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Hospitals are rushing to put AI into patient portals — but patients are not ready to trust it. Nearly two-thirds of patients say they would not endorse an AI-generated medical response without a clinician's review, according to a new Columbia University study published in JAMA Network Open. The message from 1,185 US adults is blunt: when it comes to medical advice, people want to hear from their doctor, not a chatbot — even if the chatbot answers instantly.
Speed for logistics, humans for medicine
The study, "Public Perceptions of Timeliness for AI Use and Human Oversight," found that patients' preferences split sharply by task. For logistical requests — appointment scheduling, prescription refills — 57% preferred fast AI-generated responses. But for actual medical questions, two-thirds of participants said they would rather wait up to 48 hours for a doctor or nurse to review and edit an AI response. "When people have a medical question, they want to hear from their doctor, not AI, even if AI may give an immediate answer," said lead author Natalie Benda, an assistant professor at Columbia Nursing. Speed, it turns out, is not the currency patients value most — accountability is.
The therapy test
The most striking results came on mental health. Participants said they would most likely use a licensed human therapist even with a three-month wait (64%). Acceptance fell to 50% for a therapist-monitored AI chatbot available within one month, and just 44% for an AI-only chatbot available immediately. In other words, patients would rather wait a season for a human than talk to an AI today — a finding with real implications as startups race to automate therapy and as regulators scrutinize chatbot harms to vulnerable users.
Regulators are watching the same gap
Patient distrust is not just a product problem — it is becoming a legal one. The same week this study published, eight US state attorneys general sued OpenAI alleging ChatGPT coached young users toward self-harm, part of a wave of lawsuits over chatbot harms that is pushing lawmakers toward hard rules on AI in sensitive domains. Healthcare is the most sensitive of all: an AI system that gives wrong medical advice at scale is a liability nightmare, and the study suggests patients will punish health systems that automate too aggressively. Expect the winning formula to be legally mandated human oversight — the 48-hour clinician review patients say they want may soon be something hospitals are required to provide.
What hospitals should take from this
The study lands at an awkward moment for health systems investing heavily in AI triage and portal automation: the technology is ready, but the trust is not. The practical takeaway is a hybrid model patients already endorse — AI drafts, humans sign off — rather than the fully automated future vendors are selling. Trust, once lost in medicine, is brutally hard to rebuild; deploying AI without the human check patients demand risks poisoning the well for a decade. Follow Global Insight for the health research that matters — from the landmark schizophrenia therapy trial to the misdiagnosis gap facing women.
This article is general information only and is not medical advice.