When I opened my dermatology practice 25 years ago, I used paper charts, a prescription pad, and a Dictaphone. Today, I use AI daily: for transcription, charting, and even reviewing complex labs. It’s certainly made my work more efficient.

But I’ve also seen something else: the erosion of trust between patients and physicians. I’m fortunate to practice independently, with the freedom to answer only to my patients, not a corporate boss. That independence has built loyalty, and for me, deep fulfillment.

Many of my colleagues, especially younger ones, don’t have that same autonomy. For them, medicine can feel rushed, bureaucratic, and transactional. Which is why the arrival of AI feels like both a tool and a test: Will it serve us, or will we surrender to it?

What AI can never replicate

AI can summarize labs and suggest “next best steps.” But it cannot replace the years of training and nuance that make us physicians.

A seasoned internist I know once diagnosed early ovarian cancer because her patient’s “nonspecific bloating” came with a subtle look of fatigue she had seen once before. No algorithm would have flagged it.

In dermatology, an AI can label a rash, but it cannot feel the texture, smell an infection, or read the fear in a patient’s eyes when they ask, “Is it melanoma?”

Beyond diagnosis, medicine is a practice. Each patient encounter, each misstep, and each success, sharpens our judgment. AI is trained on the crowd, on averages. But our patients don’t want an average decision. They want our decision (honed by years, even decades, of experience) that’s best for them. That is the irreplaceable human element.

What we must protect

We cannot allow AI to own our decisions.

If we do, we are no longer physicians. We become indistinguishable from scripts or robots, following prompts instead of exercising judgment. What makes us physicians is not just access to data, but the responsibility of making complex, high-stakes decisions based on years of training and thousands of patient encounters.

This is not to diminish the vital contributions of nurses, NPs, and PAs. But a physician’s role is different: to integrate data, history, and context into a decision that cannot be reduced to an algorithm. In my practice, care is delivered only by physicians, precisely because patients come to us for answers no software can provide, and for a relationship no machine can replicate. That is what we must protect.

And when we preserve that role, the rewards are not just for our patients. They are also for us. The fulfillment of practicing medicine, of knowing you made the right call for the right patient at the right time, is something no algorithm can deliver.

What we must embrace

AI can be transformative if we remain in control. Like a scalpel, it’s dangerous in the wrong hands, but indispensable in the right ones.

• Freeing our time: AI scribes can cut hours of charting, letting us look patients in the eye instead of the EHR.
• Sharpening our instincts: Feeding challenging cases into AI can spark new perspectives, but the final decision must remain ours.
• Personalizing prevention: AI can sift through years of labs to highlight trends that enrich, not replace, our judgment.

The call to physicians

Our responsibility is to both protect and pioneer.

Protect our agency. We’ve all heard of (or experienced) an AI-powered EHR that automatically alters the medical record to match “recommended” templates. This can happen without the physician’s consent. We must ask: Who owns the algorithm? Who owns the data? And most importantly, who owns the decision (and consequences)?

Pioneer new uses. Oncologists use AI to identify novel compounds and simulate trial designs for rare cancers. Family physicians use AI to flag diabetic patients at risk, leading to more proactive care.

In my practice

As an integrative dermatologist, I often see women exhausted and anxious, struggling with their skin, hormones, and sleep. AI can surface their lab trends. But it takes a physician, one who has cared for thousands of women, who knows how menopause manifests differently in someone with autoimmune disease, who can examine their skin, their hair, and look into their eyes, to decide what this woman needs.

That is what we are protecting. That is what we must never outsource.

Why this matters

The danger is not that AI will replace doctors. The danger is that we, overwhelmed or distracted, will allow algorithms to erode our authority and fracture the intimacy of care. The opportunity is to protect our decision-making, sharpen our skills, and rebuild the trust that has eroded between patients and physicians.

Patients today have more options than ever. They can see a nurse at the pharmacy, an NP online, or ask a chatbot for advice. If they choose to see you, it must be because they trust your judgment, your humanity, and your ability to see them as more than data points. That trust is the foundation of loyalty. And loyalty is not automatic. It must be earned and protected. Every time we allow AI to make decisions for us, we weaken that bond. Every time we use AI to enhance our care, we strengthen it.

And in protecting that trust, we also protect our own joy in practicing medicine. The fulfillment of knowing your work changes lives; that is something no machine will ever feel. That is why this matters. Not just for us as physicians, but for the future of medicine itself.

Jessica Wu is a Harvard-trained dermatologist, bestselling author, and health tech founder. A pioneer in regenerative dermatology, she has served as a principal investigator in Phase III and IV FDA clinical trials and wrote Feed Your Face, an Amazon Top 100 bestseller that explores the link between diet and skin condition.

She has developed skincare lines sold at national retailers, and today her focus extends beyond aesthetics to systemic factors such as nutrition, hormones, and lifestyle that influence skin health and vitality. In 2023, Dr. Wu founded Residen, a health tech platform that empowers physicians to succeed in independent practice.

She also serves on the Advisory Council on Education at Harvard Medical School and the Medical Advisory Board of the Los Angeles Zoo, and teaches and mentors young physicians. A leader at the intersection of science, innovation, and education, Dr. Wu is building a new model of health care that restores autonomy, compassion, and integrity to medicine, giving it back to doctors and patients, where it truly belongs.

Follow her on Instagram @drjessicawu and @residenUS, or visit drjessicawu.com for more about her work.