Artificial intelligence (AI) may radically alter the provision of emergency medicine (EM) over the coming decades. Before it does, we must consider this game-changing technology’s effect on emergency physicians and their patients. As we become increasingly dependent on AI, emergency physicians may lose their professional autonomy, decision-making abilities, and technical skills. Complex AI programs may become so embedded in the emergency-medicine decision-making process that emergency physicians may not be able to explain or understand them, and patients may not be able to refuse its use or refute its findings, even when ethical dilemmas are present.¹

Overreliance on AI

Overreliance on AI clinical decision aids may lead to a decline in emergency physicians’ diagnostic and decision-making skills, potentially compromising patient care if the emergency physician does not recognize an erroneous AI response. AI programs’ ability to interpret medical imaging and cytopathology often exceed human capacities to perform repetitive, complex, or intricate tasks without fatigue. Advocates assert that “losing certain skills to AI, much like the advent of calculators and the internet, is not only inevitable but also beneficial to human progress.”¹

However, the erosion of human expertise is problematic if the decline in physicians’ diagnostic and decision-making skills results in clinical errors if (or when) the technology fails.² Educators find it challenging to instill essential critical-thinking skills when students rely on AI tools to solve problems for them.³ Emergency physicians may become human mechanics, performing procedures, giving medications, and admitting patients only when instructed to do so by the AI program. Many fear that a declining emphasis on critical thought and the basic skills that comprise the art of medicine not only will compromise patient care, but also will contribute to an anti-intellectual “dumbing down” of medical practice.⁴

AI has the potential to reduce the amount of time needed for many repetitive tasks in the practice of the emergency physician. AI can analyze patterns of patient care and recommend more efficient patient throughput. The emergency physician might spend the time saved with patients, resulting in better patient satisfaction. However, that same increase of efficiency might result in a demand from the health care system for increased patient throughput, resulting in emergency physicians having to see more patients rather than spending more time with them.⁵

AI may suggest diagnoses for complex constellations of symptoms and findings, a potential boon to emergency physicians. But the danger is that, instead of consulting the literature for complex cases, the emergency physician will regard AI as an authoritative source. Emergency physicians may feel that they are giving up autonomy both in their choice of how to practice and in sorting complex and challenging analyses that are ceded to AI. Rather than helping with burnout, AI may instead become a demanding taskmaster and an enigmatic diagnostic and treatment standard for the emergency physician, leading to understandable resistance to AI by emergency physicians.