This Week in AI

This week, JCal sat down with Shiv Rao at LAUNCH Fest 2026. Shiv is a cardiologist, CEO, and co-founder of Abridge, a $5B+ company that's raised close to $1B to build vertical large language models for healthcare. Shiv breaks down why the US healthcare system is broken, how AI is already outperforming doctors on average, and what it took to build a unicorn in one of the most regulated industries on the planet.

We explore how AI is transforming doctor-patient conversations, eliminating clinician burnout, and reshaping how care is delivered and paid for.

Doctors Need 30 Hours a Day: An American Journal of General Internal Medicine study found physicians can't complete their daily workload in 24 hours. Shiv explains where all that time goes anAbridge is clawing it back.
AI Has Better Bedside Manner Than Your Doctor: Research from Harvard and other institutions now shows AI delivers more consistent answers and patients actually prefer it. Shiv explains why that's not as scary as it sounds.
The Healthcare Stakeholder Problem: Shiv invokes Conway's Law to explain why every player in the system, doctors, insurers & hospitals are pointing guns at each other instead of aligning around the patient.
A Real-Time AI Copilot for Doctors: Abridge's live assistant listens to conversations, pulls context from years of patient data, and prompts doctors with follow-up questions mid-visit to unlock insurance approvals on the spot.
The Self-Directed Patient Explosion: Nearly every patient walks in armed with ChatGPT research. Shiv explains why this is compounding the burnout crisis, not solving it.
Go-To-Market in Regulated Industries: Why "start small and swim upstream" can be a death trap in healthcare, and how Abridge's decision to target large health systems early became a core part of their moat.
Being Early Isn't Being Wrong: Abridge started three months after "Attention Is All You Need" and raised a $3M seed on a $12M pre. Shiv shares what it was like waiting years for the market to catch up.
Robotics in Healthcare: From AI-powered suturing at Johns Hopkins to the case for humanoid EMTs, Shiv lays out what's coming and what's still far off.

🔗 Learn more about Abridge: https://www.abridge.com

This Week In AI is made possible by:
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Timestamps:
00:00 Welcome & intro to Shiv Rao, CEO & co-founder of Abridge
01:20 Rural hospital closures & the necessity of AI agents
03:33 Designing an AI intake process for primary care
06:01 Solving the 30-hour workday & clerical burnout
08:25 Conway’s Law & misaligned stakeholders in healthcare
10:07 Quadratic - Bringing the productivity boost of AI into your spreadsheets. Visit https://www.quadratic.ai/twist to sign up and use the code TWIST to get one free month of their pro tier subscription.
11:50 Why patients prefer AI models over average clinicians
14:27 Moving past the charade of the all-knowing doctor
17:01 How automated notes restore human clinical presence
21:00 The Joe Rogan crowd & consumer-driven healthcare
27:29 Advances in surgical robotics & AI precision
32:44 Surviving the Bert era to reach the AI inflection point

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This week we sit down with three founders building at the frontier of AI in space, autonomous hardware, and software reliability: Philip Johnston (StarCloud), Boris Sofman (Bedrock Robotics), and Spiros Xanthos (Resolve AI). We dig into why data centers are heading to orbit, how AI is taking the wheel on construction sites, and whether the industry is moving too fast for its own good.
We explore how physical infrastructure, real-world autonomy, and AI trust are reshaping the industry from the ground up.
Sam Altman vs. Space Data Centers: He said it won't matter "this decade." But Philip breaks down why the economics of space compute are about to flip.
The Construction Labor Crisis: Half the skilled workforce is retiring in the next seven years while data center construction spend hits $700B this year alone. Boris explains why autonomous excavators aren't replacing workers, they're the only way to keep up.
AI Broke Amazon's Code: Generative AI is shipping software faster than engineers can understand it. Spiros warns that accelerating code velocity without upgrading reliability is a disaster waiting to happen.
Automation Bias & Skill Degradation: What aviation taught us about over-trusting autopilot, and what developers need to learn fast.
Why Americans Don't Trust AI: A KPMG survey puts AI's favorability between ICE and Iran. The panel debates whether healthcare, education, and construction are the three wins that could turn the tide.
Karpathy's AI Research Agent: A weekend project that fires off entire teams of AI grad students running experiments overnight. Is this what automating the scientific method actually looks like?
Anthropic vs. the Pentagon: The U.S. government threatened to label a leading domestic AI company a supply chain risk. Who gets to decide how AI is used in warfare?

