As a new IM doc, of course I’ve been freaking out quite a bit recently about AI’s ability to replace us. I’ve been spending far too much time reading all the studies and opinions, ultimately stressing over the fact that a lot of people predict I have about 5-10 years left to actually work my job as a doctor. What’s honestly bothering me more, is the number of docs that clearly have their head in the sand about this whole situation and seem to think doctors are irreplaceable. Firstly, I think people need to accept where doctors sit in society today, compared to where they once did. Back in the day, doctors were the true stewards of medicine. They studied esoteric tomes so obscure that people didn’t even bother to question them, and they were able to own and run their own clinics/hospitals. We dictated workflow, administered treatments ourselves, and managed our own compensation. Somewhere along the way, doctors started giving up their knowledge and control because they got busy, greedy, and lazy. Instead of running their clinic, they hired MBAs to handle that side of things. They also started imparting their knowledge on PA’s, NP’s, and nurses, letting them practice independently to boost productivity and handle work that they didn’t want to do. At some point in all of this change, we took both hands off the wheel. Suddenly hospital administrators are making the calls, dictating our schedules, and telling us how much we get to be reimbursed. Doctors forgot how to start IV’s and give shots, letting nurses do it instead. And suddenly, there were multiple degrees in medicine that were prescribing things for our patients, with non-proceduralists eventually giving up everything that made us valuable in the eyes of the world apart from our knowledge, title, and clinical acumen. So where does that leave us with AI coming for our jobs? Not in a good place. A lot of arguments against AI taking our jobs that I see on here tend to be physician centered, with doctors brining up reasons why we take better care of our patients than AI. But my point is that with how we have lost control in medicine, it doesn’t really matter what we think is best. So let’s look at what the other groups want. The Patients: Right now, people are not happy with the state of healthcare in this country. People want cheaper care, better access to care, more time with their doctors, longer explanations, and to not have to wait 10 months to see a specialist. Unfortunately, as we have all seen, healthcare has been heading in the exact opposite direction. You know what would be a really good solution to that? A chatbot that people can access for $15 a month and talk to 24/7 about whatever they want. Not to mention that it can adapt to speak to them in whatever way they prefer and will be able to perfectly validate everything they do. They also get to avoid talking to real people about embarrassing things and can get their refills approved at 2 AM on a holiday. Not to mention, it’ll probably be better at convincing patient’s than we are because it can cite any stat at any time (actually maybe the anti vaxxers won't like AI lol). The Hospitals/Clinics: Let’s get one thing straight. Hospital systems do not give a single shit about the patients. While they say they care about outcomes, what they really care about are numbers and reviews. How else do you explain them charging patients the same amount for shorter visits or having us empirically treat for C. diff rather than testing because they don’t want to get dinged for HAI? What they care about is productivity and profit, and it’s only getting worse every year. Need proof? Just ask your PCP friends about their yearly compensation plan changes that have them see more patients for less money. But you know what hospitals would love to do? Get a cheap AI system that they can advertise as “better than doctors.” Then they can charge patients subscription fees and only have to negotiate one contract with the AI company, rather than thousands with doctors. Even if it meant marginally worse outcomes, they wouldn’t care. And for everyone who says, “patients will revolt because they’ll want to be seen by people,” then explain to me why hospitals haven’t made care cheaper by cutting administrator pay, or extended visit times when people have been complaining about that for years? People will take what is available to them, and if hospitals remove doctors, people will adjust. The Tech Bros: This one should be obvious. They want to monopolize health care. They want to be paid billions of dollars for their AI and to be the ones who get there first. And people are way too naïve about how quickly this stuff is progressing and the effort that is going into it. They smell blood in the water, and for the first time you actually have companies point blank saying “we are aiming to outperform doctors.” Couple that with people pumping millions into these ventures, and it’s a bad recipe. And as far as the bullshit “liability” argument goes, they’ll just move the goalposts. These companies will be more than happy to get sued by patients when they’re making billions. And they’ll probably keep a few doctors on staff in their company to “support” what the AI does. The Doctors: We want what’s best for our patients, but we also want our lives to be easier. We’re happy to accept AI assistance because it can lead to better outcomes, but also because it reduces our workload substantially and means we get home to our kids sooner. We also like the idea of getting to spend more time with our patients and be more present in the room. Currently, we use it even though we know that in most cases, we’re actually training our replacements. In fact, I remember watching a robotic surgery a few years ago and a rep point blank told me, “yeah, the machine records the operation so that we can train the software to do the operation in the future.” But the real issue with us isn’t that we’re training the AI, but mainly that we have historically done nothing to protect ourselves or protect other specialties. And honestly, I don’t see that changing. As a PCP, would you be happy to accept similarly accurate AI imaging reads, even if it meant that all radiologists were out of a job? Conversely would the radiologists care if they’re reading a scan ordered by a machine vs ordered by a human? Is ortho still happy to replace knees when asked by an AI, as long as it means they get paid the same? And even within the same specialties, doctors at different points in training have different priorities which makes it harder for us to coalesce. For example, I see so many age 50+ attendings that are obsessed with AI and use it for everything. I’m not saying they’re bad people for doing that, but to them they don’t really care if it takes over the field since they’ve made their money already. I mean hell, how many rads attendings are researching AI models? They don’t care if it takes over the field, as long as they make their millions. And finally, I want to say to everyone that keeps saying “yeah but by the time they replace doctors every other job will be replaced…” Get your head out of your ass!!! Out of every job that exists, I can’t think of a job that people want to replace more! For one, it’s the most lucrative field in the country, which tech bros would love to monopolize. Secondly, hospitals could have more control and save money to make administrators richer. And finally, patients distrust healthcare and are looking for change more than ever, and a cheap AI model is a great step towards universal care while also knocking doctors down a peg. It’s not like you see people complaining all over the internet about how their local software engineer gets paid too much or is trying to give them autism. I still believe that human doctors will be able to provide better care than an AI ever will, and care could be extraordinary if we worked with AI, but that’s not the point. The point is people settle for “good enough” most of the time. Especially if that means cheaper, faster, and more available. And ESPECIALLY if it becomes the only option. It won’t matter if we know it’s dangerous or worse care, because they’re not going to ask us doctors if its ok before they decide to give an AI a medical license. I don’t mean to be such a downer, but I think it’s time for us to wake up. People are doing everything they can to replace us, and we are the only ones who will resist it. Don't expect the AMA, FDA, or your local hospital president to come to your aid when you are compared to a cheaper alternative. And if we’re going to start speaking out against it, we better start now rather than being blinded by the convenience of AI writing our notes for us. Because unfortunately, we won’t have much bargaining power when they can mostly recreate a doctor with an AI. P.S. Although he knows nothing about being a doctor, it should scare all of us that the richest man in the world is telling people not to go to medical school. Asshole or not, the guy has an insane amount of power.   submitted by   /u/Ambitious-Plane-5191 [link]   [comments]