Op-ed: Gottlieb says A.I. may take on doctors’ roles sooner rather than later
Dr. Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing startup Tempus, health-care tech company Aetion Inc. and biotech company Illumina. He is also a partner at the venture capital firm New Enterprise Associates.
Researchers at Harvard presented a study demonstrating an achievement that would challenge any medical student. ChatGPT, a large language model, passed the U.S. Medical Licensing Exam, outperforming about 10 percent of medical students who fail the test annually.
related investing news
The inevitable question isn’t so much if but when these artificial intelligence devices can step into the shoes of doctors. For some tasks, this medical future is sooner than we think.
To grasp the potential of these tools to revolutionize the practice of medicine, it pays to start with a taxonomy of the different technologies and how they’re being used in medical care.
The AI tools being applied to health care can generally be divided into two main categories. The first is machine learning, which uses algorithms to enable computers to learn patterns from data and make predictions. These algorithms can be trained on a variety of data types, including images.
The second category encompasses natural language processing, which is designed to understand and generate human language. These tools enable a computer to transform human language and unstructured text into machine-readable, organized data. They learn from a multitude of human trial-and-error decisions and emulate a person’s responses.
A key difference between the two approaches resides in their functionality. While machine learning models can be trained to perform specific tasks, large language models can understand and generate text, making them especially useful for replicating interactions with providers.
In medicine, the use of these technologies is generally following one of four different paths. The first encompass large language models that are applied to administrative functions such as processing medical claims or creating and analyzing medical records. Amazon’s HealthScribe is a programmable interface that transcribes conversations between doctors and patients and can extract medical information, allowing providers to create structured records of encounters.
The second bucket involves the use of supervised machine learning to enhance the interpretation of clinical data. Specialties such as radiology, pathology and cardiology are already using AI for image analysis, to read MRIs, evaluate pathology slides or interpret electrocardiograms. In fact, up to 30% of radiology practices have already adopted AI tools. So have other specialties. Google Brain AI has developed software that analyzes images from the back of the eye to diagnose diabetic macular edema and diabetic retinopathy, two common causes of blindness.
Since these tools offer diagnoses and can directly affect patient care, the FDA often categorizes them as medical devices, subjecting them to regulation to verify their accuracy. However, the fact that these tools are trained on closed data sets, where the findings in data or imaging have been rigorously confirmed, gives the FDA increased confidence when assessing these devices’ integrity.
The third broad category comprises AI tools that rely on large language models that extract clinical information from patient-specific data, interpreting it to prompt providers with diagnoses or treatments to consider. Generally known as clinical decision support software, it evokes a picture of an brainy assistant designed to aid, not to supplant, a doctor’s judgment. IBM’s “Watson for Oncology” uses AI to help oncologists make more informed decisions about cancer treatments, while Google Health is developing DeepMind Health to create similar tools.
As long as the doctor remains involved and exercises independent judgment, the FDA doesn’t always regulate this kind of tool. The FDA focuses more on whether it’s meant to make a definitive clinical decision, as opposed to providing information to help doctors with their assessments.
The fourth and final grouping represents the holy grail for AI: large language models that operate fully automated, parsing the entirety of a patient’s medical record to diagnose conditions and prescribe treatments directly to the patient, without a physician in the loop.
Right now, there are only a few clinical language models, and even the largest ones possess a relatively small number of parameters. However, the strength of the models and the datasets available for their training might not be the most significant obstacles to these fully autonomous systems. The biggest hurdle may well be establishing a suitable regulatory path. Regulators are hesitant, fearing that the models are prone to errors and that the clinical data sets on which they’re trained contain wrong decisions, leading AI models to replicate these medical mistakes.
Overcoming the hurdles in bringing these fully autonomous systems to patient care holds significant promise, not only for improving outcomes but also for addressing financial challenges.
Health care is often cited as a field burdened by Baumol’s theory of cost disease, an economic theory, developed by economist William J. Baumol, that explains why costs in labor-intensive industries tend to rise more rapidly than in other sectors. In fields such as medicine, it’s less likely that technological inputs will provide major offsets to labor costs, as each patient encounter still requires the intervention of a provider. In sectors such as medicine, the labor itself is the product.
To compensate for these challenges, medicine has incorporated more non-physician providers to lower costs. However, this strategy reduces but doesn’t eliminate the central economic dilemma. When the technology becomes the doctor, however, it can be a cure for Baumol’s cost disease.
As the quality and scope of clinical data available for training these large language models continue to grow, so will their capabilities. Even if the current stage of development isn’t quite ready to completely remove doctors from the decision-making loop, these tools will increasingly enhance the productivity of providers and, in many cases, begin to substitute for them.
Anne Wojcicki attends the WSJ Magazine Style & Tech Dinner in Atherton, California, on March 15, 2023.
Kelly Sullivan | Getty Images Entertainment | Getty Images
23andMe CEO Anne Wojcicki and New Mountain Capital have submitted a proposal to take the embattled genetic testing company private, according to a Friday filing with the U.S. Securities and Exchange Commission.
Wojcicki and New Mountain have offered to acquire all of 23andMe’s outstanding shares in cash for $2.53 per share, or an equity value of approximately $74.7 million. The company’s stock closed at $2.42 on Friday with a market cap of about $65 million.
The offer comes after a turbulent year for 23andMe, with the stock losing more than 80% of its value in 2024. In January, the company announced plans to explore strategic alternatives, which could include a sale of the company or its assets, a restructuring or a business combination.
23andMe has a special committee of independent directors in place to evaluate potential paths forward. The company appointed three new independent directors to its board in October after all seven of its previous directors abruptly resigned the prior month. The special committee has to approve Wojcicki and New Mountain’s proposal.
