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Pivot or Perish

How Physicians Can Reinvent Their Careers Before AI Reinvents Medicine

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Pivot or Perish

By: Harvey Castro MD
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The algorithm is already in the room. The question is whether you'll lead it or be replaced by it.

Every year, the FDA clears more AI medical devices. Ambient scribes are writing your notes. Diagnostic algorithms are reading your scans. And the career path you spent a decade building? It was designed for a world that no longer exists.

Pivot or Perish is the physician's field guide to career reinvention in the age of AI. Written by Dr. Harvey Castro — a board-certified ER physician, five-time TEDx speaker, Chief AI Officer at Phantom Space, and founder of the DrGPT platform — this book delivers a tested, neuroscience-backed framework for rebuilding your career before AI rebuilds it for you.

Inside, you'll discover:

THE PIVOT METHOD — a five-step system for physician career reinvention:
- Position Audit — map exactly where you stand and where AI threatens your specialty
- Identity Shift — the neuroscience of becoming someone new without losing who you are
- Value Architecture — build an irreplaceable skill stack AI cannot replicate
- Opportunity Mapping — find your next move across 12 emerging physician domains
- Take the Leap — execute a 90-day sprint to test your pivot without quitting your day job

What makes this book different:

- Real clinical case studies from physicians who pivoted successfully
- Neuroscience research explaining why your brain resists change — and how to override it
- AI-powered prompts at the end of every chapter so you can use AI as your career coach
- A specialty-by-specialty reckoning showing exactly how AI is reshaping radiology, pathology, cardiology, emergency medicine, primary care, and more
- Harvey's own story: from ER doc to CEO of eight emergency departments to Chief AI Officer in aerospace

This is not a book about fearing AI. It's a book about using it — to build a career that matters more, not less, in the age of intelligent machines.

Whether you're a resident just starting out or a senior physician wondering what comes next, this book gives you the framework, the neuroscience, and the 90-day plan to act.

From the author of ChatGPT and Healthcare (the first book on large language models in clinical settings) and works published with Wiley and Routledge.

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