Scaling Care with AI: Balancing Human Judgment and Clinical Trust in Healthcare

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What does it truly mean to scale care with AI inside a real hospital environment? In this episode of The Signal Room, host Chris Hutchins talks with Mark Gendreau, emergency physician and Chief Medical Officer, about the intersection of healthcare AI, ethical leadership, and AI strategy. Together, they discuss how AI is transforming clinical workflows by amplifying human judgment rather than replacing it.

They explore real-world applications in healthcare AI such as radiology co-pilots, ambient clinical documentation, and workflow intelligence designed to relieve clinician burnout. Dr. Gendreau highlights the need for responsible AI and human oversight in high-reliability healthcare settings.

The conversation also covers critical topics like AI governance, clinical trust, alert fatigue, and leadership accountability. Listeners will gain insights into why successful AI adoption in healthcare depends on culture and ethical leadership, not just technology.

This episode is essential for healthcare leaders, clinicians, informaticists, and policymakers seeking practical guidance on AI readiness, ethical AI practices, and driving AI strategies that improve patient care while maintaining human judgment at the core.

Key Takeaways

• AI delivers the most value when it amplifies clinicians, not when it attempts to replace them
• Human judgment is essential in high-risk clinical decisions, even with advanced AI support
• Ambient documentation can dramatically reduce after-hours EHR work (“pajama time”)
• Alert fatigue is a governance problem, not just a technical one
• Trust in AI is built through reliability, transparency, and clear ethical intent
• Successful AI adoption depends more on leadership and culture than IT execution
• Interoperability and governance are the biggest barriers to scaling AI across health systems
• Emotional intelligence, empathy, and shared decision-making remain human responsibilities

Guest Info

Mark Gendreau, MD, MS, CPE
Emergency Medicine Physician | Chief Medical Officer

Dr. Gendreau is an experienced emergency physician and healthcare executive with deep expertise in clinical operations, patient safety, and responsible AI adoption. He focuses on using technology to improve access, quality, and clinician experience while preserving the human core of medicine.

🔗 LinkedIn: https://www.linkedin.com/in/markgendreaumd/

Chapters (YouTube & Spotify)

00:00 – Introduction and framing the AI scaling challenge
01:18 – Workforce scarcity and why AI must amplify clinicians
02:10 – AI in radiology: co-pilots, fatigue reduction, and safety
05:26 – Ambient documentation and eliminating “pajama time”
07:17 – Using AI to improve clinician communication and empathy
09:33 – Where AI falls short and why humans must stay in the loop
12:44 – Guardrails, trust, and human-AI partnership
13:44 – Trust in AI vs trust in human relationships
16:07 – Adoption curves and clinician buy-in
18:05 – Why AI fails when treated as an IT project
20:41 – Leadership’s role in shaping AI culture
22:07 – Interoperability, governance, and scaling challenges
26:04 – Signals that an organization is truly AI-ready
29:26 – Emotional intelligence and where AI should never lead
33:59 – Alert fatigue and governance accountability
37:27 – Measuring success: outcomes, equity, and pajama time
38:36 – How to connect with Dr. Gendreau
39:31 – Episode close

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