A sentiment I, a cardiothoracic surgeon, share with orthopedic colleagues: the goal of AI in surgery is not to replace the surgeon, but to help the surgeon care smarter. It is a good phrase. It is also one that can be used to sell almost anything, so it is worth defining what caring smarter actually requires.
Caring smarter means the surgeon’s judgement is amplified, not outsourced. A tool that surfaces the relevant prior, flags the anomalous signal, or models three operative strategies against a specific patient’s anatomy makes me better. A tool that hands me a recommendation I cannot interrogate makes me a liability, because I will be the one defending the decision, regardless of which black box produced it.
The dividing line is authorship. In a cardiac case, I am the author of the plan and the person accountable for the outcome. AI that respects that relationship gives me more to reason with. AI that erodes it gives me a recommendation and a risk I did not fully understand.
This is why I keep returning to clinician-builders. The surgeons who will use AI best are the ones close enough to how a tool was built to know where it fails. Caring smarter is not a feature you buy. It is a capability you develop, and it depends on clinicians who can read a model the way they read an angiogram.
The future colleagues describe, where the physician is elevated rather than displaced, is the right one. It does not arrive automatically. It arrives when institutions invest in the clinical understanding that lets a surgeon stay the author of care while the tools get sharper.
Dr. Khalpey is chief medical AI officer at Atari AI, chair of applied clinical AI at the Atari AI Foundation and director of Khalpey AI Lab. He is a Fortune 500 advisor and author of The AI Prescription, an exploration into how AI enhances human expertise in medicine.
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