{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/psychiatrists/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Psychiatrists", "soc_code": "29-1223", "category": "Healthcare", "us_employment": 27980, "median_annual_wage": 281870 }, "verdict": "SAFE", "risk_resistance": 76, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 14, "embodiment": 8, "liability_shield": 19, "trust_premium": 18, "judgment_accountability": 17 }, "reasoning": { "task_resistance": "A 45-minute diagnostic evaluation where the differential turns on flat affect, pressured speech, and whether the patient is minimizing — plus titrating clozapine against ANC counts and negotiating a treatment plan with a family that disagrees with it — sits at 14 rather than 18 because the surrounding PHQ-9/GAD-7 scoring, note generation, and interaction screening are already machine work.", "embodiment": "An 8 reflects the physical minimum that remains: catatonia and EPS exams, AIMS scoring for tardive dyskinesia, IM long-acting injectable administration, ECT supervision under anesthesia, and being bodily present on a locked inpatient unit during a code — but a large share of outpatient med management now happens over video from a home office.", "liability_shield": "A 19 is set by the DEA registration required to write for buprenorphine, stimulants, and benzodiazepines, state medical licensure, and the fact that a psychiatrist's signature on a 5150/72-hour hold and on every prescription is the personal liability anchor in a wrongful-death or Tarasoff duty-to-warn suit.", "trust_premium": "Disclosure of suicidal ideation, command hallucinations, or abuse history is contingent on the therapeutic alliance itself, and patients routinely stay with one psychiatrist for years across medication changes — 18 rather than 20 only because much med-management volume is short, interchangeable 15-minute follow-ups.", "judgment_accountability": "Deciding to commit someone against their will, discontinuing lithium in a pregnant patient, or judging whether a threat to a third party breaches confidentiality are calls made on partial and often deliberately distorted information, with no protocol that resolves them and the psychiatrist's name on the order." }, "rationale": "Psychiatry is largely conversation and prescribing, so the documentation layer — intake summaries, progress notes, medication-interaction checks, prior-authorization letters, screening-scale scoring — is already being absorbed by AI. What does not move is the controlled-substance prescription, the involuntary-hold decision, the suicide-risk call made on incomplete information, and the patient who will only disclose to a physician they trust. Telepsychiatry lowers the embodiment moat, but licensure, DEA authority, and personal malpractice exposure remain the hard floor.", "outlook": "Demand will keep outrunning supply through the 2030s; AI will strip most of the paperwork and much of the routine SSRI-refill volume, pushing psychiatrists toward supervising larger panels and handling the acute, ambiguous, and controlled-substance cases.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "DEA's post-pandemic telemedicine controlled-substance rulemaking finalizing a requirement that Schedule II prescriptions (stimulants, ketamine) carry an in-person or synchronous physician evaluation, plus state PDMP rules naming the prescriber personally accountable for AI-suggested regimens; also state statutes (e.g. involuntary-commitment codes) that name a physician or psychiatrist as the only party who may certify an emergency hold", "plausibility": "already happening", "would_add": 1 }, { "dimension": "task_resistance", "change": "Task-mix shift: as ambient scribes (Abridge, Nuance DAX), automated PHQ-9/GAD-7 scoring and prior-auth letter generation absorb the documentation tier, the residual job concentrates on diagnostic ambiguity, treatment-resistant cases, suicide-risk calls on incomplete history, and clozapine/lithium/MAOI management — tiers with no clean ground truth. Also if boards or payers bar autonomous AI from psychiatric diagnosis, as some state AI-in-mental-health bills (Illinois HB 1806, 2025, restricting AI therapy) do", "plausibility": "already happening", "would_add": 3 }, { "dimension": "trust_premium", "change": "Malpractice suits or FTC actions following harm from consumer AI chatbots (already filed against Character.AI) hardening a market norm that psychiatric care be physician-delivered; cash-pay concierge psychiatry where the fee is explicitly for a named physician's continuity", "plausibility": "plausible", "would_add": 2 }, { "dimension": "judgment_accountability", "change": "Expansion of statutory duty-to-warn/Tarasoff-type liability and state rules making the psychiatrist the accountable party for risk-stratification outputs generated by AI triage tools, so the consequential call remains personally attributable", "plausibility": "plausible", "would_add": 2 } ], "ceiling_note": "Already at 76 with liability_shield near maximum; realistic headroom is a few points, mostly from task-mix concentration. Embodiment has no plausible upward route — telepsychiatry pushes it down, not up." }, "adjudication": null, "employment_history": { "points": [ { "y": 2019, "emp": 25530, "wage": 239200 }, { "y": 2020, "emp": 25540, "wage": 239200 }, { "y": 2021, "emp": 25520, "wage": 239200 }, { "y": 2022, "emp": 26500, "wage": 226880 }, { "y": 2023, "emp": 24830, "wage": 239200 }, { "y": 2024, "emp": 24800, "wage": 239200 }, { "y": 2025, "emp": 27980, "wage": 281870 } ], "from": 2019, "to": 2025, "change_pct": 9.6, "comparable_from": 2019, "spans_soc_revision": false }, "pivots": [], "license": "https://cookedindex.com/terms" }