The Robot Will See You Now

With the recent explosive advances in artificial intelligence, there’s been a lot of talk about computers replacing human workers. Lawyers, I’m told, will be among the first to go (insert sound of world’s tiniest violin here), quickly followed by journalists, computer programmers, and--you guessed it--doctors.

Already, there are AI programs that do a better job reading EKGs and chest x-rays than experienced cardiologists and radiologists. Can robotic anesthesiologists and dermatologists be very far behind?

I have no doubt that AI will soon replace many of the functions of primary care. What computers do best is organize and synthesize large databases of information, and that has always been one of the most daunting tasks in primary care. An AI generated differential diagnosis will be more comprehensive than anything I come up with. Prescription mistakes will become much less common. Care will follow standardized, evidence-based algorithms, instead of the whims of individual clinicians. Those improvements are already well on their way.

Still, I’m not that concerned that clinicians will be replaced entirely. The one thing that can never be standardized is patients. Sometimes they withhold information, or change their minds, or just plain lie. Sometimes they agree to a care plan and then do something else entirely. Sometimes they spend 20 minutes telling you stuff you don’t need to know before they slip in something you can’t afford to miss. And sometimes--maybe more often than not--their clinical outcome depends more on how they feel about you than it does on what you prescribe.

The defining characteristic of a great clinician has always been their ability to build a great therapeutic relationship. AI might replace a mediocre provider, but not a great one.