In Articles, blog, Doctor Health, Wealth

Have you ever had a deep conversation with a robot? Lately, I’ve considered how my own inter-personal skills might be applied to technology. After all, I am an emergency medicine doctor who now manages a string of hospitals and must be helpful to members of my staff. What if I woke up one day and they had been replaced by artificial intelligence?

Job security is an assumption new physicians and medical students dare not embrace. Not in an era when startups already have us thinking about driverless cars and questioning the efficacy of learning a second language when translation apps—mobile interpreters—are readily available.

The idea that young people should choose a career in medicine because “people will always need a doctor” should be revised. People won’t always need a human being with a medical license. They will likely turn to a computerized medical device or app.

Or maybe a robot. A pediatric robot, an OBGYN robot and even a sports medicine robot—one for every millionaire professional athlete that can afford one of their own. The interaction between the iconic (and economically burdened) family doctor and people is changing.

This is not to say there may be the Hollywood version of “robot” attending to our needs. But what if computer programs and software were available to accurately diagnose and treat ailments without the hassle of leaving home? We have seen huge strides in genetics and lab data evaluation.  You can even order chromosomal testing of your ancestry and test for disease through the mail. This would have been unfathomable 10 years ago when I was in med school!  Technology is progressing at such a rapid pace that many building blocks for future ideas have been laid. There is a solid foundation for achieving new heights.

It is not only technology that heralds a new era of the doctor-patient relationship. The corporatization and privatization of medicine has reduced the autonomy of physicians and turned them into human capital. Since cutting labor costs will always be a corporate goal, annual earnings may continue to fall for doctors, even as they are expected to be more productive, or robotic. Come to think of it, since the human capacity to help others in crisis is limited, might not a robot, free of compassion, spirituality and the damaging impact of post-traumatic stress disorder, be a better employee?


Job Market Woes

Perhaps there will simply be less positions for medical professionals, who have spent 10 years and a small fortune to be educated. There is now an app that allows us to obtain a 3-lead electrocardiogram (EKG) on our smart phones and send it off for a cardiologist to examine, if you choose to pay the $29.99 fee. This trend clearly reveals that demand for personal attention—a relationship—is on the downswing.

In The Passive Income Physician: How to Survive a Career Crisis by Expanding Net Worth I compare two mindsets in the medical field. Dr. Bliss sees the big picture and realizes the importance of expanding his economic power and view of his profession. That’s quite different from Dr. Desperate who wears blinders, has an employee mentality, refuses to accept change, and is therefore overworked and underpaid.

Although the concept of these two doctors may seem restricted to personal finances, in fact it goes deeper and grapples with individual values, endurance, and quality-of-life choices. The curriculum for medical students, and opportunities for interns, must address the evolution of healthcare trends in America, or sadly and unconsciously it may create a generation of Dr. Desperates whose purpose in life will be reduced to frantically competing for fewer jobs.

This is not to say that robotics are not a boon to practicing physicians. The technologies allow skilled men and women to work remotely (telepresence robots) or with greater precision (surgical robots). There are also pharmaceutical robots, and robots that aid the elderly. More astounding inventions that will help Mankind are surely in the works.

That said, the assumption that doctors all make a lot of money, or that they live lives of privilege must be reassessed. Not by patients, but the medical community that enlists, trains and cares for the next wave of healthcare professionals that American will need, in one form or another. If the economics of medicine are endlessly analyzed by accountants, economists and Big Pharma startups, every would-be doctor should do the same. Before applying to medical school.

If we believe medical professionals are among the untouchables—“people will always need a doctor or nurse”—take the contrarian view. The use of robotics in Detroit changed the expectations of autoworkers and their union. Could it have the same sway in medicine?  Not to say the profession will vanish, but how will this impact the future needs of physicians?  Combined with AI could the roles of mid-level providers be greatly expanded to provide a much more viable economic solution to the corporate monolith and private equity companies that paint the landscape of healthcare?

Uber and Lyft present another eye-popping milestone. The impact on the taxi industry has been monumental. Did the drivers and their managers see it coming five years ago?

In an opinion piece for the Wall Street Journal, Andy Kessler makes a strong argument for dropping foreign language requirements in American schools. Why?  In his case, after five years of studying French he confesses that he still wasn’t conversant. More to the point, these days apps provide real-time voice translation. Why waste the hours it takes to learn phrases like, je t’aime? (That’s worthy learning, actually.)

There is one language, however, that he and others like Apple CEO Tim Cook believe is essential and should be required: Fluency in coding.

I would add, and what about fluency in finance and how to create wealth?

Kessler notes that the “formerly blue-collar job” of operating tools now demands programming smarts. And yet schools insist on teaching French, Russian or Mandarin.

He then foresees education without teachers and—gasp!—“doctorless medicine.”

Fortunately, all medical students, interns and practicing physicians might consider another path, call it a “lifeline to job security.” That’s why I’ve been pondering how my conversations with robots might go. As manager of the hospital, maybe all I need do is set the record straight by writing a short directive:

                Dear Dr. Robot:

                 As you may know, I coded your brain, your heart, your capability.

                Now get to work! And don’t stop unless I say so!

                Be well, Tom


Thomas Black, MD, is the passive income physician.

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