Don't Compare It To The Almighty. Compare It To The Alternative

“Better than it is today” is the real baseline for clinical technology

Do you feel like there is a persistent disconnect in healthcare where the people who design the systems don’t talk enough to the clinicians doing the actual work? They talk to each other instead, trading ideas, insights, and predictions on insider podcasts, in investor memos, and inside essays that never reach the clinical frontline.

For clinicians, understanding these high-level system trends and financial models is a major competitive advantage. Gaining this “systems knowledge” positions you to advance your career anywhere in healthcare, whether that means stepping into executive leadership or driving high-value initiatives within your present clinical role for your current employer.

Right now, tech investors like Marc Andreessen and Ben Horowitz write influential essays on how AI should reshape medicine, while federal policymakers at CMS draft thousands of pages of payment regulations. More and more, industry insurgents see the value in debating these massive shifts publicly so that anyone paying attention can learn.

That is exactly why I write this newsletter. I invest the time to track these policies and synthesize what is being said across all of these different venues. By mixing my own policy expertise with these public signals, I can often identify what actually matters long before it becomes conventional wisdom. I do the heavy lifting to translate these complex trends so that busy clinicians can build the systems literacy they need to level up their careers.

This week, two pieces of content I consumed stood out. One came from deep inside clinical medicine, and the other came from the venture capital side. They approach AI from completely different angles yet land in nearly the exact same place. When a crossover like that happens, it deserves our attention.

The underlying theme of both pieces brings to mind a favorite political maxim of Joe Biden, a line he frequently used on the campaign trail: "Don't compare me to the Almighty, compare me to the alternative."

When it comes to deploying technology on the medical frontline, demanding absolute perfection from digital tools is a trap. The real baseline we should be measuring against isn't a flawless utopia; it is simply the reality of the alternative we are working in right now.

Dr. Bob Wachter on "Healthcare is Hard: A Podcast for Insiders" (hosted by Keith Figlioli)

I first caught wind of this discussion on the Healthcare is Hard podcast last week, where Dr. Bob Wachter spent nearly an hour breaking down what technology is actually doing to medicine. If you aren't familiar with him, he is the UCSF physician who coined the term "hospitalist" and has spent 15 years studying digital health.

His perspective is incredibly grounding for anyone feeling overwhelmed by the constant noise around AI. Here is what matters for your day-to-day work:

• "Better than today" is the right bar, not perfection. If you are already expected to digest a massive chart in minutes and keep pace with an endless flood of literature, tools that summarize and support—even imperfectly—are a massive step forward. The real risk isn’t flawed technology; it is letting a few headline mistakes halt progress that is fundamentally helpful.

• Electronic health records were just the floor, not the ceiling. Up until now, electronic records have felt like a burden. But their actual purpose was to build the digital foundation so that truly useful tools could finally emerge.

• Patients are already changing the dynamic. Patients are arriving at appointments with AI-generated symptom maps and second opinions. This shifts the dynamic of the visit and adds pressure to already tight time slots.

• Primary care gets elevated. He frames AI as a "specialist in your pocket," allowing primary care providers to manage much more complex cases natively.

Eric Larsen on Healthcare’s "Oppenheimer Moment"

The second perspective comes from a 369-page essay by Eric Larsen, President of TowerBrook Advisors. I first caught wind of this when I listened to his interview on the Heart of Healthcare podcast this week, which immediately sent me clicking over to read his full write-up. It reads like a field report from the middle of a storm, covering everything from economics to clinical tech.

You do not have to read all 369 pages to get the value out of it. In fact, if you want to absorb it during your commute or while folding laundry, you can use a free tool called Google NotebookLM to turn the entire PDF into a realistic, two-host audio podcast. All you do is upload the essay, click Audio Overview in the Studio panel, and hit Customize to tell it exactly what to focus on. Using a prompt like this works perfectly for our purposes:

"Focus on clinical AI, the liability arguments, the changing role of the clinician, and behavioral health. Emphasize practical implications for working clinicians. Skip the abstract history and geopolitics."

Select the Deep Dive option, and in a few minutes, you will have a customized audio conversation you can play on the go. You can even use the interactive mode to interrupt the hosts and ask follow-up questions.

(As a quick reminder on doing this responsibly: creating an audio version for your own learning is perfectly fine for personal use, but be sure to point colleagues to the original essay source if they want to generate their own copy.)

