There used to exist this paradigm where you'd show up to a doctor's office with anticipation. Anticipation that the man or woman that would soon walk into your exam room would possess the insight, knowledge, and context needed to resolve your worries, pains, or ailments. In many ways, that's still the case. You walk in with symptoms and you need a prescription. You walk in once a year, learn a bit more about your health and leave with more context. You walk in with worries and leave with a follow up appointment.
But today, how many patients are walking into the exam room, or skipping it entirely, already equipped with enough data and context to become active participants in their own care?
This is in no way a minimization of physicians. The sheer breadth of information they’re drawing upon cannot be replaced. I truly think that patients can augment their physicians well, so long as that relationship is mutually respected.
The Evolution
Generation 1: Physician treats patient. All knowledge is stored with physicians. The role of the physician grows as the depth of medicine grows. For the sake of this argument, I’d define this generation as the beginning of medicine to 1995.
Generation 2: Physician entertains patient, begins treatment. Patients are able to gather cursory information on their conditions or symptoms. They are engaged up until the ceiling of their knowledge, after which they return to a Gen 1 relationship.
Generation 3: Patients arrive not just with symptoms, but with structured data, logs from wearables, lab results, radiology scans, symptom timelines, and even potential diagnoses generated by consumer-facing AI tools. It is now common practice for patients to pre-process their own medical questions through AI, receiving responses that often mirror the clinical reasoning of trained providers. While physicians still hold the expertise, licensing, and responsibility to diagnose and treat, the dynamic has shifted: the patient brings more to the table than ever before. The physician’s role is increasingly one of adjudicator, interpreter, and advisor that guides decision-making alongside both patient and machine. The new clinical encounter is no longer just doctor versus illness. It’s a three-way collaboration: physician, patient, and machine.
The new exam room
Is a patient being prepared and skeptical threatening to a doctor?
It shouldn’t be. But for some it may be.
There will be two types of doctors in this next generation of care: the ones who welcome the patient and their machine, and the ones who see it as a challenge to their authority. The former will thrive. The latter will alienate patients who come in prepared, and worse, they’ll handicap themselves by ignoring tools that could make them better at their job.
This isn’t about replacing physicians with AI. It’s about changing the nature of the relationship. Patients now come in with structured lab data from services like Function or Superpower, food logs, radiology reports, maybe even a differential diagnosis from GPT-4 or Perplexity. That’s not a threat, it’s a head start.
The forward-looking doctor sees this as signal, not noise. They’ll sit down with you, pull up your data, dig into your bloodwork, and say, “Interesting, here’s where I agree, here’s where I’d push further.” They’ll augment the machine’s input with the things only they can do: palpation, inspection, intuition sharpened by thousands of cases. They’ll know where your data falls short and meet it with curiosity, not defensiveness.
Then there are the others. The doctors who refuse to look at what you bring in. They’ll order the same tests over again, not because they have a clinical reason, but because their name needs to be on it. Liability, ego, maybe just habit. They treat your curiosity like a problem to be managed, not a tool to be sharpened.
How Will Doctors Change
It’s a bit ironic that many blood testing companies market themselves as “concierge medicine,” implying you’re getting access to a high-touch MD who will walk you through everything. In practice, most people still end up seeking in-person care when something feels seriously wrong. And rightly so because when you’re dealing with horrific symptoms, the last thing you want is a PDF and a smile. You want someone in the room with you.
That’s not to say these services are useless; they’re part of the future. But right now, there's a disconnect. The PDF says one thing, your body says another, and your actual doctor might not know what to do with either.
That’s where Generation 3 doctors come in.
These are the physicians who don’t roll their eyes when you show up with a full blood panel from Function or a 10-page AI writeup on potential diagnoses. They welcome it. They expect it. And they know how to read it, not just technically, but contextually. They know what to trust, what to dig into further, and what gaps still need to be filled in person.
If these concierge testing companies are going to keep growing (and they will) there needs to be a handoff. Either they start actively referring people to Generation 3 doctors who can take the baton, or we start building infrastructure that trains and equips traditional doctors to engage with these outside inputs thoughtfully.
Because the future isn’t either/or. It’s both. It’s AI and intuition. PDF and palpation. Patient and physician. And the doctors who can blend those worlds will be the ones who actually earn trust, not just market it.
Doctors as judges
There’s an emerging feedback loop here-one that nobody’s really naming yet. As more people show up to clinics with data from third-party services, doctors are going to start forming opinions. They’re going to start rating these services, not on Yelp, but in tone, body language, eye rolls, and subtle comments like, “I’ve seen a lot of patients come in with [insert company name]... not a fan.”
Over time, this becomes its own informal reputation system. Some doctors will become allies to these companies, either because they genuinely respect the data or because they’re on payroll. Others will throw stones from across the moat, telling you horror stories of patients who skipped their physicals for three years because they thought their Function draw was “basically the same thing.”
And that’s the real tension:
Will these third-party services try to buy out medical legitimacy by recruiting physicians as in-house advisors and front-line advocates? Or will the split deepen where you’re either a company doctor or a critic warning patients away?
I don’t think it has to go binary. But right now, that’s the shape it’s taking.
The more interesting future is one where third-party diagnostics and traditional care aren’t fighting for credibility but instead they’re checking each other’s work. I want a doctor who’s seen Function labs a hundred times and can tell me what’s useful and what’s fluff. I don’t want a doctor who dismisses it all out of reflex, or worse, sees me as a problem because I brought data to the exam room.
Patients are going to remember who helped them synthesize their information and who made them feel stupid for showing up informed.