Clinical workforce debates have long centered on a core question: Who should provide care, at what level of independence and with accountability to whom? Physicians and advanced practice providers have spent years negotiating those lines through scope-of-practice legislation, title disputes and collective bargaining. Now, AI is adding new tensions to those debates — and it does not hold a license, cannot be disciplined by a medical board and has no clear place in existing oversight structures.
The tensions play out across the clinical workforce, commonly involving debates between physicians and advanced practice providers. Physician associations have long argued that expanded scopes risk patient safety, while advanced practice providers have countered that their outcomes are comparable to physicians and that restrictions primarily hurt access in underserved areas. Title and naming conventions have proven equally contested, with physicians arguing that certain designations mislead patients about a clinician’s training and credentials, and advanced practice providers arguing the titles better reflect their experience and roles.
In 2021, the American Academy of Physician Associates voted to rename the role “physician associate,” saying the change better reflected the profession’s experience and responsibilities. The AMA and the American Osteopathic Association rebuked the decision, arguing it would confuse patients. The AMA’s position since has only hardened: Its House of Delegates voted June 9 to formally oppose the term “provider” when referring to physicians, framing it as protecting the boundaries of clinical identity and accountability. Delaware in May became the fifth state to allow physician associates with more than 6,000 hours of practice to work without a formal supervisory agreement, joining Iowa, Maine, New Hampshire and Oregon.
Similar tensions exist between CRNAs and anesthesiologists, nurse practitioners and physician associates, and pharmacists and prescribing physicians. In 2022, the American Nurses Association called on the medical profession to end physician-nurse “turf wars,” arguing that perceived hierarchies are counterproductive to a healthcare system that prioritizes patients.
AI has already started entering these debates at the bargaining table. In 2024, nurses at 17 HCA Healthcare hospitals in six states ratified contracts guaranteeing them a say in how AI is implemented, with the stated goal of ensuring the technology enhances rather than replaces clinical judgment. The Alliance of Health Care Unions cited AI governance as a gain in 52 collective bargaining agreements ratified in April at Oakland, Calif.-based Kaiser Permanente; the deals came after strikes. At least 11 healthcare strikes have occurred in 2026 with AI governance among the issues at the table.
The arguments over AI’s role in the clinical workforce sharpened in December when Utah launched a pilot program developed with health technology startup Doctronic allowing AI to autonomously recommend prescription renewals for 192 common medications for chronic conditions, believed to be the first program of its kind in the country. In the current phase, physicians review the AI’s decisions before they reach the pharmacy; the program is designed to move toward greater AI autonomy in later phases. Doctronic co-founder Adam Oskowitz, MD, has characterized the AI as safer than a physician. In the pilot’s first four months, the AI recommended renewal in 72% of cases, with physicians agreeing 91% of the time, according to an analysis published by the state in May.
A perspective piece published April 23 in The New England Journal of Medicine warned the model may miss changes in clinical status for medications requiring close monitoring. The Utah Medical Licensing Board called for the program’s suspension, saying it was not consulted before the system went live.
Meanwhile, the Trump administration is pushing to formalize AI’s clinical role. It is working on a regulatory pathway for independent AI physicians and has created an expedited approval process for digital health products including AI chatbots, The Washington Post reported June 4. Health system leaders told Becker’s they are skeptical of the push for AI physicians but support using the technology to increase access.
Where AI ultimately fits in patient care remains to be determined, but it has already joined those debates.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.