designed to do.</p><p>A good answer for most people can be a dangerous answer for you. The gap between generic advice and personalized guidance is where people get hurt, and that gap only closes when the AI actually knows your health history.</p><p>The full article walks through what a generic AI answer looks like versus one grounded in your actual health history, and why the difference between a generic answer and a personal one can change what you do next.</p><p><em>Full article coming March 31: AI Without Your Health History Is Guessing</em></p><h2>3. ChatGPT Health Watches. OpenAI&#8217;s Fine Print Explains How.</h2><p>When OpenAI launched ChatGPT Health, they made a big deal about privacy. Their launch page says conversations in Health are not used to train their models. Full stop.</p><p>Their actual legal document, the Health Privacy Notice, says something different. It uses the phrase &#8220;by default&#8221; twice. The difference between &#8220;we don&#8217;t do this&#8221; and &#8220;by default, we haven&#8217;t chosen to do this&#8221; is everything when the data involved is your mental health history, your fertility records, or your STD results.</p><p>And here&#8217;s a question worth sitting with: how did OpenAI know that 40 million people use ChatGPT for health questions every day? OpenAI looked inside those conversations and categorized them. They&#8217;re watching.</p><p>The full article breaks down exactly what OpenAI&#8217;s privacy policy does and doesn&#8217;t promise, and what to look for before you paste your lab results into any AI.</p><p><em>Full article coming April 7: ChatGPT Health Watches. OpenAI&#8217;s Fine Print Explains How.</em></p><h2>4. Your Health Records Are Wrong</h2><p>Government officials, academics, and health professionals have been talking about a unified health record for decades. They haven&#8217;t built one. If you want to transfer your records to a new doctor in 2026, they&#8217;ll most likely be faxed. And faxed records will most likely sit in a file folder somewhere, much less easy for your doctor to access than your records stored in their digital system. </p><p>Combining all your records from different providers and giving your doctor access would clearly make their care more effective. But there&#8217;s a deeper problem. Even if your records were all in one place, they&#8217;d still be wrong. Prescriptions show start dates but not stop dates. Resolved conditions stay listed as current problems. Records accumulate, but they rarely get cleaned up.</p><p>Wrong records produce wrong answers, whether the one reading them is a doctor or an AI. The patient is the only person who knows what&#8217;s actually true across their full health picture.</p><p>The full article shows how you can build the complete health record that no hospital, government agency, or tech company has been able to create.</p><p><em>Full article coming April 14: Your Health Records Are Wrong</em></p><h2>5. AI Answers What You Ask. That&#8217;s the Problem.</h2><p>Every year, roughly a million new peer-reviewed medical research articles are published. No doctor can track every development across every condition. While generic AI can process it all,  it can&#8217;t connect any of it to you, because in order to pull out that relevant information, you have to know what to ask.</p><p>I have knee osteoarthritis. I&#8217;d done the research, found a specialist, and thought I knew all the treatment options available to me. I was wrong. There were treatments with real research behind them that I&#8217;d never heard of, because I hadn&#8217;t known to look for them.</p><p>The full article covers how HealthScout found treatments for my condition that my own specialist hadn&#8217;t heard of, and why an AI that only answers what you ask will never give you the full picture.</p><p><em>Full article coming April 28: AI Answers What You Ask. That&#8217;s the Problem.</em></p><div><hr></div><h2>The Common Thread</h2><p>Each of these problems traces back to the same root cause: generic AI was not designed for health. The same system that writes marketing copy and debugs code is fielding questions about chest pain and drug interactions. A blank text box that handles everything handles nothing particularly well when the stakes are personal.</p><p>After building just the scaffolding of HealthScout, the app found a 30% decline in my kidney function that my doctor had missed because each individual lab value still fell within the &#8220;normal&#8221; range. The trend only became visible when AI could see across all my providers, over time.</p><p>That&#8217;s what purpose-built means in practice &#8212; a system designed from the ground up to understand your situation before drawing a conclusion.</p><div><hr></div><p><em>HealthScout is available now on the App Store. No email required, no account. Upload one record and ask your first question in under a minute.</em></p><p><em><a href="https://apps.apple.com/us/app/healthscout/id6743687046">Download HealthScout Free</a></em></p><p></p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free to receive new posts and support my work.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div>]]></content:encoded></item><item><title><![CDATA[A Patient Advocate in Her Pocket]]></title><description><![CDATA[How one woman took control when forced to juggle multiple specialists]]></description><link>https://www.joesipher.com/p/a-patient-advocate-in-her-pocket</link><guid isPermaLink="false">https://www.joesipher.com/p/a-patient-advocate-in-her-pocket</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Wed, 01 Oct 2025 18:25:56 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!zf7E!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!zf7E!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!zf7E!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 424w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 848w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 1272w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!zf7E!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png" width="1344" height="768" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:768,&quot;width&quot;:1344,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:2148406,&quot;alt&quot;:&quot;Line drawing of a brain&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/174565485?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Line drawing of a brain" title="Line drawing of a brain" srcset="https://substackcdn.com/image/fetch/$s_!zf7E!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 424w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 848w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 1272w, https://substackcdn.com/image/fetch/$s_!zf7E!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F12e1b982-10a2-46f2-9985-3c00481c89cc_1344x768.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p><strong>Diana* had been healthy her entire life.</strong> Then, in the span of just a few months, she found herself juggling appointments between her primary care physician and two specialists: a neurologist and a cardiologist.</p><p>&#8220;All of a sudden, having a neurologist and a cardiologist, it was just crazy to me,&#8221; Diana told me. &#8220;I don&#8217;t really know how to interact with them.&#8221;</p><p>It started with mysterious fainting episodes &#8212; first on a plane, then at a restaurant where she collapsed and vomited in front of other diners. What followed was the medical equivalent of a relay race where no one passed the baton.</p><h2>The Specialist Shuffle Begins</h2><p>Her cardiologist discovered SVT (a heart rhythm disorder) and possibly atrial fibrillation &#8212; conditions requiring treatment &#8212; but saw nothing that explained the fainting. Then she found that getting a neurology appointment with insurance would take nine months. So Diana searched outside her network and finally found a neurologist who would take her sooner. </p><p>The neurologist ordered comprehensive testing in an attempt to understand the fainting, including brain scans. The results came back quickly &#8212; weeks before her follow-up appointments. So Diana had the data <em>but couldn&#8217;t understand it</em>. Most patients would have just waited anxiously. But Diana realized the results were already synchronized with HealthScout.</p><h2>Armed with Information</h2><p>&#8220;I asked HealthScout: What does it make of these recent tests and what should I ask about when I meet my doctors,&#8221; Diana explained. &#8220;And it gave me this really fabulous writeup, by doctor practice, including what I should be discussing with each.&#8221;</p><p>HealthScout didn&#8217;t just analyze her test results &#8212; it helped her document symptoms she&#8217;d been dismissing as normal aging: chronic nasal problems, occasional unsteady steps, sleep issues, fatigue. Then it organized everything by specialist, creating targeted question lists for her neurologist, cardiologist, and general practitioner.</p><p>&#8220;Before HealthScout, I would have only been able to listen to what each specialist told me, and been overwhelmed with just understanding all the information,&#8221; Diana told me. &#8220;Then afterwards, I would think of questions I <em>should</em> have asked. That would take yet more doctor&#8217;s visits, weeks out.&#8221;</p><p>This systematic preparation transformed her from a passive patient, hoping doctors would figure things out, into an informed advocate for her own care.