| While AI doctors aren’t here yet, the Trump administration is moving to integrate artificial intelligence into the nation’s health care system. The push is raising concerns among some physicians and researchers, reports Elizabeth Dwoskin in The Washington Post newsroom. Amy Gleason, leader of the U.S. DOGE Service — the government cost-cutting initiative initially led by billionaire Elon Musk — has been tasked with finding ways to embed AI throughout the health care system in her capacity as an adviser to Health Secretary Robert F. Kennedy Jr. → The administration is hailing the era of AI in medicine, touting it as the answer to the doctor shortage crisis, the chronic disease epidemic and other ills of the medical system. Gleason told Elizabeth that federal officials are working on a pathway to regulate independent AI doctors — comparing the transformation to the decades-long process that moved self-driving cars from test tracks to cities across the United States. - One of the administration’s plans is to offer more than $50 million in research awards to developers of conversational AI software that can deliver cardiovascular care, so that when a person calls a medical provider with symptoms of a heart attack, a chatbot might field the call.
→ The program is being supported by Anthropic, Amazon Web Services, start-ups Certuma and Doctronic, and several universities. (Amazon founder Jeff Bezos owns The Washington Post.) - Haider Warraich, a cardiologist with Boston Medical Center who is running the administration’s heart-disease research grant program, told Elizabeth the effort would create safety data to eventually set the stage for regulatory approval of AI doctors.
“It’s like we have all these new ‘medical students’ ready to graduate, but we don’t have a residency program, we don’t have attending [physicians] used to supervising them, [and] we don’t have an accreditation body that ensures a professional standard,” Warraich wrote recently on LinkedIn. “I do believe we can get there.” Why it matters: The changing attitude in Washington, coupled with rapid technological advances, is encouraging tech companies to sink tens of millions of dollars into AI systems that can read medical records and tell people how to act based on the information. And that information is in demand: About one-third of American adults say they’ve consulted AI chatbots for health advice in the last year, according to a KFF survey published in March. But while the evidence on medical chatbots remains mixed, some results point to the serious risks of relying on it. In a study published earlier this year, researchers at the Oxford Internet Institute found that leading AI chatbots correctly identified medical conditions just 34 percent of the time and performed no better than Google at guiding users to appropriate health decisions. BEYOND FEDERAL The Trump administration is also focused on supporting state efforts, including a pilot program in Utah that allows AI chatbots to refill prescriptions instantly. While there are humans overseeing the refill decisions, there are plans to make the program fully autonomous. → Meanwhile, the Cicero Institute, a think tank funded by right-leaning tech entrepreneur Joe Lonsdale, is pushing a bill that would allow states to create similar pilots. Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco, said studies such as the Utah pilot will provide valuable data to demonstrate whether medical tasks can be off-loaded to AI safely. But the bold claims of entrepreneurs can overstate the tech’s current capabilities, Wachter added, and gloss over kinks that could cause harm. “At some point there will be cases where we have given the AI a level of trust that it doesn’t yet deserve, and people will get hurt, and probably people will be killed,” Wachter said. You can “just feel the backlash growing.” Doctronic, which is partnering with Utah to run the program, raised $65 million over the past year. Co-founder Matt Pavelle now sees an opening from the federal government. “There’s a willingness to try new things in this administration that I have not seen in any other administration,” he told Elizabeth. POTENTIAL PITFALLS Many physicians, however, warn that AI’s limitations remain significant. → Although AI systems have passed medical licensing exams and excelled in some diagnostic tasks — such as diagnosing certain complex conditions — they often struggle with the messy realities of patient interactions. As Elizabeth put it: People don’t explain their symptoms to a chatbot the same way they would to a medical professional, and medical professionals also listen differently than software does. “People-pleasing impulses that plague chatbots can be even more dangerous in medical settings,” said Monica Agrawal, an assistant professor of biomedical engineering at Duke University who has conducted a large-scale study of chatbot responses to health-related questions on Reddit. For example, a separate Doctronic chatbot than the one in use in Utah was recently goaded by researchers into saying it would prescribe fentanyl. Pavelle, the company’s co-founder, said the drug was never prescribed because the system blocks requests for opioids. Read the full story: “Inside the Trump-backed push to bring AI doctors into American medicine.” What to watch: National medical organizations have endorsed some uses of artificial intelligence, preferring to call it “augmented intelligence” to signal that actual doctors should remain involved in patient care. But, as the technology advances and federal officials explore broader clinical roles for AI, an advocacy battle could emerge over where to draw the line between physician oversight and machine decision-making. A coalition of local governments and advocacy groups is asking a judge to pause Trump administration changes to the Affordable Care Act marketplaces, including efforts to expand access to catastrophic health plans with bare-bones coverage. The legal advocacy group Democracy Forward filed a lawsuit Wednesday on the coalition’s behalf to challenge new rules finalized by the Centers for Medicare and Medicaid Services (CMS) last month. The coalition — made up of Doctors for America, the Main Street Alliance, and the cities of Columbus, Baltimore, Chicago and Pima County, Arizona — is arguing that several provisions conflict with federal law, and were crafted “without observance of proper procedure, reasonable explanation, or meaningful response to public comments.” Regulators did not properly consider how the rule would harm millions of consumers who purchase health care on the Affordable Care Act marketplace, the suit alleges. The Department of Health and Human Services (HHS) didn’t respond to a request for comment about the lawsuit, which also names CMS, HHS, Kennedy and CMS Administrator Mehmet Oz. Alongside the lawsuit, the group then filed a motion Thursday to halt several portions of the rule while the case makes its way through the courts. They argue that the rule would impose new enrollment barriers, increase costs for consumers and reduce access to coverage before a final ruling on the merits can be reached. → The plaintiffs are asking the courts to temporarily pause several provisions of the rule, including its income-verification requirements, expanded access to catastrophic health plans that are cheaper but offer less robust coverage, and the new option to market nonnetwork plans that reimburse patients for medical services at fixed amounts instead of operating on traditional insurance networks. What to watch: There are still two ongoing lawsuits against some of the changes the Trump administration made to Affordable Care Act rules last year, including similar litigation filed by Democracy Forward. In August, a judge paused major elements of that rule while courts mull a decision, which could come at any time. Refresh your memory: WP Intelligence Lead Health Care Analyst Rebecca Adams detailed some of the potential implications of the proposal in March, and I wrote about the rules when they were finalized in May. “House bill rolls back food aid for pregnant women, children,” The Post’s Mariana Alfaro reports. “RFK Jr.’s Food Agenda Slowed by Rising Prices—and Government Pushback,” write Jesse Newman and Liz Essley Whyte at the Wall Street Journal. “Tiny HHS office tasked with protecting research participants’ safety is running on fumes,” reports Megan Molteni at STAT. “Trump’s next GOP loyalty test: Ending the changing of the clocks,” Politico’s Alex Gangitano and Kelsey Brugger write. “Acting FDA commissioner pledges to prevent political interference in rare disease meeting,” Zachary Brennan reports at Endpoints News. 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