At this point, numerous individuals have become engaged with ChatGPT. We’ve asked it to summarize a complex patient history and draft a discharge summary or explanation of a rare clinical concept. At first, it feels like magic. However, after several weeks, that same old feeling of frustration returns. Why does this still feel like more work?
The problem is not that technology is lacking. The problem is that ChatGPT was never designed for the complex, multistep workflows of clinical medicine. That mismatch is creating a new kind of exhaustion: prompt fatigue.
A tale of two Mondays
Consider Dr. Anya Sharma, an internist at City General Hospital. Her Monday morning begins the same way it does for many of us, copying and pasting raw data from the electronic health record (EHR) into ChatGPT. She prompts. She re-prompts to emphasize the cardiac history. She manually cross-references the chart to ensure the AI did not miss subtle ECG changes. By the time her documentation is finished, she is mentally drained. She is not just a doctor anymore; she’s an AI operator.
Across town, Dr. Ben Carter has a different experience. His “digital resident,” an agentic AI fully integrated into the EHR, has already been working while he slept. It synthesized the overnight admissions, flagged elevated troponin levels, and pended guideline-recommended orders for his review.
Dr. Carter spends five minutes reviewing and signing off. He walks into his first patient’s room with a clear clinical picture, ready to focus on the human side of medicine.
The difference isn’t intelligence. It is agency.
The hidden cost of the “operator” model
ChatGPT is a passive knowledge engine. It waits for a prompt, responds, and then waits again. That design forces physicians to manage every input and output: what data goes in, how it’s framed, and whether the output is accurate.
Instead of reducing cognitive load, we end up micromanaging a brilliant, very literal intern. We didn’t go into medicine to become prompt engineers.
What agentic AI changes
Agentic AI represents a fundamental shift in design. Unlike passive models, agentic systems can independently break down complex tasks into intermediate steps and execute them autonomously within defined boundaries.
Key capabilities include:
- Tool use and API integration: These systems don’t just generate text. They interact directly with EHRs, laboratory systems, and medical literature.
- Memory and context awareness: They maintain a persistent understanding of a patient’s history and the goals of the current workflow.
- Self-monitoring: They are designed to identify inconsistencies or errors and refine their output before a physician ever sees it.
This transforms AI from a conversational assistant into an active participant in clinical work.
From co-pilot to clinical supervisor
In the agentic paradigm, the AI isn’t a “co-pilot” sitting beside you while you work. It’s a digital team member operating independently on delegated tasks.
The workflow is simple: Agent proposes. Human verifies.
A physician delegates a task (drafting a progress note, reviewing labs, and identifying drug interactions). The agent performs the work in the background and presents the results for approval. The physician remains fully responsible but no longer buried in first drafts and clerical minutiae. The role shifts from firsthand operator to high-level supervisor, much like attending to a resident.
Why this reduces burnout (not just time)
Yes, the time savings are real. Early implementations of ambient and agentic AI have saved health systems more than 15,000 documentation hours in a single year. But the real benefit is cognitive relief.
When clerical tasks no longer consume us, our mental energy is freed for complex decision-making, patient communication, and judgment. It’s no surprise that more than 80 percent of physicians using these tools report improved work satisfaction.
The guardrails of the digital ward
Agentic AI is a tool to augment, not replace, clinical judgment. There are clear red lines where it must never operate independently:
- Live resuscitations: Code Blue events require immediate human decision-making.
- High-risk medications: Final prescribing authority must remain with a clinician.
- Compassionate communication: Delivering bad news is irreducibly human.
- Final diagnosis: AI can propose differentials, but physicians must confirm the plan.
Human oversight is not optional. It is foundational.
The bottom line
The transition to agentic AI will require changes in EHR vendors opening APIs, hospitals defining liability frameworks, and clinicians learning new supervisory skills.
But the takeaway for physicians is simple: Agentic AI is about delegation, not conversation. The future of medicine is not about talking to AI more efficiently. It is about leading a digital team wisely.
Harvey Castrois a physician, health care consultant, and serial entrepreneur with extensive experience in the health care industry. He can be reached on his website,harveycastromd.info, Twitter@HarveycastroMD,Facebook,Instagram, andYouTube. He is the author ofBing Copilot and Other LLM: Revolutionizing Healthcare With AI,Solving Infamous Cases with Artificial Intelligence,The AI-Driven Entrepreneur: Unlocking Entrepreneurial Success with Artificial Intelligence Strategies and Insights,ChatGPT and Healthcare: The Key To The New Future of Medicine,ChatGPT and Healthcare: Unlocking The Potential Of Patient Empowerment,Revolutionize Your Health and Fitness with ChatGPT’s Modern Weight Loss Hacks,Success Reinvention, andApple Vision Healthcare Pioneers: A Community for Professionals & Patients.