Introduction Artificial intelligence has been extensively applied in healthcare, offering significant potential to improve the quality of medical services. However, it also introduces critical challenges, such as privacy infringement, algorithmic discrimination, and ambiguous liability. The integration of artificial intelligence inevitably influences the doctor-patient relationship, which is pronounced in megacities. This study aims to explore the application of artificial intelligence in megacity healthcare system, exam the multidimensional transformation of the doctor-patient relationship and propose new governance frameworks. Methods This study examines how artificial intelligence can effectively address systemic challenges within megacity healthcare systems while leveraging technological and institutional advantages to maximize its benefits, with a focus on Beijing as a primary case. Results The integration of artificial intelligence inevitably influences the doctor-patient relationship, reducing information asymmetry, enhancing patient autonomy, and transforming the traditional doctor-patient dualistic interaction structure into a doctor-artificial intelligence-patient triad interaction structure. These effects are pronounced in megacities, presenting new challenges including crisis of trust, intensified disputes, and emotional and communication distance. Discussion Given that the integration of artificial intelligence into healthcare is inevitable, especially for megacities like Beijing, proactive governance is essential. This includes institutionalizing the triad interaction model, deepening the integration of artificial intelligence in healthcare by leveraging the advantages of megacities, and establishing regulatory frameworks to mitigate risks while harnessing potential.
Qi Chen (2025) studied this question.