NEJM AI Grand Rounds

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.

As a cognitive psychologist, Dr. Laura Zwaan studies how humans make—and learn from—mistakes. In this episode of NEJM AI Grand Rounds, she brings that lens to AI, showing how machines inherit our biases and why both need transparency and reflection. From the challenge of defining diagnostic error to the promise of “machine psychology,” Dr. Zwaan explores how human reasoning can inform safer algorithms and better care. Her message is clear: the path to trustworthy AI begins with understanding ourselves.   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. Karandeep Singh brings two worlds together: programming and medicine. In this conversation, he explains how early experiments with code led him to biomedical informatics, why gaps between paper performance and clinical reality must be confronted, and how governance committees weigh ethics and safety. Now serving as Chief Health AI Officer at UC San Diego Health, he reflects on lessons from deploying sepsis prediction tools, the risks of hype, and the promise of integration. For clinicians, Singh’s story is a reminder that the best AI is guided by patient care, deep expertise, and humility about the limits of technology. 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.