NEJM AI Grand Rounds

Clinical AI only helps patients if clinicians and health systems trust it. Seth Hain describes how Epic is building foundation models that respect institutional autonomy, minimize burden, and prioritize safety. He discusses scaling laws in structured medical data, cautious deployment for clinical interventions, and why understanding causality—not just correlation—is essential. This conversation reframes AI not as disruption, but as infrastructure for safer, more reliable care. Transcript.

For Dr. Zak Kohane, this year’s advances in AI weren’t abstract. They were personal, practical, and deeply tied to care. After decades studying clinical data and diagnostic uncertainty, he finds himself building his own EHR, reviewing his child’s imaging with AI, and re-thinking the balance between incidental and missed findings. Across each story is the same insight: clinicians and machines make mistakes for different reasons — and understanding those differences is essential for safe deployment. In this episode, Zak also highlights where AI is spreading fastest, and why: reimbursement. While dermatology and radiology aren’t broadly using AI for interpretation, revenue-cycle optimization is advancing rapidly. Meanwhile, ambient documentation has exploded — not because it increases accuracy or throughput, but because it improves clinician satisfaction in strained systems. Yet the most profound theme, he argues, is values. Models already show implicit preferences: some conservative, some aggressive. And unlike human clinicians, no regulatory framework examines how those preferences form. Zak calls for a new form of oversight that centers patients, recognizes bias, and bridges clinical expertise with technical transparency. Transcript.

In this episode, Dr. Jonathan Chen joins the hosts to discuss his path from teenage programmer to Stanford physician-informatician and why machine learning has both thrilled and unnerved him. From his 2017 NEJM essay warning about “inflated expectations” to his latest studies showing GPT‑4 outperforming doctors on diagnostic tasks, Dr. Chen describes a discipline learning humility at machine speed. This conversation spans medical education, automation anxiety, magic, and why empathy—not memorization—may become the most valuable clinical skill. Transcript.

Dr. Jeremy Friese knows medicine from both sides. A practicing radiologist and technology executive, he’s seen firsthand how administrative burden undermines care. In this episode of NEJM AI Grand Rounds, he walks through the origins of prior authorization, explains why he believes artificial intelligence can close the gap between patients and payers, and argues that real reform means showing your work—just like in math class. At Humata, he’s combining human oversight, LLMs, and interoperability to try to fix a broken system. For clinicians overwhelmed by back-office complexity, this conversation offers both urgency and optimism. Transcript.

In this episode of NEJM AI Grand Rounds, guests Drs. Alan Karthikesalingam and Anil Palepu of Google walk co-hosts Raj Manrai and Andy Beam through the making and evaluation of AMIE, an AI system designed to conduct clinical conversations with patients. Alan and Anil explain how AMIE was trained using synthetic doctor-patient interactions generated by LLMs playing multiple roles—doctor, patient, critic, and moderator. They reveal how synthetic dialogue, guided by structured feedback and grounded in search, proved more effective than noisy real-world transcripts in building a model that could reason, ask questions, and show empathy. The discussion also covers what the “long tail” of medicine demands for building robust AI systems and how AMIE might one day augment real clinical workflows. Finally, Alan reflects on how AI has changed—and how it hasn’t—in the two years since he was last on the podcast. Transcript.

Dr. Faisal Mahmood, Associate Professor of Pathology at Brigham and Women’s Hospital and Harvard Medical School, joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds to explore the frontier of computational pathology. From pioneering foundational models for whole slide imaging to commercializing a multimodal generative AI copilot for pathology, Faisal shares how his team is redefining what’s possible in digital diagnostics. He discusses the power of open-source culture in accelerating innovation, his lab’s FDA breakthrough designation, and how generative AI could trigger widespread digitization in pathology. Faisal also reflects on his creative approach to problem selection and offers a vision for a future shaped by patient-level foundation models and agent-led computational biology. Transcript.

