Pearl is a clinical professor of plastic surgery at the Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.
Many who follow the news about AI chatbots and their use in the medical field view it as a battle for supremacy between AI and physicians. But a careful analysis leads me to a different conclusion.
ChatGPT and other generative AI applications are becoming more powerful by the month. Recently, researchers organized a head-to-head contest between a chatbot and a group of physicians. The challenge: answer 195 medical questions from the r/AskDocs subreddit page. A team of independent healthcare professionals then reviewed the responses and crowned AI the clear winner.
Not only were AI-generated answers more accurate and detailed than those provided by physicians, but the bot’s responses were deemed significantly more empathetic, as well.
This AI triumph came not long after Google’s Med-PaLM 2 scored an expert-level 86.5% on the U.S. medical license exam and before ChatGPT learned to write clinical notes just as well as humans.
AI can now retain and recall a near-limitless corpus of knowledge, translate text into multiple languages and convert highly complex ideas into simple terms. These qualities make chatbots ideal for diagnosing rare diseases, offering 24/7 medical advice and improving communications with patients.
This should be viewed as great news for the healthcare industry and not as a threat to doctors. That’s because well-trained humans will always remain superior to machines in one vitally important area of medical care: Only humans can establish personal relationships built on a foundation of mutual trust and commitment.
This is a critical component of good healthcare and the best weapon in the fight against our nation’s most troublesome medical problem. Chronic disease is the nation’s leading cause of death and disability, affecting 60% of all Americans. Studies affirm that a combination of preventive care, early diagnosis and lifestyle change (diet, exercise, counseling, etc.) helps people avoid heart attack, cancer and stroke (the life-threatening complications of asthma, diabetes, hypertension and obesity and other chronic illnesses).
Communicating lifestyle and preventative care changes to a patient demands a doctor’s focused and unhurried attention—something few primary care physicians can provide today. It’s not for lack of trying or desire. Rather, the U.S. medical system doesn’t train or retain enough primary care physicians and it inadequately finances the ones it has.
Of course, one important solution is adding more primary care physicians given that the primary care workforce declined by 11% from 2005 to 2015. And, despite the worsening chronic disease epidemic, our nation spends just 6% of total healthcare dollars on primary care—a figure that hasn’t budged in two decades. This, despite a Harvard-Stanford research collaboration that found adding 10 primary care physicians to a community increases average life expectancy by 250% when compared to adding 10 specialists.
Generative AI can help people solve these problems.
Doctors are constantly battling the clock as they see more and more patients each day. The average office visit is down to 17.5 minutes, barely enough time to order tests and prescribe medications, let alone build trust, show empathy or discuss lifestyle improvements. It shows. Today, 60% of Americans feel their doctors are rushing through exams. An equal percentage of primary care doctors feel burned out, citing “increased workload” as a leading cause.
Sophisticated generative AI applications can complete some of the primary care physician’s more routine work so that doctors will have the time to do what they do best: provide the unhurried care that chronically ill patients so badly need.
The U.S. government must lead the way when it comes to protecting our nation’s health. Accomplishing that will require investments in both humans and machines. Here are three opportunities:
1. Reallocate dollars to primary care
The U.S. Department of Health and Human Services (HHS) maintains a $2.68 trillion budget for Medicare and Medicaid. A scant 2% to 5% of that spending goes toward primary care services. Bumping that allocation to 8% would allow doctors to add vital support staff— assistants, dieticians and health coaches— thus boosting expertise, giving doctors more time to build trust with patients and helping reverse our nation’s chronic disease burden.
2. Increase residency positions
The United States faces a projected shortage of up to 48,000 primary care physicians by 2034. Yet, last year, more than 1,000 doctors graduated from medical school without a residency match. That’s because there weren’t enough government-sponsored training positions available. Congress can fix this problem by funding 1,000 more primary care positions each year—a tiny expenditure that would pay for itself within a couple of years with reduced medical expenses from chronic illness.
3. Invest in AI expertise
Doctors are starting to use generative AI for everyday tasks: writing letters to insurers, transcribing notes, double-checking diagnoses and populating medical records. These robotic undertakings help free up valuable time for doctors to spend with patients. But the pace of adoption is slow. With a small investment (like the $35 billion Congress earmarked for the “meaningful use” of electronic health records in 2009), the U.S. government would accelerate the development and implementation of safe and effective AI tools for primary care.
This combination of increased training, added office support and AI assistance will help rebuild the doctor-patient relationship, address our nation’s chronic disease epidemic and improve the failing health of America. It’s naïve to believe that relying on machines or doctors alone will be enough.
