Be Curious, Not Judgmental
Ruminations and musings about healthcare AI, technology, and strategy
Category: Business
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Your Gut is a Value Function
Tim Cook once said the most important lesson he learned at Apple was to listen to his gut. That stuck with me, mostly because I had to learn it the hard way myself. Early in my career, I thought “trust your gut” was code for “I don’t have the data.” But over time, I learned to listen to my gut, just like Cook describes doing at pivotal points of his… Read more
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Strategy in the Age of Infinite Slop
“AI is going to replace McKinsey.” It’s a popular dunk on AI Twitter. The logic is seductive: if a model can generate a Porter’s Five Forces diagram and a perfectly serviceable deck in seconds, why pay millions for a team of human analysts to take six weeks? I spent more than ten years at McKinsey working on the exact problems assumed to be next on the chopping block: the ultimate… Read more
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How AI Gets Paid Is How It Scales
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Almost ten years ago at Apple, we had a vision of how care delivery would evolve: face‑to‑face visits would not disappear, virtual visits would grow, and a new layer of machine-based care would rise underneath. Credit goes to Yoky Matsuoka for sketching this picture. Ten years later, I believe AI will materialize this vision because of its impact on the unit economics of healthcare. Labor is the scarcest input in… Read more
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When AI Meets Aggregation Theory in Healthcare
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Epic calls itself a platform. And with the show of force at UGM last week, that’s exactly how the company now describes itself: inviting vendors to “network with others working on the Epic platform,” marketing a “cloud‑powered platform” for healthcare intelligence, and selling a “Payer Platform” to connect plans and providers. Even customer stories celebrate moving to “a single Epic platform.” But is Epic really a platform? The TL/DR is… Read more
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Don’t Believe the Hype — Medical Superintelligence Isn’t Here Yet
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The AGI hype is in full effect with new frontier model achievements every month and an arms-race for AI talent heating up. Last week, Elon claimed Grok 4 was “better than PhD level at everything,” with a record score on Humanity’s Last Exam and best ever on ARC-AGI-2. Google had its own announcement with MedGemma-27 B (multimodal) hitting 87.7 percent on MedQA; Microsoft had already pitched its Medical AI Diagnostic Orchestrator… Read more
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DOGE & #MakeAmericaHealthyAgain
Some personal opinions on what DOGE and #MakeAmericaHealthyAgain could do to reshape U.S. healthcare. The HHS budget is ~$1.8 trillion, ~23% of the federal budget as proposed for FY25; CMS makes up the lion’s share of the budget (>80%). Hard to imagine reducing the deficit without major changes in how healthcare is funded and delivered. In this table from the Dec 2022 OMB analysis of options to reduce the deficit,… Read more
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Fad or trend?
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Many of you are probably not old enough to remember, but there was a brief time when pet rocks were a craze and sold out in stores across the country. There have been many fads throughout history, from tulip mania to Garbage Pail Kids. When you are in the middle of a fad, it can be hard to tell that this thing that everyone is crazy about is here to… Read more
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The Ricky Bobby School of Strategy
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If you ain’t first, you’re last Ricky Bobby, Talladega Nights: The Ballad of Ricky Bobby Talladega Nights is an old Will Ferrell comedy (also starring Sacha Baron Cohen of Borat fame) about a NASCAR racer who loses his mojo after a crash and learns to regain his passion again after connecting more deeply with friends and family. Ricky Bobby’s estranged father imparts the above words of racing wisdom to an… Read more