Dr. Emily Alsentzer joins hosts Raj Manrai and Andy Beam on NEJM AI Grand Rounds to discuss the evolution of natural language processing (NLP) in medicine. A Stanford faculty member and expert in clinical AI, Emily shares her journey from pre-med to biomedical AI, the role of language models in medical decision-making, and the ethical considerations surrounding bias in AI. The conversation explores everything from the early days of rule-based NLP to the modern era of large language models, the challenges of evaluating AI in clinical settings, and what the future holds for open-source medical AI. Transcript.

In this episode of NEJM AI Grand Rounds, hosts Raj Manrai and Andy Beam interview Larry Summers about artificial intelligence’s transformative potential and its implications for society. The conversation explores Summers’ perspective on AI as potentially the most significant technology ever invented, his role on OpenAI’s board following the November 2023 leadership transition, and his thoughts on how AI will reshape economics and human society. The episode provides unique insights into AI’s development trajectory, the challenges of technological prediction, and the intersection of economics and artificial intelligence. Transcript.

In this episode of NEJM AI Grand Rounds, hosts Raj Manrai and Andy Beam interview Dr. David Ouyang, a cardiologist and AI researcher at Cedars-Sinai Medical Center. The conversation explores Ouyang’s journey from medical training to AI research and entrepreneurship, his groundbreaking work in applying AI to cardiology imaging, and the challenges of bringing AI innovations from academia to clinical practice. Ouyang discusses his experience conducting randomized controlled trials (RCTs) for AI algorithms in echocardiography, the process of commercializing research through Y Combinator, and the hurdles in reimbursement for AI-based medical devices. The episode also delves into the future of AI in cardiology, the importance of clinician involvement in AI development, and the potential impact of large language models (LLMs) on medical practice. Ouyang shares insights on balancing clinical value with business considerations in health care AI and offers advice for researchers looking to conduct clinical trials for AI technologies. Transcript.

In this episode of NEJM AI Grand Rounds, hosts Raj Manrai and Andy Beam interview Dr. Vijay Pande, a general partner at Andreessen Horowitz (A16Z) where he leads investments in health care and life sciences. The conversation explores Pande’s journey from academia to venture capital, his views on the future of AI in health care and biomedicine, and insights into the investment landscape for biotech and health tech companies. Pande discusses the challenges and opportunities in integrating AI into medical practice, the potential for AI to democratize health care access, and his thoughts on the development of artificial general intelligence (AGI). Transcript.

In this episode of the AI Grand Rounds podcast, Dr. Adam Rodman shares his unique journey from a historian to a physician deeply interested in the intersection of medicine and artificial intelligence. He highlights his unconventional path, driven by an obsession with epistemology and nosology, and his early exposure to AI through historical references and personal experiences with language models. Rodman discusses the evolution of clinical reasoning, the importance of probabilistic models, the implications of AI in diagnostic processes, and details his work with large language models like GPT-4. He also reflects on the balance between the benefits and challenges of AI in medicine, emphasizing the necessity of collaboration between computer scientists and medical professionals. Throughout the episode, Rodman underscores the potential of AI to re-humanize medicine while cautioning against misapplications of the technology. Transcript.

In this episode of the AI Grand Rounds podcast, Dr. Daphne Koller charts her professional trajectory, tracing her early fascination with computers to her influential role in AI and health care. Initially intrigued by the capacity of computers for decision-making based on theoretical principles, Koller witnessed her niche area — once considered peripheral to AI — grow to dominate the field. Her curiosity led her from abstract theory to practical machine learning applications and eventually to the complex world of biomedicine. Throughout the podcast, Koller shares her shift from pure computer science to the integration of machine learning in biological and medical research. She explains the unique challenges of applying AI to biology, distinguishing it from more deterministic fields, and how these complexities feed into her work at insitro, where she is leveraging AI throughout the drug discovery and development process, from disease understanding to therapeutic application and monitoring. She advocates for the democratizing potential of AI, underscoring its capacity to enable broader participation in scientific inquiry and problem-solving. Transcript.