Artificial Intelligence
Approved by the ACFAS Board of Directors, March 2026
The American College of Foot and Ankle Surgeons recognizes the immense potential of artificial intelligence (AI), including machine learning (ML) approaches, to transform the delivery of surgical care, education, research, and practice management. Applications already impacting foot and ankle surgeons include clinical documentation, imaging interpretation, surgical planning, patient engagement, and outcomes research. While these tools hold promise to reduce administrative burden and improve patient outcomes, they also introduce risks such as algorithmic bias, data privacy vulnerabilities, lack of transparency, and uncertainty regarding liability.
It is the position of the American College of Foot and Ankle Surgeons that:
- AI must augment and not replace clinical judgment. Podiatric surgeons retain ultimate responsibility for patient care decisions.
- Transparency and explainability are essential. AI outputs must be understandable to physicians and patients, with disclosure when AI meaningfully influences clinical decision-making.
- Equity must be prioritized. AI should be developed and validated to avoid exacerbating existing health disparities, especially among underserved populations frequently treated by podiatric surgeons.
- Clinician involvement is required. Podiatric surgeons must be engaged in AI development, testing, and validation to ensure relevance, safety, and applicability to surgical care.
- Data privacy and cybersecurity are paramount. AI adoption must comply with HIPAA and include robust safeguards against breaches, misuse, and re-identification of sensitive health data.
- Accountability must be clearly defined. Developers and institutions bear responsibility for the performance, safety, and transparency of AI tools; physicians should not be penalized for good-faith reliance on validated systems.
- Education and advocacy are central. ACFAS commits to providing its members with education on AI’s benefits and limitations, promoting responsible adoption, and advocating for appropriate oversight.
By endorsing these principles, ACFAS affirms that AI should serve as a tool to support the surgeon–patient relationship, and must be implemented in a way that safeguards patient safety, upholds professional integrity, and advances equitable access to high-quality foot and ankle surgical care.
References
- American Medical Association. Principles for Augmented Intelligence Development, Deployment, and Use in Health Care. Adopted November 2024.
The American College of Foot and Ankle Surgeons is a professional society of over 8,100 foot and ankle surgeons. Founded in 1942, the College’s mission is to advance excellence in foot and ankle surgery to achieve superior patient outcomes.