Alexander A. Morgan, MD PhD

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Alexander A. Morgan, MD PhD

Alexander A. Morgan, MD PhD

@genomicsdoc

25 years working at the intersection of AI, biotech, and healthcare. Partner at Khosla Ventures, investing in the future.

San Francisco Katılım Mayıs 2013
1.1K Takip Edilen2.2K Takipçiler
Alexander A. Morgan, MD PhD retweetledi
Keith Rabois
Keith Rabois@rabois·
My investment criteria.
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Dustin
Dustin@r0ck3t23·
Jeff Bezos just delivered the clearest definition of what artificial intelligence actually is. The market is still debating which department should own the AI budget. They’re asking the wrong question entirely. Bezos: “AI, modern AI is a horizontal enabling layer. It can be used to improve everything. It will be in everything. This is most like electricity.” This isn’t a software product. It’s the new utility grid of the global economy. Don’t treat it like a feature update. Treat it like the invention of alternating current. When a horizontal layer hits the board, it doesn’t improve a single vertical. It violently rewrites the baseline physics of every industry it touches. The companies that survive this decade won’t be the ones that bought a new AI tool. They’ll be the ones that ripped out their entire infrastructure and rewired the execution engine to run on the new grid. Bezos: “Because we are literally working on a thousand applications internally. I guarantee you there is not a single application that you can think of that is not going to be made better by AI.” The standard enterprise strategy is to launch one or two safe, isolated AI pilots and test the waters. You don’t pilot a horizontal enabling layer. You saturate the board immediately. Amazon isn’t building a single monolithic chatbot. It’s deploying a thousand specialized execution loops across every friction point in the empire. If your deployment strategy isn’t total saturation, you’re already bleeding margin to someone whose is. Interviewer: “What is it that you’re doing at Amazon?” Bezos: “AI. It’s 95% AI.” The standard CEO delegates automation strategy to a mid-level committee while focusing on quarterly earnings. The operator commanding a trillion-dollar supply chain is spending 95 percent of his personal bandwidth on a single vector. That is the market signal. If the leader of your organization isn’t driving algorithmic integration from the top down with everything they have, the company is already dead. It just hasn’t received the memo yet.
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Dustin
Dustin@r0ck3t23·
Bret Taylor, former co-CEO of Salesforce and chair of OpenAI, just redefined the unit of productivity. It’s not a person. It’s a process. Taylor: “I think the atomic unit of productivity in AI is a process, not a person.” AI won’t replace a worker. It will compress entire workflows. What used to take 17 days across departments collapses into hours. The traditional corporate model measures productivity in person-hours. The new model measures process-compression. The incumbent assumption: you buy AI to replace a junior analyst. That’s a fundamental misunderstanding. You deploy an autonomous agent to completely collapse the timeline of a business outcome. An operation requiring 17 days of bureaucratic friction gets mathematically condensed into 17 hours. You’re not buying a digital employee. You’re buying the ruthless compression of time. Using AI to speed up a single employee’s task? You’re playing the wrong game. Taylor: “There’s a legal department to do a contract. There’s some finance department, procurement. You probably have IT that’s involved to onboard them into your core systems.” Friction in the modern enterprise doesn’t come from a single worker. It comes from the endless hand-offs between siloed departments. The traditional CEO tries making each department 10% faster. The winning CEO deploys an AI overlay that autonomously bypasses the human hand-offs entirely. The algorithm doesn’t sit in the legal department or IT. It executes the entire thread simultaneously across all core systems. It doesn’t replace individual workers. It renders their departmental bottlenecks completely irrelevant. Taylor: “I think it’s wrong to think about AI as sort of replacing people. In addition to being inhumane, it’s just sort of nonsensical because AI sort of operates in the world of digital technologies.” The neural network won’t sit at a desk, pour coffee, or shake a client’s hand. It’s a sovereign engine operating exclusively in the realm of digital friction. Superintelligence isn’t your direct replacement. It’s your digital exoskeleton. The hard part of enterprise execution has never been the human element. It’s always been wrestling with archaic, fragmented software systems. When AI takes over the digital process, the biological operator gets freed from the bureaucratic drag. They instantly shift from manual processor of forms to high-leverage director of outcomes. And that’s the real transformation. Not humans versus machines. Humans commanding the compressed timelines machines execute. Whoever builds that infrastructure first turns every competitor’s 17-day cycle into a fatal disadvantage. Because they’re finishing in hours what the rest of the market hasn’t even started.
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Alexander A. Morgan, MD PhD
Alexander A. Morgan, MD PhD@genomicsdoc·
Congrats to the @Limbic_ai team for creating superhuman performance in this critically important area. A great example of AI being able to directly improve human life in a measurable way.
Vinod Khosla@vkhosla

