Rux ignores one of the main bottlenecks of clinical trials: finding the clinical trial managers whose expertise is necessary to manage them and surface candidates for them. Pharma would run as many trials as there are managers. And managers themselves could run trials more quickly if it was easy to find good candidate matches for a trial. LLMs are beginning to help them solve the problem of candidate discovery, since the right patients need to be a high dimensional match, and their fitness can only be discovered by perusing their EHRs for hours.