clinicians.dev

A community of clinical experts super-powered with skills in agentic engineering. Our roots are in coding and clinical medicine. We know how to create and supervise LLMs writing Python, SQL, R, JS, HTML. We love startups, regs, policy, UI/UX, data viz, project management, informatics. We want to create the medicine of the next 100 years.

✉ Email for Slack invite → Slack → Substack ↓ Next event

today · the wire

The Wire

What you'll be asked today — and what to say back. A couple that caught my eye this morning; the rest are on the wire.

The FTC just wrote a complaint that doubles as an audit checklist for every DTC telehealth stack

Federal Trade Commission · Jul 29

The FTC, California, and Utah sued Hims & Hers for sharing condition-level health data with Meta and Snap, charging patients almost the moment the intake form lands, and making cancellation hard — shares fell about 10% on the news. The privacy count is familiar; ad pixels leaking health data have been an OCR and FTC theme for three years. The sharper count is billing: the complaint says telling patients they'll "consult with a provider to find a treatment that's right for them" and then charging nearly instantly is deceptive. That's not an edge case, it's the default DTC telehealth funnel — intake form, pixel, auto-billed subscription. Worth diffing your own flow against this complaint today, not after a similar letter shows up.

SkepticA three-year federal investigation concluded the industry's standard growth stack might be the violation. The harder question isn't whether Hims & Hers did it — it's naming a DTC health company whose stack looks materially different.

Humana is walking away from 600,000 Medicare Advantage members — on purpose

Healthcare Dive · Jul 2026

On the Q2 call, Humana's CFO framed the 2027 exits as pruning, not panic: cutting the lower tail of profitability — mostly plans rated 3.5 stars or below — in service of a 3% pre-tax margin by 2028. They recaptured just over 40% of members from the 2025 round of exits into their own remaining plans and expect the same again this time, and individual MA membership still grew about 25% this year. The tell: they're keeping the plans with deep value-based-care penetration, so the map of where Humana stays is basically a map of where risk-bearing actually works.

The country has about one day's supply of type O blood left

American Red Cross · Jul 27

The Red Cross declared a national blood supply crisis — only the second in its history — with type O positive below a one-day national supply, and it's now limiting how much hospitals get. The Red Cross supplies roughly 40% of the nation's blood, and summer donations hit a four-year low right as trauma season demand peaked. "Limiting distributions" means hospitals stop getting everything they request, which lands on transfusion committees, massive-transfusion protocols, and elective scheduling within days. The only prior declaration needed a pandemic plus winter storms; this one is just a donation curve nobody bent back. Worth a check with your transfusion committee this week.

10,000 UC attendings, one bargaining unit

KQED · Jul 2026

UC Doctors United, backed by SEIU, Doctors Council, and the residents' union, is the largest attending-physician organizing drive in U.S. history — aiming at roughly 10,000 attendings across the system. Two things stand out: the stated drivers are staffing shortages, administrative burden, and patient loads, not pay, and it comes right after UC's residents won an 18% raise, so the playbook is already proven in-house. Most physicians are employed now rather than independent, and the conditions being organized around are the same ones showing up in every engagement survey I've seen.

Doctronic bought Summer Health — and the real asset is pediatric data

Fierce Healthcare · Jul 29

The AI primary-care startup's first move beyond adult care is acquiring the text-based pediatric care company Summer Health — and it comes with Summer's pediatric dataset attached. The interesting part isn't the visit volume, it's the data: pediatric training data is scarce because digital health chronically underinvests in kids, so an AI-native company buying a pediatric care model plus the dataset it generates gets a shortcut competitors can't easily license their way into. Worth watching whether this becomes a pattern — "AI doctor" companies treating underserved clinical segments as data acquisitions with a care model attached.

BuilderPediatrics is the proof case for the gap: of the hundreds of FDA-cleared imaging-AI tools, almost none cover kids. If your model needs a population nobody else has, buying the care delivery that generates the data may be cheaper than waiting for a dataset that doesn't exist.

Read the full wire ↗

learn by doing

Interactives

Companion experiences for the newsletter — don't just read about it, try it.

