By DAVID SHAYWITZ<\/p>\n
\u201cThere are decades where nothing happens; and there are weeks where decades happen,\u201d said Lenin,\u00a0probably never<\/a>.\u00a0 It\u2019s also a remarkably apt characterization of the last year in generative AI (genAI) \u2014 the last week in particular \u2014 which has seen the AI landscape shift so dramatically that even skeptics are now updating their priors in a more bullish direction.<\/p>\n In September 2025, Anthropic, the AI company behind Claude,\u00a0released<\/a>\u00a0what it described as its most capable model yet, and said it could stay on complex coding tasks for about 30 hours continuously.\u00a0Reported<\/a>\u00a0examples including building a web app from scratch, with some runs described as generating roughly 11,000 lines of code. In January 2026, two\u00a0Wall Street Journal<\/em>\u00a0reporters who said they had no programming background\u00a0used<\/a>\u00a0Claude Code to build and publish a\u00a0Journal<\/em>\u00a0project, and described the capability as \u201ca breakout moment for Anthropic\u2019s coding tool\u201d and for \u201cvibe coding\u201d \u2014 the idea of creating software simply by describing it.<\/p>\n Around the same time, OpenClaw went\u00a0viral<\/a>\u00a0as an open-source assistant that runs locally and works through everyday apps like WhatsApp, Telegram, and Slack to execute multi-step tasks. The deeper shift, though, is architectural: the ecosystem is converging on open standards for AI integration. One such standard called MCP \u2014 the \u201cUSB-C of AI\u201d \u2014 is now being\u00a0downloaded<\/a>\u00a0nearly 100 million times a month, suggesting that AI integration has moved from exploratory to operational.<\/p>\n Markets are watching the evolution of AI agents into potentially useful economic actors and reacting accordingly. When Anthropic announced plans to move into high-revenue verticals \u2014 including financial services, law, and life sciences \u2014 the\u00a0Journal<\/em>\u00a0headline<\/a>\u00a0read: \u201cThreat of New AI Tools Wipes $300B Off Software and Data Stocks.\u201d<\/p>\n Economist Tyler Cowen\u00a0observed<\/a>\u00a0that this moment will \u201cgo down as some kind of turning point.\u201d Derek Thompson, long concerned about an AI bubble,\u00a0said<\/a>\u00a0his worries \u201cdeclined significantly\u201d in recent weeks. Heeding Wharton\u2019s\u00a0Ethan Mollick<\/a>\u00a0\u2014 \u201cremember, today\u2019s AI is the worst AI you will ever use\u201d \u2014 investors and entrepreneurs are busily searching for opportunities to ride this wave.<\/p>\n Some founders are taking their ambition to healthcare and life science, where they see a slew of problems for which (they anticipate) genAI might be the solution, or at least part of it. The approach one AI-driven startup is taking towards primary care offers a glimpse into what such a future might hold (or perhaps what fresh hell awaits us).<\/p>\n There is genuine crisis in primary care. Absurdly overburdened and comically underpaid, primary care physicians have fled the profession in droves \u2014 some to concierge practices where (they say) they can provide the quality of care that originally attracted them to medicine, many out of clinical practice entirely. Recruiting new trainees grows harder each year.<\/p>\n What\u2019s being lost is captured with extraordinary power by Dr. Lisa Rosenbaum in her \u00a0NEJM<\/em>\u00a0 podcast\u00a0series<\/a>\u00a0on the topic. <\/p>\n <\/span><\/p>\n In a companion\u00a0essay<\/a>, Rosenbaum documents the measurable consequences when patients lose a primary care physician: a rise in mortality, emergency room visits, and hospitalizations, all in proportion to the relationship\u2019s duration \u2014 suggesting, as she writes, \u201cthat the relationship itself conferred health benefits.\u201d Worse, more than three quarters of patients never form a new PCP relationship after losing one.<\/p>\n But Rosenbaum\u2019s deepest concern isn\u2019t statistical. It\u2019s about what she calls the \u201cgood doctor\u201d phenotype \u2014 not a skill set but a style. She describes a physician whose hallmark was assuming responsibility for the totality of his patients\u2019 problems. When Rosenbaum was caring for one of his hospitalized patients, the patient insisted she update the doctor, explaining simply: \u201cHe will want to know.\u201d For Rosenbaum, having your patients intuit that you would want to know \u2014 far more than any quality metric \u2014 constitutes the essence of being a good doctor. A \u201cculture without a vision of the good doctor,\u201d she warns, \u201cis a profession without a soul.\u201d<\/p>\n Her darkest worry: the system may morph into \u201csome artificial-intelligence-enhanced triage system devoid of a relational core.