De Acupunctura is a 1683 book by the Dutch physician Willem ten Rhijne, and it came out of one of the most roundabout translation jobs on record. Ten Rhijne was living at Dejima, the artificial island off Nagasaki that was the only piece of Japan open to Europeans during the Edo period. — Read the rest
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AI is the hottest thing in medical care right now — but many of us feel trepidation about it. Just one illustrative public survey sample: An October 2025 KFF poll found just 8 percent of Americans reported feeling a “great deal” of trust in AI managing their appointments or analyzing their health records, and only 32 percent said they would trust an online health tool that uses AI to access their medical records to provide personalized health information.
But many clinicians and healthcare administrators see AI as a powerful new tool that offers myriad opportunities to streamline and improve treatment. A 2026 survey found that more than 80 percent of US doctors use AI professionally — doubling the share from 2023. Physicians are excited by AI’s potential to keep more accurate notes of interactions with patients, to act as a second pair of eyes for human doctors, and to monitor people at risk of deteriorating and ending up in a dangerous situation.
The disconnect between what people and their providers want from AI could create more distrust, at a time when faith in the healthcare system and the medical profession have slid. Patients today want to feel empowered and in control. How can that be possible when these seemingly godlike machines are becoming more and more entrenched in our hospitals and doctors offices?
The answer comes in four words: “human in the loop.” It’s the principle upon which the ethical integration of AI depends and it could help to bridge the gap between lay people and the professionals on AI in medicine. In surveys, people are much more comfortable with the idea of their doctor using AI as an assistant than with AI acting on its own. And most clinicians want to use AI in that way, as a second opinion or passive monitor, not as a replacement for their judgment. There are real fears among the healthcare workforce about that possibility: A group of NYC nurses who were recently laid off claim it’s because their labor was going to be replaced by AI. “Human in the loop” appears to be a point of agreement between doctors and patients at this pivotal moment.
“Doctors…and nurses and staff always have been interested in primarily making the best decision for the people under their care — and these tools can help with that,” Alison Callahan, a research scientist at Stanford University who works on AI programs used in the university’s health system, told me. “The interest in making sure those tools are accurate is high.”
But what does “human in the loop” really mean in practice? How can you know when and how your doctor is using AI? And what is the best way to talk to your provider about the sudden influx of artificial intelligence in healthcare before a robot starts taking appointment notes or analyzing your MRI? I called some leading experts to find out.
Patients and providers alike are incorporating AI into healthcare. Individuals are using commercial AI chatbots to ask about their symptoms or the health metrics tracked by their Apple Watch, while large academic medical centers are developing sophisticated programs and protocols to try to improve medical care at the population level.
It starts with ChatGPT, Claude, etc. — the large language models that are available to the public. People are increasingly turning to them to try to understand what’s going on with their own bodies. Individual physicians are also consulting with large language models to answer questions or get up-to-date on the latest research as they figure out how to best care for their patients.
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Then there are ways in which hospitals and doctors offices are adopting AI at the institutional level. Many facilities are using AI as a way to take, collate, and summarize notes on a patient; in theory, it’s a more organized way to keep track of the informal interactions and observations that doctors have when checking on their own patients. Hospitals are also using AI to handle some administrative tasks, like scheduling follow-up appointments; some health systems have even started to use AI to help patients get ready for appointments — to send reminders about colonoscopy prep, for example.
And finally, you have maybe the most ambitious use of AI by health systems right now: as a diagnostic and risk prediction tool. In these cases, AI might offer a second opinion when, for example, a doctor is triaging a patient in the emergency room. It might help the ER staff figure out how to prioritize patients. Or these programs could monitor people either during a hospital stay or out in the real world (by drawing data from the person’s wearable) and make predictions about who may be at higher risk of complications and require further care. AI could recommend that somebody would benefit from seeing certain specialists or receiving a specific medicine or lab test, and generally offer proactive advice about the patient’s medical care.
But at this point, AI adoption is still “highly localized,” said Jennifer Goldsack, CEO of the Digital Medicine Society, a nonprofit that works with healthcare providers, drug makers, and government agencies on how to incorporate new tech (including AI) into clinical care. It depends on the individual doctor or health system. A lot of them are setting up their own programs and their own protocols for how to use these tools.
That is a big reason why it is so important for patients to be proactive about understanding how AI is being used for their health care. You can’t make assumptions; the only way you’re going to know for sure is to ask.
By and large, experts say, patients should feel confident: Doctors and nurses want to keep a human in the loop, even as they integrate AI into their workflows.
