Physician in the Loop

AI will soon give clinicians in much of the world a specialist's knowledge for free. Poor and rural patients will gain only if someone supplies the tests, drugs, specialists and money it calls for.

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Physician groups reject claim AI is better informed than doctors; FTC probes OpenAI, Anthropic; Pennsylvania House passes health AI bill; Alabama law takes effect

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Six national physician groups said Sept. 30 that claims artificial intelligence is better informed than physicians diminish physician expertise and risk undermining patients' trust, after the health secretary praised AI second opinions at a summit.

The American Medical Association, the American College of Surgeons, the American College of Obstetricians and Gynecologists and three other groups issued the joint statement after Health and Human Services Secretary Robert F. Kennedy Jr. told the Make America Healthy Again Summit that AI offers a second opinion "much better informed than any doctor in the country," Medical Economics reported. The Federal Trade Commission confirmed an investigation of OpenAI, Anthropic and other AI companies over possible consumer harms.

In the states, the Pennsylvania House passed a bill requiring hospitals and physician offices to disclose AI use to patients and insurers to have a clinician review AI-assisted denials, and an Alabama law requiring a physician or other clinician to make prior authorization denials took effect Oct. 1. AdventHealth opened OpenEvidence to its clinical staff, and HHS launched four programs to bring AI into clinical trials.

In this episode

• Six physician groups say claims that AI is better informed than doctors diminish physician expertise and risk patients' trust
• FTC confirms investigation of OpenAI, Anthropic and other AI companies over possible harms from their products
• Pennsylvania House passes HB 1925, 144-59, requiring AI disclosure to patients and clinician review of AI-assisted coverage denials
• Alabama law requiring a physician or other clinician to make AI-assisted prior authorization denials takes effect
• AdventHealth opens OpenEvidence to physicians, nurses, pharmacists and other clinical staff inside EHR workflows
• UC San Diego Health, Harvard and Anthropic build open-source monitor that checks patient-facing AI advice against a "clinical constitution"
• HHS launches four ARPA-H programs to speed clinical trials with AI, digital twins and agents; funding not disclosed

America's health secretary says AI is better informed than any doctor. Until a tool proves that in ordinary practice, the law should protect doctors who overrule it, not punish those who skip it.

Read the letter and its sources: https://physicianintheloop.org/letters/2026-09-28/

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Most hospitalists already use AI, and Epic is bringing more of it to the wards. The minutes it saves are few, and they belong to patients and doctors, not to a higher census.

Read the special topic and its sources: https://physicianintheloop.org/specials/hospitalists-and-ai/

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Newsom signs two clinical AI bills, vetoes AI therapy limits; autonomous AI clears skin referrals; ARPA-H funds ICU digital twins; UVA cuts scribe hours

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Gov. Gavin Newsom signed two bills Sept. 30 that protect licensed clinicians' judgment over clinical AI tools in California and vetoed two others, including one that would have limited AI in psychotherapy.

The signed bills, AB 1979 and SB 503, take effect Jan. 1, 2027, and apply to physician offices and group practices as well as hospitals. The vetoes ended AB 2575, which would have protected nurses and other clinicians who override AI output, and SB 903, which passed the Senate without opposition. In the United Kingdom, an autonomous AI system discharged a quarter or more of urgent skin cancer referrals at two hospitals without clinician review, and missed six cancers, according to a congress presentation.

The Advanced Research Projects Agency for Health funded critical care digital twins at the University of Vermont and Stanford and a Stanford monitor for autonomous cardiology agents. UVA Health cut emergency department scribe hours as its ambient documentation tool spread, the student newspaper reported, and the American Hospital Association asked senators to extend HIPAA-level standards to AI vendors and help rural hospitals hire cybersecurity staff.

In this episode

• Newsom signs AB 1979 and SB 503 on clinical AI, vetoes AB 2575's override protection and SB 903's limits on AI in psychotherapy
• Autonomous AI discharges 25% to 31% of urgent skin cancer referrals at two NHS hospitals, freeing about 8,500 appointments; six cancers missed
• ARPA-H awards up to $79.4 million for ICU immune digital twins and $14.9 million for a monitor of autonomous cardiology agents
• UVA Health cuts emergency department scribe hours after a one-third budget reduction as Microsoft's DAX spreads
• AHA asks Senate to hold AI vendors outside HIPAA to its standards and to fund cybersecurity staff for rural hospitals
• PHTI survey: 68% of employers and 55% of health plans tie digital health payments to performance; 71% of systems use AI documentation
• Family doctors who disclose AI use are rated less warm and less competent in 1,030-person vignette study, most among adults under 45
• Heidi releases agents that pre-chart schedules, draft referrals and sweep panels for overdue screenings, pending clinician approval
• Ortet launches as a health AI lab with a $500 million commitment from Thoreau and NYU's Kyunghyun Cho as CEO

Software can do much of an office visit, but the law cannot yet hold it responsible. States should license its operators, with a doctor reviewing its work until trials prove it safe.