\u201d<\/p>\n Which is almost exactly what physician-entrepreneur Muthu Alagappan, co-founder of Counsel Health,\u00a0aspires to deliver<\/a>\u00a0\u2014 for the sake of patients. His starting point: 100 million Americans don\u2019t have a relationship with a doctor, good or otherwise. The relational ideal Rosenbaum celebrates is already inaccessible to vast swaths of the population.<\/p>\n At Counsel Health \u2014\u00a0recently backed<\/a>\u00a0by a $25M Series A from GV and Andreessen Horowitz \u2014 AI handles the upfront information gathering and initial clinical reasoning, functioning, as Alagappan puts it, like \u201can extremely smart medical resident that is reasoning along with them, serving up the plan and allowing them to approve or deny in a single click.\u201d Doctors see 15 to 20-plus patients per hour. The vision: primary care visits costing less than a dollar.<\/p>\n As Alagappan sees it \u201cIt\u2019s hard to fathom a cognitive aspect of the practice of medicine in primary care that a technology system is just not better suited to do than the human brain.\u201d<\/p>\n He acknowledges that humans may still be necessary for pesky, hands-on tasks like wrapping an ankle or administering a vaccine, but beyond these, he seems to believe, the future belongs to the machines. He anticipates \u201cregulation will ease and improve so that the AI can do more and more.\u201d<\/p>\n In Utah, the approach\u00a0pursued<\/a>\u00a0by a startup called Doctronic suggests such regulatory change may be closer than we think. The company\u2019s AI prescribes renewals without a physician in the loop for 190 routine medications, at $4 per script \u2014 with a malpractice insurance policy covering the AI system itself, and escalation and oversight safeguards.\u00a0 Expansion is already contemplated to states like Texas, Arizona and Missouri, with a national roll-out under consideration as well.<\/p>\n As AI capabilities compound rapidly, there is tremendous temptation to apply them wherever they fit most naturally.\u00a0 Without intentionality, this approach risks quietly redefining disciplines by the tasks the technology performs well. Because AI can efficiently process symptoms, match protocols, and renew prescriptions, we might start to define medicine as these specific tasks \u2014 in much the same way that because we can measure steps, sleep scores, and VO2 max, we\u2019re\u00a0tempted<\/a>\u00a0to define health as the optimization of dashboard metrics. As Kate Crawford astutely warned, we must not let the \u201caffordances of the tools become the horizon of truth.\u201d<\/p>\n This tension extends to biopharma R&D as well. Here, efforts to leverage AI have succeeded in limited domains with dense data and established benchmarks, but have struggled where the critical data are scarce, highly conditional, or both \u2014 as Andreas Bender, in particular, has eloquently\u00a0discussed<\/a>.<\/p>\n We\u2019re always tempted to look where the light is.\u00a0 But difficult as it can be to maintain focus on what actually matters, rather than what technology most readily delivers, it can be done.<\/p>\n For some time now, I\u2019ve argued \u2014 in this space, at\u00a0KindWellHealth<\/a>, and\u00a0elsewhere<\/a>\u00a0\u2014 that genuinely enhancing human flourishing requires attention to three broad dimensions: physiology (movement, nutrition, recovery, preventive screening), agency (your belief in your ability to shape a better future), and connection (the value of meaningful relationships and purposeful pursuits).<\/p>\n The\u00a0news<\/a>\u00a0that caught my attention recently was that someone independently built a business around exactly this framework.\u00a0Unbound<\/a>, a UK-based preventive health company operating from a single just-opened location in London\u2019s Shoreditch, describes itself as \u201cbuilt on the belief that physical, mental and social health are inseparable.\u201d<\/p>\n Several design choices distinguish Unbound from the optimization-culture norm. They measure connectedness alongside biomarkers \u2014 literally assessing social connection as a clinical input. Their medical director, Dr. Elliott Roy-Highley, frames health as \u201cnot merely the result of internal cellular mechanics, but an emergent property of social integration, purpose, and communal regulation.\u201d A coffee shop replaces the waiting room; community circles, run clubs, and art exhibitions aren\u2019t wellness window-dressing but structural commitments \u2013 the social environment is treated as meaningful part of the intervention.