The 3.5 Line

August 1, 2026 · Source: Becker's — "Humana to exit Medicare Advantage plans covering 600,000 members in 2027" (Jul 30, 2026) · MIMI Labs · CMS CPSC enrollment June 2026 × 2026 Part C & D Star Ratings

All 610 Medicare Advantage contracts with 1,000+ members on one brushable scatter — star rating against enrollment, 35.7M people. Below the 3.5 line sit 11,165,479 members; 4,233,892 are Humana's, 59.6% of its own book. The announced 600,000 exit is 14.2% of it. Stress test: r = +0.35 across 486 rated contracts, decaying to +0.22 once you drop everything under 50,000 members. Critical lens: 378 contracts carry no rating at all, and Humana's own "20% in 4-star plans" doesn't reproduce from the public files — we get 38.6%.

Fourteen Percent

August 1, 2026 · Source: Becker's — Humana CFO Celeste Mellet, July 29 Q2 earnings call, published Jul 30, 2026 · MIMI Labs · CMS CPSC June 2026 × 2026 Star Ratings

1,788 dots, one per 20,000 Medicare Advantage members, settling into star bands — then Humana's 7.1M turn red, then the 600,000 exit is bracketed as 30 of them, then 40% fade back because that's the recapture rate. Humana's 3.5-star band alone holds 40.7% of everyone in the country at 3.5 stars, and has zero members at 5.0 or 2.0. Then what national averages hide: 57% of every MA member in Montana is in a Humana contract rated 3.5 or lower, versus 3.9% in California.

Browse all interactives →

from the substack

Builder's Briefing

The newsletter — what shipped this week, what it means, and what to build next. A couple of recent issues.

Fetal AI lifts 22 points 🤰, Your devices already run AI 🕵️, Part D comes off the drip 💧

⚡ Around the Wards

Read on Substack →

Duke built its own chart reader 🔦, ~80 AnMed sites go dark 🕳️, Being safe vs feeling safe 🤔

⚡ Around the Wards

Read on Substack →

What the Vibe

Saturday, May 30, 2026 · 12p–2p ET

Vibe coding changed everything. The barrier to building just disappeared. So what's the vibe? Is clinicians.dev dead? Does knowing how to code still matter when anyone can build? Four clinician-builders. Twelve minutes each. Show us what you made — vibe-coded, hand-coded, or somewhere in between.

Tentative speakers

Joe Izzo

First, Do No Harm — Especially With Your MVP: A CMIO's Advice in the Clinician-Builder Era

Patrick Damaso

Trajectories, Not Targets: Catching Reward-Hacked Diagnostic Reasoning One ICD Branch at a Time

Sam Wang

Silent Denials, Loud Insights: Visibility into the Payors Who Won't Show Their Work

Matt Segar

From Bedside to Buyout: An EP Fellow Path to Acquisition

4 talks (12 min each)
1:1 breakouts after each
Group discussion
Open community talk: "What the Vibe?"

RSVP on Luma →

01 · Learn

AI & agentic engineering

The foundational reads, the tools clinicians-who-code are actually using, and the loop that ships.

Context engineering — the foundation

Effective Context Engineering for AI Agents

Anthropic's foundational guide.

Building Effective Agents

When to use workflows vs. agents, and how to structure both.

2026 Agentic Coding Trends Report

How teams are actually shipping with agents.

Learn `CLAUDE.md` / `AGENTS.md`

The spec files that make agentic coding repeatable.

🔁 The Ralph Wiggum Pattern — the loop that ships. Tight spec → agent implements → you verify → adjust spec → repeat. Just keep going.

Tools of the trade

Tool	Best for	Notes
Claude Code	Complex multi-file work, architecture	Terminal-native, large context. The power tool. Good for non-code tasks too.
Cursor	Daily coding with autocomplete + inline edits	AI IDE, huge user base.
Windsurf	Budget entry, Cascade collaboration	AI-native editor.
Copilot / Codex CLI	Repo-native GitHub workflows	Tight GitHub integration.