</p><h2>The Professional Patient Advocate Problem</h2><p>Diana&#8217;s experience highlighted something many patients don&#8217;t realize exists: professional patient advocates.</p><p>&#8220;People with grave conditions can hire someone at the hospital or a medical consultant to guide them every step of the way to simply remember what the doctor said and to make sure all the important questions get asked,&#8221; she observed.</p><p>But these advocates are expensive and rare. &#8220;I don&#8217;t have such a person.&#8221;</p><p>HealthScout filled that gap. It became her patient advocate &#8212; organizing information, suggesting questions, helping her remember what to discuss with each specialist.</p><div class="pullquote"><p>&#8220;It felt like having someone on my side.&#8221;</p></div><h2>The Results</h2><p>Diana&#8217;s preparation paid off across all her appointments:</p><p><strong>The neurologist delivered mostly good news:</strong> No predictive markers for Alzheimer&#8217;s &#8212; Diana&#8217;s biggest fear. And her brain volume ranked in the 90th percentile for women her age. &#8220;I am an overachiever, as I like to be, and that made me tremendously happy.&#8221;  </p><p>However, the scans revealed white spots on her brain that shouldn&#8217;t be there, potentially related to sleep issues. This led to a home sleep study to investigate sleep apnea as a possible cause.</p><p><strong>The cardiologist</strong> confirmed her heart condition wasn&#8217;t related to the neurological findings, and prescribed new medication to help manage it.</p><p><strong>Her general practitioner</strong> addressed her chronic sinus problems &#8212; something Diana had never realized was worth mentioning. &#8220;I can actually, at the moment, breathe better than I have in a long time. I just didn&#8217;t know what normal breathing should feel like.&#8221;</p><h2>The Bigger Picture</h2><p>Diana hasn&#8217;t had a fainting spell since starting this chapter in her medical journey, and the cause of the fainting still hasn&#8217;t been 100% diagnosed.  But Diana&#8217;s story isn&#8217;t about finding a hidden diagnosis or catching medical errors. It&#8217;s about successfully navigating an increasingly complex healthcare system when you&#8217;re not equipped for the journey.</p><p>&#8220;HealthScout just really helped me keep it all organized. It was just so overwhelming between cardiologist, neurologist, and the general practitioner. And because I was so tired all the time, I know I wouldn&#8217;t have asked all my questions.&#8221;</p><p>The transformation was remarkable. Instead of feeling lost in the medical system, Diana became an active participant in her care.</p><p>&#8220;I am just eternally grateful for HealthScout, just in time for my aging process,&#8221; she said.</p><h2>The Patient Advocate We All Need</h2><p>Diana&#8217;s experience reveals a fundamental truth: as we age and our healthcare becomes more complex, we all need patient advocates. But professional advocates are expensive and scarce.</p><p>HealthScout democratizes patient advocacy, giving everyone access to the kind of systematic preparation and organization that only the most resourced patients typically receive. In a system where specialists don&#8217;t coordinate, Diana became the one passing the baton between her disconnected doctors &#8212; and HealthScout gave her the confidence to do it effectively.</p><p>&#8220;It felt like having someone on my side,&#8221; Diana reflected. &#8220;HealthScout helped me feel so much more in control. I don&#8217;t mean in control of what the doctor does because in the end, the doctor should be in control of what they&#8217;re prescribing or telling me to do. But I felt in control of knowing what I should hear about and what questions I wanted to ask.&#8221;</p><p><strong>That&#8217;s the power of having a patient advocate in your pocket &#8212; not to replace your doctors, but to help you get the most out of every appointment.</strong></p><div><hr></div><p><em>*Diana&#8217;s name has been changed to protect her privacy, but her story, quotes, and medical details are real.</em></p><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><div><hr></div><p>Feeling overwhelmed by your healthcare journey? Get the patient advocate we all need, right in your pocket. <a href="https://apps.apple.com/app/apple-store/id6743687046?pt=119068287&amp;ct=substack_newsletter_Diana&amp;mt=8">Download HealthScout free in the App Store</a>.</p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/app/apple-store/id6743687046?pt=119068287&amp;ct=substack_newsletter_Diana&amp;mt=8" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!68Ep!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 424w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 848w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 1272w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!68Ep!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png" width="202" height="67.56456043956044" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:487,&quot;width&quot;:1456,&quot;resizeWidth&quot;:202,&quot;bytes&quot;:93929,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/app/apple-store/id6743687046?pt=119068287&amp;ct=substack_newsletter_Diana&amp;mt=8&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/174565485?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!68Ep!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 424w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 848w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 1272w, https://substackcdn.com/image/fetch/$s_!68Ep!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6404a4c1-102d-4d56-8371-9f8f53baeff6_1532x512.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><div><hr></div><h4>More stories of how HealthScout helped people with their healthcare</h4><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;bff05101-4ae6-4b39-8c74-fb95b0c532a4&quot;,&quot;caption&quot;:&quot;In my last post, My Next Learning Curve: Democratizing Healthcare, I made the case that patients need tools to put themselves on even footing with the complex and fragmented healthcare industry, and AI could be the catalyst to enable it.&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;What My Doctor Missed&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-05-21T14:02:30.566Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!SZAS!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/what-my-doctor-missed&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:163675175,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:4,&quot;comment_count&quot;:2,&quot;publication_id&quot;:2370201,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;3890c5a2-18d4-4a68-a163-e59f878366c7&quot;,&quot;caption&quot;:&quot;Lilo had always been fit, lean, and strong. She could eat whatever she wanted and maintain her athletic lifestyle without much thought. Then 2020 arrived, and everything changed.&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;None of Her Five Doctors Saw the Forest&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-08-27T15:59:40.307Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5hQf!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/none-of-her-five-doctors-saw-the&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:171927491,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:5,&quot;comment_count&quot;:0,&quot;publication_id&quot;:2370201,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;2ba4ac0a-a3a2-4dcc-8fa3-c22e8b5030e4&quot;,&quot;caption&quot;:&quot;Mark* had been taking a statin for years when comprehensive blood testing revealed something his primary care doctor had never checked for: elevated Lp(a).&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;Hidden in Plain Sight&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-09-02T14:03:17.295Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!XXV2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/hidden-in-plain-sight&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:172198696,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:3,&quot;comment_count&quot;:0,&quot;publication_id&quot;:2370201,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;3d31689c-104f-4062-a9ad-5a85353d3e34&quot;,&quot;caption&quot;:&quot;Maya* sat in the endocrinologist's office, freshly diagnosed with osteoporosis and facing a choice that would affect her health for years to come.&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;The Decision That Took Weeks to Research&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-09-09T17:05:29.209Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!kaLi!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/the-decision-that-took-weeks-to-research&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:172832784,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:2,&quot;comment_count&quot;:0,&quot;publication_id&quot;:2370201,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free to receive new posts and support my work.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div>]]></content:encoded></item><item><title><![CDATA[The Decision That Took Weeks to Research]]></title><description><![CDATA[How HealthScout Solved a Treatment Dilemma in Seconds]]></description><link>https://www.joesipher.com/p/the-decision-that-took-weeks-to-research</link><guid isPermaLink="false">https://www.joesipher.com/p/the-decision-that-took-weeks-to-research</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 09 Sep 2025 17:05:29 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!kaLi!