My parents moved to the United States in the 1960s as immigrant physicians. One of the doctor’s functions—taking up approximately 5% of their time—was to smear blood on microscope slide, then count the white and red cells per high powered field—the complete blood count (CBC). Today this function has been totally replaced by AI—just insert the blood and swish, fizz, whirl…the CBC results are entered into the EHR!
But we don’t have 5% less doctors, so just like any technical advancement, this has allowed us to perform more CBCs. It has replaced some specific functions—but it has not replaced the physician.
Recently several large tech companies have tried to sell AI as something new: A mysterious black box that can “sniff out” diagnoses and treatments and eventually replace docs. They seem to ignore that AI has been changing medicine all along and has not done this.
Software suggests EKG diagnoses, EHRs remind us to avoid drug/drug interactions, and monitors automatically interpret pulses and blood pressures. These resources make the doc more valuable, but change the expectation of a skilled physician. Docs in my generation need to know how to use EHRs and apply evidence-based medicine, not count blood cells on slides.
The same goes for those outside of medicine: CRMs don’t replace salespeople, but they do increase their output. Excel allows bankers to be more accurate in ways no human could before. Smart technology pushes forward the forefront and expectations of what it means to be an expert.
A top reason AI won’t replace docs: Physicians will not become robots because society does not want them to. “Doctor” comes from the Latin docere, which means “to teach”—to console, to care for, to reassure. One hundred years ago, before most medications and surgeries—there wasn’t much else a doctor could do but teach and comfort.
This humanism can’t be divorced from medicine. It’s not only about the empathy when connecting with patients, but also the art of applying the more objective science to individuals who each express disease and pain in their own way.
I have a bit of a unique view: I’m not only a practicing doctor, but also the cofounder of a clinical decision support service that would greatly benefit from the automatization of medicine. I know there are limitations to what can be made objective and automatic. The “AI” of the future will only work when skilled, caring physicians with a deep understanding of evidence-based medicine apply technology to the individual patients in front of them.