A program for prescription refills, quietly launched in the U.S. state of Utah earlier this year, has sparked a wide medical debate: Is artificial intelligence ready to take on tasks that could only be performed—until now—by doctors? As Matthew Perron (*) wrote.

Online Prescription Refills

The program allows Utah residents to avoid a doctor's visit and refill their prescriptions online using an AI-powered chatbot called 'Doctronic'.

This step appears simple on the surface, moving toward making healthcare more convenient and accessible for patients and prescribing doctors. But it also represents a landmark that breaks the usual rules, raising concerns and warnings among doctors, lawyers, and public health experts.

Doctronic's AI asks the user to list their symptoms so it can create a treatment plan.

Questions About the Role of AI in Medicine

This pilot program has revealed a set of questions about the role of AI in medicine, including how to legally regulate it, whether doctors should be given the authority to override its decisions, and what kind of safety measures are needed to protect patients.

At the heart of the debate is that laws—both at the state and federal levels—restrict the authority to prescribe medications to licensed medical professionals. Supporters argue that these laws, which have been a pillar of American medicine for over 100 years, should be updated to include AI-powered chatbots and other modern technologies.

Dr. Eric Breisman of the University of Pennsylvania says: 'We have crossed a new threshold of granting a non-human entity a medical license, whether we want to call it that or not.'

AI Cannot Practice Medicine Under Current Laws

Breisman and other experts emphasize that they are not opposed to the idea of AI prescribing medications, but they believe strict standards comparable to those for human doctors must be met. Human doctors undergo years of testing and training before receiving a license to practice medicine.

Experimental Legal Environment

In Utah, the Doctronic system was able to launch thanks to what is known as a 'regulatory sandbox,' which allows state officials to exempt AI companies—offering promising technologies—from certain laws and restrictions.

The prescription refill program is currently overseen by a board of five members specializing in AI—none of whom are doctors—who assert that they have implemented numerous safety measures. For example, during the initial phase of the program, human doctors review all refill requests processed by the Doctronic system, while the overseeing company expects to soon transition to a fully automated refill system.

Chairman of the Medical Licensing Board Unaware of Program Approval

The chairman of the state's medical licensing board stated that he and his colleagues learned about the program when news of its launch was published last January. In a letter sent by 11 board members to state authorities in March, they demanded the program be halted, citing risks associated with automatic refills of medications that could have side effects or cause drug interactions.

Doctors... Have No Say

Dr. Alan Smith, a family doctor who chairs the board (emphasizing he is speaking in his personal capacity), said: 'We were told simply: Yes, this is happening, and no, you have no say in it.'

Adding to the complexity is the fact that medical technology is traditionally regulated at the federal level, while medical professions are overseen by states.

Doctronic officials believe that the AI technology they use is part of the practice of medicine under state jurisdiction. However, the federal Food and Drug Administration (FDA) is the body responsible for overseeing AI technologies that directly affect medical care or medical decision-making—a line that some experts believe Doctronic has crossed.

Some States Pave the Way for AI in Healthcare

In an interview with Doctronic officials to disclose whether they had sought approval from the FDA, Dr. Adam Oskowitz, who co-founded the company with a tech entrepreneur, said: 'Our goal here is simply to reach patients wherever they need healthcare. And we are trying not to get bogged down in the complex details of regulatory aspects.'

In Utah, residents can visit a website dedicated by Doctronic to the prescription refill program. After identity verification, the AI chatbot asks users about their prescriptions and medical history, and checks for a valid existing prescription by linking to a national pharmacy database. If there are no obstacles, the AI can refill the prescription and send it to a local pharmacy. If further attention is needed, the chatbot transfers the patient to a doctor within Doctronic's telehealth service.

Oskowitz envisions a future where many routine medical tasks—including ordering tests and analyzing results—can be delegated to Doctronic, allowing doctors to manage the care of many more patients than they currently can.

Easing Rules on AI Use

Other states are also easing regulatory rules regarding AI, including Texas and Wyoming.

Meanwhile, lawmakers in states such as Iowa, Idaho, and others have introduced legislation to grant official licenses for AI-based medical services. Many of these bills are based on a model prepared by the Cicero Institute—a non-profit think tank that supports AI—founded by Joe Lonsdale, co-founder of the AI software company Palantir. The institute's director of health policy says that opposition to the use of AI in the medical field stems primarily from economic concerns among doctors and other healthcare workers.

Adam Meyer, an official at the Cicero Institute, said: 'The party that takes the first step will face criticism and attack; due to economic interests, workforce concerns, and the impact on jobs.'

Doctors See Potential Risks in AI-Powered Prescription Refills

Smith, the medical board chairman, says the risks to patients are real; he notes that the list of refillable medications through the Doctronic system, which includes 190 drugs, includes blood thinners, which could be dangerous if patients develop a stomach ulcer or other health conditions causing internal bleeding. Smith added: 'Often, when I see patients after six months, I find that their medical history or health status has changed. Just because a drug was previously prescribed does not necessarily mean it is suitable for the current condition.'