Field Notes

The Living Map

Most governance lives in a binder. Six shifts thatmake it live at the bedside.

The Ratio

They promised 10-80-10. Clinicians are living50-10-40. The load did not disappear. It movedrooms.

The Signs

Five Signs Someone Else Wrote Your AI Strategy:And the board approved it. The strategy exists.The ownership does not.

The Autonomy

No Return Address: A decision that moves without a named ownerreaches the patient with no return address.

The Nod

Is it governed?" gets you a smile. It nevergets you a name.

The Blind Spot

She Approved It Perfectly. TheSeat Was Empty.

The Kickstart Audit

The Five-Step Clinical AI Accountability Audit.

The Empty Booth

The Booth Nobody Stands In. The Data LayerNobody Governs.

The Puzzle

How Clinical AI Creates Risk. Five Layers.Five Failure Modes.

The Tower

The Empty Tower. Who Holds the Sky.

The Judgment

Three Questions. Then the Deployment Had an Owner.

The Contractor

More Tools. One Permit.

The 77%

A wrong answer has a trail. A missinganswer leaves nothing.

The Pie Chart

What Most Leaders Think Clinical AIGovernance Is. And What It Actually Requires.

The Handoff

The moment clinical AI was never designed for.

The Curriculum

The lesson your institution has been teaching for years

The Silence

The question every clinical AI leader must answer.

The Masquerade

Two problems hiding inside clinical AI.

The Trail

The difference between a log and an accountability trail.

The Rollercoaster

The accountability ride of deploying clinical AI.

The Adoption

The difference between adopting clinical AI and operationalizing it.

The Performed Confidence

Three questions every clinical AI boardroom needs an answer for.

There Is No Tomorrow

The Last To Know

Five things your clinicians know your board does not.

The 3 Things

What I share with every health executive before the next clinical AI deployment.