Around the world, nations differ in how they organize and pay for healthcare, but all face a common threat: the relentless rise of chronic disease. No matter the system, it’s becoming harder to keep people healthy while keeping costs under control. Increasingly, I’ve been invited to share my perspective on how emerging technologies—particularly generative AI—can help turn the tide.
Yesterday, I had the privilege to deliver the keynote presentation at The Future of Medicine event in São Paulo, where healthcare leaders, innovators and clinicians convened to discuss the innovations reshaping the medical profession.
My talk focused on the greatest opportunity to improve health outcomes and lower medical costs: helping patients prevent and better manage chronic diseases like hypertension, diabetes and heart failure. These conditions account for as many as half of all heart attacks, strokes, cancers and kidney failure. If we were able to help patients achieve excellent control of these conditions, we would save hundreds of thousands of lives annually and lower medical costs dramatically.
The audience in Brazil was particularly interested in my perspective on generative AI, the subject of my book ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine. I explained how these tools can continuously monitor patient data, flag early warning signs of a complication, recommend medication changes and educate patients in real time — bridging the persistent gap between what we know is possible in medicine and the clinical outcomes we achieve.
But even greater potential lies ahead.
Artificial general intelligence, or AGI, marks a fast-approaching milestone: the moment when generative AI reaches human-level cognition across a broad range of tasks. These systems won’t simply retrieve facts or summarize notes. They’ll reason like physicians, synthesize knowledge across specialties and support complex clinical decisions—consistently and without delay, distraction or fatigue.
Although AGI won’t solve every challenge in chronic disease management or instantly raise control rates to 90% (as the best health systems in the world have achieved), it will provide doctors and patients with an unprecedented opportunity to improve the accuracy of diagnoses and treatment recommendations, 24/7 — all without fatigue, distraction, delay or added cost.
And with experts predicting the arrival of AGI within the next five years, the time to prepare is now. The decisions we make today will shape whether AGI brings greater health, equity and savings or widens the gaps that already exist.
These innovations are especially important in Brazil, where a growing middle class is seeking high-quality medical care that is more convenient and affordable. As in the United States, chronic disease offers the clearest starting point for improvement.
In both countries, healthcare systems struggle to provide preventive care at scale. Physicians are overburdened and lack the time need to help patients manage chronic, lifelong conditions like hypertension and diabetes—or to prevent the serious complications that result. As a consequence, both nations spend the overwhelming majority of their healthcare resources treating heart attacks, strokes, cancers, kidney failure rather than preventing them in the first place.
Brazil is already home to a growing number of value-based healthcare models, many of which are aimed at serving the country’s middle class. The arrival of AGI will make these systems more powerful and effective. Paired with wearable devices and digital health records, generative AI tools will enable continuous monitoring of vital signs like blood pressure and glucose, flag issues before symptoms arise, recommend real-time treatment adjustments and deliver personalized education directly to patients. In this model, the patient’s home (not the doctor’s office or hospital) becomes the new center of care delivery.
These tools will be especially valuable in Brazil’s vast and diverse regions, where geography, income inequality and infrastructure gaps pose significant challenges. Once AGI-level expertise becomes available, the value-based approaches developed for urban populations can be extended to more rural and underserved areas. There, GenAI systems can help bridge gaps in care, supporting community-based health workers with timely, expert-level guidance—on demand and at scale.
But realizing this potential will require more than technology. It will demand strong leadership, thoughtful regulation and payment models that reward prevention and chronic-disease management, not just procedures. Policymakers must ensure that AGI tools are tested, safe and accessible. And medical schools must prepare the next generation of clinicians to partner with AGI-level apps, not compete against them.
As I told the audience in São Paulo, the promise of AGI is not science fiction. It’s a call to action. But great potential will only turn into reality if leaders are bold enough to rethink and redesign healthcare delivery systems.
I want to extend my deepest thanks to Dr. Jefferson Fernandes for his expert curation of this year’s Future of Medicine event. His leadership, vision and commitment to digital health are helping to shape global innovation in medicine. I’m also grateful to the entire team of conference organizers who worked tirelessly to make this event such a success, and to the many generous sponsors whose support made it all possible.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Check out Pearl’s newest book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine with all profits going to Doctors Without Borders.
