Dystopia Now: Artificial Intelligence and Physician Obsolescence

March 12, 2019

If you want to give away your age, tell me what Artificial Intelligence (AI) means to you. Is it HAL9000’s red eye? The self-aware evil of Skynet? An extra-creepy Haley Joel Osment? Or is it a screen that recommends a movie to you with 97% confidence or getting 500 reviews and the exact location of your next ride share? (Well, outside of BC at least.)

From self-driving cars, to delivery drones, to blockchain banking and cryptocurrency, AI is poised to change the way we live-- and the lives of millions of people with middle-class technical jobs. Machines rarely take breaks, they work overtime and holidays, and don't ask for pensions or employment insurance.

Aside from threatening health through worsening income disparities, there has been concern about what AI means to the future of physicians. Will it be the end of doctors when a machine that works at full capacity 24/7 and is readily accessible by our ever-present phones can handle medical queries? Yes and no.

As the early mixed experience of Babylon – a health service app that provides consultations with doctors and health care professionals via text and video messaging – in the UK and Rwanda has shown, there is potential for AI to help triage; indeed, this is what many services such as 811 already do. (And when the human element comes in, the default is to refer the inquirer to the emergency room "just in case”— except when it doesn’t.) There is a valid concern that AI platforms will potentially be used to provide episodic care, interfering with ongoing patient-doctor relationships.

Despite the worry, machines have not shown promise in matching the fluid thinking that doctors use every day while treating complex problems. And while cute robots may help comfort people with dementia, relationships are central to good care and can never be replaced so long as they are accessible. Instead, AI may help free up more time for these relationships by parsing through information such as thousands of images, the probability of diagnoses on a list, or recalling patients based on remote monitoring data.

So while there may be wild visions of unemployed doctors ruled by red-eyed overlords, doctors’ ability to cope with uncertainty and ever-changing variables in the context of a therapeutic relationship will always be needed in order to provide the genuine emotional intelligence that is the foundation of great care.

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