Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

Shanice Spence-Miller, MD
Tech
July 6, 2025
Share
Tweet
Share

I do not fear artificial intelligence—nor do I revere it. What I feel toward the rise of intelligent systems in medicine is something quieter: a tempered trust, a measured hope. I recognize their immense potential, but I also hold firm to the belief that the deepest work of medicine happens not through automation, but through human connection. There is a quiet power that lives between symptom and story, between numbers and nuance. It is there, in those silent spaces, that medicine breathes. And that is something no machine can fully replace.

Like many clinicians today, I have observed the increasing integration of digital tools into our work. Intelligent platforms now generate note templates, offer differential suggestions, and flag high-risk patients. They respond swiftly and uncover patterns with astonishing precision; yet their usefulness depends entirely on the quality of the input—on the prompt, the question, the framing. These systems do not know what matters unless we teach them. In this sense, prompting becomes a form of clinical communication. Much like a patient history, it reveals not just what is asked, but how carefully and intentionally we have learned to listen.

Sometimes, even I have paused when a suggestion felt algorithmically right—but intuitively wrong.

Still, there are limitations no model can overcome. A machine cannot recognize the tremble in a patient’s voice. It cannot discern that a daughter’s silence might carry more fear than words ever could. It does not feel the moral weight of choosing when to speak and when to simply remain present. Computational systems are trained to detect patterns; physicians, by contrast, are trained to hold paradox. And modern medicine requires both.

I support the use of intelligent systems in health care—not because I believe they are perfect, but because I recognize that they are incomplete. And incomplete things must be shaped. Too often, the technologies that enter our clinical spaces are designed far from the realities of patient care. Predictive models and decision-support tools are introduced without sufficient clinical involvement in their development, validation, or implementation. The result is a system intended to assist physicians, yet built with minimal input from those who know the stakes of its success or failure.

I’ve watched colleagues question the conclusions of tools they had no voice in shaping. It’s a discomfort that lingers, even when the output is accurate.

And when the stakes are high, exclusion is not neutral—it is dangerous. I have seen clinical tools misfire precisely because they were created without understanding the complexity of patient presentations or the subtleties of clinical reasoning. Well-meaning algorithms can cause harm when they do not account for the lived wisdom of those on the ground.

Physicians should not be passive consumers of these tools. We must be active participants in the infrastructure that defines them—engaged in model design, data stewardship, product refinement, and ethical oversight. When clinicians are part of the development process, we bring more than expertise. We bring judgment, context, and a profound awareness of what is at risk when systems fall short. The values embedded in these tools will always reflect the priorities of those who build them. If clinicians are absent from that conversation, then so too are the complexities of care.

Moreover, diversity in this shaping process is not optional—it is foundational. Clinicians from underrepresented backgrounds, from multilingual communities, and from under-resourced settings offer perspectives that are often missing from both datasets and design rooms. Their inclusion ensures that the systems we create do not merely reflect the majority, but accommodate the full spectrum of human experience. When we participate, we do not simply “represent”; we recalibrate. We remind the system that not every patient speaks textbook English, that not every case follows protocol, and that not every human story fits neatly within a clinical box.

These tools are listening—but to the voices they’ve been taught to hear, and the ones courageous enough to speak with intention.

And so, I believe in the potential of intelligent systems. I believe in their capacity to support us, to reduce burdens, to sharpen insight. But I believe more deeply in clinical wisdom, in moral imagination, and in the quiet decisions made by people who understand that medicine is not merely a science of precision—it is an act of presence.

Let the machine assist.

Let the mind remain ours.

Our voices are needed now—before the algorithms decide without us.

Shanice Spence-Miller is an internal medicine resident. 

ADVERTISEMENT

Prev

How subjective likability practices undermine Canada's health workforce recruitment and retention

July 5, 2025 Kevin 0
…
Next

Why testosterone matters more than you think in women's health

July 6, 2025 Kevin 0
…

Tagged as: Health IT

Post navigation

< Previous Post
How subjective likability practices undermine Canada's health workforce recruitment and retention
Next Post >
Why testosterone matters more than you think in women's health

ADVERTISEMENT

More by Shanice Spence-Miller, MD

  • You have nothing to prove: a bold message for every overwhelmed doctor

    Shanice Spence-Miller, MD
  • How physicians can reignite their spark this year

    Shanice Spence-Miller, MD
  • Harmonies of medicine: the biopsychosocial symphony

    Shanice Spence-Miller, MD

Related Posts

  • How women in medicine are shaping the future of medicine [PODCAST]

    American College of Physicians & The Podcast by KevinMD
  • Social media: Striking a balance for physicians and parents

    Dawn Baker, MD
  • From penicillin to digital health: the impact of social media on medicine

    Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson
  • Medicine won’t keep you warm at night

    Anonymous
  • Delivering unpalatable truths in medicine

    Samantha Cheng
  • Essential health messaging tips for physicians [PODCAST]

    The Podcast by KevinMD

More in Tech

  • The silent cost of choosing personalization over privacy in health care

    Dr. Giriraj Tosh Purohit
  • Why trust and simplicity matter more than buzzwords in hospital AI

    Rafael Rolon Rivera, MD
  • ChatGPT in health care: risks, benefits, and safer options

    Erica Dorn, FNP
  • Why AI must support, not replace, human intuition in health care

    Rafael Rolon Rivera, MD
  • Why health care reform must start with ending monopolies

    Lee Ann McWhorter
  • AI can help heal the fragmented U.S. health care system

    Phillip Polakoff, MD and June Sargent
  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • A systemic plan for health worker well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Why physicians need a place to fall apart

      Annia Raja, PhD | Physician
    • The joy of teaching medicine through life’s toughest challenges

      John F. McGeehan, MD | Physician
    • Why health care can’t survive on no-fail missions alone

      Wendy Schofer, MD | Physician
    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • A systemic plan for health worker well-being [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Why physicians need a place to fall apart

      Annia Raja, PhD | Physician
    • The joy of teaching medicine through life’s toughest challenges

      John F. McGeehan, MD | Physician
    • Why health care can’t survive on no-fail missions alone

      Wendy Schofer, MD | Physician
    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...