“It will be a doctor who is going to be reading that summary or a nurse who is going to be reading that summary and then taking an action to order a lab or put a recommendation in for a follow-up appointment,” Callahan said. “There is high interest in making sure that that is the right decision for that person. That hasn’t changed.”
Still, many patients say they’d be more comfortable with AI use if their doctor fully explained it in advance. And health systems may have their own priorities that push their facilities toward more rapid AI adoption and delegating more tasks to these AI tools, as seen in the recent NYC nurse layoffs.
So if you want to be informed on exactly where this technology is present and have the ability to consent to its use, you have every right to ask your doctor, experts say.
“AI is new, but the trust that serves as the foundation of the physician-patient relationship is not,” Timothy Keyes, a machine learning scientist at Stanford Health Care, told me over email. “To that end, I think that conversations about medical AI use should be open, honest, and transparent — just like any other conversations about shared decision-making in the clinical environment should be.”
For some things, your doctor should be asking you proactively if you consent to AI use — note-taking, for example. At my most recent primary care appointment, my doctor asked me if it’d be okay for him to use AI to take and summarize notes from our conversation; Goldstack told me she’d experienced the same at recent physician visits. (This is probably the most common AI use that you will encounter, and Keyes said it’s worth considering giving your consent: “There is growing evidence that they reduce physician burnout and save them at least a bit of time each day writing notes.”)
There are also a number of direct questions that you can ask:
And the transparency goes both ways. If you’re asking a question because you consulted ChatGPT before your appointment, tell your doctor. If you’ve talked with a chatbot because of mental health struggles, tell your doctor. And at the same time, feel free to ask your physician how you yourself could actually use AI in a responsible and productive way to improve your health.
“This opens up the opportunity for both the physician and the patient to be humans-in-the-loop,” Keyes said, “in different parts of the loop, with different perspectives, using an AI system to better understand the bigger picture.”
In a way, the novelty of AI and its rapid adoption is an opportunity for all of us to be nosier and more inquisitive patients. What all of these questions really come down to, Callahan said, is how your doctor is making decisions about your health care. That is relevant to all of us, no matter how AI is involved or even if there is no AI being used at all.
Callahan said she always has a list of questions for her doctor when they recommend a course of treatment: “What are the factors in my health that are informing this recommendation that you have? Would you be making this recommendation for other patients who are similar to me? What can you tell me about the outcomes that I might expect to experience if I say yes to this?”
“I actually think if they can point to the part of your health that is connected to the decision, whether or not an AI tool helped to make that connection is secondary to their ability to communicate effectively to me about it, and help me to feel engaged in making a decision about my own care,” she said.
AI is changing medicine quickly, for both patients and their doctors. The best way to stay ahead is to talk about it.
What caused the ongoing outbreak of cyclospora, the diarrhea-causing parasite currently spreading across the United States? Michigan officials have been saying for weeks that they believed the outbreak may be linked to bagged salad or salad kits. What we were waiting to learn was the specific brands and specific products in question.
And late last week, it looked like we finally had the answer — but then things quickly got cloudy.
On July 16, the Washington Post reported, citing anonymous sources, that the outbreak had been linked to shredded iceberg lettuce supplied to Taco Bell by Taylor Farms. A day later, Taylor Farms said it was withdrawing products from US stores and restaurants based on information from the FDA.
But then on July 19, per NBC News, the FDA said that there had been a false positive for cyclospora when testing a sample of Taylor Farms iceberg lettuce; Taylor Farms said in its own statement that the FDA had “apologized” for the mix-up. The next day, the company and the federal government were stuck in a semantic argument: Per NOTUS, the FDA insisted it did not “officially apologize” to Taylor Farms but “explain[ed] factually the issues” with the false positive.
So where does that leave us right now? Officials still believe that Taylor Farms iceberg lettuce was the source of the Michigan outbreak. But whether those are the only products driving the outbreak remains unclear, with almost every state now reporting at least one cyclospora case in 2026. And on Thursday afternoon, the FDA announced that it was tracking a second outbreak linked to other unspecific products, though details were otherwise scarce.
Any outbreak of food-borne illness requires careful public communication. Officials need to tell people how to avoid contaminated food without scaring them away from eating fresh fruits and vegetables altogether.
But instead, many Americans have been left wondering what, exactly, they’re supposed to do. As one frustrated Reddit user put it: “So is the damn lettuce bad or not????” (If you need some advice on what foods are safe and what foods to be cautious about, we have a story for you.)