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Maya* sat in the endocrinologist's office, freshly diagnosed with osteoporosis and facing a choice that would affect her health for years to come.</p><p>"You have two main options," the specialist explained matter-of-factly. "Fosamax, which is a weekly pill, or Reclast, an annual IV infusion. Both are effective treatments."</p><p>Then came the part that left Maya feeling adrift: "I'll let you decide which one you prefer."</p><p>No recommendation. No guidance about which might work better for her specific situation. Just two options and a decision that felt too important to make without more information.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!kaLi!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!kaLi!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 424w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 848w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 1272w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!kaLi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png" width="1456" height="776" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/ea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:776,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:1252311,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/172832784?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!kaLi!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 424w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 848w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 1272w, https://substackcdn.com/image/fetch/$s_!kaLi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fea21d4b7-209a-4a70-8e26-a7e348583ff4_1922x1024.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><h2>The Friendship Network Investigation</h2><p>What do you do when your doctor won't make a recommendation? Maya did what many of us do &#8212; she crowdsourced the decision.</p><p>"I wrote to my network of girlfriends, accumulating several dozen stories of what others had experienced," Maya told me. For weeks, she collected testimonials, experiences, and opinions from friends who had faced similar choices.</p><p>The pattern that emerged was telling. Several friends mentioned they had tried Fosamax but experienced stomach problems that forced them to switch treatments. These stories resonated with Maya &#8212; she remembered having gastrointestinal issues with other oral medications in the past, though they seemed minor and distant.</p><p>Based on these friendship consultations, Maya concluded that Reclast would be the safer choice. She could avoid the potential stomach issues that had plagued her friends and that she vaguely remembered experiencing herself.</p><p>It was solid reasoning, but it had taken weeks of research and dozens of conversations to reach that conclusion.</p><h2>The Instant Answer</h2><p>Then Maya got access to HealthScout during our beta testing phase.</p><p>Curious to validate her weeks of research, she asked a simple question: "Should I take Fosamax or Reclast to treat my osteoporosis?"</p><p>HealthScout's response was immediate and definitive: Given her documented history of GI problems with oral medications, Reclast would indeed be the better choice.</p><p>"HealthScout arrived at an answer within seconds that I had taken weeks to research," Maya marveled.</p><h2>What Her Doctor Didn&#8217;t Consider</h2><p>The key difference? HealthScout had access to Maya's complete medical history, including those "minor" GI issues from years past that her endocrinologist had never connected to her current treatment decision.</p><p>"My endocrinologist had not picked up this issue as it was minor and very far in my past," Maya explained. To be fair to the specialist, those old medication intolerances were buried somewhere in Maya's long medical history, and the endocrinologist was focused on treating osteoporosis, not excavating every past drug reaction.</p><p>But HealthScout could see the pattern instantly. It knew that patients with a history of GI problems with oral medications are better candidates for IV therapies when both options are clinically equivalent.</p><h2>The Information Gap</h2><p>Maya's experience highlights a crucial gap in how medical decisions get made. Her endocrinologist was perfectly qualified to treat osteoporosis and offered two excellent treatment options. But without the time or tools to synthesize Maya's complete medical history, the specialist couldn't provide the personalized guidance Maya needed.</p><p>This left Maya to conduct her own research through friendship networks &#8212; a common but inefficient approach many patients resort to when faced with medical decisions.</p><h2>The Validation</h2><div class="pullquote"><p>HealthScout validated in seconds a decision that took Maya weeks to research.</p></div><p>But the real value wasn't just speed &#8212; it was confidence. Instead of relying on friends' anecdotal experiences, Maya now had an evidence-based recommendation rooted in her own medical history.</p><p>She could approach her next appointment knowing she had made the right choice for her specific situation, armed with the medical reasoning she needed to discuss with her endocrinologist.</p><h2>The Bigger Picture</h2><p>Maya's story illustrates how much medical decision-making happens in the gaps of our healthcare system. Specialists focus on their area of expertise but may not have the time or comprehensive view needed for fully personalized recommendations.</p><p>Patients are left to navigate complex treatment decisions with incomplete information, often turning to friends, family, or "Dr. Google" for guidance that may or may not apply to their specific medical situation.</p><p>HealthScout bridges this gap by giving patients access to their complete health story, enabling informed medical decisions based on their unique history rather than generic advice or anecdotal experiences.</p><p>What medical decisions might you be facing that could benefit from seeing your complete health picture?</p><div><hr></div><p><em>Update September 17, 2025</em></p><p>HealthScout is now out of beta and available for iOS users in the US.  Download it today to see what critical information your health records hold.</p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/us/app/healthscout/id6743687046" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png" width="512" height="203.95604395604394" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:580,&quot;width&quot;:1456,&quot;resizeWidth&quot;:512,&quot;bytes&quot;:212524,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:&quot;&quot;,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/us/app/healthscout/id6743687046&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/173631149?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><div><hr></div><p>*Maya's name has been changed to protect her privacy, but her story, quotes, and medical details are real.</p><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><p></p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free to receive new posts and support my work.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><div><hr></div><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;cf235a45-9540-4910-aa64-e02107ea377f&quot;,&quot;caption&quot;:&quot;Mark had been taking a statin for years when comprehensive blood testing revealed something his primary care doctor had never checked for: elevated Lp(a).&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;Hidden in Plain Sight&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-09-02T14:03:17.295Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!XXV2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/hidden-in-plain-sight&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:172198696,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:3,&quot;comment_count&quot;:0,&quot;publication_id&quot;:null,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div><div class="digest-post-embed" data-attrs="{&quot;nodeId&quot;:&quot;4cd53dcd-d8c6-4b8b-aab2-8774c75d125e&quot;,&quot;caption&quot;:&quot;Lilo had always been fit, lean, and strong. She could eat whatever she wanted and maintain her athletic lifestyle without much thought. Then 2020 arrived, and everything changed.&quot;,&quot;cta&quot;:&quot;Read full story&quot;,&quot;showBylines&quot;:true,&quot;showDescription&quot;:true,&quot;showImage&quot;:true,&quot;size&quot;:&quot;md&quot;,&quot;isEditorNode&quot;:true,&quot;title&quot;:&quot;None of Her Five Doctors Saw the Forest&quot;,&quot;publishedBylines&quot;:[{&quot;id&quot;:10899928,&quot;name&quot;:&quot;Joe Sipher&quot;,&quot;bio&quot;:&quot;Helping regular people navigate the complex healthcare system&quot;,&quot;photo_url&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/e7324c13-3f1e-405f-a293-10b0945d3701_256x256.png&quot;,&quot;is_guest&quot;:false,&quot;bestseller_tier&quot;:null}],&quot;post_date&quot;:&quot;2025-08-27T15:59:40.307Z&quot;,&quot;cover_image&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5hQf!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png&quot;,&quot;cover_image_alt&quot;:null,&quot;canonical_url&quot;:&quot;https://www.joesipher.com/p/none-of-her-five-doctors-saw-the&quot;,&quot;section_name&quot;:null,&quot;video_upload_id&quot;:null,&quot;id&quot;:171927491,&quot;type&quot;:&quot;newsletter&quot;,&quot;reaction_count&quot;:5,&quot;comment_count&quot;:0,&quot;publication_id&quot;:null,&quot;publication_name&quot;:&quot;Joe Sipher&quot;,&quot;publication_logo_url&quot;:&quot;https://substackcdn.com/image/fetch/$s_!5vbZ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9cac4fe1-5286-4e60-b8a4-65a3d94e6de2_120x120.png&quot;,&quot;belowTheFold&quot;:true,&quot;youtube_url&quot;:null,&quot;show_links&quot;:null,&quot;feed_url&quot;:null}"></div>]]></content:encoded></item><item><title><![CDATA[Hidden in Plain Sight]]></title><description><![CDATA[His doctor missed a life-saving heart treatment hiding in plain sight. What was it?]]