AI, AI, everywhere and what a choice to make

"Water, water, every where,And all the boards did shrink; Water, water, every where,Nor any drop to drink."Samuel Taylor Coleridge wrote these famous lines in his 1798 poem The Rime of the Ancient Mariner about a ship’s crew dying of thirst while surrounded by the very thing that might save them, unable to use it.These days, our challenge for medical administration is one of abundance: too much paperwork, too many demands in our time and too much choice when it comes to solutions.Gone are the days of paper charts. Of office assistants scurrying at the start of the day to collect overstuffed manila folders with frayed forms bursting out like an overstuffed pita. Of flipping through binders to find the last consultant report, hoping that the handwriting would be legible and the sheet wouldn't have decayed too much.With EMRs and now AI, the cadence of clinical practice is unrecognizable. AI MOAs triage calls and schedule and reschedule appointments. AI Inboxes sort incoming faxes. (Faxes? In 2026? Well, maybe some things don't change.) AI scribes capture meandering meetings and multilingual visits and produce scarily accurate notes (reference to “bologna amputations” aside).And now AI is at the bedside offering quick advice, like an indefatigable 24/7 preceptor. Want to know what other tests to order for that persistent hyperkalemia? AI will get you all the advice and algorithms you could want. Want to know how to wean clozapine in your new elderly patient? Here are the latest articles. Want to produce a patient handout on Brandt-Daroff exercises in Bahasa? Just specify Baku or Melayu and AI will serve it to you within the minute.With so many options, the challenge now is less how to find information, but which source to use. Like a spouse sent to pick up yogurt, it can feel like we're choosing between Greek, non-fat, and fruit-on-bottom: there are many good choices, but which one do we really want?One AI listens to the visit and considers real time patient information in its answer.Another scans the chart and uses history in shaping its advice.Some are endorsed by journals like JAMA or aggregators like Healio.Where’s an honest doctor to turn?Eventually, these companies may coalesce into a few dominant superpowers as we have seen with other technology like phones and social media and the EMRs we are all beholden too. Perhaps some will capture enough of the market to figure out interoperability and make the choice easy.Until then, it can feel like we are ships adrift, the challenge no longer how to find water, but rather where in the ocean to start drinking.Dr. Eric Cadesky is a full-service family doctor in Vancouver.

AI, AI, everywhere and what a choice to make

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