“We believe that our Proposal provides compelling value and immediate liquidity to the Company’s public stockholders,” Wojcicki and Matthew Holt, managing director and president of private equity at New Mountain, wrote in a letter to the special committee on Thursday.
Wojcicki previously submitted a proposal to take the company private for 40 cents per share in July, but it was rejected by the special committee, in part because the members said it lacked committed financing and did not provide a premium to the closing price at the time.
Wojcicki and New Mountain are willing to provide secured debt financing to fund 23andMe’s operations through the transaction’s closing, the filing said. New Mountain is based in New York and has $55 billion of assets under management, according to its website.
23andMe declined to comment.
WATCH: The rise and fall of 23andMe
Hims & Hers
Shares of Hims & Hers Health tumbled more than 23% on Friday after the U.S. Food and Drug Administration announced that the shortage of semaglutide injection products has been resolved.
Semaglutide is the active ingredient in Novo Nordisk‘s blockbuster weight loss drug Wegovy and diabetes treatment Ozempic. Those medications are part of a class of drugs called GLP-1s, and demand for the treatments has exploded in recent years. As a result, digital health companies such as Hims & Hers have been prescribing compounded semaglutide as an alternative for patients who are navigating volatile supply hurdles and insurance obstacles.
Compounded drugs are custom-made alternatives to brand-name drugs designed to meet a specific patient’s needs, and compounders are allowed to produce them when brand-name treatments are in shortage. The FDA doesn’t review the safety and efficacy of compounded products.
Hims & Hers began offering compounded semaglutide to patients in May, and it owns compounding pharmacies that produce the medications.
Compounded medications are typically much cheaper than their branded counterparts. Hims & Hers sells compounded semaglutide for less than $200 per month, while Ozempic and Wegovy both cost around $1,000 per month without insurance.
The FDA said Friday that it will start taking action against compounders for violations in the next 60 to 90 days, depending on the type of facility, in order to “avoid unnecessary disruption to patient treatment.”
“Now that the FDA has determined the drug shortage for semaglutide has been resolved, we will continue to offer access to personalized treatments as allowed by law to meet patient needs,” Hims & Hers CEO Andrew Dudum posted Friday on X. “We’re also closely monitoring potential future shortages, as Novo Nordisk stated two weeks ago that it would continue to have ‘capacity limitations’ and ‘expected continued periodic supply constraints and related drug shortage notifications.'”
Him & Hers’ weight loss offerings have been a massive hit with investors. Shares of the company climbed more than 200% last year, and the stock is already up more than 100% this year despite Friday’s move.
Even before it added compounded GLP-1s to its portfolio, the company said in its 2023 fourth-quarter earnings call that it expects its weight loss program to bring in more than $100 million in revenue by the end of 2025.
Despite the turbulent regulatory landscape, Hims & Hers has showed no signs of slowing down.
On Friday, the company announced it has acquired a U.S.-based peptide facility that will “further verticalize the company’s long-term ability to deliver personalized medications.” Hims & Hers will explore advances across metabolic optimization, recovery science, biological resistances, cognitive performance and preventative health through the acquisition, the company said.
That move comes just days after Hims & Hers also bought Trybe Labs, the New Jersey-based at-home lab testing facility. Trybe Labs will allow Hims & Hers to perform at-home blood draws and more comprehensive pretreatment testing.
Hims & Hers did not disclose the terms of either deal.
Technology
Tesla recalls more than 375,000 vehicles in U.S. due to failing power-assisted steering systems
Tesla models Y and 3 are displayed at a Tesla dealership in Corte Madera, California, on Dec. 20, 2024.
Justin Sullivan | Getty Images
Tesla is voluntarily recalling 376,241vehicles in the U.S. to correct an issue with failing power-assisted steering systems, according to records posted to the website of the U.S. National Highway Traffic Safety Administration.
In a safety recall report posted on the NHTSA website, Tesla said the recall includes Model 3 and Model Y vehicles that were manufactured for sale in the U.S. from Feb. 28, 2023, to October 11, 2023, and that were equipped with a certain older software release.
The records said printed circuit boards in the steering systems in affected vehicles could become overstressed, causing the power-assist steering to fail in some cases when a Tesla vehicle rolled to a stop and then accelerated.
When electronic power-assist steering systems fail in a Tesla, drivers need to exert more force to steer their cars, which can increase the risk of a collision.
Tesla told the vehicle safety regulator that it was not aware of any crashes, injuries or deaths related to the power steering failures, and that it was offering an over-the-air software update as a remedy.
The recall follows an earlier related probe and voluntary recall in China concerning the same systems.
President Donald Trump has appointed Tesla CEO Elon Musk to lead a team that is slashing the federal government workforce, and in some cases, regulations and entire agencies. Those cuts already affected the NHTSA, an agency Musk has long seen as standing in the way of some of his ambitions at Tesla.
The regulator has been engaged in a yearslong investigation into safety defects in the systems that Tesla markets currently as its Autopilot and Full Self-Driving (Supervised) options. The features do not make Tesla cars into robotaxis. They require a human driver ready to steer or brake at any time.
The Washington Post reported on Thursday that Musk’s team has led mass firings at the NHTSA, reducing the agency’s workforce and capacity to investigate companies including Tesla by about 10%.
Tesla didn’t respond to a request for comment.
-
Sports2 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports11 months agoStory injured on diving stop, exits Red Sox game
-
Sports1 year agoGame 1 of WS least-watched in recorded history
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports3 years ago
Team Europe easily wins 4th straight Laver Cup
-
Environment2 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years agoGame-changing Lectric XPedition launched as affordable electric cargo bike
-
Business2 years agoBank of England’s extraordinary response to government policy is almost unthinkable | Ed Conway