></description><link>https://www.joesipher.com/p/hidden-in-plain-sight</link><guid isPermaLink="false">https://www.joesipher.com/p/hidden-in-plain-sight</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 02 Sep 2025 14:03:17 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!XXV2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!XXV2!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!XXV2!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 424w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 848w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 1272w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!XXV2!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png" width="1456" height="1063" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:1063,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:3663717,&quot;alt&quot;:&quot;Pencil drawing of a human heart&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/172198696?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="Pencil drawing of a human heart" title="Pencil drawing of a human heart" srcset="https://substackcdn.com/image/fetch/$s_!XXV2!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 424w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 848w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 1272w, https://substackcdn.com/image/fetch/$s_!XXV2!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F6916bafd-2f68-4cc7-b160-cc126db6bf9c_1922x1403.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Mark* had been taking a statin for years when comprehensive blood testing revealed something his primary care doctor had never checked for: elevated Lp(a).</p><p>"I'd never even heard of it," Mark told me. "Turns out 10-15% of people have high Lp(a), but most doctors don't routinely test for it. This was my first time."</p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe to my free newsletter for updates on HealthScout.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><p>Lp(a) is a particularly dangerous marker for heart events that's almost entirely genetic. Unlike regular cholesterol that responds to diet and exercise, you're essentially stuck with whatever Lp(a) level you inherited. High levels dramatically increase cardiovascular risk, yet many physicians don&#8217;t regularly screen for it.</p><p>Mark's primary care doctor had never tested for Lp(a) and had never mentioned it, despite Mark having other cholesterol markers. </p><p>But the elevated Lp(a) meant Mark was at higher cardiovascular risk than anyone realized.</p><h2>What His Doctor Missed</h2><p>When Mark asked the HealthScout beta about his Lp(a) results, it recognized he was already on a statin, and then flagged something his doctor hadn't mentioned: Ezetimibe.</p><p><strong>Mark:</strong> "HealthScout told me about this daily medication that works alongside statins to help lower LDL and ApoB levels &#8212; and might even help with Lp(a) marginally. I'd never heard of Ezetimibe before. I still can't pronounce it."</p><blockquote><p><strong>&#8220;HealthScout caught something that was right there in my results, but that neither my doctor nor I had noticed.&#8221;</strong></p></blockquote><p>HealthScout knew about research on treatment combinations for this specific risk factor, specifically studies on using Ezetimibe alongside statins for people with elevated Lp(a). While his primary care doctor focused only on the standard cholesterol markers that looked acceptable, HealthScout knew about treatment combinations and newer research protocols for this specific risk factor.</p><p><strong>Mark:</strong> "The crazy thing is, when I looked back at my blood test interpretation, there was actually a reference to Ezetimibe buried in the fine print. HealthScout caught something that was right there in my results, but that neither my doctor nor I had noticed."</p><h2>Armed with Information</h2><p>When Mark brought HealthScout's findings to his doctor, everything changed. His physician looked at the evidence, agreed that Ezetimibe could help reduce Mark's cardiovascular risk, and prescribed it immediately.</p><p>"Go HealthScout!" Mark texted me after starting the medication. "Worth every penny of my subscription!"</p><p>Mark's experience demonstrates exactly how HealthScout is designed to work &#8212; not by replacing doctors, but by empowering patients with informed questions. His primary care doctor had the knowledge and willingness to prescribe combination therapy; he just hadn't initially considered this newer approach for Mark's specific risk profile.</p><h2>The Bigger Picture</h2><p>Mark's story reveals how much medical information can slip through the cracks of our healthcare system. His comprehensive blood panel contained the exact information needed to guide treatment decisions, but crucial details were buried in fine print that neither patient nor doctor initially caught.</p><p>This happens constantly in medicine. Test results arrive with pages of data, appointment times are limited, and doctors must process information for dozens of patients daily. Important treatment options &#8212; especially newer combination therapies &#8212; can easily be overlooked.</p><p>That's where HealthScout provides unique value. It has infinite patience to review every detail of your health records, cross-reference findings with current research, and may uncover treatment options to discuss with your doctor.</p><div><hr></div><p><em>Update September 17, 2025</em></p><p>HealthScout is now out of beta and available for iOS users in the US.  Download it today to see what treatment options might be hiding in your health records.</p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/us/app/healthscout/id6743687046" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png" width="512" height="203.95604395604394" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:580,&quot;width&quot;:1456,&quot;resizeWidth&quot;:512,&quot;bytes&quot;:212524,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:&quot;&quot;,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/us/app/healthscout/id6743687046&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/173631149?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><div><hr></div><p><em>*Mark's name has been changed to protect his privacy, but his story, quotes, and medical details are real.</em></p><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare professionals for medical decisions.</em></p><p></p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe to my free newsletter for updates on HealthScout.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div>]]></content:encoded></item><item><title><![CDATA[None of Her Five Doctors Saw the Forest]]></title><description><![CDATA[How HealthScout Connected Dots That Five Years of Specialists Missed]]></description><link>https://www.joesipher.com/p/none-of-her-five-doctors-saw-the</link><guid isPermaLink="false">https://www.joesipher.com/p/none-of-her-five-doctors-saw-the</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Wed, 27 Aug 2025 15:59:40 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!5hQf!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!5hQf!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!5hQf!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 424w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 848w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 1272w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!5hQf!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png" width="1456" height="818" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/d33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:818,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:3030986,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/171927491?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!5hQf!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 424w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 848w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 1272w, https://substackcdn.com/image/fetch/$s_!5hQf!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fd33163c6-2cc6-49d3-8edb-5c6ae3acd201_1922x1080.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Lilo<a class="footnote-anchor" data-component-name="FootnoteAnchorToDOM" id="footnote-anchor-1" href="#footnote-1" target="_self">1</a> had always been fit, lean, and strong. She could eat whatever she wanted and maintain her athletic lifestyle without much thought. Then 2020 arrived, and everything changed.</p><p>It started with her clothes not fitting. Her middle was expanding despite her best efforts with diet and exercise. "It's menopause," her ob-gyn explained when she brought up the weight gain. "Middle section fat is part of the deal."</p><p>Then came the digestive issues &#8212; constant bloating and diarrhea that made her athletic activities uncomfortable. Her ob-gyn suggested this might be another menopause side effect.</p><p>But the problems kept multiplying.