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A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future
From the author of the
New York Times
bestseller
The Digital Doctor
comes a bold, insightful exploration of how artificial intelligence is revolutionizing healthcare—and why that matters.
Healthcare has long resisted the forces of digital disruption that have transformed nearly every other industry.
Until now.
In A Giant Leap, physician and thought leader Robert Wachter chronicles medicine’s AI awakening. Drawing on painstaking research and interviews with more than 100 pioneers at the intersection of medicine, technology, policy, and business, Wachter describes how AI can now match—and sometimes surpass—physicians in areas ranging from diagnosis to empathy.
Even as AI enters hospitals and clinics to assist with documentation, recommend treatments, interpret images, and guide surgeries, challenges remain—including hallucinations, biases, and misinformation. Yet, Wachter argues, in a healthcare system buckling under the weight of medical errors, limited access, maddening paperwork, clinician burnout, and crushing costs, AI doesn’t have to be flawless to be useful—it just needs to be better. And, if we make the right choices, it will be.
Blending clinical insight, vivid storytelling, and journalistic precision, A Giant Leap is a timeless and engaging guide to how AI is changing what it means to heal and be healed in this age of astonishing technology.
Healthcare has long resisted the forces of digital disruption that have transformed nearly every other industry.
Until now.
In A Giant Leap, physician and thought leader Robert Wachter chronicles medicine’s AI awakening. Drawing on painstaking research and interviews with more than 100 pioneers at the intersection of medicine, technology, policy, and business, Wachter describes how AI can now match—and sometimes surpass—physicians in areas ranging from diagnosis to empathy.
Even as AI enters hospitals and clinics to assist with documentation, recommend treatments, interpret images, and guide surgeries, challenges remain—including hallucinations, biases, and misinformation. Yet, Wachter argues, in a healthcare system buckling under the weight of medical errors, limited access, maddening paperwork, clinician burnout, and crushing costs, AI doesn’t have to be flawless to be useful—it just needs to be better. And, if we make the right choices, it will be.
Blending clinical insight, vivid storytelling, and journalistic precision, A Giant Leap is a timeless and engaging guide to how AI is changing what it means to heal and be healed in this age of astonishing technology.
352 pages, Hardcover
Published February 3, 2026
62 people are currently reading
335 people want to read
About the author
Robert M. Wachter
9 books20 followersRobert Wachter, MD is Professor and Chair of the Department of Medicine at the University of California, San Francisco (UCSF). Author of 300 articles and 6 books, he coined the term “hospitalist,” the fastest-growing medical specialty in U.S. history. He is past-president of the Society of Hospital Medicine, past-chair of the American Board of Internal Medicine, and an elected member of the National Academy of Medicine. In 2004, he received the John M. Eisenberg Award, the nation’s top honor in patient safety. Modern Healthcare magazine has ranked him as one of the 50 most influential physician-executives in the U.S. more than a dozen times; he was #1 on the list in 2015. His 2015 book, "The Digital Doctor," was a New York Times bestseller. His new book is "A Giant Leap: How AI is Transforming Healthcare and What That Means for Our Future."
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Displaying 1 - 9 of 9 reviews
Review of advance copy received from Netgalley
I thought it would be fitting for a book about AI to have its review written by AI—based on my own thoughts. So I provided a few bullet points and asked ChatGPT to do the job. What follows is the result. It is imperfect, distorted, and at times reads as if the AI fundamentally misunderstood me.
Yes, progress in AI is fast—astonishingly so. Every few months we are told that what failed yesterday works flawlessly today. But that is beside the point. This is only a book review. The consequences are trivial. Now imagine the same process applied to your health.
An AI that “mostly understands” you. An AI that improves with updates. An AI that gets it right—except when it doesn’t. In this case, the misunderstanding is no longer an annoyance or an academic curiosity. It is your diagnosis. Your treatment. Your life.
Mistakes in a review can be edited. Mistakes in medicine cannot.
-->
AI in Healthcare: Progress Toward the Light, or a Quiet Drift Toward Dependence?
The promise of artificial intelligence in healthcare is often framed as self-evident progress: automate routine tasks, reduce errors, and free doctors to focus on what matters most—the patient. But this optimistic narrative deserves scrutiny. When examined closely, the rise of AI in medicine raises uncomfortable questions about time, trust, responsibility, competence, and resilience. The issue is not whether AI is powerful—it clearly is—but whether increasing dependence on it is moving healthcare toward human flourishing or systemic fragility.
