AI Has Human Doctors Asking: What’s Left for Us?

Don’t be fooled by the question mark in the title of an article published this month 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 begrudgingly 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,” they write. Those tasks include taking medical histories, establishing a diagnosis , identifying what tests are needed, prescribing treatment , and managing chronic diseases. You know, doctoring . AI is now so good, they argue, that clinicians should refrain from meddling, because “humans in the loop degrade AI performance.” Stand back, doc, and let AI do its thing. Which used to be your thing.

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?”(again, rhetorical) and penning a 101-page treatise in 2016 to that effect. “I said bullshit, there’s no way,” says Emanuel. “What doctors do is too complicated.”

But about a year ago, Emanuel’s friend Robert Wachter sent him galleys of his book A Giant Leap , where Wachter, who is head of medicine at UCSF, outlined a world where first-class medicine would be a collaborative process between AI and doctors, but the masses in “economy class” would mostly make do with AI alone. Emanuel began to think that Khosla might be right. He suddenly flashed on a frightening question: “If AI takes over, what’s left for doctors to do?”

First he needed to validate the premise. He asked Khosla to collaborate, and the VC suggested that his son Neal Khosla join the effort, along with Emanuel’s researcher. Neal runs Curai Health , an online company that uses AI to treat patients, with a staff of doctors to prescribe medicine and handle more complicated issues. (This conflict of interest is disclosed in the paper, along with Vinod Khosla’s relevant investments and Emanuel’s various grants and consultancies.) The coauthors 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.”