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Family physician Tod Stillson discusses his article “Why AI in medicine elevates humanity instead of replacing it.” Tod explains how his career evolution revealed that artificial intelligence is not a threat to the medical profession but a necessary tool for reshaping care delivery. He argues that physicians must actively lead the integration of AI to ensure that clinical judgment is amplified rather than overridden by automation. The conversation covers the necessity of digital fluency, the shift toward structured asynchronous data collection, and how these technologies can actually restore the human connection by relieving administrative burdens. Listen to discover why the next generation of doctors must master both stethoscopes and software to meet evolving patient expectations.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Tod Stillson, family physician. Today’s KevinMD article is “Why AI in medicine elevates humanity instead of replacing it.” Tod, Happy New Year and welcome back to the show.

Tod Stillson: Kevin, it is great to be back with you. Happy New Year to all your listeners as well.

Kevin Pho: All right. We were talking offline. A lot of times we have been talking about things like employment contracts. But this is something new that we are talking about with you today: how AI intersects with health care. We have so many tangents that we could do with that. We talk about this a lot on the podcast. Give us your take on it. Tell us what your article is about, and we will certainly go from there.

Tod Stillson: I guess if I were to state the spirit of my article, it is that I believe that doctors of the future, myself and yourself included, need to be digitally fluent. We need to understand the digital landscape and how the new technologies can assist us at being better doctors and providing better care to our patients.

I think we need to not operate out of fear. This is a moment in time when doctors should stand up and be leaders on this front, not passive. I think being passive is what led to a lot of the corporate takeover of medicine over the last 30 or 40 years. At this very important moment in time, it is time for us to stand up and take control of something that we should own.

Kevin Pho: AI definitely is a transformative technology, especially in medicine. It is a little bit of the Wild West. We are trying to figure out how it is going to disrupt our workflows. I am sure you are familiar with the saying that AI is not necessarily going to replace doctors, but doctors who are fluent in AI are going to replace doctors who aren’t, right?

Tod Stillson: Yes, totally.

Kevin Pho: So when you say doctors need to be digitally fluent, what does that mean?

Tod Stillson: To think of it in the most simplistic of ways, there was a generation ago when doctors were maybe fearful of the stethoscope. They wondered what the stethoscope was going to do in terms of how that affected taking a patient history. Was a stethoscope going to replace what a doctor could do through a history and exam?

The reality was it was just an assistant device. Now that assistant device has become a tool that is wrapped around our neck and we use it every day. I really see the digital aspects of medicine, AI assistants, and other compute technologies are going to simply assist us in being more efficient and more capable.

Are we going to lose the importance and value of a patient history? No. In my world as a family doctor, that is still 80 percent of the work that I do. It is taking a good history. But how we assess, how we get to it, how we organize it, how we shape it, and then how we document it all is going to be dramatically improved with the assistance of compute and AI technology. It is not to be feared; it is to be embraced and used for our benefit.

Kevin Pho: Right now, I think that the biggest way AI is being incorporated in our workflows, like you said, is with AI-assisted documentation, ambient AI scribes, and sometimes programs that can look up evidence, kind of like ChatGPT for doctors. How are you envisioning AI being intertwined with our workflow?

Tod Stillson: I think it is critical to the current way that medicine is structured for physicians working under corporate control. We have been so used to doing all of their corporate machine work. Now, with the assistance of AI, we can become a lot more efficient at the work that we have been doing at this point, which is pointing, clicking, and other manual entry of information.

I think AI is such low-hanging fruit. I certainly know I use it in my clinical practice every single day. What is important for doctors to recognize is if you are using it, it does not replace what you do; it simply augments it. I would say virtually 100 percent of the notes that I allow AI to help take for me, I still touch up. I still look at them, and I still review them. I might change a word or a sentence in my note. But that is way more efficient than me having to do it the old-fashioned way or the old way of copying and pasting where it was really just a bunch of gobbledygook that was of no value.

Now we are really being able to integrate the humanity of it all. I think that is the real easy, low-hanging fruit in terms of that assistive technology for us. Now when it comes to clinical matters, I think that is where the new frontier is going to begin. That is when we start to really allow it to assist us.

