In 1847, Ignaz Semmelweis asked the doctors in the Vienna maternity clinic where he worked to wash their hands in a chlorine solution before examining patients. Deaths on the ward fell from about 18% to about 2% within two months. In healthcare, small changes in practice can have disproportionately large effects, because the healthcare system affects everyone and the stakes are literally life and death. We think AI has the potential to revolutionize healthcare, contributing to a dizzying array of changes. But institutions are failing to adjust to meet the moment, despite widespread interest in change from patients and providers.

Americans are racing ahead with using AI for medical advice. Roughly a third of Americans have used AI for health information, and one in four did so in the past month, through chatbots like ChatGPT. Who uses these tools the most? Younger people, and people who might not have access to a doctor, such as those who are uninsured or who can’t afford a visit. This is a form of unmet demand—clearly people want more access to healthcare. And while it’s laudable that people are finding creative ways to meet their needs, doing so cuts both ways, because when a chatbot is wrong, the consequences tend to fall on the people least able to absorb them.

Doctors, too, are adopting AI, and mostly on their own. OpenEvidence , a free clinical reference that doctors can use without institutional support, skyrocketed from about 3 million physician consultations a month to about 18 million a month a year later, in December 2025.

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