It may sound like a funny question, but it’s a profoundly serious one. The problem isn’t just that people are confused about their lettuce. The Trump administration’s handling of the cyclospora outbreak — from its conflicting public messages to accusations of political favoritism — has left many Americans even more confused about whether they can trust anything they’re hearing from the government. That’s a dangerous place to be during any public health emergency.
We are approaching 10,000 cyclosporiasis cases across the US this year: Michigan alone has recorded 7,664 as of this morning, Ohio has seen more than 1,200, and more than 40 states have now reported at least one case in 2026. The country usually sees a few hundred cases at most in a given year. Cyclosporiasis, the disease caused by the cyclospora parasite, leads to what public health experts describe as “watery” and “frequently explosive” diarrhea. While it isn’t typically life-threatening, it can cause serious complications: 160 people have been hospitalized in Michigan since the outbreak began.
Our political wellness landscape has shifted: new leaders, shady science, contradictory advice, broken trust, and overwhelming systems. How is anyone supposed to make sense of it all? Vox’s senior correspondent Dylan Scott has been on the health beat for a long time, and every week, he’ll wade into sticky debates, answer fair questions, and contextualize what’s happening in American healthcare policy. Sign up here.
And so for those of us who very much hope to eat fresh produce but do not want diarrhea, there’s a bit of urgency to figure out where the cyclospora is coming from. Food-borne illness investigations are already inherently difficult because of how globalized our food supply has become: Produce can travel all over the country and the world before it comes to your grocery shelf, and the process of government health workers interviewing the people who get sick and cross-checking to identify the shared foods that they might have in common is laborious.
Once investigators find a source, the information has to be shared clearly and responsibly. That is where the Trump administration has tripped up this week.
Trump — and Health Secretary Robert F. Kennedy Jr. in particular — came into office criticizing the public health establishment. They accused officials of misleading the public about the novel coronavirus and the vaccines developed to fight it, while failing to convey the nuances of the pandemic. But now, as they grapple with the incomplete picture of the cyclospora emergency, they are making many of the same mistakes.
“They’re very similar problems, even if on the outside, they don’t look quite the same,” said Michael Mackert, director of the Center for Health Communication at the University of Texas at Austin. “The underlying commonality is very much that we are dealing with imperfect information all the time.”
In any outbreak, some uncertainty is to be expected. Investigators have struggled to identify the source of earlier cyclosporiasis outbreaks too. And the FDA maintains that the likely source of the outbreak is Taylor Farms iceberg lettuce, based on the information they have gathered from sick patients and other sources, no matter the false positive result that has sparked so much confusion.
“The epidemiological evidence is so strong that the lack of a positive test is almost meaningless,” said Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia.
But the mistake that the Trump administration made was in sharing preliminary results and then having to issue a seemingly contradictory statement shortly afterward.
“FDA should have waited for confirmation of the presumptive results before going public,” Diez-Gonzalez said.
Investigations like these are hard enough — but when you add in the public health funding cuts of the past 18 months and the casual and widespread corruption characteristic of the Trump administration, trust in the government’s public health apparatus has sunk even lower.
It’s created just the conditions for conspiracies to bloom. “Unfortunately our FDA is compromised,” wrote one top commenter on Reddit. “I would not trust what comes out of it during this administration.”
Several news outlets and influential social media accounts noted that Taylor Farms had donated $1 million to Trump’s MAGA super PAC and, in the middle of the controversy, received a private White House meeting. According to the New York Times, Taylor Farm officials used that meeting to dispute the findings that their products were responsible for the outbreak — and shortly thereafter, the FDA made its “false positive” announcement.
The administration insists that their decision-making is being guided by science, but even the appearance of impropriety has become a common theme in the press coverage. The broader uncertainty and distrust may help to explain why it’s not only Taco Bell and Taylor Farms taking a hit right now: According to Market Watch, Chipotle and the fast-casual salad chain Chopt have also seen a decline in traffic in recent weeks.
Public health requires public confidence. Perceived influence from special interests is a problem, even if the interactions didn’t alter the FDA or CDC’s actions.
Kennedy, who helms our government’s health department, should understand this well: His Make America Healthy Again movement made restoring public trust a central part of its message while accusing the existing public health establishment as being in league with special interests.
The cyclospora outbreak has revealed how difficult that is to do in practice.
In trying to communicate nuanced information during an active outbreak — while consulting interested parties like Taylor Farms itself — the administration has instead fueled doubts about the credibility of its messaging
Even before cyclospora turned eating salad into a leap of faith, Trump had a poor track record: His administration has slashed CDC staff, brought on vaccine skeptics to set vaccine policy, and clashed with the scientific establishment on a number of high-profile issues, like the time Trump held a televised press conference to argue a disproven theory that Tylenol can cause autism.
