My new Substack: Will AI Rescue Primary Care?
Why AI-enabled solutions have mostly failed to solve the primary care crisis, and my hope/prediction that the endgame will likely be a new two-tiered system that increasingly relies on AI for basic care needs.
robertwachter.substack.com/p/will-ai-re...

Just 1 month until my 29th (!) annual Management of the Hospitalized Patient CME course in SF, Oct 30-Nov 1. Great topics (mostly clinical, for hospitalists & others who care for inpatients), awesome faculty. Co-sponsored by SHM.
Hope you can make it!
managementhospitalizedpatient.ucsf.edu

My latest Substack: As OpenEvidence sprinted past UpToDate to become medicine's best AI-enabled point-of-care tool, I've been waiting for UTD's response. Now it's here, raising fascinating questions about which knowledge base should be our source of truth.
robertwachter.substack.com/p/medicines-...

Everyone hates prior auth, so I was surprised last month when Medicare rolled out a new prior auth program. AI can solve the prior auth mess–but it means replacing our fax-based system with AI-powered chart reviews. My new Substack on how this could work.
open.substack.com/pub/robertwa...

To me, understanding the "Productivity Paradox" is vital for appreciating why digitizing healthcare has been so hard, why the EHR has been so fraught, and why AI in medicine will be bumpy (but positive in the end).
Great explainer by @johncassidysays.bsky.social www.newyorker.com/news/the-fin...

My book on healthcare AI, "A Giant Leap" (sites.prh.com/agiantleapbook), is still a few months out, but it's a thrill to receive endorsements from early readers.

Here are a couple of new ones, from two of my heroes: ‪@zekeemanuel.bsky.social‬ and Peter Lee from @microsoft.com

I loved (and agree with) today's @axios piece on AI. The big thought:
"[Leaders] with the most insight, power & money share the AI obsession. The topic is daunting, sprawling, occasionally scary & often eye-popping. It's worthy of your time to start obsessing." www.axios.com/2025/09/02/a...

More on AI-induced deskilling – terrific piece in today's @nytimes.com by Teddy Rosenbluth, with thoughts by @adamrodmanmd.bsky.social, Chris Longhurst, and me on implications, and how to – and whether we need to – mitigate the loss of skills. www.nytimes.com/2025/08/28/w...

My newest Substack post: in light of the Lancet study that found deskilling after brief use of AI-colonoscopy, I discuss AI-based deskilling in medicine, how other industries handle it, and why we're not asking the right questions. Don't forget to subscribe (free). open.substack.com/pub/robertwa...

Very exciting to see the endorsements ("blurbs") begin to roll in for my upcoming book, "A Giant Leap: How AI is Transforming Healthcare and What That Means for Our Future" (Portfolio/Penguin Books, Feb 3, 2026).
Three of them – from John Halamka, Sherry Turkle, and Vinod Khosla - below. Thanks!

In my new @SubstackInc, I tell the story of AI scribes – why starting with scribes was a wise choice for both health systems & start-ups; how scribes went from gee-whiz innovation to commodity in 2 years; & why scribes need to be just the start of the AI journey.
open.substack.com/pub/robertwa...

My book on AI and Healthcare, "A Giant Leap," is still 6 months out. But there's too much happening not to start a Substack.
Every month, I'll cover the key trends in AI-meets-healthcare: clinical, tech, business, ethics. More forest than trees. Subscribe: open.substack.com/pub/robertwa...

I appreciate @Medscape featuring me as one of its "visionaries" in its "Medscape 2050: The Future of Medicine" series.
I weigh in on various aspects of AI-meets-healthcare in short videos.
www.medscape.com/viewarticle/...

We've lost another healthcare giant: Lucian Leape, the father of the modern patient safety movement and a person of remarkable character & integrity.
My wife @katiehafner wrote his @nytimes obituary – it rightly highlights both his impact & his courage. www.nytimes.com/2025/07/01/h...

While early studies showing #genAI passing MD license/board tests & "showing" empathy were cool, the @Google AMIE study & new @Microsoft diagnosis study arxiv.org/abs/2506.22405 make clear that AI will beat physicians in diagnosis. We'll still need docs, but this'll change our work & training.

Thrilled to see my book on healthcare Al available for preorder! sites.prh.com/preview/6f5c...
I tried to cut through the hype, with stories & insights on everything from scribes to surgery, hallucinations to misinformation, med education to regulation. Plus "Will there be doctors?"@portfoliobooks

With great sadness, I note the death of my friend & colleague Holly Humphrey, CEO of @macyfoundation. Holly's career was a model of integrity, grace, and joy, and her influence on medical training – and thousands of trainees – was profound. Rest in peace.
macyfoundation.org/news-and-com...

The end of AHRQ (@AHRQNews) is a blow to the safety & quality fields.
I also just learned of the demise of AHRQ PSNet, which my @UCSF team & I launched ~20 years ago as the go-to federal patient safety resource, before handing it off to our friends @ucdavis for the past 6 years. RIP.

Happy 10th anniversary of ACGME-accredited CI fellowships! Scroll through this thread from @ramankhannasf.bsky.social, DoC-IT’s CI fellowship director, for more on our program and fellows!

@amiainformatics.bsky.social @julia-adler-mils.bsky.social @bobwachter.bsky.social

So thrilled to welcome this extraordinary group of 64 young physicians to @UCSF and @UCSFimresidency. A great day!

(UCPC=UCSF Health-based primary care program; SFGH=San Francisco General-based primary care; PSTP=physician-scientist training program) @UCSFIMChiefs @UCSFDOM

Yesterday, two of my healthcare heroes passed away – both brilliant, insightful & very funny.
Jim Reason, the UK psychologist whose "Swiss cheese model" helped define the field of patient safety;
And Ian Morrison, the Scottish futurist who explained healthcare with unmatched wit & wisdom.
RIP.

It was an honor to give the yearly Lundberg Institute lecture at the Commonwealth Club of California. My topic: "AI in Healthcare: Will the Reality Match the Hype." On YouTube here:
www.youtube.com/watch?v=Bz1e...