Alex Butler, MD, MS

I practice pediatric hospital medicine and have a master's in clinical informatics. Through RAD Medical, I work with early-stage health tech companies as their clinician: the experienced voice in the room while everyone else is moving fast.

I've spent time on both sides of the divide that most health tech falls into. I've helped build and ship clinical products at River Records and Alcott, and I hold fractional roles with Tennr and Concordare Trials. I also still see patients, which is the whole point. The clinical instinct I bring to a product decision comes from the same work your software has to survive.

Here's what I've come to believe after enough of both: the hardest problems in clinical software usually aren't about the model. They're judgment calls, dozens of them, made early and quietly, often by people who have never been responsible for a patient at 3am. My job is to be there for those calls before they're locked in, and to keep the answer pointed at what's actually good for patients and the people caring for them.

What I care about

Most of my writing comes back to a few questions. When does a human actually need to be in the loop, and when is "human in the loop" just there for the lawyers? Who is accountable when a system does exactly what it was built to do and the patient still ends up worse? What happens to patients as AI works its way into the visit? I try to argue these from the bedside, which is usually the view that's missing from the conversation.

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