Patients draw the line at AI decisions without clinician review

Clinical takeaway: Ask patients what role they want AI to play in their care. More than half of patients are comfortable with AI deciding diagnosis and treatment, when a clinician can override it. 

Most primary care physicians already use AI for at least one work task, from looking up medication information to drafting clinical notes. But only one in five have had formal training in it. Where patients stand on AI taking part in diagnosis and treatment matters as clinicians decide how much work to hand over to it. 

Surveys of patients and primary care physicians now test how patient attitudes shift with the level of clinician involvement. The physician survey also asked what physicians expected patients to say. 

For diagnosis and treatment, 56% of adults who had seen a primary care provider in the past year were comfortable with AI making the decision when a clinician could override it. Only 9% were comfortable with no clinician review. Fewer patients, 38%, were comfortable when AI only assisted and the clinician decided. The advantage of override over assist-only nearly vanished for imaging review and narrowed to four points for medication decisions. Without clinician review, between 13% and 11%, respectively, were comfortable with AI reviewing images or deciding on medications. 

Primary care physicians expected less comfort than patients actually reported: for diagnosis and treatment under clinician override, 36% said most of their patients would be comfortable, against 56% of patients who said they were. Expectations ran 11 points below patient answers for imaging review and seven points below for medication decisions. 

Among the primary care physicians surveyed, 89% reported using AI for at least one of seven work tasks in the past year. Only 20% reported any formal training in it, from 30% in hospital or health system practices to 11% in independent practices. 

A probability-based Gallup Panel survey in August 2026 covered 5,330 US adults who had seen a primary care provider in the past year. A separate opt-in survey polled 1,007 practicing primary care physicians. Neither survey tested safety or outcomes. 

Among patients uncomfortable with AI deciding diagnosis and treatment or reviewing images without clinician review, the option to request that review would raise comfort for just under half, more than any other factor tested. Privacy protections, evidence of safety and effectiveness, lower costs, and faster decisions each would persuade no more than a third. 

“AI has enormous potential to improve healthcare, but patients are sending a clear message that they are not afraid of using the technology, and want their providers involved, not replaced,” said Timothy Lash, president and chair of the West Health Policy Center. “This makes it critical that providers have the training to use it effectively and patients have trust in how AI is being used to guide medical decisions.” 

Source: Raynes S (2026 Nov 9) Gallup. Providers Underestimate Patient Comfort With AI in Care