Dr. Jane Purvis, MD, FRCP(C), is a rheumatologist, the former Co-Chair of the OMA PSC, and the Government Affairs Lead for the Ontario Rheumatology Association. Dr. Chandi Chandrasena, CCFP FCFP, is a family physician, lecturer at the University of Ottawa and Chief Medical Office, OntarioMD.
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.
This article is a call to action to physician associations and professional bodies. As artificial intelligence rapidly enters clinical practice, decisions about governance, standards, and implementation are being made quickly and often without sufficient physician leadership. If the profession does not actively engage now, the AI systems that shape our workflows and influence patient care may be built around priorities that do not reflect the realities of clinical practice. Our aim is to encourage our associations to step forward and to help physicians understand why their engagement at this moment matters.
The question facing Ontario’s health-care system is no longer whether artificial intelligence (AI) will play a role in care delivery. It already does – AI tools are being used in exam rooms, embedded in electronic medical records and accessed by patients directly, often before a physician is ever consulted.
The real question is whether AI will be integrated in a way that strengthens patient care, supports physicians and upholds the core values of medicine or whether it will be adopted haphazardly, driven by commercial interests and system pressures, leaving physicians reacting to technologies they did not design and do not govern.
AI holds enormous promise. When thoughtfully designed and carefully implemented, it has the potential to reduce administrative burden, improve clinical decision-making, enhance system planning and support patients in navigating an increasingly complex health-care landscape. Yet without clear, focused, physician-led and patient-centred governance, the AI we get may not be the AI we need.
AI is gaining momentum in Ontario in part because our health-care system is under extraordinary strain. Community-based and primary care are increasingly fragile. Patient volumes are rising, complexity is increasing, physicians are facing relentless administrative demands from forms, documentation and non-clinical tasks. These pressures contribute directly to burnout, early retirement and reduced access to care.
Against this backdrop, AI has presented itself as a compelling solution, promising efficiency, scalability, cost containment and convenient care. It offers the possibility of doing more with fewer human resources in a system already struggling to meet demand. Aggressive marketing, often directed not only at health-care organizations but also directly at patients, has boosted expectations. Many of these tools are being adopted quickly, often without independent evaluation or robust local validation.
Some early applications of AI have delivered tangible benefits. AI scribes, for example, have demonstrated the potential to reduce time spent charting, allowing physicians to focus more fully on the patient in front of them. Even modest time savings, when multiplied across thousands of clinical encounters, can translate into meaningful reductions in workload and burnout. Other jurisdictions are piloting AI-assisted prescription renewals and administrative triage, pushing beyond simple transcription toward more complex clinical-support tasks.