The nature of the relationship between clinicians and their patients has evolved as medicine as evolved. For centuries, the doctor held exclusive knowledge and issued ‘orders’. Today, doctorsare expected to take a holistic approach, providing care that is tailored to each patient’s wishes and based on shared decision-making. The future use of AI technologies has the potential to cause a further seismic shift in the culture of interactions between clinicians and patients.Much of this depends on the nature of the interface between the public and AI. Applications could range from a doctor-facing decision support tool, potentially unnoticed by the patient,to an autonomous AI system accessible from the patient’s own devices, diagnosing and treating conditions without human clinical involvement.As AI systems become more autonomous with a greater degree of direct-to-patient advice,a significant need arises to establish the role of clinicians in maintaining quality, safety, patient education and holistic support.The psychological impact on both patients and doctors of the presence of AI must be anticipated, including an inherent reluctance to disagree with the recommendations of digital systems