Will Technology Replace Doctors?

Joe FlowerPut the question in 1880: Will technology replace farmers? Most of them. In the 19th century, some 80% of the population worked in agriculture. Today? About 2% — and they are massively more productive.

Put it in 1980: Will technology replace office workers? Some classes of them, yes. Typists, switchboard operators, stenographers, file clerks, mail clerks — many job categories have diminished or disappeared in the last three decades. But have we stopped doing business? Do fewer people work in offices? No, but much of the rote mechanical work is carried out in vastly streamlined ways.

Similarly, technology will not replace doctors. But emerging technologies have the capacity to replace, streamline, or even render unnecessary much of the work that doctors do — in ways that actually increases the value and productivity of physicians. Imagine some of these scenarios with me:

· Next-generation EMRs that are transparent across platforms and organizations, so that doctors spend no time searching for and re-entering longitudinal records, images, or lab results; and that obviate the need for a separate coding capture function — driving down the need for physician hours of labor.

· Deep and automated real-time cost analysis per case, per work unit, and per procedure that allows healthcare organizations to offer single-price bundles for much of the work that they do, from hips and knees to births to diabetes control. This would help eliminate much of the 1/3 of all healthcare that is simply wasted in an attempt to drive revenue streams in a fee-for-service code-driven medical world. It would also eliminate the enormous amount of physician and staff time devoted to arguing with insurance companies (estimated cost across healthcare: $80,000 per physician per year).

· Mobile healthcare through Bluetooth patches, embedded chips, wrist bands, smart jewelry, and handheld devices that allows physicians and healthcare organizations real-time monitoring of at-risk and chronic patients, improving their health, driving down the need for acute interventions, and driving down costs — partly by driving down the need for physician labor hours in both the chronic and acute phases.

· Deep Big Data ability to aggregate de-personalized data across organizations, functions, and regions into distributed virtual n-dimensional queriable databases that allows healthcare managers to determine what’s working, what’s efficient, what’s waste, combined with lean initiatives to drive iterative process change throughout the organizations as a normal constant part of doing business.

· A similar ability on the part of purchasers across the system to better determine real quality and real efficiency among providers, as large purchasers are able to do with their suppliers in most industries. This would also drive out waste and lower the need for physician labor hours.

In this ideal vision of technohealth, the one thing that is not attenuated is the need for doctors doing good, real, hands-on doctoring. Healthcare at its core is inalterably retail, putting the physician’s expertise, insight and persuasive power together in a trusted relationship with a single patient with their single body and their individual decision-making power. Ideally, the tech that clears away wasteful procedures and unnecessary administrative tasks and streamlines the monitoring of at-risk and chronic patients will actually leave more physician time and more bandwidth for that strong, trusted patient relationship that is by far the most efficient communication structure in all of medicine.

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24 replies »

  1. I also don’t think technology will replace doctors. Although when we look at the future there is a chance of technology overtaking doctors. As the new invention is rising day after after. So it’s quite possible in future.

  2. I don’t think technology will replace doctors but yet “compliment” his or her practice. The biggest technological push for hospitals is to go-live with Certified Physician Order Entry or “CPEO.” The technology has actually been proven to reduce errors and make the patient experience more seamless. However, this will not be fully automated but technology will be a “tool” for physicians, pharmacists, and registered nurses.

  3. Absolutely No the technology itself is a by product of human beings…but technology cannot be ignored

  4. I sure hope technology won’t replace doctors. There are still some good physicians out there who continue to show care and compassion towards their patients, in such ways that a computer could not. There will always be a need for doctors.

  5. I agree with Keith, technology will just make the doctor’s job easier and faster. We cannot replace doctors with technology because there are a lot of things that a doctor can do which technology cannot. And I think doctor’s care has a unique touch in every patient.

  6. A comparison with farmers misses the difference between what doctors do and what farmers do. Are there more or less engineers now than in 1880? There are far more engineers today because cognitive skills are difficult to automated and the demands of complex technology demands more minds to keep it running. There will be more doctors needed in the future for the same reason. To advance technology it takes people that think – something computers do poorly.

  7. Tony, that’s an interesting little bit of a story. My wife just got some test results back which caused the doctor to recommend two further tests to rule out a problem. We are living with some worry right now.

    But the point of your story changes depending on a detail: Was your wife’s doctor just one of those who ignored the changed guidelines and wanted your wife to continue having routine mammograms? Or was there something that the doctor noticed or intuited in the patient encounter that caused the doctor to tell her to get another mammogram?

    Mammograms are actually a good example of the in the argument about how much information is too much. The Canadian National Breast Screening Study (available at which involved 90,000 women over 25 years, showed no advantage to mammograms plus physical exams over physical exams alone and teaching women proper self-exam. And the study showed that 22% of the growths detected by mammograms were over-diagnosed, that is, they did not proceed to be clinically important. In the extra worry and biopsies and other testing involved, they were literally too much information.

    • Plus, those extra procedures mean both more costs and more harm caused. When we do too much it will cost in lives lost and more complications. Medical care is not an unmitigated good. So we can predict that looking at everything in total, mammograms for those younger than the cut off are more likely to be harmed by the procedure than to benefit. If your goal is to catch every cancer, you would start mammograms at the age of 20. If your goal is to improve the health of your patients, you would wait until the age cut off.

