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Episode Summary

Dr. Lucy McBride sits down with Dr. Bob Wachter, chair of the Department of Medicine at UCSF and bestselling author of A Giant Leap to discuss artificial intelligence in healthcare. They explore the current frustrations with electronic health records that don't communicate with each other, the unprecedented rapid adoption of AI scribes and tools among clinicians, and how AI can free doctors from documentation burden to focus on patient relationships. The conversation addresses the promise of democratizing healthcare access through AI, but also the critical need for oversight of tech companies whose profit motives may not align with patient welfare.

The Electronic Health Record Problem

Both patients and doctors are frustrated with fragmented EHRs—multiple patient portals that don’t communicate with each other create disparate care and wasted time

Doctors spend huge amounts of time documenting in EHRs but get very little useful intelligence out of them

AI as Documentation Solution, Not Relationship Replacement

The act of caring for another human being is relationship-based, rooted in trust, rapport, and understanding the whole person

AI can make the paperwork and documentation side more efficient, giving doctors more time to care for the person, not just their lab data

The Rapid Adoption of AI Tools in Medicine

The uptake curve of AI scribes and knowledge tools among clinicians has been astounding

This rapid adoption reflects the superpowers of the tools and the desperation clinicians feel to better manage administrative burdens of care

Patient Access to Information vs. Understanding

Federal statute now requires patients to see doctors’ notes, lab results, and x-ray results through patient portals

Patients see abnormal results but the portal gives them absolutely no assistance understanding what it means

Portal access has created an average of three hours of after-hours work for physicians

The Promise of Scalable Healthcare Access

AI offers potential for patients to get fast, fact-based information

The scalability and access to information that AI provides could democratize healthcare beyond just those who can afford to pay for a doctor

This accessibility represents a significant opportunity to expand quality medical guidance to more people

The Perils of Profit-Driven AI in Healthcare

AI companies building healthcare tools didn’t take the Hippocratic Oath and will be trying to maximize revenue

AI without physician oversight, training, and guidance is unlikely to prioritize patient welfare over economic advantage

If stewarded by physicians who understand the human elements of care, AI holds promise to help elevate, not eliminate, the patient-doctor relationship (read Dr. McBride’s article about why AI won’t be able to replace doctors here)

Upshot

The question isn't whether to adopt AI tools (doctors already do), but how to shape them so they serve patients and preserve the human elements of care. Doctors and patients alike must be part of the solution—ensuring AI becomes a tool for democratizing quality healthcare rather than creating new barriers driven by profit motives disconnected from the Hippocratic duty to put patients first.

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