Generative AI is fast becoming the first-place people turn for expert advice. The advice it provides can be directional rather than neutral, shaped in part by the choices of its designers and regulators. When clients consult AI before meeting an expert, they carry this directional advice into a relationship that once rested on the expert’s judgment alone. We study its consequences in healthcare through a large-scale preregistered field experiment at a Chinese hospital, where we randomize patients’ access to an AI chatbot before their outpatient visit. Examination of the conversation logs shows that the chatbot routinely cautions against the use of medications, especially Traditional Chinese Medicine and antibiotics, while issuing clean recommendations for diagnostic testing, consistent with the liability-driven guardrails encoded in AI training. This directionality propagates into clinical practice. Prescription rates decline among treated patients while diagnostic testing increases, and these effects are more pronounced among physicians who are receptive to patient input and those with more intensive prescribing styles. Beyond shifting healthcare utilization, survey results show that AI access reduces patient compliance and satisfaction, shifting the balance of authority between patients and physicians.

Speaker: Lingsheng Meng is a Senior Research Scholar at the Stanford Center on China’s Economy and Institutions (SCCEI). His research interests are in the fields of labor economics, development economics, and public economics. So far, the bulk of his work is highly empirical and concerned with six main areas: (1) social mobility; (2) inequality; (3) gender disparities; (4) the role of government; (5) political connections; (5) higher education; (6) the US-China trade war. His work appeared in the Journal of Public Economics, the Journal of Human Resources, the Journal of Development Economics, and other peer-reviewed journals. Lingsheng received a Ph.D. in Economics from the University of Maryland at College Park in 2010, an M.Phil. in Economics from the Chinese University of Hong Kong in 2004, and a B.A. in Economics and Thai from Peking University in 2002. Before joining Stanford, he taught at Tsinghua University from 2010 to 2017 and at the Chinese University of Hong Kong from 2017 to 2022.