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1Dr. Jane Purvis, MD, FRCP(C), 2Dr. Chandi Chandrasena, CCFP FCFP,

1is a rheumatologist, the former Co-Chair of the OMA PSC, and the Government Affairs Lead for the Ontario Rheumatology Association. 2is a family physician, lecturer at the University of Ottawa and Chief Medical Office, OntarioMD.

CLINICAL TOOLS

Abstract: AI is rapidly integrating into Ontario’s healthcare system, offering benefits like reduced administrative burden and improved clinical decision-making, but carrying significant risks including patient safety concerns, equity gaps, and erosion of primary care. Effective, physician-led governance is essential to ensure AI complements rather than replaces human-centred care.
Key Words: Artificial intelligence, physician governance, primary care, health equity.
1. AI tools are already embedded in Ontario’s clinical environments, often adopted without independent evaluation or robust local validation.
2. While AI scribes and clinical decision-support systems offer real efficiency gains, risks include hallucinations, diagnostic errors, and erosion of the therapeutic relationship.
3. Poorly governed AI threatens to fragment longitudinal primary care, which depends on continuity, trust, and contextual knowledge that algorithms cannot replicate.
4. Equitable AI implementation requires inclusive training data, privacy safeguards, and deliberate policy oversight—market forces alone are insufficient.
AI supplements, never substitutes: AI chatbots process snapshots of information and lack relational memory or accountability — patients who arrive with AI-formed diagnoses may need careful, time-conscious counselling to realign expectations.
Document AI-influenced encounters carefully: AI scribes can introduce inaccuracies into the medical record; physicians retain medicolegal responsibility and should review all AI-generated documentation before signing.
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Related Terms: Technology in Medicine, artificial intelligence, physician governance, primary care, health equity
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