S1E17 The Clinic of the Future with Dr. Holly Tse: What's Broken, What's Next, and How AI Changes Everything PART 2

Episode Summary — Part 2: Clinics of the Future with Dr. Holly Tse The cliffhanger is over. In Part 1, Dr. Holly Tse laid out everything wrong with primary care today. In Part 2, she builds the thing she believes can replace it. Her framework is called the Clinic of the Future — and it starts with a radical proposition: break the visit. Break the PCP. Maybe even break the note. Replace all of it with a continuous flow of care, supported by a trusted multidisciplinary team, standardized clinical protocols, and AI tools that do the heavy lifting so physicians can do what only physicians can do. Dr. Tse introduces two AI agents at the center of her vision: Charlie, a patient-facing empathetic agent available around the clock to listen, coach, and navigate; and Emily, an in-EMR clinical intelligence agent that synthesizes patient data in real time — surfacing rising risk, flagging missed refills, summarizing entire workup histories before you even ask. Together, they represent a shift from reactive, encounter-based medicine to proactive, panel-level care. The conversation gets honest about what stands in the way: a fee-for-service payment model that still rewards discrete visits, clinicians who are skeptical by training, patients who are increasingly transactional, and real HIPAA and liability questions that nobody has fully answered yet. Dr. Tse's position on all of it is grounded — value-based care is the financial engine that makes the flow of care work, and CMS's stated goal of moving all Medicare patients into VBC arrangements by 2030 means the window is closer than it feels. She and Dr. Diarra also go somewhere most healthcare podcasts don't: the future role of the physician when AI can handle the bread-and-butter cases. Dr. Tse's honest read is that physicians who don't evolve toward higher-complexity cognitive work risk being compensated like advanced practice providers — and she thinks that conversation is already happening, just not loudly enough. The episode closes with practical advice for independent and small practice physicians on where to start with AI today: website chatbots for FAQ and scheduling, productivity tools like Claude's Cowork for synthesizing presentations and documents, and a simple guiding question — what keeps you up at night, and can a tool help with that first? If Part 1 was the diagnosis, Part 2 is the treatment plan — specific, ambitious, and delivered by someone who has lived at every level of the healthcare system and still believes it can be redesigned for good.