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Sarah Lewen: The More Capable the Machines Become, the More Human Connection Matters
Sarah Lewen/LinkedIn
Aug 23, 2026, 16:36

Sarah Lewen: The More Capable the Machines Become, the More Human Connection Matters

Sarah Lewen, Founder and CEO of Carousel Fertility, shared on LinkedIn:

”Two academic fertility papers I devoured this week frame the entire debate over AI in medicine, and they left me more committed to an increasingly contrarian position I hold as a founder building AI in fertility care.

The first, from the Hastings Center: the law’s main tool for policing AI in care mostly catches the easy case, like the chatbot one state is suing for fabricating its therapy credentials. The authors’ conclusion has stayed with me all week. Substantive clinical conversations are now happening outside any licensing framework, at a scale no medical board has ever policed.

The second, in JAMA, is more unsettling. Ezekiel Emanuel and colleagues argue that autonomous AI, with no physician in the loop, may soon outperform both doctors and doctor-plus-AI teams at five core cognitive tasks, from diagnosis to chronic disease management. The evidence is serious. In one cited study, an AI ranked the correct diagnosis first in 60 percent of complex cases. The physicians managed 16.

So the law cannot yet police the conversation, and the machine may soon outperform the doctor. For an AI health founder, those two facts together read as either a green light or a warning. It depends entirely on what you believe your product is for.

Here is what I noticed, though, buried in the middle of the JAMA piece. Nearly all of that dazzling evidence comes from clean clinical vignettes handed directly to the models. The authors themselves cite research showing that the transmission of information between the model and the actual human is a particular point of failure.

AI is approaching superhuman at medicine on paper, yet it remains weakest at the exact thing patients need most: conversation with a real, frightened, hoping woman, whose information arrives messy and whose stakes arrive at midnight.

That conversation is the layer we are building at Carousel Fertility, and after this week’s reading I am more committed than ever to our architecture: our Carousel AI never renders the verdict. Not because I doubt the capability curve. Because in fertility care, diagnostic accuracy was never the scarce resource. Knowing precisely when a conversation belongs to a physician, and getting her there, is.

The capability question will be settled by benchmarks. The trust question will be settled by builders, one design decision at a time, years before regulation arrives. I know which question I am staking my company on.

The more capable the machines become, the more the fertility industry will need a layer built to protect the clinician-patient relationship rather than replace it.

And a grateful nod to my advisor: the right advisors do not hand you answers. They hand you better questions.”

Read further.

Title: Will Autonomous AI Exceed AI-Aided Physicians as the Best Medical Care?

Authors: Ezekiel J. Emanuel, Abe Baker-Butler, Neal Khosla, Vinod Khosla

You can read the Full Article in JAMA.

Sarah Lewen: The More Capable the Machines Become, the More Human Connection Matters

Stay informed with the latest updates in fertility and reproductive medicine on Fertility News.

Abe Baker-Butler AI in Fertility Ezekiel J. Emanuel Fertility Fertility News Hastings Center Jama Brookes Neal Khosla OBGYN reproductive health Reproductive Medicine Sarah Lewen Vinod Khosla Women’s Health
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