The Perceived Influence of AI on the Craftsmanship of Physicians: Qualitative Interview and Focus Group Study

Health care systems face rising demand and persistent staff shortages, intensifying pressure on the quality and sustainability of care. Artificial intelligence (AI) is increasingly being introduced to improve efficiency and decision support across clinical domains. While these tools promise operational gains, they can also reconfigure how physicians work, make judgments, and interact with patients, all elements of physicians' craftsmanship. However, most research emphasizes technical performance rather than AI's broader implications for physicians' craftsmanship.

This study aims to explore how physicians define craftsmanship in medicine and how they perceive AI to influence its professional and personal dimensions, with the goal of deriving practical principles for responsible AI design and implementation in hospital care.

We conducted a qualitative, exploratory study in two phases (December 2024 to September 2025). Phase 1 involved semistructured interviews with 20 physicians from different hospital types and diverse specialties within the Netherlands. Phase 2 comprised two focus groups with physicians, physicians in training, hospital staff, policymakers, and AI developers during a national symposium, using an interactive, persona-based design to cocreate practical design principles.

Physicians described craftsmanship as their commitment to deliver the best possible care through human judgment, empathy, and contextual understanding. Perceived AI effects clustered in two areas: professional and personal dimensions. In professional dimensions, AI was seen to support workflow efficiency, documentation, data integration, and aspects of analytical reasoning, potentially freeing time for patient contact and reflection. Conditions for adoption included human-in-the-loop oversight, explainability, traceability, and AI literacy. In personal dimensions, empathy, contextual interpretation, and ethical judgment were viewed as inherently human and resistant to substitution. Concerns centered on de-skilling, less room for independent judgment, and threats to professional autonomy. Some variation was observed across specialties in how tasks and AI's role were framed, reflecting their specific clinical contexts, but all shared the same core aim of delivering high-quality care. Based on the focus group discussions, the following design principles were identified that articulate how AI can be implemented in alignment with medical craftsmanship: consider a business case and strategic rationale; start from real clinical needs; let professional groups take the lead; design for contextual diversity; use user research for validation; design AI as supportive, not intrusive; safeguard autonomy and trust; cocreate with end users; learn across contexts; and use AI as a mirror for craftsmanship.

AI seems to affect the conditions of professional craftsmanship and, thereby, indirectly the personal dimensions of it. This should be considered in design and implementation, while recognizing that continued interaction with AI may gradually reshape what craftsmanship itself comes to mean.