Medical agents and the rise of agentic medicine: a new clinical science and a global agenda for accountable action

Medical artificial intelligence is moving beyond prediction and content generation toward goal-directed reasoning, tool use, and controlled execution, giving rise to new scientific questions that transcend model performance evaluation. We propose agentic medicine science, a discipline that investigates how medical agents participate in clinical action within defined objectives, human oversight, and institutional boundaries, and how such participation affects patient outcomes, care processes, and health system performance. Its fundamental unit of analysis is the patient – professional – agent – health system (PPAHS) composite system. Its  knowledge architecture comprises three pillars: clinical action, clinical evidence, and accountability and governance; global translation is guided by a 4S agenda of standards, science, safety, and solidarity. We distinguish medical GPTs, automated workflows, medical agents, multi-agent systems, and embodied agents, and propose a tiered evidence pathway extending from technical validation and clinical validation to clinical outcomes research and continuous post-deployment monitoring. Chinese practices, including closed-loop pulmonary nodule management and hospital-at-home care coordinated with cloud-based outpatient services, suggest that the value of medical agents lies not in replicating physicians, but in reorganising fragmented knowledge, tasks, and responsibilities into a  continuous care system that is verifiable, controllable, and accountable.

Key Words: medical agents; agentic medicine; large language models; clinical evaluation; artificial intelligence governance; human–AI collaboration; health-system reform