Artificial intelligence as a new participant in the physician-patient relationship

Advantages, disadvantages, and the physician's role as manager of the doctor–artificial intelligence–patient triad

Abstract

Since the time of Hippocrates,medicine has been the art of two people: one who suffers and one who knows.Clinical practice, medical ethics, and professional identity itself were built on this fundamental relationship,a dyad sustained by trust and an asymmetry of knowledge that the physician managed for the patient's benefit. Artificial intelligence(AI) has begun to alter this age-old architecture.It is no longer merely another tool in the clinician's hands,like the stethoscope or electrocardiograph were in their day, but an agent that interprets,suggests,and at times makes decisions:a third participant, invisible yet influential, in the consultation room.The dyad has become a triad. This essay proceeds from, and elaborates upon,a conviction:if the clinical relationship now incorporates an algorithmic actor, someone must be accountable for the whole, and that someone remains, necessarily,the physician.This report examines the nature of this new responsibility,that of managing the triad,and why it is particularly urgent for cardiology in our region.