Ask a resident at one of a growing number of academic centers where they looked something up, and the answer is increasingly a retrieval-augmented assistant wired to the institution's own formulary, protocols and guideline subscriptions. The reference lookup has become conversational, and usage numbers suggest it has largely displaced the search bar it sits next to.

The clinical content teams responsible for these systems describe their main work as citation discipline. A system that answers well but cites loosely trains users to stop checking, which is precisely the behavior that makes the occasional wrong answer dangerous.

The current best practice, as far as one is emerging, is to render the answer as an assembly of quoted source passages rather than a synthesis, with the model doing retrieval and arrangement rather than prose generation. Physicians describe these systems as less pleasant and more trustworthy.

Vendors selling the more fluent alternative argue that quoted-passage systems fail on exactly the questions users most want answered — the ones requiring synthesis across sources. Both things appear to be true, and no institution we spoke with has found a clean way to have both.