Timestamps:
00:00 — Welcome to This Week in AI: Episode 4
01:22 — Philip Johnston (Star Cloud): Why data centers in space will dominate
03:35 — Boris Sofman (Bedrock Robotics): Autonomizing construction equipment with AI
08:44 — Spiros Santos (Resolve AI): Intro & AI-generated code's "high blast radius" problem at Amazon
09:31 — Squarespace: Turn your idea into a beautiful website! Go to http://www.squarespace.com/twist for a free trial. When you’re ready to launch, use offer code TWIST to save 10% off your first purchase of a website or domain.
10:35 — Deep dive: Amazon's code red meetings & trusting AI-generated code too much
13:20 — Automation bias & skill degradation: the aviation autopilot analogy
17:09 — Why Americans distrust AI: and what the industry should do about it
20:05 — Notion ad
21:29 — KPMG survey results: only 9% of large companies plan job cuts from AI, 55% plan to hire more; panel debates job displacement fears
31:43 — AI's PR fix: healthcare, education & construction as the big three wins
39:22 — World models & humanoid robots: LeCun's $1B bet & the Figure video controversy
47:59 — Star Cloud's 88,000-satellite constellation: economics of space compute
56:05 — Andrej Karpathy's AI research agent: automating the scientific method
1:01:04 — Anthropic vs. the military: supply chain risk, Dario's dilemma & the Iran strike claim
1:07:50 — Hiring pitches & outro: Star Cloud, Bedrock Robotics, Resolve AI

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This week we sit down with three founders building at the frontier of AI infrastructure, evaluation, and hardware: Chase Lochmiller (Crusoe), Naveen Rao (Unconventional AI), and Anastasios Angelopoulos (Arena). We dig into the real bottlenecks slowing down the AI buildout, how to standout in the job market as AI matures, and the explosive government standoff between Anthropic and the Pentagon.
We explore how AI infrastructure, open source models, and policy are reshaping the industry from the ground up.
The Anthropic-Pentagon Standoff: The U.S. government blacklisted a leading domestic AI company for the first time. Who sets the rules for AI in warfare?
Jevons Paradox & AI: Every efficiency gain in intelligence-per-watt creates more demand, not less. AI infra is positioned to capture the largest market humanity has ever built.
OpenClaw & Open Source Mania: The open-source AI agent that just became GitHub's most-starred project. It now runs locally on your phone.
Should You Learn to Code?: Yes, but not as a trade skill. Bootcamp-style training is dead. Understanding how machines work is what separates leaders from everyone else.
Rethinking the Computer from Scratch: Naveen's team is building chips that mimic biology, targeting 1,000x efficiency gains.
The Coming Labor Crisis: Anastasios argues most valuable work is just training humans for repeatable tasks, and that work is disappearing. Chase counters that digital labor is a new variable in the GDP equation.
This Week In Startups is made possible by:
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Timestamps:
00:38 — Welcome to This Week in AI
01:21 — Show intro and guest introductions (Chase from Crusoe and Anastasius from Arena)
02:22 — Crusoe's Stargate partnership: 1.2GW campus for Oracle and OpenAI in Abilene, Texas
03:09 — Rethinking computing from first principles for 1,000x efficiency
06:53 — How Arena went from a Berkeley side project to half a billion conversations
09:28 — Quadratic - Bringing the productivity boost of AI into your spreadsheets. Visit https://www.quadratic.ai/twist to sign up and use the code TWIST to get one free month of their pro tier subscription.
12:01 — Open source AI explosion: On-device models, token costs, and adoption
15:31 — Defining AGI: Clay Math millennium problems, moving goalposts, and what AI still can't do
22:08 — Notion - Notion brings all your notes, docs, and projects into one connected space that just works with AI built right in. Try Notion, with Notion Agent, at https://www.notion.com/twist

