AI has arrived in medicine, and right at the center of that wave is Dr. Shiv Rao, a cardiologist turned entrepreneur who co-founded Abridge in 2018 with a mission to make technology serve clinicians, not sideline them.
In this first-ever in-person episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Shiv for an unfiltered conversation about the state of AI in medicine and how it’s changing clinical workflows. They explore what AI means for physician agency, and why this moment demands leadership from doctors themselves.
For Shiv, Abridge was never about automating physicians, but instead, about turning the most human part of care — the conversation — into something actionable. He describes it as “conversation to note, to code, to claim, to care,” a seamless flow where every word contributes to better outcomes, smarter systems, and more meaningful work.
What began as a startup that was considered by health systems to be “a party trick,” as Shiv puts it is now operating at scale across hundreds of health systems. Abridge’s technology helps clinicians stay present with patients while handling the documentation, compliance, and downstream workflows behind the scenes.
But this conversation doesn’t stop at the technology itself. Shiv and Graham dive into the heart of medicine’s identity crisis and tackle what’s at the root of physician burnout and how AI can restore purpose for the profession.
Shiv calls it a “movement,” and it’s one where doctors, nurses, and technologists must work together to reshape healthcare from within.
In a world of AI hype and corporate spin, this episode offers something rare: clarity, humility, and a vision grounded in both patient care and real-world innovation.
Every meaningful moment in healthcare begins with words: the exchange between a clinician and a patient, or a clinician and another clinician, that shapes everything that follows. Shiv believes this dialogue is the most upstream and underused data set in medicine, capable of driving documentation, analytics, and decision support. Abridge was founded on this insight, creating technology that listens, learns, and translates those conversations into structured clinical intelligence. By capturing the nuance of human interaction, it not only saves time but also helps doctors better understand and serve their patients.
Shiv makes it clear that Abridge’s mission is not to automate doctors but to amplify what makes them indispensable. “We’re not going to fully automate doctors,” he says. “We’re going to force-multiply them.” The company’s technology works quietly in the background, like good air conditioning, handling administrative tasks so physicians can focus on the people in front of them. In doing so, Abridge repositions AI as a way to restore humanity to medicine rather than remove it.
Shiv argues that the label ‘AI Scribe’ is far too narrow for what Abridge is building. The company is not just producing notes; it is creating a platform that connects conversation to every layer of the care experience, from coding and claims to care management and even clinical trial recruitment. This approach allows clinicians to move seamlessly between patient interaction and operational efficiency without the friction that has long defined digital health. For Shiv, progress is not simply about typing less, but about building systems that think and work alongside doctors.
Shiv sees the rise of AI in healthcare as a movement that requires physician leadership, not a passing phase of hype. He urges doctors to take part in shaping the technology’s future, saying, “Don’t shy away from it. Run into it.” Whether through advising, founding a company, or simply providing feedback, clinicians have a responsibility to make sure AI reflects their judgment, ethics, and compassion. The future of medicine, Shiv believes, will be determined not by the technology itself but by who steps forward to guide it.
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