</p><h2>The Specialist Shuffle</h2><p>Her blood work started showing high cholesterol and concerning liver enzyme readings. Her primary care doctor did what primary care doctors do when faced with complex, interconnected symptoms: <strong>she referred Lilo to specialists.</strong></p><p>Over the next five years, Lilo found herself in a medical pinball machine. GI specialist for the digestive issues. Liver specialist for the enzymes. Neurology for some symptoms. Sleep specialist for others. When she needed knee surgery for a torn meniscus, a hematologist had to clear her first due to her history of blood clots twenty years apart.</p><p>The hematologist found more concerning blood readings and sent her back to the GI and liver specialists for additional tests, then on to a vascular surgeon to investigate her clotting history. The vascular surgeon diagnosed thoracic outlet syndrome and recommended removing her top rib bone.</p><p>She had both surgeries - the knee and the rib removal - and recovered fully. But five years later, she was still dealing with the same core issues: unexplained weight gain, persistent bloating and diarrhea, high cholesterol, and elevated liver enzymes.</p><h2>What Each Doctor Saw</h2><p>Each specialist looked through their particular lens:</p><ul><li><p>The ob-gyn saw menopause</p></li><li><p>The GI specialist saw digestive symptoms</p></li><li><p>The liver specialist saw enzyme readings</p></li><li><p>The hematologist saw clotting risk</p></li><li><p>The vascular surgeon saw structural issues</p></li></ul><p>Each treated their piece of the puzzle. <strong>None looked at the whole picture.</strong></p><p>"The maddening part is that no doctor is looking at all of this holistically for me," Lilo told me. Her primary care doctor suggested a statin for the cholesterol but was nearly impossible to reach for follow-up appointments.</p><h2>What HealthScout Saw</h2><p>When Lilo got access to <a href="https://www.healthscout.co">HealthScout</a> during our beta test, she asked it to look at her complete health history across all these providers and symptoms.</p><p>HealthScout immediately flagged something none of her specialists had mentioned: her history of PCOS (polycystic ovary syndrome).</p><p>The AI pointed out that PCOS could be contributing to multiple issues her doctors were treating separately &#8212; the stubborn weight gain, the persistent bloating, and possibly even the liver enzyme readings. These weren't separate problems requiring separate specialists; they were potentially connected manifestations of an underlying condition.</p><p>HealthScout also analyzed her expensive cardiac CT scan results alongside her other tests and suggested she likely didn't need the statin her primary care doctor recommended. The imaging showed her actual cardiovascular risk might be lower than her cholesterol numbers suggested.</p><h2>The Power of the Complete Picture</h2><p>What made the difference? HealthScout had access to Lilo's complete health story, across providers, across years, across specialties. It could see patterns that individual doctors, each focused on their area of expertise and limited by 15-minute appointment slots, simply couldn't detect.</p><p>More importantly, it translated these connections into informed questions Lilo could bring back to her doctors. Instead of passively receiving fragmented care, she could now drive the conversation.</p><p>"All of the interaction with HealthScout has provided me with more informed questions I can ask my doctors and drive my care proactively," she explained.</p><h2>The Broader Problem</h2><p>Lilo's story illustrates a fundamental flaw in our healthcare system. It&#8217;s become so specialized that it has lost the ability to see patients as whole human beings with interconnected systems.</p><p>The irony is that Lilo had excellent medical care. She saw skilled specialists at reputable institutions. She received appropriate treatment for each individual issue. But no one was connecting the dots.</p><p>This isn't a failure of individual doctors. It's a systemic problem. Our healthcare system rewards specialization and volume over holistic thinking and pattern recognition. Doctors have neither the time nor the tools to synthesize information across multiple specialties and years of care.</p><p>That's where HealthScout comes in. <strong>It's not replacing doctors &#8212; it's empowering patients.</strong> Lilo's complete health story revealed patterns she and her doctors never knew existed. </p><p>What could yours reveal?</p><div><hr></div><p><em>Update September 17, 2025</em></p><p>HealthScout is now out of beta and available for iOS users in the US.</p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/us/app/healthscout/id6743687046" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png" width="512" height="203.95604395604394" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:580,&quot;width&quot;:1456,&quot;resizeWidth&quot;:512,&quot;bytes&quot;:212524,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/us/app/healthscout/id6743687046&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/173631149?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><div><hr></div><p><em>HealthScout is an educational tool only and does not provide medical advice, diagnosis, or treatment. Always consult with qualified healthcare</em> <em>professionals for medical decisions.</em></p><div class="subscription-widget-wrap-editor" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe&quot;,&quot;language&quot;:&quot;en&quot;}" data-component-name="SubscribeWidgetToDOM"><div class="subscription-widget show-subscribe"><div class="preamble"><p class="cta-caption">Thanks for reading! Subscribe for free.</p></div><form class="subscription-widget-subscribe"><input type="email" class="email-input" name="email" placeholder="Type your email&#8230;" tabindex="-1"><input type="submit" class="button primary" value="Subscribe"><div class="fake-input-wrapper"><div class="fake-input"></div><div class="fake-button"></div></div></form></div></div><div class="footnote" data-component-name="FootnoteToDOM"><a id="footnote-1" href="#footnote-anchor-1" class="footnote-number" contenteditable="false" target="_self">1</a><div class="footnote-content"><p>Lilo&#8217;s name has been changed to protect her privacy.  She has been using the HealthScout beta for several months.</p></div></div>]]></content:encoded></item><item><title><![CDATA[What My Doctor Missed]]></title><description><![CDATA[A Medical Mystery Solved While Building HealthScout]]></description><link>https://www.joesipher.com/p/what-my-doctor-missed</link><guid isPermaLink="false">https://www.joesipher.com/p/what-my-doctor-missed</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Wed, 21 May 2025 14:02:30 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!SZAS!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>In my last post, <a href="https://www.joesipher.com/p/my-next-learning-curve-democratizing">My Next Learning Curve: Democratizing Healthcare</a>, I made the case that patients need tools to put themselves on even footing with the complex and fragmented healthcare industry, and AI could be the catalyst to enable it.<br><br>Today I'm thrilled to announce <a href="https://www.healthscout.co">HealthScout</a>, a specially tuned AI chatbot designed to do just that &#8212; empower patients with their own health data coupled with the power of AI.  Armed with HealthScout, patients can use their entire health record as context &#8212; across providers and time &#8212; to answer questions and explore options about their unique health journey. This is something people just can&#8217;t do using Google and generic AI chatbots. </p><h2>True Story</h2><p>While developing the app, I got to use it with my own health data, and was <em>shocked</em> that this combination of my health data plus AI revealed aspects of my health that neither my doctors nor I were aware of.</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!SZAS!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!SZAS!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 424w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 848w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 1272w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!SZAS!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png" width="1024" height="968" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:968,&quot;width&quot;:1024,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:2374320,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/163675175?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5b3e0e21-b49a-4622-bbaf-fbb991c52854_1024x1024.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!SZAS!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 424w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 848w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 1272w, https://substackcdn.com/image/fetch/$s_!SZAS!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F1ae862ba-b913-4d61-99a4-902d42e3dd97_1024x968.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><blockquote><p><strong>Patient (me):</strong><br>Is there anything I can do about my worsening knee, back, and shoulder pain? Ibuprofen helps&#8230;but only for a few hours.</p><p><strong>Primary Care Physician:<br></strong>I&#8217;ve had many patients successfully use over-the-counter doses of naproxen (Aleve) with great results. Take one in the morning and one at night for three days and see how you feel.</p></blockquote><p>Later&#8230;</p><blockquote><p><strong>Patient (me):<br></strong>It's been a bit over three weeks and I have to say, [naproxen has] made a significant improvement to all my joint problems. I'm actually able to do things I wasn't able to just a month ago. Good news, thank you!