The governance gap no one is solving.

Artificial intelligence (AI) is rapidly entering clinical practice, yet the governance models needed to ensure its safe, ethical, and equitable use have not kept pace-particularly in community and safety-net settings. Existing frameworks, designed for large academic systems, are often impractical for frontline physicians, creating a dangerous gap between AI adoption and oversight. This article reframes AI governance as a clinician-centered enabler rather than a compliance burden. We propose a pragmatic model built on clear accountability, defined use guardrails, basic safety and bias checks, transparency, and lightweight workflows-supported by a scalable hub-and-spoke approach leveraging trusted professional organizations. Without intentional governance, AI risks amplifying disparities and eroding trust. Done well, it becomes a force multiplier-extending high-quality, equitable care into the communities that need it most. For community physicians, AI governance is not optional; it is essential to protecting patients, preserving clinical judgment, and ensuring that innovation advances equity rather than harm.