The rise of the machines in healthcare. What it portends for clinicians and other workers.

This morning I came across an interesting article by Jason Hiner on ZDNet. The article, When robots eliminate jobs, humans will find better things to do, examines how innovation and new technologies have disrupted jobs throughout history. It makes the case, be it in farming or the manufacture of automobiles, that while disruption in the workforce does happen and some people do suffer as a result, new opportunities arise and the benefits to society overall are mostly positive. You might want to read the article and then jump back here for further exploration of the topic.

Being deeply entrenched in the tech industry and having spent most of my career practicing medicine or working as a hospital executive, I often ponder how advances in artificial intelligence, machine learning, machine vision, and robotics will impact health and healthcare delivery. I can tell you that I have seen very clear signs that these technologies will have an impact. In fact, I'm sure some of you who work in healthcare have already experienced how technology is reshaping things, and in some cases eliminating jobs. The hospital lab is an easy example. I remember when highly educated lab workers peered into microscopes to manually count and "differentiate" blood cells. Today, this is mostly done by machines. In fact, many manual processes and procedures in the lab have been completely taken over by machines in the modern hospital. I'm sure you can think of examples in other hospital departments as well, such as autonomous robotic carts that now travel the elevators and hallways delivering supplies in some hospitals. But this is really just the tipping point for the changes I foresee.

Doctors, nurses and other clinicians may think they are immune from the rise of the machine. They are not, although some roles have more immunity than others. I've been telling my physician colleagues who work in "visual" fields like pathology, dermatology, and radiology that within a decade, they may find their jobs disrupted. The same may be true for fields of medicine that are mainly cognitive. In some instances the machines are already getting better than their human counterparts in looking at visual images of pathology, skin lesions, x-rays, and other imaging studies and arriving at a likely diagnosis. This is also true for super computers that can sort though vast amounts of data and review the entire history of medical literature when tasked with stack-ranking the most likely diagnosis from the information being supplied. You may have also heard about new machines showing up in operating rooms that can be monitored by lesser trained clinicians to replace anesthesiologists or reduce their numbers. Depending on the subspecialty, I even tell some of my surgical colleagues to be wary of the robots that are coming for their work.

I believe this trajectory of machines over humans will play out in many areas of medicine and clinical care over the decades ahead. However, as Jason Hiner explains in the aforementioned article, this isn't necessarily bad. It will allow the humans to find better things to do.

For some time I've been telling young people that a career in medicine, especially primary care, makes very little economic sense if you factor in the high cost of getting a medical education and lost earnings over a period of eight or more years time. Putting the same energy into many other disciplines would likely result in a better financial outcome. So, for heaven's sake, don't go into medicine unless you totally have a passion for the work. If you are in it for the money, you'll likely be disappointed.

So how might smart machines and robotics improve this picture? I believe this makes it possible for people with far less education, aided by smart technology, to be equally if not more effective in delivering quality care. The most highly trained among us will take on much higher level roles, also aided by technology. The machines will one day eliminate many of the mundane tasks in our institutions, allowing the humans to do more meaningful work. Maybe we'll even figure out how to make coding and billing a bit less painful. Yes, there will be disruption and some of it will be unpleasant, but if it gives the humans more time for compassion, for holding hands, for empathy and emotion in the delivery of care, then on balance I think it may turn out to be a very good thing.

Bill Crounse, MD Senior Director, Worldwide Health Microsoft