</p><p>Questions: Am I on this forever now? Are there long term side effects?</p><p><strong>Primary Care Physician:<br></strong>I would say, take it for as long as you feel that you are getting benefit from it, and stop it periodically/regularly to see if you still need to be taking it. Many people take naproxen twice per day for decades.</p></blockquote><p>So, I happily continued to take naproxen and later switched to a similar non-steroidal anti-inflammatory (NSAID) called celecoxib that clinical trials have shown to be easier on the stomach. I told friends of the miracle as well.</p><h3>What My Doctor Saw</h3><p>A year later at my next wellness check-up, my eGFR lab (a measure of kidney function) came back and looked like this.  </p><div class="captioned-image-container"><figure><div class="image-link image2" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!wEIi!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 424w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 848w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1272w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png" width="1456" height="270" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/aca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:270,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:93957,&quot;alt&quot;:&quot;My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/163675175?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal" title="My eGFR as Reported by Labcorp. The lab result is 69 which is on the lower end of normal" srcset="https://substackcdn.com/image/fetch/$s_!wEIi!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 424w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 848w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1272w, https://substackcdn.com/image/fetch/$s_!wEIi!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Faca5116a-3f2b-4f05-84ea-e6a72e8631be_1928x358.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></div><figcaption class="image-caption">My eGFR as Reported by Labcorp</figcaption></figure></div><p>On the lower end of Normal, is normal, right? My primary healthcare provider is One Medical, which allows doctors to spend a <em>generous</em> 30 minutes for wellness checks (many providers only allow 15 minutes). Still 30 minutes really isn&#8217;t that much time, so I&#8217;m guessing my doctor scanned my labs for &#8220;High&#8221; markers, and given the Labcorp generated chart above for my eGFR, he moved right past it. </p><p>I did too.</p><h3>What HealthScout Saw</h3><p>Four months later, when I started working on HealthScout, my own health records were the only data I could test with. As soon as it was hobbling, I excitedly started asking test questions of this fresh new AI model. One of my early questions to evaluate HealthScout&#8217;s analytical ability was: </p><blockquote><p><em>Do you see any trends that show a relationship between my medications and my lab results?</em></p></blockquote><p>To my surprise, HealthScout suggested that my recent <em><strong>kidney function decline</strong></em> could have something to do with my regular use of NSAIDs. </p><p><strong>What???? What kidney function decline?!</strong> </p><p>I peppered HealthScout with lots of questions and learned exactly what it meant. Later I built this chart showing what HealthScout saw (HealthScout doesn&#8217;t have charting&#8230;yet). </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!0_UW!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!0_UW!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 424w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 848w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1272w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png" width="1456" height="971" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:971,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:45498,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/163675175?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!0_UW!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 424w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 848w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1272w, https://substackcdn.com/image/fetch/$s_!0_UW!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5eb23fc8-99c6-435b-8660-275727826142_1728x1152.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>Unlike my One Medical primary care physician, HealthScout had access to my entire health history <em>across three providers over a decade</em>. </p><p>With this historical context, HealthScout saw that my eGFR steady state was around 90, and when it dropped 30% in only seven months, that&#8217;s at least a <strong>yellow flag</strong>.</p><p>Further, while it seems many primary care physicians use the standard &gt; 60 eGFR as &#8220;normal&#8221; measure as shown in the Labcorp chart, HealthScout knew about a more granular classification nephrologists (kidney doctors) use. Under this kidney health classification system, my 69 eGFR was not really &#8220;normal,&#8221; but rather quickly approaching &#8220;moderate&#8221; kidney disease as shown in the chart above.</p><p>Last, HealthScout recognized that I started on my NSAIDs in February 2024. It <em>connected the dots</em> and suggested that my NSAID use could have caused my kidney function to decline.<br><br>Wow.  </p><h2>What Are The Implications</h2><p>Of course, HealthScout&#8217;s observation about my kidney health being related to NSAID use is correlation and not causation. It noted that many other factors could have caused my eGFR to be lower including being poorly hydrated on the day of the test, complications with other medications, eating too much protein, and sadly &#8220;age.&#8221;</p><p>I&#8217;m not confident HealthScout (or anyone) could answer definitively why my eGFR went down, but HealthScout was the first system to point out that it did go down in a concerning way.</p><p>This experience highlights how HealthScout can help:</p><ul><li><p>Identify patterns in your health data that individual doctors might miss</p></li><li><p>Connect information across multiple healthcare providers and years of records</p></li><li><p>Translate concerning trends into actionable questions for your next doctor visit</p></li><li><p>Put you in control of your complete health story</p></li></ul><p>Because of HealthScout, I'm now armed with intelligent questions for my doctor about my kidney health. That's the essence of how HealthScout can empower you.</p><div><hr></div><p><em>Update September 17, 2025.</em></p><h2>PostScript</h2><p>After I wrote this original post, my kidney function worsened, I was referred to a nephrologist (kidney specialist), and ended up getting a biopsy, which confirmed that NSAIDs caused my kidney function decline.  </p><p>The good news is that as long as I stay off NSAIDs, drink lots of water, and eat a healthy diet, my kidneys should heal.  </p><h2>HealthScout Now Available!</h2><p>Even better news &#8212; the beta is over and HealthScout is now available. If you&#8217;re curious if your own health records contain hidden information, <a href="https://apps.apple.com/us/app/healthscout/id6743687046">download HealthScout free</a> from the App Store. </p><div class="captioned-image-container"><figure><a class="image-link image2" target="_blank" href="https://apps.apple.com/us/app/healthscout/id6743687046" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png" width="512" height="203.95604395604394" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:580,&quot;width&quot;:1456,&quot;resizeWidth&quot;:512,&quot;bytes&quot;:212524,&quot;alt&quot;:&quot;&quot;,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://apps.apple.com/us/app/healthscout/id6743687046&quot;,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/173631149?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" title="" srcset="https://substackcdn.com/image/fetch/$s_!H388!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 424w, https://substackcdn.com/image/fetch/$s_!H388!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 848w, https://substackcdn.com/image/fetch/$s_!H388!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1272w, https://substackcdn.com/image/fetch/$s_!H388!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2cdf9ca1-9628-4eab-8dc8-2b526d7eaf4a_2867x1143.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div></div></div></a></figure></div><p><br></p><p></p><p></p>]]></content:encoded></item><item><title><![CDATA[My Next Learning Curve: Democratizing Healthcare]]></title><description><![CDATA[My Book Launch Was Great, But Now I'm Focused on Something New]]></description><link>https://www.joesipher.com/p/my-next-learning-curve-democratizing</link><guid isPermaLink="false">https://www.joesipher.com/p/my-next-learning-curve-democratizing</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Wed, 30 Apr 2025 15:02:09 GMT</pubDate><enclosure url="https://substack-post-media.s3.amazonaws.com/public/images/b2098b72-8f4c-424b-8895-83ba59e46a5a_1344x768.jpeg" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Since launching <em>Outsmart the Learning Curve</em> in December, I've been tackling what might be America's steepest learning curve: our fragmented, opaque, and ridiculously expensive healthcare system. </p><p>What I've discovered is a new approach that could help patients wrestle control of their medical journey from the healthcare system by empowering people with their own information. Information that is rightfully theirs but nearly impossible to acquire and often difficult to understand &#8212; a way of democratizing healthcare.