23:07 — System 1 vs. System 2 thinking and where compute actually happens
26:31 — Crusoe Spark: Modular data centers that go where the power is
34:33 — Model compression is moving faster than anyone predicted
36:51 — Jevons Paradox, the employment question, and the coming labor crisis
45:53 — Abundance, advice for young people, and the importance of learning to code
64:41 — AI in warfare: Corporate responsibility, inevitability, and national obligations

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Jason Calacanis sits down with two founders building at the frontier of AI products and infrastructure: Tanay Kothari (Wispr Flow) and Richard Socher (You.com & AIX Ventures). They dig into the Citrini "doom post" that rattled markets, the real economics of automation waves, and how AI-first teams are being rebuilt from the ground up.
We explore how the agentic shift is reshaping companies, costs, and careers:
The AI Doom Post Debunked: Why the viral Citrini Substack predicting 10% unemployment and an S&P crash is completely wrong.
AI-First Hiring: How Wispr Flow shipped their #1 Android voice app with one engineer running ten Claude agents simultaneously — and stopped hiring junior developers entirely.
Customer Support at Scale: How Wispr went from needing 200 support agents to 4 by automating 15 distinct support loops, from bug tickets to product feedback.
The Cognitive Surplus: Why automation doesn't destroy jobs, it creates the next wave of businesses nobody has predicted yet.
Open Source vs. Closed Models: Why DeepSeek forced every major lab to innovate faster, and how Wispr built its own 90% gross margin voice model by starting on open source.
Taiwan & the Chip Risk: Apple's Mac Mini onshoring, the 2027 CCP military warning, and the five contingency plans the world is quietly building around TSMC.
OpenClaw Mania: Producer Oliver joins the show to talk about how he is using OpenClaw to do his tasks for him.

This Week In Startups is made possible by:
Notion - https://www.notion.com/twist
Quadratic - https://www.Quadratic.ai/twist

Timestamps:
00:01:16 - Welcome & Guest Introductions: Tanay Kothari (Wispr Flow) and Richard Socher (You.com)
00:03:33 - Why Voice Dictation Finally Works: How Wispr turns rambling speech into send-ready messages
00:05:43 - Foot Pedals, Rings & the Future of Voice Input Modalities
00:09:32 - The Citrini "Doom Post": The viral Substack predicting 10% unemployment and an S&P crash
00:11:52 - Quadratic - Bringing the productivity boost of AI into your spreadsheets. Visit https://www.quadratic.ai/twist to sign up and use the code TWIST to get one free month of their pro tier subscription.
00:14:28 - Debunking the Doom: Cognitive Surplus, the Lump of Labor Fallacy & Why People Adapt
00:22:08 Notion ****- Notion brings all your notes, docs, and projects into one connected space that just works with AI built right in. Try Notion, with Notion Agent, at https://www.notion.com/twist
00:26:18 - Open Source vs. Closed Models: How DeepSeek Forced Innovation & Who Wins the Cost Race
00:38:05 - Building AI-First Teams: Certifications, Agent Management & the New Skill Stack
00:43:42 - Customer Support Reinvented: How Wispr Went from 200 Agents to 4
01:16:29 - Breaking News: Apple Onshores Mac Mini to Houston & The Taiwan Chip Risk Explained

