Who pays for the answer? Health AI business models and what they do to your architecture

A medical AI that is free for doctors makes me ask one question first: who is paying?

STAT reported in January 2026 that OpenEvidence, a tool clinicians use to ask medical questions and get cited answers, is free to US clinicians who verify with a national provider number, and that advertising is its primary business model. The same report covers a $250 million raise.

That is a clever way to put a tool in front of doctors. It also raises a fair question: if an ad sits next to a medical answer, how do we know the ad is not shaping the answer? The company's advertising policy says advertisers cannot influence the information it provides, and that the answer system and the ad system are fully unconnected. That is the company describing itself. I have seen no independent test either way, and I'm not claiming a problem. The funding details above are from press reporting.

The business model is an architecture decision, whether or not anyone writes it down.

None of these is automatically good or bad. Each one tells you what to test.

Tabibu is a free health-information assistant that started in Kenya, with paid Basic and Pro plans for features like document reading. I know the pull of "keep the user happy", which is why the safety rules are written as tests: it does not diagnose, does not call a result normal, and does not change a dose. It has no clinician review yet, and the site says so.

I am not claiming my model is cleaner than anyone else's. I am saying one habit would help the whole field.

Show who pays. Show how the answer was built.

Not in a footer nobody reads. Next to the answer, in plain words: where the sources came from, whether anything was paid for, and what the tool will not do.

Should a medical answer ever sit next to an ad? I can see arguments on both sides and would like to hear yours.

General information, not medical advice.

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