Ask a real question. Put the specialty, the setting, and what you want back. “Prostate cancer PSMA, community clinic, what does the guideline actually say about the next scan interval” will beat “what do I do next.” You get a better answer when you ask the question you would ask a colleague in the hallway.

Open the citations. Every answer is supposed to sit on peer-reviewed sources. Click them. If the sentence in the answer is not in the paper or the guideline, you do not have an answer. You have a fluent paragraph. The product is the source list, not the summary.

Do not paste the chart. As of April 2025 they will sign a BAA and they say you can put PHI in. That does not mean you should dump the note. You almost never need a name, an MRN, or a date of birth to get a useful answer. Ask the clinical question. Leave the identifiers out. If you do put PHI in, you are on their BAA, and that is a contract you should have actually read.

Watch the Share button. Threads are private by default. Share can email a conversation or make a public link. Never make a public link if any patient detail is in that thread.

It is not a consult. It is a search with a synthesis. It does not examine the patient. It does not sign the plan. If you cannot show where a sentence came from, do not file it. Fluency does not transfer authority.

CME is extra, not the point. If you are NPI verified, you can turn a question you already asked into free CME or CE, but only after you finish the reflection. The search alone is not the credit. Do not let the credit change what you ask.

If it saves you a hunt through PubMed and you still check the source, keep it. If you are copying the answer into the note unread, turn it off.

More to come!

I’m Travis Mendel. Radiation oncologist. Medical Director at Rio Grande Cancer Specialists and Rio Grande Urology in El Paso. I write this because I use the tools, and because most of the writing I see comes from people who do not sign the note.

This is not clinical decision support. It is not a vendor roundup, and it is not a case that AI will replace you.

You do not let a tool near a patient or a chart until you can answer four questions.

1. Who can see the data, and where does it go?

If audio, a note, or a chart leaves the office, you need a name for who receives it and a place for where it sits. A public chatbot is out. That is a third party you did not contract, on servers you do not control, with a retention story you cannot check. Local models are the default because the data stays on hardware you own. If a vendor has to see PHI, you want a BAA that covers this workflow: this product tier, these connectors, this retention. A BAA is a contract, not a privacy sticker. If you cannot name the destination, the tool stays off.

2. Has it been validated for the specific clinical task?

A demo is not validation. “Works for documentation” is not the same as validated for this note, in this specialty, in this EHR, against this template. If they claim ambient capture of a follow-up visit, you want evidence on that task. Not a staged new-patient video. Not a different specialty. Not an Epic integration you do not have. Until you have that, treat the output as untested draft language. If you cannot get even that, do not use it.

3. Can its outputs be audited and traced?

If you cannot show where a sentence came from, do not file it. The model drafts. You see the source: the transcript, the report, the policy line, the lab. A clean paragraph with no trail is a guess. When something is wrong in six months, you need to reconstruct what the tool saw and what you signed. No trail, no tool.

4. Does it reduce cognitive load rather than add to it?

A tool that drafts a note and then asks you to click through three extra screens has not helped. A tool that writes a message you still have to rewrite, then drops the rewrite back in your inbox, has added work. The test is whether the person who already owns the step is lighter after the draft. If it adds load, turn it off. Time back to the physician is the point. A second inbox is not.

Treat these tools like a good resident. Fluent, fast, sometimes confidently wrong, always supervised. Draft work you can inspect and correct is fine. Diagnosis, treatment, final consent, dose, and plan sign-off are not. Fluency does not transfer authority.

More to come!