Adapting to the Age of AI in Clinical Dermatology

Matthew Bruno, PA-C, a physician assistant practicing at the Dermatology & Skin Cancer Surgery Center in Allen, Texas, tackled the accelerating role of artificial intelligence (AI) in clinical dermatology during his session at Maui Derm NP+PA Fall 2025 in Nashville, Tennessee.¹

“Whether you’re mad [at it] or you're afraid of it, just know that there's no turning back. AI is here to stay,” Bruno began. “The key is trying to understand it and how it benefits us.”

Bruno opened with a foundational overview of AI, describing the spectrum of its capabilities and offering examples of its systems and applications. He outlined the distinction between narrow AI, which is task-specific, and general AI, which aims to replicate broader human cognitive functions. Generative AI tools like ChatGPT fall into this evolving space and are becoming increasingly intertwined with clinical practice.

From a dermatological implementation standpoint, AI’s clearest and most immediate value lies in administrative support. Tasks such as appointment scheduling, prior authorization appeal letters, and clinical documentation are now routinely augmented by AI-driven tools. Electronic medical records are beginning to integrate AI-powered scribes, improving both efficiency and accuracy in clinical notes.

In diagnostic and predictive medicine, AI applications include imaging analysis for melanoma detection, radiological interpretations, and platforms like Delphi 2M that analyze biobank data to predict disease risk. AI is also embedded in telemedicine platforms and wearable devices, offering real-time data monitoring for cardiovascular and neurological conditions.

Bruno also addressed the ethical and legal implications of AI use in medicine. He emphasized that AI systems can inherit and amplify biases present in training data related to race, gender, or other demographic variables, underscoring the need for thoughtful data curation and algorithmic oversight. Privacy concerns were also highlighted, especially in light of AI’s capacity to re-identify anonymized patient data.

Medico-legal accountability remains a murky area, according to Bruno. As AI becomes more involved in diagnostic and treatment decision-making, clinicians must be vigilant. A critical point made was that clinicians bear ultimate liability, even if an AI tool contributes to a diagnostic error. Therefore, the concept of "human-in-the-loop" is not just ideal—it is necessary for risk management.

The session also touched on how insurers are already leveraging AI to scrutinize medical records and deny claims based on detected documentation gaps. Consequently, Bruno advised clinicians to develop a working knowledge of AI to protect both their practice and their patients. Over-reliance on AI, particularly in place of sound clinical judgment, was flagged as another pitfall.

“On a transparency side, we really need to understand that patients are trying to understand this too...It's a lot of this fear of the unknown,” Bruno noted. “There's actually a survey that said the patients who were made aware that their physicians were using AI had a lower trust rate in them.”

To empower clinicians, Bruno introduced AI-enhanced clinical support platforms such as Open Evidence and ScholarRx. These platforms offer peer-reviewed, vetted information and aim to convert raw data into actionable knowledge. They serve as both educational and clinical tools, bridging the gap between AI output and evidence-based practice.

The presentation concluded with a call to action: clinicians must proactively engage with AI, identify trustworthy tools, and adapt to a landscape where AI is not merely a tool but an integrated partner in health care delivery. As Bruno puts it, information alone is inert—it is the application of information that produces knowledge.

“Everyone's using AI in every aspect of the business. It's going to quickly evolve in practice and it's going to incorporate every facet of it. I highly encourage you to start looking into it, get comfortable with it, and define trusted sources,” Bruno concluded.

Reference

1. Bruno M. AI in Your Practice. Presented at: Maui Derm NP+PA Fall 2025; September 20-23, 2025; Nashville, Tennessee.