Generative AI should not be handed its own medical license, the top two leaders of the Federation of State Medical Boards argue. In a First Opinion essay, CEO Humayun Chaudhry and board chair Christy Valentine Theard contend the technology belongs inside the oversight structures that already govern doctors, with accountability following the degree of human control.
The federation advises all 69 state and territorial boards that license physicians across the US. Its members are fielding the question more and more, as state lawmakers, pilot programs and health systems push AI deeper into clinical work and ask who answers for its decisions.
Chaudhry and Valentine Theard stress that a license carries legal and ethical weight far beyond the ability to answer questions well. It is bound to human judgment, professional conduct, transparency and a duty to put patients first, and it exists because society grants physicians exclusive privileges in exchange for accepting extraordinary responsibilities. An algorithm, they argue, cannot yet take on that compact alone.
Instead, the federation proposes governing generative AI within existing professional and institutional structures, with responsibility scaled to the system’s level of autonomy and the degree of human oversight. That keeps a clinician accountable for AI-assisted decisions while allowing the technology to expand its role over time.
The position gives state boards a clear starting point as they confront a wave of new questions: when a machine recommends a treatment, who answers for the outcome? The federation’s answer is that the physician using the tool remains the accountable party, and licensing AI as a separate practitioner would blur that line rather than clarify it.