<\/p>\n Perhaps most distinctive is a post-assessment \u201cfuture self\u201d exercise \u2014 an evidence-backed positive psychology intervention that asks participants to envision their optimal future self and identify personal barriers to achieving that vision.\u00a0 By strengthening the psychological connection between present and future selves, the exercise\u00a0enhances<\/a>\u00a0goal clarity, self-efficacy, and motivation for behavior change. This process\u00a0works<\/a>\u00a0through narrative mechanisms \u2014 imagining, evaluating, and orienting toward personally meaningful goals \u2013that translate assessment insights into actionable health strategies.<\/p>\n Crucially, Unbound doesn\u2019t reject measurement and technology. They offer a companion app for extending connection and tracking recommendations beyond the clinic; their assessments integrate blood work and physical performance testing alongside the emotional and social components.\u00a0 As Unbound puts it: \u201cYes, we use tools like clinical testing \u2014 but not as a way to measure your worth or push you to chase perfection. We use them to guide and support a much bigger goal: helping you live the life you want, with clarity and confidence.\u201d The intent: leverage science and technology with intentionality, pointing them where they should be aimed, rather than where they are most inclined to go.<\/p>\n Of course, there\u2019s a large gap between a compelling concept and improved health. It\u2019s possible Unbound will prove to be savvy wellness marketing aimed at motivated, affluent urbanites. The people who walk into a trendy Shoreditch health studio are already relatively motivated and likely already drawn to purposeful engagement. The evidence that the program actually improves health, while theoretically grounded, remains to be seen.<\/p>\n But the interest Unbound has attracted reveals a substantial appetite for something beyond relentless metric optimization \u2014 and there\u2019s little in their approach that seems especially proprietary. The same foundational principles \u2014 deepen connection, develop agency, attend (with compassion) to physiology \u2014 all could be applied at scale by incumbents and digital platforms. Peloton, for instance, has the community infrastructure and the user engagement; what it lacks is a framework that extends beyond leaderboards and performance dashboards toward something that might help users not just perform but flourish.<\/p>\n GenAI is advancing at a pace that would have seemed fantastical even a year ago; the developments of the last few weeks have forced even seasoned skeptics to recalibrate. There is tremendous incentive \u2014 and good reason \u2014 to ride this technology wave toward compelling opportunities like the crisis in primary care. But as these capabilities compound, the central challenge will be ensuring the technology serves what patients and people actually need, rather than allowing those needs to be defined by what the technology most readily delivers. The risk of essentially reducing health to what can be optimized by technology is real, as so many tech-powered companies in healthcare, biotech, and fitness demonstrate. But it is also possible to leverage technology in service of a more complete and less reductive vision \u2014 attending to physiology, agency, and genuine human connection \u2014 as Unbound suggests, and hopefully, many others pursue.\u00a0<\/p>\n Dr. David Shaywitz, a physician-scientist, is a lecturer at Harvard Medical School, an adjunct fellow at the American Enterprise Institute, and founder of KindWellHealth, an initiative focused on advancing health through the science of agency<\/em>.\u00a0This piece was\u00a0previously published<\/a>\u00a0on the Timmerman Report<\/em><\/p>","protected":false},"excerpt":{"rendered":" By DAVID SHAYWITZ \u201cThere are decades where nothing happens; and there are weeks where decades happen,\u201d said Lenin,\u00a0probably never.\u00a0 It\u2019s also a remarkably apt characterization of the last year in generative AI (genAI) \u2014 the last week in particular \u2014 which has seen the AI landscape shift so dramatically that even skeptics are now updating…<\/p>\n","protected":false},"author":0,"featured_media":11501,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-11506","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/11506"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11506"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/11506\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/11501"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=11506"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=11506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Two Visions of Primary Care<\/h4>\n
Who\u2019s in charge?<\/h4>\n
A Company Built on What Matters<\/h4>\n
Bottom Line<\/h4>\n