Robert Wachter
Professor and chair of the Department of Medicine at UCSF who writes about patient safety, hospital medicine and technology in healthcare. Author of A Giant Leap (2026). Writes Pattern Recognition, a newsletter on healthcare AI.
Robert Wachter did not write this page.
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Our reading
The rise of AI in healthcare will lead to the dissemination of specific encoded values at scale.
Their wordsAs AI-enabled decision support becomes more robust, more persuasive, and perhaps even agentic, it will quietly encode one set of values and disseminate it at scale.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Our reading
AI's primary impact on healthcare costs will be through its influence on clinical decisions.
Their wordsBut AI's real impact on costs will come through its effect on clinical decisions.
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsAs these tradeoffs become explicit, we can expect a vigorous debate about rationing. And in the U.S., we can guarantee it will be politicized.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece
- 4 weeks earlier
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Their wordsThis means that the AI we already have is good enough to address many of our most important clinical problems.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Their wordsEven if not a single new model were released in the next few years, it would take that much time for healthcare to build sensible local governance, to agree on and adopt reasonable regulations, to work through the politics and changes in the payment system, to retool our training programs, and to see which of the hundreds of AI companies vying for a place in healthcare's ecosystem survive.
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsWhat I hope doesn't happen is that a general antipathy toward AI and AI companies bleeds into a slowdown in the implementation of healthcare tools that can - today - save lives, ease suffering, and improve the lot of both patients and clinicians.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece
- 3 weeks earlier
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Their wordsGiven a curated set of facts, AI will often outperform humans in diagnosis and management decisions - and we doctors may sometimes get in the way if we try to intervene.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Their wordsAll of this means that AI's diagnostic performance on a curated set of clinical facts should not be taken as compelling evidence that "Dr. AI" can replace actual doctors, who are experts in creating correct and useful problem representations.
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsI can imagine a system in which basic preventive and urgent care is provided quite competently - and less expensively and more conveniently - by AI, whereas more complex care, both clinical and emotional, is provided by humans.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece
- 3 months earlier
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Our reading
The growing backlash against AI may profoundly affect the pace of AI implementation in medicine.
Their wordsBut there's no firewall between healthcare and the rest of our lives, and so the growing backlash may profoundly affect the pace of AI implementation in medicine.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Our reading
Healthcare may be the industry where AI has the greatest positive impact on the average person.
Their wordsConversely, healthcare may be the industry where AI has the greatest positive impact on the average person - meaning that AI executives should focus more on talking about it, while talking less about insider brass rings like achieving artificial general intelligence (AGI).
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsI believe the new AI will be good for health and healthcare, in part because the technology is remarkable and in part because the status quo is woefully lacking.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece
- 5 months earlier
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Their wordsMy prediction is that AI will lead to the loss of hundreds of thousands of healthcare jobs, but few of these will be among physicians, allied health professionals (AHPs), and nurses, at least in the next decade.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Their wordsThe displacement of human workers performing non-client-facing work - particularly entry-level workers - seems certain to be mirrored in every knowledge-based field, such as accounting, consulting, law, and software development.
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsFor the foreseeable future, it's more likely that AI and robots will assist nurses in performing their jobs more effectively - enabling them to practice closer to the top of their license - than replace those jobs entirely.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece
- 2 weeks earlier
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Their wordsHealthcare AI will realize its full transformative potential, even though most healthcare AI start-ups will fail.
↗Robert Wachterrobertwachter.substack.com 1st of 3 in this piece
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Their wordsthe growth of AI in healthcare will ultimately track with the technology's transformative capabilities.
↗Robert Wachterrobertwachter.substack.com 2nd of 3 in this piece
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Their wordsin healthcare at least, today's AI boon is built on too solid a foundation to sink entirely.
↗Robert Wachterrobertwachter.substack.com 3rd of 3 in this piece