What if the way we measure a doctor's productivity is completely wrong?

Software companies have already abandoned "lines of code" as a productivity metric — they now budget in tokens, the fundamental unit of AI work. Some developers spend $10,000-20,000 a month on AI agents. Microsoft says 30% of its code is AI-written. The old measurements are dead.

Meanwhile, healthcare is still stuck on RVUs — a system where physicians spend two hours on EHR documentation for every one hour with patients, family doctors lose 86 minutes every night to "pajama time" charting, and Medicare physician payment has declined 26% since 2001 after adjusting for inflation. Value-based care was supposed to fix this. It didn't. CMS's own innovation center actually increased federal spending by $5.4 billion between 2011 and 2020.

In this episode, I lay out the case for replacing RVUs with token-based measurement — shifting the question from "How many patients did you see?" to "How much agentic activity did you perform to improve population health?" I walk through the data from JAMA, McKinsey, MedPAC, and the AMA's own admission that MIPS is broken, and explain why AI-augmented healthcare systems should receive better reimbursement, not worse.

This isn't a theoretical framework. The AMA just added 26 new CPT codes for clinical AI solutions. CMS launched the ACCESS Model in February 2026. The transition is already underway — the only question is whether your organization is measuring what matters.

Full sources and the deep dive: danmccoymd.substack.com

Want a personal walk through, check out our AI consultancy at RocketTools.io.

The Pentagon just labeled Anthropic — the company behind Claude AI — a national security supply chain risk. Not because they're a foreign adversary. Because they refused to remove two guardrails: no mass surveillance of Americans and no autonomous weapons without human oversight.

The $200 million contract is canceled. The Trump administration ordered every federal agency and defense contractor to phase out Anthropic's technology. Anthropic is preparing to sue.

But the Pentagon fight is the opening act. The real story is what AI can already do with your health data — and why the rules protecting it don't work anymore.

In this episode:

• How AI re-identifies "anonymous" medical records for 800,000+ Americans even after removing all 18 HIPAA-required identifiers
• Why your body is becoming a biometric database — facial reconstruction from MRI scans (83-98% accuracy), chest X-rays as fingerprints, and 12 million voice biomarkers extracted per minute of a telehealth call
• Dario Amodei's four warnings about government AI misuse
• The HIPAA timeline: written in 1996, last major update in 2003, new rules expected late 2026 — none of which address AI re-identification
• Why Fitbit, Apple Watch, Oura, and AI health chatbots aren't covered by HIPAA at all
• What the Anthropic situation tells us about who's drawing the line on your health data (spoiler: almost nobody)

The rules haven't caught up to the technology. This episode breaks down exactly where the gap is and why it matters.

Full sources and the deep dive: danmccoymd.substack.com

The common story about healthcare cybersecurity is that big hospital systems are the targets. The reality is more complicated. Rural America is ground zero — and the math is brutal.

The Change Healthcare attack knocked out 50% of all U.S. medical claims processing. 80% of physician practices lost revenue. 300 hospitals didn't even apply for federal relief — mostly small and rural. But that was the supply chain breaking. The direct attacks on rural hospitals are worse.

In this episode, I break down three things:

First — what the Change Healthcare attack actually revealed about how fragile small-provider healthcare really is.

Second — why rural hospitals are easier targets with the same valuable data. 69% lack basic multi-factor authentication. Most have one or two people handling all of IT — cybersecurity, printers, wifi, everything. And attackers know rural hospitals are more likely to pay ransoms because they can't afford to go offline when the nearest alternative is an hour away.

Third — the AI double-edged sword. Only 29% of healthcare executives feel prepared for AI-powered attacks. But AI might also be the thing that levels the playing field for small providers who will never be able to hire a security team.

Full sources and the deep dive: danmccoymd.substack.com/