October 25, 2026 | Patient Safety, Plastic Surgery Consultation, Plastic Surgery News
MDLinx asked physicians how worried they are about AI in medicine. One word of mine made the piece.
“Moderately. The failure I worry about is not a dramatic one. It is a confident wrong answer delivered in fluent medical English to someone who has no way to check it. In surgery we have decades of practice at recognizing a bad result. We have very little practice at recognizing a bad output that reads well.”
Here is the rest, from my own consults.
Why It Is So Hard to Catch
“It’s really difficult to recognize hallucinations or wrong information, because AI always feels like an authority, all-knowing. I’ve had experiences where I’m researching a topic and AI comes up with completely false references to support what it’s saying. So this is really the difficult part, and the one where the doctor can come in and rectify and explain what is actually happening, or what’s actually in the literature. So many times when I’m researching a topic, after I receive an answer I’ll ask for references, and then I’ll go look for the source to see if it exists, and read about it to make sure it’s factual. Sometimes, if the information seems strange, I’ll ask again in another question, and a lot of times it will recognize that it made a mistake and rectify it.”
“And one of the most dangerous answers AI can give is false reassurance, that you shouldn’t be worried, that it’s really nothing, when in fact it may be, and only a doctor can make that determination.”
The Patient Who Arrives Already Diagnosed
“Yes. A well-informed patient walks in with better questions than they had three years ago, and that is a real gain. But I now see a category of patient I did not see before: someone who has been talked into alarm by a chatbot that had no images, no history, and no exam. They arrive convinced something is wrong. Most of my visit is spent undoing a diagnosis nobody made. On the aesthetic side it runs the other way, where a patient has been told a procedure is simpler than it is and shows up expecting a result that the anatomy will not give.”
“It’s also not good at predicting results, especially in cosmetic or plastic surgery, where a patient may upload a photo and ask for the postoperative result, which may or may not be a good expectation or even a possible one. This is where the surgeon’s experience and assessment of each patient’s anatomy and tissues comes in.”
“I would never trust it with anything that requires a physical exam. AI has now been trained to recognize photos and evaluate lesions, but it cannot touch and feel the way we do when we perform a physical exam, to evaluate hernias or rectus diastasis, masses or lumps in the body or breast, skin laxity, and quality of skin.”
What I Would Actually Require
| Safeguard | Why |
|---|---|
| A named clinician accountable for every output that touches a patient | Responsibility settled before anything goes wrong |
| Disclosure in plain language, not the word AI buried in an intake packet | The patient knows what the tool did |
| Testing on the population being treated | “I practice on a border, and a tool validated somewhere else may not behave the same way here.” |
| Monitoring after deployment | Implants get it; software changes faster |
“We do not approve an implant and then stop looking at it. We track it, and we find out years later that a device behaves differently in the field than it did in the trial. Software has a harder version of the same problem, because it changes after it ships and the version treating a patient today may not be the version that was tested.”
Where I Land
“I don’t think AI would realistically replace office visits. The main factor is the physical exam, which is absent. A lot of times there’s no check of the vitals either, unless a patient has a way to measure these and upload them at the same time. I think it’s a supplement to medical care.”
“I’ve always said that an educated patient is a better patient. I’m a proponent of educating patients, and the use of AI is a way to educate yourself more efficiently than going to the library and reading a bunch of books and articles.”
Prepare with it. Do not let it examine you. The how-to is in using AI before a doctor visit; the commentary is on drworldwide.com and the patient-side version on the Southwest Plastic Surgery post.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. He completed Harvard’s certification in AI in Healthcare and uses AI in his practice.
Ready to Talk?
Bring the chatbot’s answer. I will tell you which parts are right, and then I will examine you.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