Read the special topic and its sources: https://physicianintheloop.org/specials/practicing-without-a-license/

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Kennedy calls AI better informed than any doctor; McKinsey sees AI in up to 22% of outpatient claims; Oura postpones IPO; Penn Medicine adds OpenEvidence

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Health and Human Services Secretary Robert F. Kennedy Jr. told the Make America Healthy Again Summit in Washington on Sept. 29 that artificial intelligence can give Americans a second opinion better informed than any doctor.

Kennedy also said OpenAI CEO Sam Altman had told him it would be "malpractice" to diagnose without consulting AI, Forbes reported. A day earlier, McKinsey & Co. estimated that AI could perform the work behind 16% to 22% of U.S. outpatient claims, from low-complexity office visits to imaging interpretation. Smart ring maker Oura postponed its IPO on the eve of trading, and Penn Medicine opened OpenEvidence to 10,000 clinicians.

In California, Gov. Gavin Newsom's deadline to act on four health-AI bills, including limits on AI marketed as therapy, falls today. A University of Florida study found that five AI evidence-search tools each missed large shares of the published evidence on a clinical question.

In this episode

• Kennedy tells MAHA Summit that AI gives a second opinion "much better informed than any doctor in the country"
• McKinsey estimates AI could perform 16% to 22% of U.S. outpatient claims, including 5% to 7% that are imaging interpretation
• Oura postpones its Nasdaq IPO a day before trading was to begin, citing IPO market "uncertainty"
• Penn Medicine makes OpenEvidence available to 10,000 clinicians across its seven hospitals
• No AI evidence-search tool tested found 12% of a gold-standard evidence set; single queries often returned none of it
• Five-variable model predicts intractable hypoxemia during one-lung ventilation in repeat lung surgery with validation AUROCs of 0.75 to 0.78
• Cooper pilots Microsoft's Dragon Copilot for nurses in New Jersey after licensing it for more than 1,300 clinicians
• Newsom's deadline arrives on four California health-AI bills, including SB 903's limits on AI marketed as therapy
• Senate health committee schedules no vote on FDA nominee Heidi Overton; STAT reports vote waits until after midterms

Colorado funds rural tele-ICU with $169.6 million; coding vendors dispute insurers on AI costs; AI score predicts heart failure deaths; robot data flags surgical skill

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Colorado awarded $169.6 million on Monday to 91 rural health care providers for about 250 projects, including tele-ICU, telehospitalist and remote patient monitoring services, under the federal Rural Health Transformation Program, the state said.

The awards cover 52 rural or frontier counties and three rural census tract counties and were chosen from 112 eligible applications seeking more than $250 million, according to the state's Department of Health Care Policy and Financing. The same day, the Centers for Medicare and Medicaid Services announced $51 million for chronic disease prevention through 68 rural hospital districts and authorities in Texas. Neither announcement names an artificial intelligence project.

Makers of hospital coding software disputed insurers' finding that AI-assisted billing added $942 million in costs, Healthcare Dive reported. New papers in npj Digital Medicine describe an Oxford heart failure mortality score, a University of Pennsylvania CT model and a Japanese analysis of robot motion during prostate surgery. It was otherwise a quiet day for new developments.

In this episode

• Colorado awards $169.6 million to 91 rural providers for tele-ICU, telehospitalist, remote monitoring and other projects
• Coding software makers say AI captures missed services as insurers tie $942 million in added costs to hospital AI billing
• Oxford's 11-variable AI heart failure score predicts one-year death with C-index of 0.801 in 373,389 patients, above an adapted MAGGIC score
• Penn radiology team trains CT vision-language model on more than 400,000 scan-report pairs and tests it on 20,000 held-out people
• Robot motion data separate expert from less experienced surgeons in 98 robotic prostatectomies with an AUC of 0.892
• Remote blood pressure monitoring reached 5.2% of eligible patients at a Deep South health system; a few doctors made most referrals
• Optum Health names former AI scribe company chief Wes Donohoe CEO for AI and product innovation

The $10 billion a year goes to states, not hospitals. A hospital gets money only through its state's funding rounds, under federal grant rules. Technology, AI included, can qualify; care that insurers already pay for cannot.

Read the special topic and its sources: https://physicianintheloop.org/specials/rural-health-transformation-program/

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Medicare now pays technology firms for results, and a smart-ring maker will promote one of them to its members. Primary care deserves the same deal, or Medicare will pay twice for fragmented care.

Read the special topic and its sources: https://physicianintheloop.org/specials/access-primary-care/

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