Bob Wachter

Produce better outcomes for patients, lower costs, and add some relief for beleaguered doctors and nurses.

Then you say, however, that the success of all this will depend on history, politics, economics, pride, regulations, leadership, lawsuits, guilds, culture, workflows, inertia, greed, hubris, vibes, and zeitgeist, as much as biographical processing units, diffusion models, and neural networks.

In other words, the tech can work, but then we get those layers of people who may feel that their realms are being infringed upon.

So...

The way you describe it there, it sounds like what some people like to call a wicked problem, which is basically unsolvable because there are so many constituencies and so many of those constituencies have incentives that are cross-purpose with the other constituencies.

So when you take a look at the big picture, how much optimism do you have?

Do you think that the upsides of this technology will be able to be successfully integrated into healthcare delivery itself?

Or do you think that AI becomes yet another piece of the mess that is the U.S.

healthcare system?

I would interpret that very, very, very long sentence as saying it's not just about the power of the incumbents, although it's a very real part of it.

It's about the complexity of medicine.

It's about the regulatory environment, which, for important reasons—

says there are certain things that we're going to restrict people's ability to do or require that a human does it rather than a bot.

It just says that this technology can be really, really spiffy and still not deliver because so much of it depends on humans and their systems and their governance and their culture.

and their own self-interest.

I hearken back to the old Yogi Berra-ism.

In theory, there's no difference between theory and practice, and practice there is.

I think that's what we're going to see.

In practice, that's where the rubber is going to hit the road here.

I think it's going to be net very positive.