The substrate: portable verified identity, a record of contribution that survives employers, and what human expertise is for once answers are free.
6 field notes in this topic
95% of surveyed family physicians report requesting informal medical advice from colleagues, yet only 11% feel satisfied doing so. None of it appears in a CV, a promotion packet, or an RVU report. The record captures billing. It skips the work that actually holds medicine together.
45% of 14,764 studied guideline authors had a financial conflict of interest, and among studies that checked, 32% had industry payments they never disclosed. The tool that finds the expert and the database that discloses the payment have never been joined.
A median of only 11% of cardiology guideline recommendations rest on strong trial evidence; 48% rest on expert opinion alone. For that entire zone, medicine's only tools are anonymous crowd polls or a guideline process too slow to help this week.
Only 11.3% of surgical residents call their case logs highly accurate, and the record is orphaned entirely at graduation. A pilot's logbook is owned by the pilot. A physician's procedural history belongs to whichever employer happened to be watching.
Doximity can show a physician has 4,200 followers. Nobody can show who that physician actually calls when a case doesn't fit the textbook. The two numbers are not correlated, and medicine has never built the second one.
81% of physicians now use AI in practice, up from 38% in 2023. One AI answer engine reports roughly 18 million clinical consultations a month. Roughly one in five LLM answers to oncology questions contains inaccurate information, and leading models elaborate on planted false clinical details in up to 83% of vignettes. Nothing routes from a questionable AI answer to an accountable human.