  8. I don’t know if technology will fully replace doctors as such. I think technology will help doctor help more people in more effective and efficient ways. No tech advancement or invention will have the capacity to feel the compassion to help a patient.

  9. This is a very thought-provoking topic. I would just have to say that some care could not be replaced by a real human, sure, medical processes replaced by technology will be more efficient and productive.These are thoughts to ponder.

  10. This is an interesting and valuable exchange of opinions. The path forward in health care seems to be using the tools Joe mentions to support primary care physicians–and actually teams of people from many disciplines headed by a PCP–and to reduce the need for specialists. Better care for chronic conditions will mean less surgeries and other expensive specialties. Space-age technology in health care is also moving more things within the range of a non-specialist, even a non-MD.

  11. The more monitoring and real time data, the more intervention will be required with more complications and adverse effects and more costs.

    No, wearables and health tech will not solve health care’s problems just like computers did not lead to fewer work days or a paperless society.

    • > The more monitoring and real time data, the more intervention will be required with more complications and adverse effects and more costs.

      Let me follow your logic here: The more you know about the patient, the more you intervene. But the result of those interventions is not to actually prevent any acute problems or to prevent, say, metabolic syndrome from becoming diabetes. The only important outcome of those interventions is more complications, adverse effects and costs.

      So I assume in your practice you try to know as little as possible about your patients’ health, so that you intervene as little as possible, thereby sparing them the complications, adverse effects, and costs?

      Or are you merely assuming that all health tech will be done badly, implemented stupidly, and used poorly? Anything can be shown not to work if it is done stupidly.

      • No.
        I’m suggesting that more information and more data beyond a certain point may not be helpful.

        Just as we discourage the use of tests when the result may not change the treatment plan, we must be cognizant that more information may have potential deleterious effect.

        It is not that I want to know “as little as possible” about patients, it’s more an issue of will the information having potential to cause iatrogenic illness and not be beneficial.

        This has little to do with how well the health tech is implemented…just that essentially every intervention, including preventative measures, have potential for adverse outcomes.

        I’m asking “Where is the point of enough information?”

        At what point does more information potentially become unhelpful and costly or even harmful.

        Worth asking.

        • But what is that point – and who gets to decide?

          “Too much information” certainly isn’t in the top 10 problems hampering patient care at this point, is it?

          • That’s arguable.
            Choosing Wisely is a program to reduce unnecessary testing and procedures that don’t improve health or that have potential to cause harm.

            Perhaps we need the same with information.

            More and more information may not be helpful to a patient’s care.

        • I think it is more about having access to the right information when you needed vs. an available ocean of information. With the right tech, you eliminate redundancies, clerical error and even the manual processes allowing providers to gain time back in their day to do what they love to do. Also, the bottom line aspects for a health system are immense when this is done properly.

          • Yes, the question is what is the right information. For instance, one new technology now available is the VisiMobile wrist monitor system. The monitor, about the size of a cell phone, straps on your wrist, an oximeter is strapped around a finger and a couple of sensors are stuck on your chest. It measures ECG, heart rate, blood oxygen, blood pressure, respiration rate and skin temperature — it’s a quick strap-on vital signs monitor.The low price and ease of use mean that you could put it on literally everyone who is in a hospital bed, or even send them home with it for their home convalescent period.

            But there is a real question whether such blanket use would yield much new actionable information, or simply overwhelm the staff with alerts that they would have to ignore.

            Such monitoring systems have to be wisely implemented to produce actionable, meaningful information. A patient’s weight is less clinically important than a sudden change in weight, or a weight that is outside of certain normal parameters. The same is true of many measures.

            Perhaps I am too much of an optimist, but I do believe that we can figure out how to use these new sources of information and communication smartly, to improve care and reduce both neglect and over-diagnosis and over-treatment.

  12. I think Joe is exactly right.

    Technology is not going to replace doctors.

    It is, however going to redefine doctors. A bunch of people who are currently doctors are going to stop being doctors. Other people who are now working in non-doctor roles (nurses, PAs, pharmacists) are going to be doing doctor stuff. And web-based self-service heathcare, where consumers almost never see a living bresthing doctor and do a lot of things themselves, is going to shake things up …

    Will it be all good? No. Will it change the world? Yes.

  13. Are IT guys creating programs that will do the work of IT guys? Seems like that is what they need to work on. When we got our EMR we were told of all the money we could save by getting rid of $8/hour medical record personel only to find out that we had to then hire $40/hr IT guys to help run the dumb thing.

  14. The real question: will technology replace venture capitalists?

    I vote yes. Think about it. Why waste all of that money paying vc firms to do what any self respecting algorithm developed by a Stanford drop out should be able to tell you to do?


  15. PLEASE REPLACE ME! I BEG OF YOU! my 401k is big enough to retire anyway, my 80 year old ladies with there little white purses and knee high hose and the old crumudgeons with velcro rockport walking shoes are tired of hearing me ask them how they are doing, they just want an app or fitbit to import data and monitor vital. when there spouse gets dementia and the person that have loved for 50 years is only a shell of a person they just want to twitter out there emotions to there virtual friends. BLAH BLAH BLAH.

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