Dan Donoho on Surgical Data Science, Regulation, and the Humanoid OR

Send us Fan MailEpisode SummaryAnthony DiGiorgio and Anish Koka sit down with Dr. Dan Donoho, an NIH-funded neurosurgeon-scientist at Children's National Hospital and George Washington University, and founder of the Surgical Data Science Collective and the Foundation for Digital Neurosurgery, for a wide-ranging conversation on AI in medicine. Donoho explains why surgeons get almost no structured feedback after a case, walks through a randomized controlled trial showing AI-coached medical students outperformed those coached by humans on simulated tumor resections, and argues that most regulatory "barriers" to deploying AI in healthcare are cultural rather than statutory. The conversation moves through the limits of tactile sensation in surgical AI, why he expects innovation to come from small agile practices rather than large insurance-pay hospitals, his family's data science lineage, humanoid robots performing laparoscopic surgery, the anti-data-center backlash, and ongoing surgical AI trials in Ethiopia and Tanzania.Chapter Markers00:16 Introduction and guest background01:16 The Surgical Data Science Collective and the problem of lost surgical knowledge03:26 How AI could replace the mentor's voice in a surgeon's head06:50 Tactile feedback and the limits of video-based AI in surgery08:47 The RCT: AI coaching vs. human coaching in medical students11:48 What's the gold standard for grading surgical performance14:42 Who validates the AI — the EKG problem and patient outcomes as the real judge17:19 Humanoid robots, self-driving cars, and low-hanging AI fruit in clinics20:27 Regulatory barriers to AI in EHRs — culture vs. statute22:09 Doctronic, AI prescribing, and licensure25:12 Where Dan's interest in data science started26:39 His father, statistician David Donoho, and the rise of empiricism28:09 The "don't go into medicine" narrative and why it's wrong30:26 COVID as a case study in bureaucratic drag on technology adoption33:27 Should the FDA regulate surgical AI products35:50 Andromeda Surgical, humanoid robots in the OR, and the cost gap38:27 The anti-data-center movement and the history of sabotage39:54 Global AI competition and China's Kimi K3 model42:41 How to measure whether an AI model is actually better44:34 Model size vs. training — why prompting changes performance45:46 What the surgical community currently measures, and why it's the wrong thing47:23 The Tanzania surgical AI trial and other real-world deployments49:03 What actually scares Dan about AI51:21 Will AI democratize power or concentrate it52:15 Closing questions — what's next, including the Ethiopia partnershipCo-Host Handle@anish_koka and @drdigiorgioShow Handle@drsloungepodSubscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrRApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658YouTube: https://www.youtube.com/@TheDoctorsLoungePodDr. Daniel Donoho Website & XWebsite: https://www.surgicalvideo.io/X: https://x.com/ddonoho🔗 Connect with the Hosts:• Dutch Rojas on X• Dr. Anthony DiGiorgio on X• Dr. Anish Koka on X• Dr. Dan Choi on X• Dr. Sanat Dixit on X