Agentic frameworks & orchestration

CrewAI— multi-agent orchestration, clinical workflow pipelines
LangGraph— graph-based agent workflows with state
AutoGen— Microsoft's multi-agent conversation framework
MS Agent Framework 1.0— production .NET + Python
DSPy— programmatic LLM pipelines, good for clinical NLP

02 · Communities

Communities, courses, substacks

Where clinician innovators and clinician builders are hanging out.

EHRs, FHIR, fake patients

The pipes you'll need when you're actually building.

EHRs & FHIR

🔑 SMART-on-FHIR / OAuth flow — fhir.epic.com/Documentation?docId=oauth2

Clinical datasets worth knowing

From CXRs to genomes to ICU waveforms. Filter by name, modality, or license.

Name	Relevance	License
ReXGradient-160K	160k multi-site CXR + reports — vision-language radiology sandbox.	Harvard DUA, non-commercial
CheXpert Plus	Large paired CXR–report set; benchmarked in many papers.	Stanford DUA, free research
Endoscapes 2023	Open laparoscopic chole frames — segmentation / CVS detection.	CC BY-NC-SA 4.0
Surg-3M	3M surgical frames powering "SurgFM" foundation model.	TBA, expect research-only
AFRICAI Repository	Imaging sets from African centres — fairness & domain shift.	Mixed open licenses
OpenOximetry	Waveforms + skin-tone data for pulse-ox bias work.	PhysioNet credentialed
DeepLesion	32k CT slices with bounding-box lesions; detection / tracking.	NIH DUA, research-only
BioASQ Synergy 2024	Biomedical Q-A pairs — LLM eval set.	CC BY 2.5
CliniFact	Clinical-trial fact-checking corpus — fine-tune retrieval / RAG.	MIT
Hallucination Annotations	Doctor- & LLM-written discharge summaries with token-level labels.	PhysioNet credentialed
Clinical-Trial Eligibility QA	QA pairs linking MIMIC-IV to apixaban RCT criteria.	PhysioNet credentialed
PIFIR	Wearable PPG/ECG for arrhythmia-free interval prediction.	PhysioNet restricted
GREGoR R02	Rare-disease genomic + phenotypic harmonised data.	dbGaP controlled
Synthetic Rare-Disease EHRs	Benchmark synthetic EHRs for low-prevalence conditions.	CC BY
Korea4K	4k Korean genomes — ancestry diversity for variant calling.	EGA controlled
OpenNeuro	20k+ public neuro-imaging sessions; BIDS-ready.	CC0 / CC BY-SA
Bridge2AI-Voice	Multimodal speech (voice, vitals) for health AI.	PhysioNet restricted
PMDB Pain Monitoring	Wearable IMU + self-report pain diary.	CC BY 4.0
DREAMT Wearable Sleep	Apple Watch PSG pairs for sleep-staging models.	PhysioNet restricted
MC-MED	Multi-condition medical dialogue (GPT / human).	PhysioNet credentialed
Wearable Stress Dataset	Smartwatch vitals + stress labels — mental health ML.	PhysioNet restricted
MIMIC-IV v3.1	Flagship 380k-patient de-id EHR; ED + ICU tables.	PhysioNet credentialed + CITI
MIETIC	Italian clinical-notes corpus with entity spans.	PhysioNet credentialed
ODD (Opioid Behavior)	Annotated notes for opioid-related behaviour NLP.	PhysioNet credentialed
UK Biobank	500k UK adult cohort — EHR, surveys, genetics.	Controlled access
All of Us (NIH)	1M-goal US cohort — EHR, surveys, genomics, wearables.	Registered + Controlled tiers
TCGA	~11k patients across 33 cancer types — multi-omics + clinical.	Partially open
AmsterdamUMCdb	First open European ICU DB — 23k admissions.	DUA required
ADNI	Longitudinal Alzheimer's — serial MRI/PET, clinical, biomarkers.	Free non-commercial
ABCD Study	10k youths — neuroimaging, cognitive, mental health, genetic.	NIMH controlled access
NHANES (CDC)	US national survey — health, nutrition, lab data.	Public domain
CheXpert (original)	224k chest X-rays, 65k patients — labeled findings.	Free non-commercial
EchoNet-Dynamic	10k+ cardiac ultrasound videos with EF + ventricle volumes.	Non-commercial
Synthea	Realistic synthetic patient records — full EHR.	MIT
1000 Genomes	WGS from ~2,500 diverse individuals — human variation reference.	Open access
DementiaBank (Pitt)	Speech recordings + transcripts from Alzheimer's patients + controls.	Consortium access
VitalDB	6,300+ surgeries with continuous high-freq vital sign waveforms.	Open, registration + DUA
Medical Segmentation Decathlon	10 open datasets for 3D medical image segmentation.	CC BY-SA 4.0
PANDA	10k+ prostate biopsy WSIs with Gleason grades.	CC BY 4.0

