Most physicians see AI as something happening to medicine. Dr. Byron Crowe is one of the few who decided to make it happen himself.

In this episode of How I Doctor, Offcall co-founder Dr. Graham Walker sits down with Dr. Byron Crowe — internal medicine physician, former Harvard Medical School faculty, and Chief Medical Officer of Doctronic — to discuss the most provocative development in healthcare AI yet: the nation's first state-approved program allowing AI to autonomously renew prescriptions, currently live in Utah.

This episode doesn't traffic in hypotheticals. The program is running right now. And the questions it raises are ones every physician is going to have to answer eventually — whether they're ready or not. Who's responsible when AI gets a prescription wrong? Is the current system it's replacing actually any better? And if AI can handle the routine work, what does that mean for the physicians who've been doing it? Byron has thought harder about these questions than almost anyone in medicine. He's the first author on the Society for General Internal Medicine's position statement on generative AI. He's published peer-reviewed research in JAMA on AI's diagnostic capabilities. And now he's running clinical strategy for a company that calls itself your personal AI doctor — and means it.

Byron doesn't come to this conversation to sell the technology. He comes to make the case that the status quo — millions of prescription refills processed via portal clicks with minimal physician review — is already broken, and that AI done right, with graduated autonomy, genuine accountability, and clinicians at the center, is an improvement worth taking seriously. It's a conversation that will challenge what you think you know about where medicine is headed and who gets to decide.

What You'll Learn

What "AI-native care" actually means and why Byron argues it's a fundamentally new care model — not just a faster version of telehealth
How Doctronic's graduated autonomy model works in Utah, from full physician review of every refill to eventual full autonomy with retrospective oversight
Why Byron believes not a single doctor will lose their job to AI — and what "doctor reassignment" actually looks like in practice
What "careworthiness" means as a moral standard, and why Byron thinks it matters more than any technical benchmark
Why most health AI companies make the same fatal mistake when entering clinical medicine — and how Doctronic is trying to avoid it
Where Byron draws the hard line on AI autonomy — and the one place he says AI should never act alone

Resources & Where to Find Byron

Byron's LinkedIn

Byron's Substack: Always On Call

Doctronic

🩺 Offcall is more than a platform — it’s a community. Join today!

📝 For a full transcript of this episode click HERE

🎧 Subscribe to receive new How I Doctor episodes directly in your feed here: https://episodes.fm/1767429315

👨‍⚕️Follow Dr. Graham Walker on

LinkedIn https://www.linkedin.com/in/graham-walker-md/

IG https://www.instagram.com/ubergraham/

Bluesky https://bsky.app/profile/drgrahamwalker.com

✉️ Join our newsletter On/Offcall here https://offcall.beehiiv.com/subscribe

🟧 Follow Offcall on

LinkedIn https://www.linkedin.com/company/joinoffcall/

IG https://www.instagram.com/offcalldotcom/

TikTok https://www.tiktok.com/@offcalldotcom