As healthcare organizations increasingly rely on unstructured data like clinical notes, pathology reports, and discharge summaries, de-identifying patient information becomes mission-critical. Whether for research, AI training, or compliance, healthcare providers must ensure Protected Health Information (PHI) is removed at scale and with precision. Two solutions often considered for this task are John Snow Labs’ Medical Text De-identification and Microsoft Presidio. While both are powerful tools for identifying and redacting sensitive data, they serve very different use cases — and their effectiveness in healthcare settings diverges sharply.