“Unfortunately, this is another example of a missed opportunity to establish credible and trusted communications to prepare the public to understand the real risks from the pathogen and confidence in the food safety and information from the FDA,” Scott Ratzan, editor-in-chief of the Journal of Health Communication: International Perspectives, told me. “Faith in our institutions continues to erode. We could do better.”
We are lucky cyclospora is not a deadly disease. Next time, the stakes for these miscues could be much higher.
As I am typing this, a device rests on my wrist that purports to unlock a trove of real-time information about my body’s performance. I can click a button and check my heart rate and review how much it’s varied over the course of the day. It can tell me how many steps I’ve taken, how many minutes I’ve been “active” throughout the day, and — if I wore it while I slept — just how well I rested, according to the data its sensors can pick up from my arm.
The Apple Watch is a remarkable piece of technology, when you stop and really think about what it does. It’s no surprise, perhaps, then, that we have collectively become obsessed with these things. One 2023 government survey found that one in three Americans wear a smartwatch or wristband to track their health and fitness. More recent industry surveys put that figure even higher: More than half of the US population owns a wearable or connected device and tracks at least one health metric with it.
That’s a lot of people who are swimming in the ocean of information that our Apple Watches, and FitBits, and Oura Rings, and Whoops report back to us. Dr. Michael Joyner, who studies the physiology of exercise at the Mayo Clinic, said he has a three-pronged criteria for thinking about the usefulness of these metrics: Is it measurable? Is what you’re measuring actually meaningful? And is the information that you’re receiving actually actionable?
“If one or two are missing, the thing may be the most interesting thing in the world. It may be cool,” he said. “But it’s not going to make a difference in long-term outcomes.”
Across medicine, we are developing remarkable tools for detecting things in the human body, outpacing our ability to interpret what we are finding. We are getting closer to a future where these devices could offer invaluable insights into how our body is performing outside of the doctor’s office or hospital, but here in the present, we should keep our expectations in check.
Here’s what you should know about some of the most common metrics that wearables track.
These devices claim to track both old-fashioned and new-fangled measures of your body’s performance. You’ve got your heart rate — something humans have been able to pick up from the wrist before anybody had dreamed of smart devices — and your step count. My Apple Watch estimates how many calories I have burned throughout the day. The Oura Ring takes your temperature, which can help predict ovulation or offer an early sign that you’re coming down with something.
Our political wellness landscape has shifted: new leaders, shady science, contradictory advice, broken trust, and overwhelming systems. How is anyone supposed to make sense of it all? Vox’s senior correspondent Dylan Scott has been on the health beat for a long time, and every week, he’ll wade into sticky debates, answer fair questions, and contextualize what’s happening in American healthcare policy. Sign up here.
But as the technology has gotten better, new measures for things many of us have never heard of have emerged. Heart rate variability, or HRV, has gained a lot of recent interest. It assesses the tiny variations, measured in milliseconds, in the rhythm of your heartbeat; the Economist dubbed it “the most useful indicator” of your overall health. Some devices then use HRV to deliver “recovery” scores that judge how well your body bounces back from your workout or “stress” scores that attempt to quantify how much strain you are under.
HRV demonstrates the conundrum that wearables can present to us, Joyner said. The metric itself has a scientific basis: Researchers have, in fact, found that the amount your heart rate varies over time is associated with your overall health. In general, a higher HRV is better than low, because it suggests your body is more adaptable and better regulated.
But that doesn’t necessarily mean that tracking your HRV from minute to minute with a smartwatch will translate to better health. For starters, we don’t have specific interventions for improving HRV, Joyner said. We don’t even have universally accepted definitions of what high or low HRV is.
In any case, the best strategies are the same heart health guidelines we’ve known about for decades: don’t smoke, don’t drink to excess, eat a healthy diet, exercise. You didn’t need a smartwatch to tell you that’s the best way to take care of your heart, Joyner pointed out. So what good was really derived from closely monitoring your HRV?
“As an individual metric that you can track and do something about, it’s interesting, but there’s no definitive data that you’re going to get better,” Joyner, who was speaking for himself and not the Mayo Clinic, said. “Follow the guidelines. People who follow the guidelines are going to do better on these metrics. But whether you can intervene specifically to make the metrics better or should pay much attention to them, who knows?”
