Don’t be fooled by the question mark in the title of an article published in the Journal of the American Medical Association. When the authors, including medical superstar Ezekiel Emanuel and venture capitalist Vinod Khosla, asked, “Will Autonomous AI Exceed AI-Physicians as the Best Medical Care?” they were being rhetorical. Their answer is an emphatic YES. Many in the medical world are reluctantly coming to terms with the premise that patients can get the best treatment by a hybrid approach where doctors work in consultation with well-trained bots. But this article’s thesis is that AI alone can deliver the best outcomes.
Review of all published articles on AI in medicine since January 1, 2024, shows that medicine is rapidly approaching the transition point at which AI alone will exceed physicians and physician AI-hybrids in providing the best care at five fundamental medical tasks. Those tasks include taking medical histories, establishing a diagnosis, identifying what tests are needed, prescribing treatment, and managing chronic diseases. AI is now so good, they argue, that clinicians should refrain from meddling, because “humans in the loop degrade AI performance.”
Lead author Emanuel—brother of Ari and Rahm, chair of the Department of Medical Ethics and Health Policy at Penn and a renowned oncologist—told me that for many years, he’d dismissed the idea that AI could perform core medical functions. He would run into Khosla at conferences in the 2010s, and the VC would bend his ear about how AI would be doing 85 percent of what doctors did by 2035. It was a hobbyhorse Khosla had been riding for years, writing a 2012 piece in TechCrunch asking, “Do We Need Doctors or Algorithms?” and penning a 101-page treatise in 2016 to that effect.
The co-authors set out to look at all the studies on AI medicine that they could find from January 2024 to the present and concluded that, in many cases, a “superior autonomous AI” will likely surpass humans using AI by 2030. That prediction, they admit, is “unsettling but seems probable.” Unsettling is an understatement. One of the loudest dissenting voices is John Whyte, CEO of the American Medical Association, which represents all those doctors who will be worrying about what’s left. When I talked to him, Whyte began by noting what he saw as the paper’s shortcomings, including that some of the studies it surveyed are simulations, not blind experiments, and they don’t all support the article’s conclusion.
Seeking a second opinion, I consulted Wachter. He’s singled out in the first paragraph as the guy who wrongly argues that AI-only treatment will be “economy class.” (I know Wachter personally.) Surprisingly, Wachter concedes that the authors of the paper have a point. “The argument they’re making is important,” he says. AI is good, he says, and right now AI and humans together are better. “But that can no longer be chiseled into a tablet. There will be times when humans will muck up the performance.”
