Four Questions with Humayun "Hank" Chaudhry

Humayun “Hank” Chaudhry, DO, MACP is president and CEO of the Federation of State Medical Boards, the national non-profit representing the state medical and osteopathic boards that license and discipline physicians. He spoke with Ruth Reader at a Jefferson AI symposium about the draft guidance FSMB expects to issue before the end of December, what the right word even is for approving an AI, and where liability lands when something goes wrong.

This conversation has been edited for length and clarity.

Ruth Reader: As AI starts practicing aspects of medical treatment, how is the Federation of State Medical Boards thinking about its role in ensuring AI is up to the task?

Hank Chaudhry: Right now we're in the process of having lots of conversations to see what we can do. As you may know, we have a working group that has had some good conversations. We're probably weeks away from issuing a draft guidance, probably before the end of December, and we'll send that out broadly to stakeholders to get their feedback and input. We'd like to put something together for the state boards by April. That's our annual meeting.

And it probably doesn't end there, because we're not going to be able to answer all the questions. We're still learning a lot.

We feel we need to do this because, as you might have heard, in the healthcare workforce we have a shortage. That's why some states in the last two and a half years made changes to their legislation to, for example, bring in internationally trained physicians without having to do U.S. training, which was a big change. Why did they do that? Because of healthcare, because of the needs of the residents of each of those jurisdictions. This was blue states, red states, so it's not even political.

So we're motivated to figure this out, and we're having the right conversations.

Ruth Reader: What have you learned so far?

Hank Chaudhry: The primary purpose of a state medical board, statutorily, is to protect the public. And so, as I hear about how exciting AI is, that's great. I'm also concerned about what happens when there's a mistake or harm is done. How do we avoid that? And then once it happens, how do we figure out a process akin to what we do with humans to prevent it from happening again? That's an area that we are more concerned about probably than other groups. So while I'm cautiously optimistic, like many others, we want to be careful on behalf of the state boards and with the state boards so that we figure this out right.

Ruth Reader: Do we license AI the way that we license doctors?

Hank Chaudhry: We're looking at everything from that question to even some of the labels that we use. What is the right word? Is it licensure? Is it certification? Is it authorization? Is it approval? We have to even get the terminology right. I don't see too many state medical boards pushing their own approach. I think they're all looking to FSMB and others to give them some guidance. So I think that's helpful, because having more than 50 different approaches is probably not going to be helpful.

Ruth Reader: A lot of doctors — and not only doctors — feel they shouldn't carry sole liability when AI is involved, and that there should be shared liability. Is the liability question something FSMB is thinking about?

Hank Chaudhry: I don't know if we'll weigh in with some specific guidance, but we have talked about it in terms of who is ultimately liable — and even initially, when something goes wrong, how do you figure out what went wrong? Not to apportion blame in and of itself, but also to prevent harm in the future. We all believe, and I believe, that when a mistake is made, you try to learn from it, and you try to figure out what went wrong. Was it a system-wide issue? Was it a random issue? Could this happen again? Was this a pattern? And then, what can you share with others to prevent that kind of a mistake from happening? So we've discussed it, but I'm not sure we'll have any specific guidance, because in some ways it requires other parts to fit in.

What do I mean by that? The federal government and their approach, and the state laws — there are some state laws already that may impact what a state board says. As it relates to licensure, I guess it also depends on how you answer that question of whether we're licensing AI or whatever the case may be. So stay tuned.

About Humayun "Hank" Chaudhry, DO, MACP

Dr. Chaudhry is President and CEO of the Federation of State Medical Boards. A graduate of NYU, NYIT College of Osteopathic Medicine (NYITCOM) and Harvard TH Chan School of Public Health, Dr. Chaudhry did a rotating internship at St. Barnabas Hospital, New York, followed by an ACGME-accredited Internal Medicine residency at NYU Langone-Long Island Hospital, where he served a year as Chief Medical Resident. He is a Past President of the American College of Osteopathic Internists (ACOI).

Dr. Chaudhry served as a DME at Long Beach Medical Center, New York, and as Chair of the Department of Medicine and Assistant Dean for Pre-Clinical Education at NYITCOM. He rose to the rank of Major in the U.S. Air Force Reserves, where he was a Flight Surgeon. He served as Health Commissioner for New York's Suffolk County from 2007-2009 and is the author or co-author of over 80 peer-reviewed articles and co-author of two books. From 2016-2018, he was Chair of the International Association of Medical Regulatory Authorities. In 2022, he was listed by Modern Healthcare as one of the 100 Most Influential People in Healthcare.