A golden tray sits on the Resolute Desk as President Donald Trump speaks during an announcement on American nuclear innovation in the Oval Office at the White House on July 24, 2026, in Washington, D.C. Trump is signing multiple executive orders targeting the nuclear energy sector and easing rules for new reactors and nuclear fuel supply chains.
Trump’s hubris rivals the fallen heroes of ancient Greek mythology
In January, the New York Times asked President Donald Trump if there were any limits on his global powers.
“Yeah,” the president responded, “there is one thing. My own morality. My own mind. It’s the only thing that can stop me.”
That was eight months ago, but fortunately Christopher Nolan’s blockbuster adaptation of “The Odyssey” has made ancient Greek literature newly relevant. Before that window closes, I’d like to talk about hubris.
Today, the term mostly means excessive pride or arrogance. That’s part of what the Greeks meant by it too, but the meaning was a bit richer and more specific. Hubris was an insolent or outrageous act that offended the gods, often because the transgressor was claiming abilities or authorities that solely belonged to supreme beings.
Nolan renamed and slightly modified the concept of xenia for the film, calling it “Zeus’ law.” In the director’s telling, mortals should follow the rules laid out by the gods, specifically the requirement to treat strangers with respect lest they be gods in disguise.
In a sense, hubris is the opposite, or at least the rejection, of xenia. The hubris of the suitors, and at times Odysseus himself, invites punishment by the gods and their mortal instruments.
Which brings me back to Donald Trump. His claim that there are no constraints on his personal power to dictate events on the global stage was one of the greatest expressions of hubris ever uttered by a political leader.
Trump’s claim was obviously false when he made it.
He vowed that he could end the Russia-Ukraine war in 24 hours. He’s proved powerless to make that happen. If he had divine powers to work his will, why would he have balked at implementing his tariffs so often that Wall Street adopted the “TACO trade” term for his deals? “TACO” stands for “Trump always chickens out.”
And why would Trump have made so many embarrassing concessions to China — from rescinding tariffs on Chinese goods to allowing them to buy crucial and incredibly valuable computer chips?
But Trump saw his success at capturing Venezuelan strongman Nicolas Maduro as proof of his ability to launch missiles to the same effect as Zeus’ lightning bolts. Trump believed he was the most powerful man who ever lived.
This is no exaggeration. In March, when the Iran invasion seemed successful, Trump gave a document penned by“Presidential Historian David King” to New York Times reporters Maggie Haberman and Jonathan Swan purporting to prove that Trump was “the most powerful person to have EVER walked this planet.” King was, in fact, a businessman and occasional caddy for legendary golfer Gary Player.
King compared Trump favorably to many of history’s most powerful, and often heinous, figures: Alexander the Great, Attila the Hun, William the Conqueror, Napoleon Bonaparte, Joseph Stalin, Genghis Khan, Mao Tse Tung, Adolf Hitler and Vladimir Lenin. Many of these men thought they were the most powerful person in the world, too. And many were defeated precisely because they believed it.
At least Napoleon and Hitler had a string of truly impressive victories before they learned the folly of hubris. The limits on Trump’s power have been exposed by far less august forces than the combined might of the allies in World War II or the fearsome Russian winter.
Iran is a comparatively middling power. But the regime’s ability to absorb punishment while imposing its will on the Strait of Hormuz has proved to be a greater constraint on Trump’s power than his morality or mind. We should note that, at least rhetorically, his morality has not proved much of a constraint. He has repeatedly promised to destroy Iranian “civilization” if the regime refuses to capitulate.
But they haven’t — and won’t anytime soon — because the regime’s tolerance for pain far outstrips Trump’s. The combined fear of skyrocketing oil prices, outrage of Gulf state potentates, diminishing weapon supplies and domestic unpopularity is doing the work that international law, congressional oversight and the collective opinion of foreign policy experts can’t or won’t do.
If I considered Trump more heroic than reason and facts could allow, I would say his Sisyphean predicament has the whiff of Greek tragedy to it. Trump is vexed by the fact that the Iranians won’t honor deals or ratify his countless premature claims of victory — giving new meaning to his vow that his presidency would make people tired of winning. It’s almost like they’re out-Trumping Trump.
Things might have gone better if he’d heeded that great Greek tragedian Sophocles: “For Zeus utterly abhors the boasts of a proud tongue.”
____
Jonah Goldberg is editor-in-chief of The Dispatch and the host of The Remnant podcast. His Twitter handle is @JonahDispatch.