Do People Prefer Human Doctors and Psychiatrists or AI?

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New research suggests that, for now, people prefer human doctors over AI substitutes, especially in the field of mental health and psychiatry.

Reactions to Clinical Scenarios in Four Medical Specialties

The research, conducted with 1,183 participants from Germany, Austria, and Switzerland, asked individuals to evaluate 12 hypothetical patient-doctor scenarios across four medical fields: cardiology, orthopedics, dermatology, and psychiatry. Each scenario involved interactions with one of three types of "clinicians": a human doctor, a doctor collaborating with an AI system, or an AI system alone, such as a chatbot.

Strong Preference for Human Doctors Over AI

The findings revealed a clear preference for human doctors over hybrid doctor-AI options or AI alone in all scenarios. The presence of AI—whether as a standalone system or in collaboration with a doctor—reduced trust, increased privacy concerns, and resulted in people feeling less comfortable candidly discussing their health issues, especially when it came to mental health. Participants were also less inclined to follow treatment recommendations when AI was involved.

Presence of AI in Psychiatric Visits Heightened Privacy Concerns

The limiting impact of AI presence in clinical interactions was most pronounced in psychiatry compared to other medical fields. Participants were significantly less willing to share personal information with a psychiatrist using AI and reported much lower levels of trust and satisfaction compared to scenarios involving other specialists.

This is likely due to heightened concerns about privacy and the sensitive nature of information shared with psychiatrists. Also, empathy and human connection are crucial in meetings with psychiatrists and therapists, and the presence of AI may disrupt the sense of privacy and one-on-one relationships.

The Future of AI Integration Into Patient Care: The Artificial Third

The presence of AI in the therapeutic relationship between patient and doctor or therapist has been termed "the artificial third," inspired by psychoanalyst Dr. Thomas Ogden's concept of the "analytic third." The concept of "the artificial third" refers to AI as a third entity, interrupting the dyad between the patient and doctor or therapist and creating a triadic structure instead. For example, this would be like turning on the "AI companion" feature on Zoom during video conference calls with clients or patients, which would create an artificial "presence" in the virtual room. Or a psychiatrist using an algorithm to provide a second opinion about a diagnosis.

The impact of AI presence as the artificial third in psychiatry and psychotherapy merits further research, especially since it may alter or dilute trust, reduce the client's sense of safety, and reduce the disclosure of sensitive information. There are potential upsides, however, including enhancing diagnostic capacities or delivering and allowing certain types of therapy to be more accessible, affordable, and scalable.

The clinical consequences of AI integration in a patient-doctor interaction will likely vary based on the type of clinical visit, design, and role of AI. The presence of AI may feel less intrusive at a one-time diagnostic evaluation compared to a long-term psychotherapy session. The impact of "the artificial third" may be greater and more consequential in psychotherapy modalities like psychodynamic psychotherapy, which utilizes the dynamics of the therapeutic relationship.

Attitudes toward AI in healthcare will likely evolve as people become more familiar with its benefits and have more positive experiences interacting with AI. A hybrid doctor-AI collaborative approach that still ensures trust and empathy at the center of the interaction will be more successful than replacing physicians, psychiatrists, and therapists with AI.

Collaborative AI tools have the strong potential to enhance personalized diagnosis and treatment, particularly when used under the supervision of experienced human doctors. AI advances are already being implemented in specialties like radiology, where algorithms can help detect imaging abnormalities. AI-powered clinical decision support systems are being studied to improve diagnostic, prognostic, and treatment decisions. Additionally, AI systems incorporated into patient communication, education, and documentation could alleviate some of the administrative burdens faced by healthcare providers, potentially reducing clinician burnout.

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Integrating AI agents directly into patient-doctor interactions—especially in psychiatry—requires careful design, clinical oversight, patient education, and ethical considerations. Naming AI agents or designing them with behaviors that mimic empathy can enhance trust, but this approach must be cautiously balanced against the risks and consequences of overtrust, dilution of the therapeutic relationship, and potential misuse of sensitive information.

Marlynn Wei, M.D., PLLC © Copyright 2024