</p><h2>Book Launch Highlights</h2><p>First, I want to thank every one of you who supported the book development and launch. The response has been incredible. </p><ul><li><p><em>Outsmart the Learning Curve</em> reached #1 New Release in Amazon&#8217;s Business &amp; Motivation category over Christmas 2024</p></li><li><p>The <a href="https://www.amazon.com/Outsmart-Learning-Curve-Ordinary-Extraordinary/dp/B0DZZNJG55/ref=tmm_aud_swatch_0?_encoding=UTF8&amp;dib_tag=AUTHOR&amp;dib=eyJ2IjoiMSJ9.KHCWWNHPWggeFfEch_0b0w.dTnjLrL4JrFSg--IJ2bgKCq_zLGcEEjCxW0lABqAO00&amp;qid=&amp;sr=">audiobook</a> version launched this month.  Yes, I narrated it!</p></li><li><p>We secured a Chinese language rights deal (<strong>&#31616;&#20307;&#20013;&#25991; </strong>in 2026!)</p></li><li><p>And I was honored to receive this incredible endorsement:</p></li></ul><blockquote><p>"Brilliantly captures how regular people transform obstacles into extraordinary outcomes. A compelling, insightful guide to accelerating your growth."</p></blockquote><p>&#8211;Nir Eyal, bestselling author of <em>Hooked</em> and <em>Indistractable</em></p><h2>What&#8217;s Next: Solving Healthcare?</h2><p>While celebrating this milestone, I found myself facing a different type of learning curve that millions of Americans struggle with daily: <strong>navigating our complex healthcare system</strong>.</p><p>After 45 years of pickup basketball, both knees staged a revolt. And the healthcare system left me with an ultimatum between full knee replacement (don&#8217;t image search that) or continuing to inadequately ease my suffering with physical therapy, ibuprofen, and rest. </p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://substackcdn.com/image/fetch/$s_!oLk_!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!oLk_!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 1456w" sizes="auto, 100vw"><img src="https://substackcdn.com/image/fetch/$s_!oLk_!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png" width="1456" height="832" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/da0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:832,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:1347087,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:null,&quot;belowTheFold&quot;:true,&quot;topImage&quot;:false,&quot;internalRedirect&quot;:&quot;https://www.joesipher.com/i/161273680?img=https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png&quot;,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!oLk_!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 424w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 848w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 1272w, https://substackcdn.com/image/fetch/$s_!oLk_!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fda0b2f24-c9d0-4f88-b7d5-a38aa777eba5_1922x1098.png 1456w" sizes="auto, 100vw" loading="lazy"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p></p><p>Despite spending a lot of time with Dr. Google and AI chatbots, I found myself lost in a maze of medical terminology and conflicting recommendations. Further, my healthcare team was highly constrained by 1) time, 2) their speciality, and 3) the healthcare system itself. </p><h2>Why &#8220;The System&#8221; Fails Patients</h2><p>The U.S. healthcare system is complicated and often ineffective in part because it&#8217;s controlled by large, inflexible entities like insurance companies, the FDA, pharmaceuticals, and healthcare providers. While they are all trying to do good things, their siloed structure, bureaucratic red tape, and, sadly, a profit motive, often get in the way of providing great healthcare. Individual doctors and nurses are often heroic, but because of the controlling entities, most spend no more than 15 minutes on a patient, and few are able to see your whole health picture because of so much specialization and the fragmented nature of healthcare providers&#8217; data systems.</p><div class="pullquote"><p>It is the helpless patient who is often most motivated to solve their problem<em>.</em> </p></div><p>Patients and their advocates often do have more of a whole health picture but need help remembering it, communicating it, and exploring it on their own. Patients themselves are often victims of the system and advocating for themselves takes energy&#8230;a lot of energy. Patients are often swimming upstream and lack the knowledge or stamina to challenge the system. They're at the mercy of &#8220;The System.&#8221;</p><h2>Healthcare Information Gap</h2><p>Part of the reason understanding and advocating for your own health journey is so difficult is that healthcare has arguably the largest information gap between any service and its customers. </p><p>Patients often don't know enough to ask the right questions or evaluate their options. This is made worse by the fact that the patient&#8217;s own data can sometimes inadvertently be held from them. When the information is provided, it uses cryptic language that keeps patients from truly understanding their own problems. </p><p>There&#8217;s essentially a language barrier between the medical world and its patients. If the patient doesn&#8217;t ask for clarifications and/or the doctor is too busy, the patient really can&#8217;t understand or help solve their own problem.</p><p>In addition, medical records are often scattered across multiple providers, which makes it nearly impossible for patients to maintain their comprehensive health history. It&#8217;s unlikely that any single doctor can access all this data, which is often critical. </p><h2>Google and AI Chatbots Aren&#8217;t Good Enough</h2><p>As I mentioned above, I used Google and AI chatbots to navigate alternatives for fixing my knees when cortisone shots wore out after six weeks. At first, the internet and AI were giving me the same generic advice I heard from my doctors. Why? Because:</p><ul><li><p>Google 1) gives you links to pages most likely to be clicked, not necessarily the best or latest information, and 2) Google doesn&#8217;t have the <em>context</em> of my personal medical history. You get generalized info.  </p></li><li><p>AI Chatbots can be fed more context, but it&#8217;s pretty near impossible to feed it ALL the context.  </p></li></ul><p>But I was desperate, so I started uploading all my MRIs, clinical notes, medications, and more into Anthropic&#8217;s Claude. To be fair, extracting all my data out of four different patient portals, squeezing it into a size that is acceptable to AI models, and uploading it in an AI-readable form was a ton of work &#8212; work that most people would not or could not do.  </p><p>Once my health records were uploaded, I was able to question the AI more broadly and deeply about my options as well as explore alternatives that my doctors rolled their eyes at. I eventually found a treatment and provider that worked &#8212; on Friday I ran for the first time in six months! </p><h2>Solving Healthcare from the Patient Perspective</h2><p>This whole experience made me think that while solving our healthcare gridlock from the inside is an intractable problem, <strong>arming consumers with tools to help them navigate this complex system could be revolutionary</strong>. </p><div class="pullquote"><p>I want to democratize healthcare.</p></div><p>Next week I&#8217;ll share more about the tool I&#8217;m building that empowers patients to navigate the healthcare system more easily. </p><p>In the meantime, what&#8217;s the most baffling healthcare moment you&#8217;ve faced? Comment below.</p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/p/my-next-learning-curve-democratizing/comments&quot;,&quot;text&quot;:&quot;Leave a comment&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/p/my-next-learning-curve-democratizing/comments"><span>Leave a comment</span></a></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/subscribe?&quot;,&quot;text&quot;:&quot;Subscribe now&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/subscribe?"><span>Subscribe now</span></a></p>]]></content:encoded></item><item><title><![CDATA[My Book Launches Today and I'm Grateful]]></title><description><![CDATA[Today is launch day for Outsmart the Learning Curve!]]></description><link>https://www.joesipher.com/p/my-book-launches-today-and-im-grateful</link><guid isPermaLink="false">https://www.joesipher.com/p/my-book-launches-today-and-im-grateful</guid><dc:creator><![CDATA[Joe Sipher]]></dc:creator><pubDate>Tue, 10 Dec 2024 15:02:13 GMT</pubDate><enclosure url="https://substackcdn.com/image/fetch/$s_!0iB4!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png" length="0" type="image/jpeg"/><content:encoded><![CDATA[<p>Today is launch day for <em><a href="https://www.amazon.com/Outsmart-Learning-Curve-Ordinary-Extraordinary/dp/B0DGYPNYBM/ref=tmm_hrd_swatch_0?_encoding=UTF8&amp;dib_tag=AUTHOR&amp;dib=eyJ2IjoiMSJ9.KHCWWNHPWggeFfEch_0b0w.dTnjLrL4JrFSg--IJ2bgKCq_zLGcEEjCxW0lABqAO00&amp;qid=&amp;sr=">Outsmart the Learning Curve</a></em>!</p><div class="captioned-image-container"><figure><a class="image-link image2 is-viewable-img" target="_blank" href="https://www.amazon.com/Outsmart-Learning-Curve-Ordinary-Extraordinary/dp/B0DGYPNYBM/ref=tmm_hrd_swatch_0?