OpenEvidence has revenue of $50 million - but a valuation of $6.1 BILLION. Question for all the “AI can’t replace doctors!” naysayers: What do *you* think OE’s long-term monetization pathway looks like? What are investors expecting will happen to justify this valuation?

Oh, sure - maybe the investors are just wrong. Maybe OpenEvidence will remain free for you and just keep selling ads. Maybe it’ll become a moderately-priced subscription service like UpToDate. (But those business models won’t generate the ROI that high powered investors want.)

Maybe OpenEvidence and every other AI company will stay in their lane and only provide “solutions” so you can work smarter and faster. Maybe you’ll sit at the helm of a vast AI-driven clinical enterprise as its indispensible middle man, just rolling in clinical revenue!

Or maybe… just maybe… these companies will see that instead of selling a service that is only worth as much marginal value as it provides to your practice, they could just cut out the middle man and go for a much bigger prize: Physician’s professional fees.

Right now, 8.6% of healthcare spending goes toward doctor compensation. This is a ~$430 BILLION dollar market. Whoever successfully disrupts it by making a bot that takes the professional fees won’t just be rich - they may become one of the richest people who has ever lived.

While there are *some* physician tasks that a bot can’t do well, *most* doctor decisions could be automated by AI (+/- a scribe, nurse, surgical tech, EMT, etc.).

And when I say these decisions could be automated - I don’t mean they could possibly be automated by some super-advanced, hypothetical AI system of the future. I mean they could be automated RIGHT NOW. The only thing keeping this from occurring now are the regulatory barriers.

Spare me the copium about how patients want real doctors (assuming costs are equal, right?), or the edge cases that a Super Doctor would handle (while ignoring the low functioning doctors already surpassed by LLMs), or the fact that AI hallucinates (as if human doctors don’t).

Spare me, also, the copes about how AI doctors require gold-standard evidence (this is a political decision, not Journal Club), or that liability/malpractice is an insurmountable obstacle (vs. a cost of doing business that all parties have incentives to work out).

But go ahead and try to make some other argument for why this won’t happen if you like. I’d love to believe you. But I probably won’t - because the prize is too large, and the regulatory barriers are already getting frayed.

Already, some politicians have proposed recognizing chatbots as prescribers under the FDA. https://www.congress.gov/bill/119th-congress/house-bill/238…

Meanwhile, the “doctor shortage” and looming Medicaid funding crises get media coverage every day. So what happens with a tech CEO approaches legislators and says, “I can fix these problems.”

“My Bot Doctors will see your Medicaid patients - and we’ll save taxpayers millions doing it. We’ll also serve the underserved where human doctors won’t. But we need NPI and DEA numbers; laws to let the bots work and require insurers to pay them; malpractice caps; etc., etc.”

Do the politicians say no? I don’t think so. But even if they do - right now - they won’t for long. The financial incentives are too great, and eventually the regulatory barriers will fall. Investors see it now.

If this isn’t enough of a rant for you, you can listen to more here: Yes, Doctors: AI Will Replace You https://youtu.be/kALDN4zIBT0

…with even more rebuttals of silly counterarguments here: PART 2: Yes, Doctors, AI Will Replace You https://youtu.be/Vfe-OthXmKw