Our first letter to the editor
This is Second Opinion’s first letter to the editor. We encourage readers to engage with us and send their thoughts. If we ever write something that you’d like to respond to in this format, please reach out.
To the editor:
For years, the question has been whether AI will replace doctors. On October 5, Utah changed the question. Nolla Health became the first company authorized to let its AI do the core thing physicians do: make a diagnosis and decide what to prescribe, on its own. Initially, physicians review every prescription before it gets sent. As the pilot advances, as many as 90% won’t be reviewed individually at all.
Whether Nolla succeeds or fails, we’ll look back on this as the moment the debate moved from “Will AI replace doctors?” to “How should we regulate AI replacing doctors?”
That’s why it matters that we get this right. Whatever happens with Nolla will set the template for every AI clinical pilot that follows, in Utah and in every state watching Utah.
Ruth Reader’s October 12 piece asked whether Utah approves pilots based on their utility or their level of risk. Fair question, and state law answers it: both. To get into the sandbox, a company has to show that its product’s likely benefits outweigh the risks, and that the size and length of its test are limited to match those risks. The criteria are public, and so is the process, including outside clinical review and a published evidentiary standard.
But the devil is always in the details, and in this case the relevant details are how the state applied the law, and they aren’t public. The details I want to see: the reasoning for each approval and what its reviewers found.
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