Whether you listen to it or scan it, or don’t have a chance to get around to either, here are my core takeaways specifically for clinicians, in two minutes:

• The biggest bottleneck right now is liability. The technology is already good enough in narrow areas. The real question is who agrees to carry the legal responsibility when using it. The organizations that step up and assume that liability will win the market. Once that happens, the standard of care flips. Using AI becomes the baseline protection, and not using it becomes the mistake, because if a clinician bypasses the tool and misses something the technology would have caught, they are suddenly legally exposed. 

• You become the clinical anchor, not the data entry clerk. Instead of losing hours to hunting down templates or copy-pasting notes, you step into the role of the expert evaluator. Your value shifts from doing the manual grunt work to verifying the accuracy of the tools—like auditing an AI-generated patient summary before it goes into the chart, validating a diagnostic recommendation against your own clinical judgment, or guiding how a communication model interacts with your patients. You are the final safety check that ensures the technology is clinically sound and safe. 

• The quickest win is in behavioral health. The near-term unlock is behavioral health, where AI's unlimited patience and availability meet a system that has been failing patients for decades.

Larsen is direct and critical of organized medicine, arguing that professional groups sometimes dress up self-protection as patient safety. It might make you uncomfortable, but it is worth engaging with anyway!

What This Means for Your Career

When a clinical insider like Wachter and an investor like Larsen describe the exact same trends from two completely different viewpoints, it means the shift is real.

The real risk to clinicians is not that AI will replace you. The risk is that the healthcare system moves slowly, and people outside the clinic will redraw the career landscape while you are busy focusing on your patients.

That is exactly why I write this weekly email. These insights should not be locked away in corporate board packets, podcasts meant for an investor audience, investor memos, or buried under layers of industry jargon that you do not have time to wade through. My job is to take those high-level signals, strip out the buzzwords, and translate them into exactly what they mean for your daily practice and your long-term career. The clinicians seeing patients every day are the ones whose roles are actually changing, and you deserve to see these shifts coming just as early as the people betting capital on them.

Understanding these high-level trends gives you options. The forces shifting our industry are opening up adjacent career paths that did not exist in the recent past, like clinical informatics, AI governance, product design, and strategic advisory roles. 

Also, you don’t have to leave your current employer or exit clinical practice to benefit from this. Simply building this literacy lets you drive practical, high-value projects right where you are, establishing a foundation for future career optionality. For example, instead of waiting for a corporate-mandated technology roll-out to disrupt your floor, you can volunteer to pilot a new clinical protocol or champion an efficiency initiative inside your own department. 

When you can look at a problem, like a bottleneck in patient discharge, and propose a workflow adjustment that uses existing tools to shave thirty minutes off the process, leadership is likely to listen. And it proves you understand how operational efficiency connects to the bottom line, repositioning you as a strategic leader.

If you’ve managed to pull off a workflow pilot or a small efficiency project in your own department, reply and tell me how you did it. I’d love to feature real frontline examples in a future essay!

Sources & further reading

The two pieces of content I referenced:

• 🎧 A Giant Leap for Healthcare: Dr. Bob Wachter on AI, Clinical Workflows and the Patient-Doctor Relationship — Healthcare is Hard: A Podcast for Insiders (hosted by Keith Figlioli), April 16, 2026 · 46 min. Listen to the episode · Browse the show

• 📄 Eric Larsen, Healthcare's Oppenheimer Moment: The Industrialization of Intelligence and the Future of U.S. Healthcare — TowerBrook Healthcare Institute, June 2026. The essay is circulated by TowerBrook (where he shares it), and can also be found in the show notes of this Heart of Healthcare episode. Also, hear him unpack the argument on The Heart of Healthcare's listener Q&A episode.

Referenced:

• Andreessen Horowitz (a16z) on AI in healthcare — Bio + Health hub · a strong single read: Julie Yoo, Why Will Healthcare Be the Industry That Benefits the Most from AI?

• CMS payment regulations — cms.gov

The tool for creating an audio overview of content:

• Google NotebookLM — notebooklm.google · Audio Overviews

*Disclaimer: All opinions and ideas expressed in this article are solely mine and none represent a recommendation or should be viewed as advisement of any kind to anyone to do anything.*