Welcome back! If you’re new to ctrl-alt-operate, we do the work of keeping up with AI, so you don’t have to. We’re grounded in our clinical-first context, so you can be a discerning consumer and developer. We’ll help you decide when you’re ready to bring A.I. into the clinic, hospital or O.R.
It has been a tumultuous holiday week for OpenAI and the entire AI ecosystem. We’ll catch you up. Also, Happy Birthday to Ctrl-Alt-Operate! We turn 1, and we’ll reflect on how the world has changed in the past year.
Table of Contents
📰 The News: The Wild, Wild West Coast: OpenAI implosion
🤿 Deep Dive: Ctrl-Alt-Operate turns 1 ⭐️
📰 The News: Trouble in Paradise at OpenAI
Odds are the followers of this newsletter are up to speed on the drama at OpenAI. Even if you are, so much has happened that its worth going over:
A week ago, Sam Altman was fired as the CEO of OpenAI. Why would a board fire the chief executive of what is widely touted as a possibly humanity-altering company? That’s a great question and precisely what everyone was thinking. OpenAI's board cited a “lack of candid communication,” but the ambiguity of their statement only deepened the mystery and speculation.
What followed was something that I hope Michael Brown’s team, and the executives of Netflix, are already planning to make a bestseller and blockbuster. The impact was immediate and dramatic: key figures like Greg Brockman, OpenAI's president, resigned in a show of solidarity or discontent, signaling a deep rift within the organization.
The plot thickened when rumors of Altman's potential reinstatement surfaced, hinting at a tug-of-war between OpenAI's nonprofit roots and its profit-driven ambitions, fueled by major investors like Microsoft. As the saga unfolded, Microsoft CEO Satya Nadella announced that Altman and Brockman would lead a new AI division at Microsoft, a move that seemed to mark the end of their OpenAI tenure. However, in a stunning reversal, OpenAI declared Altman's return as CEO, alongside a reshuffled board, culminating a week of high-stakes corporate drama. This tumultuous episode at OpenAI underscores the intricate challenges of balancing ethical considerations and business objectives in the frontier of AI technology, leaving all of us, and all of Twitter, eagerly watching what comes next.
By the end of the week, Altman and Brockman were back at OpenAI. Oh, and Larry Summers (yes, former Secretary of the Treasury under Clinton, former president of Harvard) is now on the OpenAI board.
What does this all mean for healthcare, healthcare builders and those interested in AI?
In the short term, not much. With the key leadership now stable at OpenAI, I don’t expect the pace of innovation to change. That being said, this week shows how fragile the current ecosystem is. If Altman did leave, and employees left with him, that would create a power vacuum that leaves the whole industry vulnerable.
If you are a builder in healthcare AI, reducing reliance on one specific model or company, making your platforms modular, and being adaptable to the inevitable shake ups of the future is key.
Deep Dive: Ctrl-Alt-Operate Turns One!
Just over a year ago, we sat down and decided to start writing in public (FYI, this was before chatGPT came out). 35 issues later, we are still here for our (mostly) weekly look at the latest, greatest and generally most interesting obscure factoids from the tech world that physicians and surgeons need to know about.
It’s amazing how far we have come since our first issue, and also how little has fundamentally changed. So let’s indulge in a brief trip to the internet wayback machine to take stock of how far we have come, and how far we still have to go.
So here’s our first newsletter:
We identified three early themes that would go on to make waves over the course of 2023:
Generative AI is extremely flashy, but difficult to put into high-reliability applications.
ML advances are rapidly lowering the entry costs for physicians to get in the trenches of software and ML development
The need for a central node to connect clinicians and computer scientists around health care, improving collaboration and accelerating joint projects.
In large part, all of these stories were the central story of 2023, but there were a few things that we didn’t fully discuss (but should have).
Healthcare operations will be the first site of AI penetration as this is most similar to existing consumer technologies (e.g. business operations)
Efforts to implement HAI within the enterprise will face incredible degrees of resistance from existing stakeholders. Successful efforts combine internal champions, data sensitivity, and successfully address business goals
The vast majority of the work remains undone, even at one year in. This will be a 10-15 year transformation project.
But, the investment in healthcare AI has never been bigger; see pitch from VC giant Sequoia. And large healthcare systems like Kaiser and Emory are already partnering and rolling out documentation systems using AI. So we are making progress.
As we approach one year of Ctrl-Alt-Operate, we’d like to put out a call to action to think bigger. The ones who are behind the drive of AI often call it a once in a generation technological change, and use analogies like… the invention of electricity. The power of this cannot be overstated. How do we use this technology to fundamentally change how we practice medicine, how we deliver care, and how we operate on a daily basis for the betterment of patients? This is our challenge, and why we keep on writing.
Feeling inspired? Drop us a line and let us know what you liked.
Like all surgeons, we are always looking to get better. Send us your M&M style roastings or favorable Press-Gainey ratings by email at ctrl.alt.operate@gmail.com