The first assumption worth challenging is that shifting work from doctors to AI will automatically give doctors more time for patients. History suggests otherwise. Administrative software, electronic health records, and digital reporting were all introduced with the same promise, yet many physicians today report less meaningful patient contact, not more. Time saved is rarely returned to human connection; it is often absorbed by new forms of documentation, monitoring, compliance, and productivity targets. Without structural change, AI risks becoming another efficiency tool that benefits systems and insurers more than patients.
This matters because healthcare is not merely a technical service. It is deeply personal, emotional, and grounded in trust. Human presence—eye contact, tone of voice, the ability to sit with uncertainty—cannot be replicated by machines. A diagnosis delivered by an algorithm may be statistically impressive, but trust is not built on probability alone. Patients trust doctors not only because of what they know, but because of how they listen, interpret context, and take responsibility. The more AI moves from tool to authority, the more this relational foundation is weakened. And a reasonable question follows: how much do we truly trust a machine, especially one we cannot question, confront, or hold morally accountable?
Which leads to responsibility. Machines can and do make mistakes. So do humans—but when humans err, responsibility is at least conceptually clear. With AI, accountability becomes diffuse. Is it the doctor who followed the recommendation? The hospital that deployed the system? The developer who trained the model? The insurer who mandated its use? In practice, responsibility tends to flow downward, not upward, and there is a real risk that clinicians will be pressured to defer to AI not because it is always right, but because deviating from it is legally dangerous. In such a system, critical thinking is not encouraged—it is penalized.
Proponents often argue that AI is simply better at diagnosis. In some domains, this is undeniably true. Algorithms excel at pattern recognition, such as reading ECGs or imaging scans, where even trained clinicians may struggle with ambiguity. But diagnostic accuracy is not the same as clinical excellence. The best doctors are not necessarily those who rely on the most technology, but those who integrate observation, experience, intuition, and restraint. Many exceptional clinicians practiced—and still practice—without constant digital assistance, guided by deep internalized knowledge rather than external systems.
There is also a neglected question of resilience. Imagine prolonged power outages, war, infrastructure collapse, or any scenario where electricity and networks are unavailable. These are not science fiction; they are historical realities. A healthcare system that cannot function without AI, software, or electricity is a brittle system. Reports from organizations like Doctors Without Borders in the 1980s praised doctors trained in austere conditions—such as many Polish physicians—for their ability to operate with minimal tools, improvisation, and judgment. That kind of competence is not backward; it is robust. As we move toward AI dependence, we risk losing skills that cannot be quickly relearned when systems fail.
So are we moving toward the light or toward doom? The honest answer is: both are possible. AI can be an extraordinary assistant—augmenting perception, reducing cognitive load, and improving outcomes—if it remains a tool under human authority. But if it becomes a crutch, an arbiter, or a shield against responsibility, it may erode the very qualities that make medicine humane, ethical, and resilient.
Progress in healthcare should not be measured by how much intelligence we outsource, but by how well we preserve judgment, accountability, and human connection while using technology wisely. The danger is not AI itself. The danger is forgetting how to practice medicine without it.
Yes, progress in AI is fast—astonishingly so. Every few months we are told that what failed yesterday works flawlessly today. But that is beside the point. This is only a book review. The consequences are trivial. Now imagine the same process applied to your health.
An AI that “mostly understands” you. An AI that improves with updates. An AI that gets it right—except when it doesn’t. In this case, the misunderstanding is no longer an annoyance or an academic curiosity. It is your diagnosis. Your treatment. Your life.
Mistakes in a review can be edited. Mistakes in medicine cannot.
-->
AI in Healthcare: Progress Toward the Light, or a Quiet Drift Toward Dependence?
The promise of artificial intelligence in healthcare is often framed as self-evident progress: automate routine tasks, reduce errors, and free doctors to focus on what matters most—the patient. But this optimistic narrative deserves scrutiny. When examined closely, the rise of AI in medicine raises uncomfortable questions about time, trust, responsibility, competence, and resilience. The issue is not whether AI is powerful—it clearly is—but whether increasing dependence on it is moving healthcare toward human flourishing or systemic fragility.