05 · Conferences

AI & health conferences

Borrowed from Raihan Faroqui's healthcare AI resource guide. Filter to find your tribe.

06 · Jobs

Job boards that don't suck (as much)

What they are. Not endorsements — just the lay of the land.

jobs.heyhealthtech.com
Rock Health Capital
MDisrupt
PharmDs in IT
AMIA
General Catalyst— surprisingly good for startups
Matchday Health
Wellfound
Look for Zebras
Fractional Jobs
HealthTech Nerds Jobs

07 · Startup

So you want to build a startup

But don't know anything about tech/stack, marketing/sales, finances, management.

Life hacking / survival

Because clinician-builders need to not burn out.

09 · Experiments

LLM matrix tests (alpha)

Testing out LLMs with fake patient scenarios generated by GPTs.

Past events

Where we've been.

Fall 2025 Conference

Time	Speaker	Talk
1:00p	TBD	Welcome
1:10–1:22p	Josh Mandel, MD	Conversational Interoperability for Prior Auth and Beyond — MCP, A2A, and the Unreasonable Effectiveness of Making Data Accessible
1:35–1:47p	Jung Hoon Son, MD	Data CPR: How LLMs Revive Buried Clinical Insights
2:00–2:12p	Jason Theobald, MD	Contain Multitudes: A Docker Intro
2:25–2:37p	Calvin Johnston, MD	Software Design and Family Medicine: Overlapping skill sets
2:50p	TBD	Wrap-up

Summer 2025 Conference

Time	Speaker	Talk
1:00p	Kevin Maloy, MD	Welcome
1:10–1:22p	Vishnu Ravi, MD	Digital Health that Ships: An Open Framework You Can Use Today
1:35–1:47p	Alex Dummet, MD	Topic TBD
2:00–2:12p	Pawan Jindal, MD	Startup Survival 101: A Clinician's Guide
2:25–2:37p	Omar Usman, MD	Change Data Capture (CDC): A Defiant Approach
2:50p	Kevin Maloy, MD	Wrap-up

Fall 2024 Conference (Nov 9, 2024)

Time	Speaker	Talk
1:00p	Kevin Maloy, MD	Welcome
1:10–1:22p	Paulius Mui, MD	From 0 to 1: Becoming a Clinician Who Codes
1:30–1:42p	Brian Fung, PharmD	Path of the Clinician Engineer
1:50–2:02p	Joe Izzo, MD	The Coding CMIO — it's okay to get your hands dirty
2:10–2:22p	Karambir Khangoora, MD	Learning to Code as a Clinician: Building Medagogy
2:30–2:42p	Joey LeGrand, PharmD	One Brain Can Be Better Than Two
2:50p	Kevin Maloy, MD	Wrap-up

Podchat — Should Hospitals Mandate GenAI Training? (Aug 29, 2024)

Listen to a short podcast, then talk about whether it's right or wrong. Original from Bill Russell at This Week Health. → Meetup event

clinicians.dev

The Wire

Interactives

Builder's Briefing

What the Vibe

AI & agentic engineering

Context engineering — the foundation

Learn CLAUDE.md / AGENTS.md

Tools of the trade

Skills marketplaces

Healthcare MCPs

Agentic frameworks & orchestration

Communities, courses, substacks

EHRs, FHIR, fake patients

EHRs & FHIR

Generate fake patients

Clinical datasets worth knowing

AI & health conferences

Job boards that don't suck (as much)

So you want to build a startup

Life hacking / survival

LLM matrix tests (alpha)

Past events

Learn `CLAUDE.md` / `AGENTS.md`