Medicine and Science from The BMJ

The shadow use of Gen AI in the consultation room

Dec 16, 2025
David Navarro, a research fellow in generative AI, joins GP Marcus Lewis, participatory eHealth expert Charlotte Blease, orthopaedic professor Teppo Järvinen, and MSF clinician Dr. Shafal Tuyusul Abdelkadi. They discuss the unofficial rise of generative AI in clinics, shaping triadic care for clinicians, patients, and AI collaboration. Teppo reveals that a decade-long surgical trial showed no benefit over placebo, questioning ongoing practices. Meanwhile, Dr. Shafal highlights the urgent need for support in Nigeria’s cholera crisis.
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INSIGHT

Triadic Care Changes The Clinical Triangle

  • Triadic care adds AI as a third participant alongside clinicians and patients in diagnosis and management.
  • David Navarro says AI changes how evidence is delivered, making it conversational and engaging.
INSIGHT

Shadow AI Is Already Widespread

  • Surveys find rapid shadow AI adoption by clinicians using commercial tools like ChatGPT for clinical tasks.
  • Charlotte Blease reports many use AI for documentation, differential diagnosis, referrals, and treatment suggestions.
INSIGHT

Patients Use AI But Want Human Final Say

  • Patients increasingly use AI to research symptoms and medications and may come to consultations better prepared.
  • They remain reluctant to have clinical decisions fully outsourced to AI and want doctors to retain final judgment.
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