Infinite mental health services affordable @Limbic_ai. Key finding in Nature Medicine: nature.com/articles/s4159… Limbic Layer™ turns any frontier LLM into a behavioral health specialist, improving therapeutic performance (as judged by other therapists), patient experience, and clinical outcomes. 75% of Limbic's AI sessions ranked among the top 10% of human therapist sessions, demonstrating superior clinical performance in a fully autonomous setting. CBT rated superior to both human clinicians and underlying LLMs

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Alexander A. Morgan, MD PhD@genomicsdoc·
IMHO, one of the main challenges some incredibly smart and talented potential entrepreneurs have, particularly those who spent time in academia, is around this very concept.
Big Brain Business@BigBrainBizness

Ken Griffin, founder of Citadel, has a $10 plaque behind his desk that reads: "If we're all going to eat, someone has to sell." Of all the things this man could surround himself with, he chose a cheap plaque with a blunt truth about business. "You're always selling. You're selling to candidates. You're selling to vendors, you're selling to counterparties, you're selling to customers." And if you're always selling, you know what you're going to hear a lot of? "No." Griffin doesn't sugarcoat it. He tells two stories that illustrate just how brutal rejection can be. 1994 was a rough year, with Citadel losing ~4% of its capital. Griffin flew to Switzerland for a crucial lunch meeting, sat down, and his guest arrived only to say: "Oh, I thought you were John Griffin from Fen Church. I got to go." His lunch date got up and left the table. Later that afternoon, a Swiss banker spent 45 minutes with him in a beautiful office, smoking a cigar, before closing with: "Such a pity that such a bright young man picked the wrong career." Two rejections in one day for the founder of one of the most successful hedge funds in history — and his takeaway was simply this: "You just have to tolerate. You're going to hear no a lot, but you need to become accustomed to having to market your ideas and market what you represent and what you stand for." Absorbing rejection and continuing anyway is the actual skill, whether you're hiring, raising capital, or winning customers. Most people avoid selling because they're afraid of no. The ones who build great things have learned to expect it.

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Alexander A. Morgan, MD PhD
Alexander A. Morgan, MD PhD@genomicsdoc·
The general trend of waves of innovation is quite historical, e.g. rail barons were tech founders of their era literally riding a wave of innovation/capabilities. We are of course in one around AI right now.
Startup Archive@StartupArchive_

Sam Altman explains how to come up with a great startup idea “Wait to have a good idea before you start a startup. If you start a startup without a good idea… you’ll be under pressure to make something up and it won’t work that well. The very best startups are all started because someone believes so passionately in an idea and they believe that a startup is the best way to make that happen.” As Sam explains in the clip below, the hard thing about good ideas is they require original thought. Most people just copy other people’s thoughts, but it’s usually disastrous if you try to copy someone else’s idea. For example, thousands of social media and photo sharing apps were started after Facebook and Instagram, but very few went anywhere. You want to do something that’s new and different. A good way to come up with startup ideas is noticing problems in your own life: “It’s not true that all successful startups are started to solve a problem that the founders have themselves, but it’s a very high percentage. If you go back and think about the transformational companies, most of them start with someone solving their own problem.” Another thing you notice if you go back and look at all the really successful companies is that many of them were early to a massive technology wave. Sam believes these “Great Waves” are why great companies tend to cluster in time (e.g. Amazon and Google with the Internet wave; Uber, Airbnb, Snapchat, Instagram, WhatsApp with the mobile wave; etc.). “A really good question ask is: What is the wave that’s starting right now?” Sam also wrote an essay on this: Idea Generation. Video source: @WaterlooENG (2017)

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Vinod Khosla
Vinod Khosla@vkhosla·
Infinite mental health services affordable @Limbic_ai. Key finding in Nature Medicine: nature.com/articles/s4159… Limbic Layer™ turns any frontier LLM into a behavioral health specialist, improving therapeutic performance (as judged by other therapists), patient experience, and clinical outcomes. 75% of Limbic's AI sessions ranked among the top 10% of human therapist sessions, demonstrating superior clinical performance in a fully autonomous setting. CBT rated superior to both human clinicians and underlying LLMs
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Reads with Ravi
Reads with Ravi@readswithravi·
I’m in love with this sentence: “The degree to which a person can grow is directly proportional to the amount of truth he can accept about himself without running away.”
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Finding Compounders
Finding Compounders@F_Compounders·
Steve Jobs email to Apple employees “Excellence, then, is not an act, but a habit”
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Alexander A. Morgan, MD PhD@genomicsdoc·
It's unfortunate that entrepreneurs tend to be more selective of employees (usually highly reversible decision) than they are of their investors (very hard to reverse).
Startup Archive@StartupArchive_