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This Week In Startups is made possible by:Gusto - Try Gusto today and get 3 months free at [Uber.com/twist](http://uber.com/ai-solutions)Crusoe Cloud - Reserve your capacity for the latest GPU’s at [Uber.com/twist](http://uber.com/ai-solutions)Uber AI Solutions - Book a demo today at [Uber.com/twist](http://uber.com/ai-solutions)*Today’s show: It’s a packed show! We’ve got YouTuber and Openclaw enthusiast Matthew Berman, Ryan Yaneli, founder of Nextvisit, and Jason Grad, founder of Massive! We’re all in on Openclaw, but we have no doubts there’s still room in the market for a GIANT Openclaw consumer app to shift the paradigm. What will that look like? Will it be an app? Will it be baked into the iPhone? Let’s explore!**Timestamps:* 00:00 Intro02:04 Why Matthew thinks Openclaw is not ready yet to be brought to the consumer04:45 Jason doesn’t want hundreds of different apps, and thousands of tabs05:45 Why Ryan sees open claw giving consumers access to opportunities they couldn’t have gotten to otherwise.07:02 Only 10% of people are technical enough to install openclaw08:16 Would Openclaw be better off as an app?08:27 *Gusto*. Check out the online payroll and benefits experts with software built specifically for small business and startups. Try Gusto today and get three months FREE at [Uber.com/twist](http://uber.com/ai-solutions)00:10:52 The killer use case that could bring Openclaw to the consumer00:12:13 Why Meta acquired Manus.00:15:13 How Ryan uses Openclaw in his personal life00:18:44 *Crusoe Cloud*: Crusoe is the AI factory company. Reliable infrastructure and expert support. Visit [crusoe.ai/savings](https://www.youtube.com/redirect?event=video_description&redir_token=QUFFLUhqa1E3eXB2eW9RS1gwd2RNM1EtU3E5ZERteFA1QXxBQ3Jtc0tsZS1VX0NCcXh6UW4tSi10TU1DbDhkMFIwQUhXLWktNC00cFFrdVhocGdMeldhSDJiU0tPQ0dyVDZjLU9zMnNIdWprRHFhVDZ0M1JnRWRrTktVLVpDRU9IMG5mMXBucDRlWGtVeWx1UHpzSzlsT1dSOA&q=https%3A%2F%2Fcrusoe.ai%2Fbuild&v=TItdrQuJdsw) to reserve your capacity for the latest GPUs today.00:23:24 What Jason’s “Clawpod” does00:24:38 Jason demos his Openclaw workflow00:28:23 *Uber AI Solutions -* Your trusted partner to get AI to work in the real world. Book a demo with them TODAY at [Uber.com/twist](http://uber.com/ai-solutions)00:30:04 How Matt used Openclaw to figure out he’s been having stomach issues00:32:27 What will be the ultimate UX for AI?00:38:53 Anthropic has patched the ability to use Openclaw through its pro plan!00:42:20 Matt and Jason hope for a multi-model future — but we haven’t made progress!00:52:21 Jason has skepticisms about the Openclaw foundation00:52:59 Ryan predicts a new Openclaw fork coming from the shadows!00:54:21 Peter Steinberger is going to OpenAI, NOT to work with Openclaw… Will he “orphan” openclaw?00:58:19 does raspberry AI stand a chance against Apple?*Subscribe to the TWiST500 newsletter: [https://ticker.thisweekinstartups.com](https://ticker.thisweekinstartups.com/)Check out the TWIST500: [https://www.twist500.com](https://twist500.com)Subscribe to This Week in Startups on Apple: https://rb.gy/v19fcp*Follow Lon:X: https://x.com/lons*Follow Alex:X: https://x.com/alexLinkedIn: [⁠https://www.linkedin.com/in/alexwilhelm](https://www.linkedin.com/in/alexwilhelm/)*Follow Jason:X: https://twitter.com/JasonLinkedIn: [https://www.linkedin.com/in/jasoncalacanis](https://www.linkedin.com/in/jasoncalacanis/)Check out all our partner offers: https://partners.launch.co/*Check out Jason’s suite of newsletters: https://substack.com/@calacanis*Follow TWiST:Twitter: https://twitter.com/TWiStartupsYouTube: https://www.youtube.com/thisweekinInstagram: [https://www.instagram.com/thisweekinstartups](https://www.instagram.com/thisweekinstartups/)TikTok: https://www.tiktok.com/@thisweekinstartupsSubstack: [https://twistartups.substack.com](https://twistartups.substack.com/)