The first assumption worth challenging is that shifting work from doctors to AI will automatically give doctors more time for patients. History suggests otherwise. Administrative software, electronic health records, and digital reporting were all introduced with the same promise, yet many physicians today report less meaningful patient contact, not more. Time saved is rarely returned to human connection; it is often absorbed by new forms of documentation, monitoring, compliance, and productivity targets. Without structural change, AI risks becoming another efficiency tool that benefits systems and insurers more than patients.
This matters because healthcare is not merely a technical service. It is deeply personal, emotional, and grounded in trust. Human presence—eye contact, tone of voice, the ability to sit with uncertainty—cannot be replicated by machines. A diagnosis delivered by an algorithm may be statistically impressive, but trust is not built on probability alone. Patients trust doctors not only because of what they know, but because of how they listen, interpret context, and take responsibility. The more AI moves from tool to authority, the more this relational foundation is weakened. And a reasonable question follows: how much do we truly trust a machine, especially one we cannot question, confront, or hold morally accountable?
Which leads to responsibility. Machines can and do make mistakes. So do humans—but when humans err, responsibility is at least conceptually clear. With AI, accountability becomes diffuse. Is it the doctor who followed the recommendation? The hospital that deployed the system? The developer who trained the model? The insurer who mandated its use? In practice, responsibility tends to flow downward, not upward, and there is a real risk that clinicians will be pressured to defer to AI not because it is always right, but because deviating from it is legally dangerous. In such a system, critical thinking is not encouraged—it is penalized.
Proponents often argue that AI is simply better at diagnosis. In some domains, this is undeniably true. Algorithms excel at pattern recognition, such as reading ECGs or imaging scans, where even trained clinicians may struggle with ambiguity. But diagnostic accuracy is not the same as clinical excellence. The best doctors are not necessarily those who rely on the most technology, but those who integrate observation, experience, intuition, and restraint. Many exceptional clinicians practiced—and still practice—without constant digital assistance, guided by deep internalized knowledge rather than external systems.
There is also a neglected question of resilience. Imagine prolonged power outages, war, infrastructure collapse, or any scenario where electricity and networks are unavailable. These are not science fiction; they are historical realities. A healthcare system that cannot function without AI, software, or electricity is a brittle system. Reports from organizations like Doctors Without Borders in the 1980s praised doctors trained in austere conditions—such as many Polish physicians—for their ability to operate with minimal tools, improvisation, and judgment. That kind of competence is not backward; it is robust. As we move toward AI dependence, we risk losing skills that cannot be quickly relearned when systems fail.
So are we moving toward the light or toward doom? The honest answer is: both are possible. AI can be an extraordinary assistant—augmenting perception, reducing cognitive load, and improving outcomes—if it remains a tool under human authority. But if it becomes a crutch, an arbiter, or a shield against responsibility, it may erode the very qualities that make medicine humane, ethical, and resilient.
Progress in healthcare should not be measured by how much intelligence we outsource, but by how well we preserve judgment, accountability, and human connection while using technology wisely. The danger is not AI itself. The danger is forgetting how to practice medicine without it.
August 16, 2025
A Giant Leap : How AI is transforming healthcare and what that means for our future by Robert Wachter M.D. is a fascinating and informative read, and one that gives a realistic overview of the topic in pragmatic terms without resorting to hyperbole or setting unrealistic expectations. While the use of AI in the medical field, as in so many others, is controversial, it is not going to be possible to put the genie back into the bottle, the technology is out there and in use so the best we can strive for is to ensure that it is used ethically and responsibly.
As a practicing doctor who also works in academia the author examines the use of the technology in his current day to day practice as well as touching on how the rapidly evolving tech will require changes to the way doctors and other medical professionals are trained, after all any tool, including AI is only as useful as the person using it is skilled. The author is very aware of the concerns and hesitation from both medical professionals and the general public and does his best to explain how the weaknesses in the technology evolve and how they can be prevented in the future, and generally speaks in favour of a model where AI is not used to replace clinical staff but rather to eliminate some of the more routine tasks and administrative burdens they face, freeing up more time for patient focussed care. The balance between autonomous AI based care and human oversight is a fine line and one that is bound to shift as the technology develops and its use becomes more widespread and I found much of the discussion of the topic in this book enlightening and thought provoking, overall it left me a little more hopeful and much better informed about the issue.
I read and reviewed an ARC courtesy of NetGalley and the author, all opinions are my own.
