**Nathan Labenz** (0:00)
Hello, and welcome back to The Cognitive Revolution. Today's episode is brought to you in part by Granola. To help new users experience the power of the Granola platform, Granola is featuring AI recipes from AI thought leaders, including several past guests of this show. There's a Replet recipe that converts discussion notes to an application build plan, a Ben Tassel recipe that creates content production plans, and a Dan Schipper recipe that looks across multiple sessions to identify cultural trends at your company. My own recipe is a Blind Spot Finder. It looks back at recent conversations and attempts to identify things that I might be missing. This has already proven useful in the context of contingency planning for my son's cancer treatment, and as I use it more and more, it's getting better and better at suggesting AI topic areas that I've neglected and really ought to explore. See the link in our show notes to try my Blind Spot Finder recipe and experience how Granola makes your meeting notes awesome.
Now, today, my guest is Karan Singhal, who leads Health AI at OpenAI and who was just named to the Time 100 Health List for his pioneering work. This episode began to come together last year on Thanksgiving when I emailed Karan, who I'd met a couple times at AI events, to say thank you for all of his work on AI for Health, and to let him know what a difference ChatGPT had made for me and my family in the context of my son's cancer diagnosis. As it turned out, that was just as OpenAI was preparing to make a major product push, with ChatGPT Health, which allows users to connect ChatGPT to data sources including electronic medical record systems and consumer wearables, plus a physician-facing ChatGPT for Health Care, both launching in early 2026 In this episode, we dig in to how Karan and team have achieved attending physician-level performance with their latest models. Their plan to ensure that this capability does benefit all of humanity, and their vision to raise not just the floor, but also the ceiling of human health with continued research and even better models to come. Highlights of this conversation include how OpenAI works with more than 250 human doctors to ensure accurate, robust, and culturally appropriate responses. How they built Healthbench, which contains some 49,000 evaluation criteria to measure models' performance. And how models have already gone from a 0% score on Healthbench Hard by GPT-40 when the benchmark was first created to today already 40%. Plus, an overview of my experience using large-language models to navigate a health emergency, including the critical importance of giving models as much context as possible on your situation, and how that's about to get dramatically easier as ChatGPT Health rolls out globally. We also discuss how 230 million people are already using ChatGPT for health questions on a weekly basis. The first randomized trial of AI copilots for physicians, which OpenAI conducted with Kenya's Penda Health System, and which did show a statistically significant improvement in outcomes for patients whose doctors used AI. And why Karan believes, based on the reception that OpenAI is getting from health systems, that 2026 will be the year that using AI becomes a standard part of medical practice. From there, we go on to cover the steps that OpenAI is taking to ensure privacy and security of users' health information, how they're using worst-of-end measures to make sure models first do no harm, while at the same time striving to maximize value by training AIs to acknowledge their uncertainty as they offer their best guesses, how Karan understands the relationship between AI for health, AI safety plans, such as scalable oversight, and AI alignment more broadly. Karan's report that OpenAI's model's chain of thought reasoning has not drifted toward neural ease, as much as some reports had previously caused me to believe, the future of medical multimodality, which will do a much better job of converting data to value, and which inspired me to buy a whoop wristband to start collecting data on myself, and the compounding effect of parallel advances in AI for science, the growing potential for NF1 treatment plans and Medical Move 37s, and the possible need for an update to the rules governing access to experimental medicines and information sharing. Finally, Karan describes OpenAI's utopian plan to make ChatGPT Health available to all users globally for free with no ads, an early form of Universal Basic Intelligence that I really think everyone ought to celebrate as a triumph of human ingenuity and goodwill.
Zooming out, in the grand scheme of AI development, I think it is fair to say that we have far more questions than answers. And in my mind, all outcomes, from a post-scarcity utopia to literal human extinction, absolutely remain on the table. I signed the recent call for a ban on superintelligence because I do worry that an AI arms race, driven by recursive self-improvement loops, could easily get out of control. And yet, at the same time, capabilities like this, which have been so valuable for me and my family, and which will undoubtedly save millions of lives in the coming years, are for me both an incredibly inspiring accomplishment and a practically irrefutable argument for the upside of AI. The question at this point is not whether we will create powerful AI systems, but exactly what form they will take and under what circumstances and incentives they'll be developed and deployed. Karan's work demonstrates that for the moment at least, we can have it all. AI systems meticulously crafted to minimize downside risk, which are both capable and efficient enough to meaningfully improve the human condition globally. There is a ton of work left to be done both inside and outside of the frontier companies to make sure that these lofty standards don't slip in the face of intensifying competition. But today, if you or a loved one are facing a complex health challenge, you owe it to yourself to take full advantage of the incredible medical expertise that Karan and others have managed to build into systems like ChatGPT Health. With that, I hope you enjoy this inspiring look at the frontier of medical AI with OpenAI's Head of Health, Karan Singhal. Karan Singhal, Head of Health AI at OpenAI. Welcome to The Cognitive Revolution.
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