As chatbots master medical facts, therapeutic skills psychiatry may become the most durable ones
STUDY: Ng SV, Acad Psychiatry 2026
STUDY TYPE: Opinion letter
FUNDING: Independent
Background
Medical training rewards recall: lithium toxicity thresholds, drug interactions, board-exam trivia. Artificial intelligence (AI) now does that well. A recent editorial argued AI will replace psychiatrists, and this one argues the opposite.
The Argument
The author lists four competencies that should outlast automation:
- Participation in the encounter. AI answers only what it’s given, and patients often leave out the clinically relevant details. A randomized study found chatbot accuracy fell sharply when members of the public described their own symptoms.
- Discernment. Patients will arrive overwhelmed by information, and they need help narrowing options to one that fits their life.
- Comfort with uncertainty. Chatbots tend to answer confidently even when wrong. Good clinicians name what isn’t known and still reach a shared decision.
- Presence as a clinical tool. The warmth, anxiety, or boredom a patient stirs in you is data about how that patient moves through the world (counter-transference information).
Practice Implications
- Learn more about humanistic therapeutic skills.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
