Evidence-based care – The Health Care Blog

When Artificial Intelligence Starts Rewriting Reality

Mar 5, 2026

By BRIAN JOONDEPH

Artificial intelligence is quickly becoming a core part of healthcare operations. It drafts clinical notes, summarizes patient visits, flags abnormal labs, triages messages, reviews imaging, helps with prior authorizations, and increasingly guides decision support. AI is no longer just a side experiment in medicine; it is becoming a key interpreter of clinical reality.

That raises an important question for physicians, administrators, and policymakers alike: Is AI accurately reflecting the real world? Or subtly reshaping it?

The data is simple. According to the U.S. Census Bureau’s July 2023 estimates, about 75 percent of Americans identify as White (including Hispanic and non-Hispanic), around 14 percent as Black or African American, roughly 6 percent as Asian, and smaller percentages as Native American, Pacific Islander, or multiracial. Hispanic or Latino individuals, who can be of any race, make up roughly 19 percent of the population.

In brief, the data are measurable, verifiable, and accessible to the public.

I recently carried out a simple experiment with broader implications beyond image creation. I asked two top AI image-generation platforms to produce a group photo that reflects the racial composition of the U.S. population based on official Census data.

You Owe Me a BMW

Jan 29, 2015• 7

By ROBERT McNUTT, MD

During a move necessitated 20+ years ago by my change from a “private practice of medicine” life to a “back to school” life, I decided to undertake the move on my own using a rented van. I also had to affix a small trailer packed with furniture to the van. As I lifted the not so heavy trailer to the hitch, one of my children ran toward the trailer. I stopped my child’s progress with a holler and an out-stretched hand. As I did that, a disc in my back popped and dropped me to the ground. I have had back pain every day since. I have managed my back pain on my own. But, I now think it is time to start using my medical insurance to pay for the care of my back pain. So, fellow insured, you owe me a BMW.

Yes, a BMW. I know that my back pain is a subjective complaint and you can’t prove or disprove that I have it. I also know that there is no measure of my back pain; I can grade it on a scale from 0-10, as some do, but that is such a difficult task that I can’t internally come up with a number. I am sure, though, that the number changes daily. Even if I could assign a number to my pain, there is no guarantee that you would assign the same number should you suffer the exact pain as me, or that you could assign a number to my complaint better than I could. The pain is there, though. I feel it and alter my activities to not exacerbate.

Recently, a friend gave me a ride in his BMW. The seats fit my back to a t and as I sat there, my pain abated. I asked him to turn on the heated seats. Even more remarkable pain relief followed. In fact, after the ride in his car, I had no back pain for over 3 weeks, the first 3-week, pain-free stretch of time in over 20 years. So, since insurance plans often pay for some types of interventions such as heaters, buzzers, or needles, as examples, to help people with their back pain, so, then, shouldn’t insurance pay for a BMW for me? I think so.