The rapid advancement of artificial intelligence (AI) has sparked a pressing debate: Should AI be licensed to practice medicine independently? As leaders of the Federation of State Medical Boards (FSMB), we believe the answer is a resounding no, at least for now. Medicine is not just about generating answers; it's about upholding a social contract based on trust, competence, ethics, and accountability. A medical license grants authority and privileges, and with that comes the responsibility to put patients first.
FSMB's role is to guide medical boards in navigating this evolving landscape. We advocate for regulating AI within existing professional structures, ensuring responsibility aligns with autonomy and human oversight. While AI tools can relieve administrative burdens and improve access, they should not be treated as separate practitioners.
In 2024, FSMB's House of Delegates adopted a policy guidance document, emphasizing the responsible integration of AI into clinical practice. This guidance, aimed at medical regulators and clinicians, encourages the use of AI to enhance care but cautions against shifting professional responsibility. State medical boards regulate physicians, not machines, and physicians must remain accountable for any harm caused by AI.
The introduction of bills in Idaho and Iowa proposing separate licensing boards for autonomous systems highlights the need for careful consideration. These bills, though unsuccessful, reveal a growing trend of treating AI as a potential replacement for human physicians. However, medicine is not just another commodity; the stakes are too high. The public deserves clear accountability and recourse when AI-related harm occurs.
Recent events in Utah, where an AI-powered prescription renewal pilot program drew attention from the medical licensing board, underscore the importance of collaboration between industry and medical regulators. Even when innovation moves through a state's AI apparatus, medical boards must have a say when patient safety is involved.
FSMB's 2024 policy advises states to work with their medical boards when exploring AI applications in healthcare. Innovation and oversight should be partners, not opponents. FSMB is updating its guidance to address the latest advancements in AI, recognizing the need to distinguish between licensing human clinicians and authorizing AI tools.
The debate extends beyond conference panels. Federal and state lawmakers, technology offices, and the public are all asking who should regulate autonomous systems in healthcare. The answer lies with the institutions that understand professional standards and clinical risk in medicine: state medical boards.
As sociologist William Bruce Cameron wisely noted, "Not everything that counts can be counted." As AI systems become more capable, the challenge is to maintain clear lines of human accountability and patient trust. The FSMB and its workgroups are committed to tackling these complex questions head-on, ensuring that AI enhances healthcare without compromising patient safety and the social contract of medicine.