As a practicing doctor who also works in academia the author examines the use of the technology in his current day to day practice as well as touching on how the rapidly evolving tech will require changes to the way doctors and other medical professionals are trained, after all any tool, including AI is only as useful as the person using it is skilled. The author is very aware of the concerns and hesitation from both medical professionals and the general public and does his best to explain how the weaknesses in the technology evolve and how they can be prevented in the future, and generally speaks in favour of a model where AI is not used to replace clinical staff but rather to eliminate some of the more routine tasks and administrative burdens they face, freeing up more time for patient focussed care. The balance between autonomous AI based care and human oversight is a fine line and one that is bound to shift as the technology develops and its use becomes more widespread and I found much of the discussion of the topic in this book enlightening and thought provoking, overall it left me a little more hopeful and much better informed about the issue.
I read and reviewed an ARC courtesy of NetGalley and the author, all opinions are my own.
December 2, 2025
I have been using ChatGPT for simple wellness queries but I have always wondered how much trust I could put in it in terms of comprehensiveness, reliability, and medical integrity. A Giant Leap made me excited about future possibilities in the medical realm while also grounding me in today’s reality.
A Giant Leap strikes a balance between overhyped optimism/total reliance on AI and doomsday fears/conspiracy theories. The potential for generative AI to not only pore through thousands of medical content on the web in seconds, but also to analyze, iterate, interpret, diagnose, and even recommend several treatment options is clear. Dr. Wachter, however, tempers this optimism with stories that show it is not yet at a point where medical diagnosis and treatment recommendations can be fully delegated to AI without physicians in the loop.
Dr. Wachter succinctly summarized his thoughts on AI: “True transformation will emerge through AI’s ability to help diagnose illnesses, recommend treatments, coordinate care, facilitate precision medicine, and empower patients with self-management tools—not from solving important but relatively small-bore problems like documentation and prior auths.” I guess the only question left is WHEN.
Personally, I think it will be challenging to get humans to completely trust a non-human when it comes to the health of loved ones. I think it will take longer and many more success stories before AI earns the complete trust of patients. I can see a day when we would live in a world where physicians and medical staff interact closely with AI to give patients holistic, comprehensive, and safe medical care. But replacing physicians and medical staff totally? Not just yet.
This book is great reading for anyone in the healthcare industry, interested in tech (specifically AI), or even considering investing in AI platforms.
Thank you to Netgalley, Dr. Wachter, and Portfolio for this ARC. All opinions here are my own.
A Giant Leap strikes a balance between overhyped optimism/total reliance on AI and doomsday fears/conspiracy theories. The potential for generative AI to not only pore through thousands of medical content on the web in seconds, but also to analyze, iterate, interpret, diagnose, and even recommend several treatment options is clear. Dr. Wachter, however, tempers this optimism with stories that show it is not yet at a point where medical diagnosis and treatment recommendations can be fully delegated to AI without physicians in the loop.
Dr. Wachter succinctly summarized his thoughts on AI: “True transformation will emerge through AI’s ability to help diagnose illnesses, recommend treatments, coordinate care, facilitate precision medicine, and empower patients with self-management tools—not from solving important but relatively small-bore problems like documentation and prior auths.” I guess the only question left is WHEN.
Personally, I think it will be challenging to get humans to completely trust a non-human when it comes to the health of loved ones. I think it will take longer and many more success stories before AI earns the complete trust of patients. I can see a day when we would live in a world where physicians and medical staff interact closely with AI to give patients holistic, comprehensive, and safe medical care. But replacing physicians and medical staff totally? Not just yet.
This book is great reading for anyone in the healthcare industry, interested in tech (specifically AI), or even considering investing in AI platforms.
Thank you to Netgalley, Dr. Wachter, and Portfolio for this ARC. All opinions here are my own.
October 2, 2025
This book strikes a much-needed balance between tech optimism and doomsday fear-mongering: a nuanced discussion of artificial intelligence in healthcare. And what a fascinating one it was!
I know little (hint: nothing) about how healthcare works, despite, like every other human, depending on it for survival, so I appreciated how accessible he made his writing.
For a text with technology at its core, it spends most of its time on the human questions. What happens to empathy when machines join the process? How do we balance innovation and safety?
His storytelling makes these quandaries understandable without sacrificing depth, using examples from hospitals already implementing these systems.
I appreciated his careful nuance, and skepticism mixed with hope. Yes, there’s so much we could (and continue to get) wrong, but what about everything we could get right? How we approach anything new is just as important as what we approach.
