CAIHL read · Jun 13, 2026
Actual Intelligence: the skill AI cannot replace
Framework
What CAIHL does
Critical AI Health Literacy (CAIHL) is an analytical lens — Hugo Campos and Liz Salmi's 2025 National Academy of Medicine commentary, "Critical AI Health Literacy as Liberation Technology." It applies Paulo Freire's theory of critical literacy to health AI.
The central question CAIHL asks is whose interests does this AI actually serve? Four dimensions answer it: who is the primary user, where is it hosted, whose interests does it advance, and does it expand or constrain patient agency.
This deep-read separates the four dimensions on a single item from the day's scan, so you can see the specific structural shape of the AI in question — not just the bucket it landed in.
The four dimensions
How this item reads through CAIHL
Primary user
clinician
Clinicians or care teams are the primary users. Patients are affected downstream.
Hosting
public
Hosted for public use (ChatGPT, Claude, consumer apps). Anyone with a device can use it.
Interests
patient-aligned
Interest structure prioritizes patients. Operates on a philanthropic, public-service, or advocacy footing.
Agency
expanding
Expands patient capabilities, supports their questions, increases their ability to act on their own values across and beyond health systems.
Editor's CAIHL read
One-sentence synthesis
Clinician-voice naming of the irreducible-skill layer; expanding agency by reframing what the AI can and cannot stand in for.
In the scan
How this item appeared in the daily scan
Editor's note: The replacement frame is the assumption the AI tooling pitch makes. The 'actual intelligence' counter-frame is the assumption the participatory-medicine literature has been making about the patient's role for two decades. Different vocabulary, same argument.
Summary: KevinMD: Clinician essay reframing 'actual intelligence' — clinical judgment in conditions of uncertainty — as the irreducible skill AI in medicine cannot replace, regardless of capability gains in the model.
methodology
Limitations
CAIHL is a lens, not a verdict. The four dimensions are conditions of use — reassess them when a tool's business model, deployment context, or patient behavior changes. See the NAM commentary for the full framework.