What Values are in AI? A Conversation with Dr. Zak Kohane
From NEJM AI Grand Rounds by NEJM Group
December 17, 2025 · 1h 18m · Episode 37
About this episode
Dr. Zak Kohane discusses the personal and practical implications of AI in healthcare, emphasizing the importance of understanding the values embedded in AI models.
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…
People in this episode
Guest: Dr. Zak Kohane
Topics covered
- AI in healthcare
- clinical data
- diagnostic uncertainty
- EHR
- reimbursement
- ambient documentation
- patient values
Keywords
- AI
- healthcare
- EHR
- diagnostic uncertainty
- reimbursement
- ambient documentation
- patient values
- bias
- clinical expertise
- technical transparency
Mentioned in this episode
Organizations: NEJM Group
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