_encoding=UTF8&amp;dib_tag=AUTHOR&amp;dib=eyJ2IjoiMSJ9.KHCWWNHPWggeFfEch_0b0w.dTnjLrL4JrFSg--IJ2bgKCq_zLGcEEjCxW0lABqAO00&amp;qid=&amp;sr=" data-component-name="Image2ToDOM"><div class="image2-inset"><picture><source type="image/webp" srcset="https://substackcdn.com/image/fetch/$s_!0iB4!,w_424,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 424w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_848,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 848w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_1272,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 1272w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_1456,c_limit,f_webp,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 1456w" sizes="100vw"><img src="https://substackcdn.com/image/fetch/$s_!0iB4!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png" width="1456" height="819" data-attrs="{&quot;src&quot;:&quot;https://substack-post-media.s3.amazonaws.com/public/images/acede305-e528-4360-a258-82e8e892b3df_1920x1080.png&quot;,&quot;srcNoWatermark&quot;:null,&quot;fullscreen&quot;:null,&quot;imageSize&quot;:null,&quot;height&quot;:819,&quot;width&quot;:1456,&quot;resizeWidth&quot;:null,&quot;bytes&quot;:671399,&quot;alt&quot;:null,&quot;title&quot;:null,&quot;type&quot;:&quot;image/png&quot;,&quot;href&quot;:&quot;https://www.amazon.com/Outsmart-Learning-Curve-Ordinary-Extraordinary/dp/B0DGYPNYBM/ref=tmm_hrd_swatch_0?_encoding=UTF8&amp;dib_tag=AUTHOR&amp;dib=eyJ2IjoiMSJ9.KHCWWNHPWggeFfEch_0b0w.dTnjLrL4JrFSg--IJ2bgKCq_zLGcEEjCxW0lABqAO00&amp;qid=&amp;sr=&quot;,&quot;belowTheFold&quot;:false,&quot;topImage&quot;:true,&quot;internalRedirect&quot;:null,&quot;isProcessing&quot;:false,&quot;align&quot;:null,&quot;offset&quot;:false}" class="sizing-normal" alt="" srcset="https://substackcdn.com/image/fetch/$s_!0iB4!,w_424,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 424w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_848,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 848w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_1272,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 1272w, https://substackcdn.com/image/fetch/$s_!0iB4!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Facede305-e528-4360-a258-82e8e892b3df_1920x1080.png 1456w" sizes="100vw" fetchpriority="high"></picture><div class="image-link-expand"><div class="pencraft pc-display-flex pc-gap-8 pc-reset"><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container restack-image buttonBase-GK1x3M"><svg aria-hidden="true" width="20" height="20" viewBox="0 0 20 20" fill="none" stroke-width="1.5" stroke="var(--color-fg-primary)" stroke-linecap="round" stroke-linejoin="round" xmlns="http://www.w3.org/2000/svg" class="icon-noB79L"><g><path d="M2.53001 7.81595C3.49179 4.73911 6.43281 2.5 9.91173 2.5C13.1684 2.5 15.9537 4.46214 17.0852 7.23684L17.6179 8.67647M17.6179 8.67647L18.5002 4.26471M17.6179 8.67647L13.6473 6.91176M17.4995 12.1841C16.5378 15.2609 13.5967 17.5 10.1178 17.5C6.86118 17.5 4.07589 15.5379 2.94432 12.7632L2.41165 11.3235M2.41165 11.3235L1.5293 15.7353M2.41165 11.3235L6.38224 13.0882"></path></g></svg></button><button tabindex="0" type="button" class="pencraft pc-reset pencraft icon-container view-image buttonBase-GK1x3M"><svg xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="lucide lucide-maximize2 lucide-maximize-2 icon-noB79L"><polyline points="15 3 21 3 21 9"></polyline><polyline points="9 21 3 21 3 15"></polyline><line x1="21" x2="14" y1="3" y2="10"></line><line x1="3" x2="10" y1="21" y2="14"></line></svg></button></div></div></div></a></figure></div><p>The chapter &#8220;Get Help&#8221; describes why doing anything transformational by yourself is impossible. Writing this book proved that point. I'm deeply grateful to these amazing people who helped turn this vision into reality.</p><p>First, a heartfelt thank you to the courageous individuals who generously shared their stories:</p><ul><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Martha Ni&#241;o</a>, who made the incredible journey from a silenced undocumented immigrant to a trusted Fortune 500 manager, published author, accomplished public speaker, and creator of her own foundation dedicated to giving hope to immigrant students.</p></li><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Helen Wells</a>, who was dissuaded from following her passion for art at 17, was rejected from art school at 29, and after another decade, finally quit her day job to become a self-supporting artist.</p></li><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Jason Lee</a>, whose parents drilled into him since early childhood that he would become a doctor. A struggle with organic chemistry coupled with a vision that came to him during a concert led to this 26 year-old running an eight-figure real estate business.</p></li><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Jeremy Schifeling</a>, who went from a failing kindergarten teacher to a sought-after consultant at Harvard, Stanford, and nearly every top MBA program in the world.</p></li><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Chase Friedman</a>, a buoyant 25 year-old who was paralyzed in a freak accident and stunned doctors with his amazing recovery.</p></li><li><p><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Jason Christie</a>, a promising &#8220;golden child&#8221; of medical research who somehow failed on his first seven attempts to get NIH grant funding before making a career out of life-saving contributions to the field of lung transplantation.</p></li></ul><p>I&#8217;m also incredibly thankful for the many people who supported me, cheered me on, and bravely gave me the cold, hard truth about my work as it progressed.</p><p>First, my patient, kind wife, <strong>Mary Sipher</strong>, who has the skill to switch careers and become a copy editor, if she only had a glimmer in that area. Next, a heartfelt thank-you to my daughter, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Ali Sipher</a><strong>,</strong> who may have been my most valuable critic and confidant through this process. A special thank-you also to my sister,<strong> Lynn Sipher</strong>, who helped shape the book by applying her compassionate lens on the world to every word she reviewed. And, of course, I can&#8217;t forget my talented and supportive writing coach, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Nicola Kraus</a>, who guided me through every step of the publishing process.</p><p>A deep thank-you to all the people who reviewed early drafts, who were gracious enough with their time for interviews, or who collaborated on ideas and suggested potential subjects, including <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Michelle Azimov</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Andrea Butter</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Charles Cushing</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Sarah Dobson</a>, <strong>Amelia Duran-Stanton, </strong><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Lee Epting</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Irwin Epstein</a>, <strong>Jonah Gutenberg, Bruce Jacobs, </strong><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Jeremy Kahn</a>, <strong>Randy Komisar, </strong><a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Ryan Lindner</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Prashant Mahajan</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Lori Mazan</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Kathleen McShane</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Lisa Morgan</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Lori Pappas</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Daniel Parris</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Kate Purmal</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Denise Robinson</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Bill Rogers</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Ari Roisman</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Melina Schaefer</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Daniel Sipher</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Devan Sipher</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Josh Sipher</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Christine Tao</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Laura Thompson</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Ben Villagra</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Madelaine Claire Weiss</a>, <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Beth Wolff</a>, <strong>David York</strong>, and <a href="https://www.linkedin.com/article/edit/7271346732158849025/#">Heather Yurovsky</a>.</p><p>I think the book can help people struggling with their career or finding their way.  Please take a look and share it with those you think might benefit.</p><p></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/p/my-book-launches-today-and-im-grateful/comments&quot;,&quot;text&quot;:&quot;Leave a comment&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/p/my-book-launches-today-and-im-grateful/comments"><span>Leave a comment</span></a></p><p class="button-wrapper" data-attrs="{&quot;url&quot;:&quot;https://www.joesipher.com/p/my-book-launches-today-and-im-grateful?utm_source=substack&utm_medium=email&utm_content=share&action=share&quot;,&quot;text&quot;:&quot;Share&quot;,&quot;action&quot;:null,&quot;class&quot;:null}" data-component-name="ButtonCreateButton"><a class="button primary" href="https://www.joesipher.com/p/my-book-launches-today-and-im-grateful?utm_source=substack&utm_medium=email&utm_content=share&action=share"><span>Share</span></a></p><p></p>]]></content:encoded></item></channel></rss>