Elon Musk on how choosing the wrong VC almost killed Tesla "If you have a choice of a lower valuation with someone you really like or a higher valuation with someone you have a question mark about, take the lower valuation." Elon tells part of the story of how he got this wrong when Tesla raised its Series C in 2006. He was choosing between two competing bids from Kleiner Perkins and VantagePoint. Kleiner offered a $50 million pre-money valuation. VantagePoint offered $70 million. Musk told Kleiner that if John Doerr joined the board, Tesla would do it at $50 million. However, John had too many other obligations at the time and couldn't commit to another board seat. Tesla ended up going with VantagePoint, which Musk says, "was probably a mistake". In November 2007, VantagePoint tried to lead a deal that would have seriously diluted Musk's control of the company. That attempt ended up failing. But a year later, VantagePoint almost blocked the deal that saved the company from bankruptcy. In December 2008, Musk needed to raise $40M. One week from running out of money and bouncing payroll, Musk managed to cobble together $20M and asked Tesla's other investors to match it. They agreed, but Musk noticed a problem while finalizing the paperwork. VantagePoint had signed all of the paperwork except for one crucial page. When Musk phoned up Alan Salzman, VantagePoint's cofounder and managing partner, Salzman informed Musk that the firm had a problem with the investment round because it undervalued Tesla. They then backed out of the deal. Musk believed that Salzman's tactics were part of a mission to bankrupt Tesla, oust him as CEO, recapitalize Tesla, and emerge as the major owner of the carmaker. This forced Musk to take another huge risk: Tesla recharacterized the funding as a debt round rather than an equity round, knowing that VantagePoint could not interfere with a debt deal. The deal ended up closing on Christmas Eve, hours before Tesla would have gone bankrupt. Musk had just a few hundred thousand dollars left and could not have made payroll the next day. Musk ultimately put in $12M personally, and the investment firms put up the rest. As for Salzman, Musk said, "He should be ashamed of himself." Musk compares choosing a VC to getting married. It's incredibly important to work with people you respect and trust. Valuation shouldn't be the only thing founders optimize for.

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Eric Topol
Eric Topol@EricTopol·
When your "normal" abdominal CT tells you about the 5-year future risks that can't be seen by radiologists, but can by AI (Merlin) nature.com/articles/s4158…
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Alexander A. Morgan, MD PhD
Alexander A. Morgan, MD PhD@genomicsdoc·
Really interesting in retrospect as I think he is laying out the thinking that led directly to OSX, which was the changeover point when I went from using a Sun Box for coding and a Windows PC for desktop apps to a single machine.
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Massimo
Massimo@Rainmaker1973·
Richard Axel was hilariously incompetent as a medical student, so he struck a deal with the Johns Hopkins to receive an MD on the condition that he would never practice medicine. He then switched to biology and won the Nobel Prize in Medicine in 2004 for his work on olfaction.
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Alexander A. Morgan, MD PhD
Alexander A. Morgan, MD PhD@genomicsdoc·
Just got the 2025 update from @KariusInc. They did 35,893 tests in 2025. It's *not* a screening test, it guides therapy selection and treatment planning when it is used, often in critically ill patients, tremendous amount of impact and lives saved.
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Alexander A. Morgan, MD PhD
Alexander A. Morgan, MD PhD@genomicsdoc·
One of the greatest gifts I have ever received is to be able to learn from these giants.
Jack Altman@jaltma

New Uncapped with two of the greats, @vkhosla and @rabois. I don't think I've seen them on a podcast together so I was especially excited about this. I asked them about how they work together, how they see the world, what's changed in tech, and of course a little bit about their politics. Enjoy. (0:00) Intro (0:58) The working relationship (4:26) Pie chart on what’s discussed (7:11) Ethos of investors today vs the past (10:42) Comparing FF and KV (12:46) What makes a great founder (22:56) Alpha in today’s market (30:05) Themes in AI (38:23) How AI companies are built (46:23) Interests outside of AI (53:12) Their politics on X (58:24) Evolution of political leanings

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Chris Elmendorf
Chris Elmendorf@CSElmendorf·
An architect who does multifamily housing throughout CA told me recently, "The secret's not out, but San Francisco, erstwhile worst offender, has become one of the easiest places to get projects entitled & permitted in CA." I asked what changed. He said, "The mayor." 1/5
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