Dr. Ami Bhatt, chief innovation officer at the American College of Cardiology, told me that the bedrocks of evaluating your heart health are still the old mainstays like your blood pressure and your cholesterol, along with newer metrics checked via blood test such as ApoB and lipoprotein. Are you a smoker? What’s your family history?
The value from wearables is less about the specific numbers they are reporting — especially with something like HRV, for which there are not universal guidelines — and more about the long-term trends they can track. By collecting your personal data over time, they can help you figure out what’s normal for you and help you notice if something changes. So don’t freak out if your HRV is different from somebody else’s, or you see one abhorrent reading in your daily report. But if you notice a change in your resting heart rate or HRV that persists over time, then it might be worth going to see a doctor about it.
“We don’t want to overreact to just one abnormal reading,” Bhatt said. “If you just know your baseline when you’re relatively healthy, you can catch the trends.”
It’s all about having realistic expectations about what your wearable can deliver — and recognizing that, for some things, the old ways are still better. When it comes to those metrics that incorporate HRV to determine your stress and “recovery,” Joyner said that self-reported data (literally, how do you feel?) remains the more accurate way to evaluate a person.
And at a certain point, your wearable can straight-up make your health worse. Fixating too much on your sleep problems, for example, can paradoxically cause more sleep problem. An American Society of Sleep Medicine survey this year found that 76 percent of US reported losing sleep because they were worrying about their sleep. It’s a problem — dubbed “orthosominia” — that scientists have been warning about for nearly a decade: the possibility that our obsession with better sleep, and doing things like wearing a device to track our sleep, could actually give us insomnia.
Bhatt said she’d like to see these devices develop the capability to detect when a user may be checking their data a little too compulsively. Joyner, for his part, said he worried that the culture around health and wellness could, ironically, create a lot of stress for the people who get deeply invested in tracking their activity.
“I actually worry we’re entering a too-much-information world,” he said. “It’s going to be anxiety-provoking.”
Even as we recognize the limitations of wearables, that doesn’t mean they can’t be useful — and they’re going to keep getting better.
Right now, there are obvious situations where a wearable can be helpful. As Bhatt suggested, they can help you understand your personal baseline and notice any changes. Certain patients, such as those with congenital heart failure, can clearly benefit from ongoing monitoring of their heart’s performance, per the American Heart Association. Anybody can use a wearable to make sure their heart rate doesn’t reach dangerous levels during a workout. And these devices could ultimately prove effective in catching underlying heart problems — but there is still work to do. A 2019 study on wearables and atrial fibrillation is telling: At the time, only a tiny percentage of wearers received a notification of an irregular heartbeat, suggesting that there were others that the devices were missing. But, for those who did get an alert, the majority of them did in fact have A-fib. (The FDA has since said that several smartwatches are capable of A-fib detection.) Some patients who have had a serious cardiac event are being asked to put on a wearable, so their doctors can remotely monitor their heart, utilizing an AI assistant that checks the incoming data for any signs of a pending emergency.
And these are the worst wearables we’ll ever have. The future iterations of these devices are going to become more precise and more integrated with AI, which could allow them to ultimately provide more value to the people wearing them. The hypothetical potential for integrating wearables with health care delivery more broadly is immense.
“None of these things will exist in a silo,” Bhatt said. “Your health records, how you’re doing, your wearables, your lab data, people are going to be pulling those together…and trying to give you insights.”
But for now, for the average person, it’s more of a personal choice. Joyner, whose work is all about maximizing human performance, does not wear a smartwatch. Bhatt likes to experiment with different devices with a certain goal in mind, like trying to improve her sleep over the course of a few months.
As Bhatt put it to me, if a wearable motivates you to take your health more seriously, then it’s already doing your body some good. “The best health metric is the one that changes what you do in a way that improves your health,” she said. “For you and I, that may be different things. For your grandmother, it’s something else. For the woman down the road, it’s something else.”
At the most fundamental level, people who use wearables tend to move more when they do — up to 40 more minutes of walking per day, according to a 2022 Lancet study. That is a gain for their health; recent research has shown that even a little bit of movement can have life-saving benefits. The more wearables encourage people to move, the more they can deliver real health benefits.
So if you like wearing one, that’s fine. I’m not dropping my Apple Watch’s step tracker any time soon, because it pushes me to get moving. But be mindful of how your use affects you and how preoccupied you are with certain metrics. Stress is one of the worst things for your health. So is a lack of sleep. If you find your sleep metrics are keeping you up at night, or that your sleep seems to have gotten worse since you started using it, it’s okay to take it off.
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