Searching For The Next Search – The Health Care Blog


I didn’t write about ChatGPT when it was first introduced a month ago because, well, it seemed like everyone else was. I didn’t play with it to see what it could do.  I didn’t want it to write any poems. I didn’t have any AP tests I wanted it to pass. And, for all you know, I’m not using it to write this. But when The New York Times reports that Google sees ChatGPT as a “Code Red” for its search business, that got my attention.

A few months ago I wrote about how Google saw TikTok as an existential threat to its business, estimating that 40% of young people used it for searches. It was a different kind of search, mind you, with video results instead of links, but that’s what made it scary – because it didn’t just incrementally improve “traditional” search, as Google had done to Lycos or Altavista, it potentially changed what “search” was.    

TikTok may well still do that (although it is facing existential issues of its own), but ChatGPT could pose an even greater threat. Why get a bunch of search results that you still have to investigate when you could just ask ChatGPT to tell you exactly what you want to know?

Look, I like Google as much as anyone, but the prospect that its massive dominance of the search engine market could, in the near future, suddenly come to an end gives me hope for healthcare.  If Google isn’t safe in search, no company is safe in any industry, healthcare included.

“No company is invincible; all are vulnerable,” said Margaret O’Mara, a professor at the University of Washington told NYT. “For companies that have become extraordinarily successful doing one market-defining thing, it is hard to have a second act with something entirely different.” One Google executive described how Google responded to ChatGPT as “make or break” for the company.


The problem with ChatGPT for search is two-fold. The first is that, while it will give you a plausible sounding answer to almost anything you ask it, as Emily Peck of Axios noted, “ChatGPT has no idea whether anything it says is true.” 

At least with traditional search results, you can see results from several sources and evaluate their credibility. With ChatGPT all that happens behind the scenes. ChatGPT doesn’t care whether what it is telling you is true or not; it’s just interested in providing you a response. That hopefully is something that will improve as ChatGPT “learns” to distinguish true from potentially true to unlikely to probably false and to demonstrably false. Over time, it could probably do that as well as (most) users do. 

The second problem is even more dangerous, for Google: it doesn’t fit with the digital advertising model that delivers most of Google’s massive revenues. “Google has a business model issue,” AI expert Amr Awadallah, told NYT. “If Google gives you the perfect answer to each query, you won’t click on any ads.”

And this threat is happening at a time when Google’s share of digital dollars is already declining.


Forrester Research analyst Rowan Curran sees ChatGPT as a major turning point for AI, telling Venture Beat: “The only thing that I’ve been able to compare it to is the release of the iPhone.”  There were smartphones before the iPhone, just as there were AI chatbots before ChatGPT, but the iPhone raised expectations dramatically. Mr. Curran feels ChatGPT is having a similar effect:

I think what is really unique here is we have a technology that is useful today, that is advancing very quickly, and that we are all learning about in real time — in terms of both how to use it and how to prevent it being used in negative ways.

Sridhar Ramaswamy, co-founder and CEO of ad-free search platform Neeva, is similarly excited, telling NYT: “Last year, I was despondent that it was so hard to dislodge the iron grip of Google. But technological moments like this create an opportunity for more competition.”

In addition to Neeva and Dr. Awadallah’s Ventura, there’s AI-driven search engine, “the AI search engine you control.” As with ChatGPT, users take their chances on the accuracy of results; the site warns: “This product is in beta and its accuracy may be limited,” and  “ is not liable for content generated.” 

It’s not as though Google has been ignoring AI. Google helped develop what led to ChatGPT, and has a chatbot technology of its own – LaMDA (Language Model for Dialogue Applications) that is so powerful that some feared it was, in fact, sentient. In addition, Google has a host of AI-based products and tools it is working on. Given its market dominance and reputation, though, it has to be careful how it introduces any innovations.

The very nature of what we expect “search” to be is changing. Results might be a text conversation” with a chatbot. It might be curated videos. It might be Dalle-E 2 or Stable Diffusion creating explanatory images, or it might be your favorite expert explaining it to you in a deepfake video. That’s technology evolving.

The business model problem is far deeper. If search has been, essentially, a way to serve up targeted ads, then a chatbot or other model that doesn’t easily accommodate ads is a problem for companies that have relied on them. And companies that don’t rely on ads to generate revenue have to come up with other revenue sources, in an online world where users expect most things to be “free.”


Healthcare has similar issues with AI. As with search, the first is that it is going to enable new ways of delivering information and even care. Initially it won’t do so with as much accuracy as humans, but it will learn quickly and at some point it will rival – or even exceed – human experts. Healthcare can dig in its heels and stick to the human-driven model, but the AI-driven changes are coming.

Again, as with search, the business model challenge is even greater. The healthcare business model is both exceeding expensive and insanely complicated. It isn’t built at all on what is best for people’s care, much less their health. AI will enable models that are far cheaper, far faster, and potentially much simpler. Healthcare will fight to maintain its sources of revenue, but the revolution is coming.

If I were Epic, the Cleveland Clinic, United Healthcare, Big Pharma, or any of healthcare’s other dominant entities, I’d be watching how Google responds to ChatGPT. 

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