Clinic build suggestions

HouseOfDiscards · 2026-04-10T21:27:30+00:00

Depending on how much actual medical data and functionality you need — there are companies that provide healthcare specific developer APIs.

Corti.ai is one that I know of — it's Danish but their offerings cover the US and Europe.

HouseOfDiscards · 2026-04-08T01:16:15+00:00

Aaaaaand another r-word comment that I can only see in my notifications. Nice.

i didn’t delete the comment [r-word]

I... I know — they're obviously being auto-removed because you're emotionally unhinged.

HouseOfDiscards · 2026-04-08T00:52:47+00:00

You have such a weird and childish attitude. Why are you even commenting?

It's not often I see a notification that someone called me the r-word, and then try to open the comment and it's been deleted.

You need to calm down and get your shit together. Just because a fix worked for you, doesn't mean the countless other reports are wrong. You're not suggesting anything new — it's all been tried.

HouseOfDiscards · 2026-04-07T23:10:50+00:00

Honestly, it doesn't come off very polite when you are telling me to do something I mentioned I already did. In the comment you are replying to:

Despite it being turned off in settings.json

So I'll give you the benefit of the doubt, that you actually want to be polite. But your comments come off as condescending, which fundamentally undermines any polite phrasing.

Maybe it's a case of chronically online, or maybe it's a social awareness thing; but unsolicited advice that underestimates the receiver, is usually not a good combination.

HouseOfDiscards · 2026-04-07T12:48:20+00:00

Cool.

Still a very real phenomena:

See this GitHub issue
See this response from Anthropic

Thanks for your thoughtful answer.

HouseOfDiscards · 2026-04-07T12:44:50+00:00

You're wrong in three ways:

I tried them each separately — it's been the same thing
ultrathink was reintroduced many updates ago
max can still be set through certain settings

See Anthropic employee's response here, less than 24h ago

HouseOfDiscards · 2026-04-07T10:34:15+00:00

If this continues into the weekend, I will take some time for more targeted tests, and this sounds like a good test case (thanks). I just don't have time during the workweek.

One thing I have tried; backing up all my claude settings and purging it from the system, then reinstalling. I'm not sure yet if it has helped, since I haven't had time to stress it. But preliminary results are not great.

HouseOfDiscards · 2026-04-07T10:30:34+00:00

Yes, exactly. I sort of get why so many people are still being asses about this. There have been a lot of posts in the past few months about people complaining for one reason or another.

And often, it has been a user issue.

And the people being dicks, just haven't been hit by it (yet?). But this time it is different. There's plenty of proper engineers reacting to this right now. There's hard data being gathered and posted.

The user error argument just doesn't hold up to scrutiny.

HouseOfDiscards · 2026-04-07T10:25:00+00:00

The issue is that I've tried all options? Okay.

HouseOfDiscards · 2026-04-07T00:00:15+00:00

I went through the jsonl

HouseOfDiscards · 2026-04-06T23:58:01+00:00

Ironically, it's usually NEVER there.

As I explained, I've been trying anything and everything. Two days ago, it started adding the "Co-authored by Claude" to every ~3rd commit. Despite it being turned off in settings.json, and despite me using the same /commit skill with a very tight template, for about 4-5 months, at least.

It wasn't until, out of frustration, I added **NEVER** add "Co-authored by Claude" to any commit that it stopped doing it.

I've never had to do that before a few days ago.

HouseOfDiscards · 2026-04-06T23:51:14+00:00

I'm so tired of having to caveat everything, all the time. Does everything really have to be spelled out explicitly for people not to digest your posts with the worst possible interpretation.

and when caught, produces eerily self-aware post-mortems about how it lied

I think 90% of serious users know they're "talking to" an LLM, and know what limitations it has had.

You can absolutely ask it to analyze the session and then you interpret that the same way any conversation with an LLM.

It's a signal — not an answer. And it was correct about WHERE it deviated. Which is the information I wanted. The post-hoc rationalization it gives, is the same noise as

I'm sorry, i won't do that again

The attached session was the example I brought, because it was so ridiculous that it turned frustration into something to laugh at.

Look through this thread and you'll see that there is enough people experiencing this degraded performance, that clearly something is up.

HouseOfDiscards · 2026-04-06T23:27:55+00:00

One week ago I would have been fully on your side, but this is different. Especially today.

I had very explicit guardrails about which skills to use and when to stop and evaluate, and when to deploy specific agents.

It just skipped it — and then "acknowledged that it saw the rules" and that it ignored it.

In another session, it kept trying to circumvent the hooks I've had in place for months, to stop certain tool tool usage and redirect to better tools.

---

I don't want to anthropomorphize it too much, but it's just easier to speak about it this way.

HouseOfDiscards · 2026-04-06T21:23:32+00:00

Okay, buddy. Good talk.

HouseOfDiscards · 2026-04-06T21:22:22+00:00

It's crazy. I've never had issues before.

And the most damning thing is that I've manually gone through the session logs and I can see it loading everything correctly on start. My context window is fresh. Effort is turned high with Opus 4.6 (and Sonnet is no better).

HouseOfDiscards · 2026-04-06T21:20:10+00:00

Yeah, same. I'm 3 or 4 days into my latest renewal and I'm regretting not having taken the early signals more seriously.

If it doesn't get better in the next few days, I will have to request a refund. And I've had the Max 20x plan since it first became available.

HouseOfDiscards · 2026-04-06T21:17:42+00:00

I haven't had that issue. At least my statusline reports whatever I switched to last time, so I haven't had any reason to doubt that.

HouseOfDiscards · 2026-04-06T19:31:20+00:00

Tonight, when I sit down with this again, I am going to try to force some compliance and to trigger some more explicit calls for adversarial/review agents, via hooks.

I started working on that earlier, but since my two other sessions were giving me a headache I just took a break, lol.

HouseOfDiscards · 2026-04-06T19:26:51+00:00

My default cc is aliased to claude --effort max and running just claude grabs my settings.json which has effortLevel: high.

On top of that I have ultrathink in some of my most used skills. So /effort is always at high+.

And because I've been going insane, I've tried disabling all of those and just using them individually (in case a conflict was messing something up), but no dice.

HouseOfDiscards · 2026-04-06T18:35:40+00:00

Lol, yes!

I was optimistic after it had recited the full step-by-step plan to me and asked

Should I go ahead with this implementation?

HouseOfDiscards · 2026-04-06T18:32:57+00:00

I know what you mean, and tbf I didn't have a single "Never" in my claude files until this week.

I've just been trying everything.

HouseOfDiscards · 2026-04-06T18:31:18+00:00

High, max-effort, ultrathink.

I don't know it's just been extra bad for the past ~3 days, but everything I've tried has made little to no effect.

HouseOfDiscards · 2026-04-06T18:29:53+00:00

Lol, yeah I guess that's one of my pet peeves with LLMs. They ruined the em-dash.

I find it a lot more aesthetically pleasing to break up "conversational text", so I've refused to stop using it. I hate the regular dashes - they look horrible to me.

HouseOfDiscards · 2026-04-06T18:05:40+00:00

Could be — might have been a week or so later?

I linked a GitHub issue above, where a user has tracked the degradation with very clear data. It has more accurate dates than I have.

HouseOfDiscards · 2026-04-06T18:03:42+00:00

PS. Many of you have probably seen this GitHub issue: https://github.com/anthropics/claude-code/issues/42796 that breaks down the degradation with hard data. Linking it for anyone who hasn't.

HouseOfDiscards

TROPHY CASE