I will use an example. I still do this in family medicine. You talked about using it for looking up information. I am not afraid to take a handful of symptoms that I am a little unsure about what the next diagnostic step is and ask AI to help me develop a differential diagnosis. That just cues in my mind the things I need to be thinking about. It does not make the decisions for me. It does not order the tests for me. But it allows me to make sure that I am not missing things as a thorough and competent physician.

Quite honestly, we all have blind spots at times as clinicians, and it is OK to acknowledge that. It is OK to find some assistance from technology to help for the sake of the patient to make sure that you do not miss something. I think those are a couple of examples of what really lays right in front of us. It is easy to use, easy to pick up, and easy to find assistance with.

Some of the other elements of AI assistance with what we do clinically get into some grayer space in terms of how much assistance we are going to allow it to give us. That is more in the realm of the initial chest X-ray reading for a radiologist, the pathologist reading of a slide, or the cardiologist reading of the EKG. We are all used to doing EKGs in our office where the computer gives us the reading and we kind of override it. We look at it and say, “Thanks for the assist to tell me what you think it says,” but we all override it. This is stuff that we are used to doing every day. We are going to find more and more efficient ways to provide care through the use of that technology.

Kevin Pho: Now in your article, you talk about how AI can elevate that doctor-patient connection. What would that look like to you?

Tod Stillson: First of all, I think it is fair for us to acknowledge that we now live in a generation where patients come in having already done their searches prior to coming in. They want to talk about some of the things that they found online in regards to the care that we are providing for them.

The old version of that was the classic Google search, the quote “Google doctor.” The patient would come in and say, “I think I have this from the Google doctor.” We would laugh and maybe take into account some of the things that they had learned. Now it is actually getting a little more detailed. They are using ChatGPT and other AI technologies to get a deeper understanding of medicine. They come in sometimes with an outlined differential diagnosis and some drill-down information.

We are going to either embrace that or fear it. Patients are coming in equipped, having had chatbot conversations already. We do not need to fear that; we can actually embrace it and use it to move us forward. I think also from a clinical workflow standpoint, we can use it to benefit us.

In my world of being much more in the clinic environment than the hospital, we can use technology and AI to enhance our workflows. A lot of us are used to that in the clinic environment already where we have standard operating procedures and engineered workflows for our patient experience. Whether it is the front desk, the triage nurse, or the nurses, all of those things have been organized or engineered in a way that makes them efficient for our use.

For me, I always use standing orders as a clear way for my staff to execute work. They do not have to ask me; they are going to do it. All of these things lend themselves to AI technology and other resources to help us really provide better care to the patients. At the end of the day, it does not replace us. We still need our judgment. We still need our clinical decision making. But it packages it in a more efficient way for us to actually take advantage of that and to use it most efficiently.

Kevin Pho: I am hearing an underlying current that some of our colleagues are a little bit hesitant to embrace AI. What are the common arguments that you are hearing from them in terms of articulating their hesitancy to take that leadership position when it comes to AI in medicine?

Tod Stillson: First of all, I think unfortunately we have not been invited to be at the table when it comes to these things. You have corporations that have taken the lead on these. It is the corporation of health care and medicine as a whole. It is technology corporations that are trying to take the lead on this on the West Coast, East Coast, and Silicon Valley. The physicians are not necessarily invited to be the leaders, but we have the capability, and this is that moment in time when we do need to lead and stand up.

That can be as innovative as starting your own company that wades into those waters and uses technology to provide patient care, which is what I am doing with ChatRx. But it can also be as important as just simply serving on a board, being a medical director, and working in alignment with those corporations that are doing the work. They need that physician clinical experience to help provide that leadership.

If we are not doing that and we are passively letting somebody else outline that work for us, the outcome is not going to be nearly as good as if we are involved in the process. Again, I think that is what happened in the last 30 years with the corporatization of medicine. We let somebody else outline it for us, and the end result was not the best for us as physicians, nor do I think it was the best outcome for patients, to be honest.

Kevin Pho: You talk about the corporatization of medicine over the last few decades. I can also point to how EMRs, or electronic medical records, were implemented without physician input, and look at where that brought us now in terms of the goals of EMRs not being in the clinician’s best interest. So I certainly agree with you that AI is just as transformative a technology, and it is absolutely important that we need to take leadership in that.

