The Role of Artificial Intelligence in Shaping the Doctor–Patient Relationship: A Narrative Review
Emanuele Maria Merlo, Giulio Sparacino, Orlando Silvestro, Maria Laura Giacobello, Alessandro Meduri, Marco Casciaro, Sebastiano Gangemi, Gabriella Martino
Abstract
The doctor-patient relationship is a central factor in healthcare delivery. Artificial Intelligence (AI) represents an emerging technological frontier whose implications remain to be fully clarified. Evidence-based studies provide reliable analyses of effects and offer a deeper understanding of both limits and benefits. This narrative review aimed to explore the role of AI in modern clinical practice, with particular reference to its effects on the doctor-patient relationship. Scopus and Web of Science databases were searched between 1 and 10 December 2025 to identify suitable studies. Inclusion criteria comprised English-language articles published in the last 10 years, with a direct focus on the doctor-patient relationship and exclusively employing empirical research designs. A total of 21 studies published between 2021 and 2025 were identified as eligible. The most common AI applications were conceptual systems discussed at a perceptual level (thirteen studies), followed by simulated AI decision-making scenarios (two studies). Implemented AI applications were less frequent and mainly included AI-based clinical decision support systems, administrative and documentation-focused tools, and a small number of conversational or relational AI applications (six studies in total). These studies focused on patients, healthcare professionals, and medical students preparing for future clinical roles. Results highlighted generally positive patient attitudes toward AI, often mediated by educational level, technological familiarity, and risk awareness. Among healthcare professionals, positive attitudes also emerged, although concerns regarding epistemic and professional values were noted. Greater involvement of clinicians in its development was consistently recommended. Findings from academic samples aligned with those of patients and clinicians, showing that integrating AI with traditional clinical practices was consistently preferred. Empathy, compassion, effective communication, accuracy, ethics, and trust were highlighted as fundamental values essential for mitigating risks. These elements are fundamental to the effective implementation of technologies aimed at improving clinical practice, while an integrative perspective is needed to safeguard the doctor-patient relationship. Overall, the use of AI in medical practice emerged as promising. Further studies should strengthen the empirical basis of the field to support an evidence-based approach to AI integration in healthcare.