Medicine’s future isn’t just written in code. It’s reimagined in how we care for each other.
I received an early copy courtesy of the publishers via Netgalley. All opinions are mine alone.
I know little (hint: nothing) about how healthcare works, despite, like every other human, depending on it for survival, so I appreciated how accessible he made his writing.
For a text with technology at its core, it spends most of its time on the human questions. What happens to empathy when machines join the process? How do we balance innovation and safety?
His storytelling makes these quandaries understandable without sacrificing depth, using examples from hospitals already implementing these systems.
I appreciated his careful nuance, and skepticism mixed with hope. Yes, there’s so much we could (and continue to get) wrong, but what about everything we could get right? How we approach anything new is just as important as what we approach.
Medicine’s future isn’t just written in code. It’s reimagined in how we care for each other.
I received an early copy courtesy of the publishers via Netgalley. All opinions are mine alone.
February 12, 2026
This is Nonfiction and it explores how AI is already transforming healthcare and how its impact will likely grow in the coming years. The author dials in on both the opportunities and the challenges that the use of AI brings. His enthusiasm for AI's potential is clear, but he also urges careful and responsible use and I will also add, for doctors to stay involved and not turn it all over to AI.
The primary focus here is healthcare, but he also touches on how AI is shaping, and will continue to shape, many other aspects of daily life. There is plenty of food for thought here.
Overall, it's a forward looking discussion that encourages curiosity while acknowledging ethical thoughts and considerations. But all in all, this was kind of fascinating, so 4 stars.
The primary focus here is healthcare, but he also touches on how AI is shaping, and will continue to shape, many other aspects of daily life. There is plenty of food for thought here.
Overall, it's a forward looking discussion that encourages curiosity while acknowledging ethical thoughts and considerations. But all in all, this was kind of fascinating, so 4 stars.
October 8, 2025
This is a very comprehensive view of how AI and the health industries can assist together. The author is a Doctor Who has used AI he give different views about the use of AI in the health field. He gives numerous examples of how it can be used to help doctors and also the drawbacks of using AI. I found this very interesting book and a very comprehensive view. I recommend this careers or are interested in the use of AI in the healthcare field.
Review of advance copy received from Netgalley
Giant Leap is one of the most comprehensive and clear-eyed books I’ve read on the current and future role of artificial intelligence in healthcare. Wachter thoughtfully explores how AI intersects with patients, clinicians, health systems, and technology companies, balancing optimism with realism. What stands out is how grounded the discussion feels—less hype, more insight into how healthcare and AI actually meet in practice.
August 7, 2025
using AI and LLM make you scum
December 16, 2025
Full disclosure: I went into this book vehemently opposed to AI except for when it's used for lifesaving medical purposes (e.g., AI can detect cancer before the human eye can). I wanted to try this book to broaden my perspective and hear from an expert in the field.
So I really appreciate this well-written, factual, and comprehensive book, even if I'm not convinced by all of its conclusions. Wachter provides plentiful real examples to support his points. He also provides necessary nuance in the conversation, recognizing that AI has a lot of dangers (hallucinations that can cause harmful errors in medicine; bioterrorism, etc.). Despite acknowledging known and possible issues with AI, he nonetheless encourages its use in a variety of medical settings. It's concerning to hear something along the lines of "AI could cause massive problems, but we have to risk it, because things in healthcare are really bad and we medical professionals need help." Of course, he's right that we need regulation. I just hope that he's also right that AI will do more good than harm. I give this book 4.5 stars rounded up to 5!
Thank you to NetGalley and Portfolio for the free eARC. I post this review with my honest opinions.
So I really appreciate this well-written, factual, and comprehensive book, even if I'm not convinced by all of its conclusions. Wachter provides plentiful real examples to support his points. He also provides necessary nuance in the conversation, recognizing that AI has a lot of dangers (hallucinations that can cause harmful errors in medicine; bioterrorism, etc.). Despite acknowledging known and possible issues with AI, he nonetheless encourages its use in a variety of medical settings. It's concerning to hear something along the lines of "AI could cause massive problems, but we have to risk it, because things in healthcare are really bad and we medical professionals need help." Of course, he's right that we need regulation. I just hope that he's also right that AI will do more good than harm. I give this book 4.5 stars rounded up to 5!
Thank you to NetGalley and Portfolio for the free eARC. I post this review with my honest opinions.
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