So in terms of tangible ways we can do that, you mentioned being on boards of these companies and being on committees in your hospital. Tell us what are some of the things that you specifically are doing in terms of taking that lead and maybe others can be inspired by your example and model themselves after you?

Tod Stillson: I am an entrepreneur by spirit. I have led a lot of physicians and coached physicians in that context and have a lot of teachings on that. I decided I did not want somebody else to do it for me. I wanted to define what the family doctor of the future looked like for me: someone who was digitally fluent and looked well.

As I retired from my 30-year practice in rural family medicine, I pivoted to start a virtual telemedicine company called ChatRx that provides acute treatment of 39 common infections online. It leans into AI and what technology can provide for us. It engineered a system that allows patients to have an amazing experience basically in five minutes, 24/7. Their acute infections are identified and treated, and a prescription is sent to the pharmacy.

That is what technology can allow us to do. I did not passively sit back and let somebody say they would do that for me. I jumped in and have spent the last two years developing an FDA-approved software as a medical device and getting this product to the marketplace. Do not let somebody else define it for you. Go out and do it yourself. Wade into the marketplace and frankly do it for the sake of patients and our medical community because we need to be leading this charge, not letting others do it for us.

Kevin Pho: What about those physicians who maybe aren’t as AI-fluent as you or me? They may be really hesitant to use even something as basic as Gemini or ChatGPT. What are some of their first steps in order to become better AI-fluent?

Tod Stillson: I think there are a couple of points. Number one is just using it in your everyday life and getting more comfortable with it. We all get on our computer, phone, or digital device and search for things like airline tickets, a hotel room, the lowest gas prices, or where we can get a prescription. Just become a little more comfortable with what searches and life look like in the post-Google search days. Nowadays, it is going to be via AI or a search engine that is going to look a little bit different than the Google search of the past. Getting comfortable in the marketplace with it is number one.

Number two, I think that the easiest place for doctors to wade into is in that exam room with an ambient AI note-taker. I really think that is the simplest way for a doctor to do it. You can turn it on, let it take some notes for you, and begin to get a feel for it. You can choose to use them or do it the old-fashioned way.

What I have seen with doctors that I have worked with in the clinic environment over and over again is that they may fear it and resist it for a little bit. But once they step in, put their toe in the water, and go, “Wow, that’s actually pretty cool, it’s almost kind of scary how good it is,” the light bulb just goes off. They think: “Why am I working so hard when I could use this technology so I can get home at 5:00 rather than 6:00 every night?” That did not affect or negatively impact patient care. It actually allowed you to be more comfortable, more relaxed, and not feel like you are in a hurry all the time because in the background you have this ambient AI taking notes for you.

What I feel like is I am able to do what I did way back in the day. I look at the patient eye to eye, not worry about the computer in the room, and sort of just talk, listen, talk, listen. I use my brain to provide that diagnostic skill that we all do very well typically in the exam room, but the ambient AI is capturing all of it, and it is really pretty cool.

Kevin Pho: We are talking to Tod Stillson, family physician. Today’s KevinMD article is “Why AI in medicine elevates humanity instead of replacing it.” Tod, as always, we will end with some take-home messages that you want to leave with the KevinMD audience.

Tod Stillson: My take-home message is that AI does not replace thinking. For physicians, do not fear that using AI in your everyday work environment is going to replace the importance of what you bring to the knowledge economy. The humanity of what you bring, the diagnostic skills that you bring to it, the decision making that you bring to it, and the ability to listen as a human being one to another is not lost.

You are simply allowing the assistance of technology to allow you to be more efficient, more dynamic, and really be a better physician. You are getting rid of some of the clutter that can be easily organized and offloaded to somebody else in the exam room and clinical setting that you are in.

The last thing I want to say is to take a page out of my book at ChatRx. Go to ChatRx.md and take a look at what I have created. See that this is something maybe you could do because I want to inspire other physicians to not passively let large corporations take control of medicine at this moment in time. We need to wade into these waters and use our expertise to make a difference.

Kevin Pho: Tod, thank you so much for sharing your perspective and insight. Thanks again for coming back on the show.

Tod Stillson: Thanks, Kevin. It is great to be with you again.