The Minimization of the Physician, Part 1: It’s Not the Strongest That Survive…

It is not the strongest of the species which survives, nor the most intelligent…but the one most responsive to change. – Charles Darwin

In early 2017, I spent a week in Silicon Valley. I went to a conference that focused on start ups in the tech world (What else would a conference in Silicon Valley focus on, right?). I also had several one-on-one meetings with people from technology companies to explore how technology could be used to enhance the patient-physician relationship. Frankly, I was surprised as to what I found.

Two things became abundantly clear to me during that week:

  1. I used to think it was a parody, but the HBO series Silicon Valley is as close to a documentary as you can get without calling it a documentary (I wish I was joking.)
  1. There is a massive effort to use algorithms and robots to replace Doctors

The only evidence I can provide for you regarding point # 1 is to tell you to watch the HBO series and then experience a week in Silicon Valley talking with entrepreneurs and start-up founders.

However, I can offer you this evidence for point #2:

Go to an internet search engine and type: replacing doctors with algorithms.

You will get more articles than you can read. These articles are appearing not just in “weird” places that only “tech nerds” read. As early as 2012, the vaunted Fortune Magazine has had articles discussing this issue.

Here are just a few of the pages and pages of examples:

  • Technology will replace 80% of what doctors do – Fortune Magazine
  • Can An Algorithm Diagnose Better Than A Doctor? – The Medical Futurist
  • Do We Need Doctors Or Algorithms? – TechCrunch
  • Will medical algorithms replace doctors? – MB Financial Bank
  • Healthcare Analytics: Algorithm is the new doctor and data is the new drug – Analytics Magazine
  • London hospitals to replace doctors and nurses with AI for some tasks – The Guardian
  • Will Robots Replace Doctors? – Imaging Technology News
  • Prepare Yourselves, Robots Will Soon Replace Doctors In Healthcare – Forbes Magazine
  • Scanadu CEO: Algorithms will replace docs to prescribe meds – Med City News
  • Vinod Khosla: Machines will replace 80 percent of doctors – wired.com
  • AI found better than doctors at diagnosing, treating patients – Computer World

Let’s face it: many (if not most) of the programmers, developers, and entrepreneurs in Silicon Valley maintain the mantra of “making the world a better place with technology.” These programmers, developers, and entrepreneurs in Silicon Valley see the world in bits, bytes, 1s and 0s, and scale. I’m not going to go into the psychology of this; however, one can not deny the economics of it. 

A good example of this comes from the great book Eat People: and Other Unapologetic Rules for Game-Changing Entrepreneurs by Andy Kessler, the tech analyst-turned tech investor-turned tech and healthcare writer for the Wall Street Journal. His book title and “Rule #7” are about eliminating people as much as you can, mostly because people are inefficient and expensive.

If you, as a doctor, haven’t experienced this already, you soon will. Incomes are dropping, or at least pressure is being put onto the incomes of doctors. As a doctor, your income may be the same, but you are being asked to do more and more for the same amount of pay. That is an example of the decreasing of “real income.”

We’re told time and again that there is a shortage of doctors, but doctors are doing more and more for less and less pay. (This is the opposite of what real economics – supply and demand – should be showing us. When there is a shortage of some thing, whether a commodity or a service, and the demand for that thing remains the same or increases, that thing should become more valuable and more expensive. But that is not happening for doctors.)

Algorithms, which are the basis for Artificial Intelligence (“AI”) and machine learning, are loved simply because the code is pure, simple, controllable, inexpensive, and, here’s one of the two most sought after concepts in Silicon Valley, “scalable.”

This is not a “The End is Nigh” message. Well, maybe it is. But only for those who will not adapt.

You are likely familiar with the phrase “only the strong survive.” However, this is actually a misquote of what Charles Darwin actually said; the accurate quote is “only the adaptive survive.”

So, what can a doctor do? 

There are a lot of options; most require at least a lot of thought. In some instances, there will need to be an incredible amount of adaptation.  With that, the place to begin is actually the easiest – and, almost counterintuitively, the most difficult. 

You must change your mindset. 

The way you see the world. The prisms through which you look and interact; and the things that you believe. Yes, even the things you believe to be foundational elements of your life as a doctor must be reviewed. You must unplug yourself from the Matrix of Modern Medicine.

And, for the love of all that is still holy, stop referring to yourself and other doctors as “providers.” It’s one of the reasons why we’re in this mess in the first place.

“Providers” are cogs in the machine. If you don’t know history – or didn’t pay attention in high school history class – one of the main reasons why the industrial revolution advanced was because of interchangeable parts. As a “provider” of medicine and healthcare, you are seen by those who are not doctors (and, unfortunately, by some who are) as interchangeable parts in the scaling of medicine and healthcare.

Again, what is a doctor to do?

Adapt. 

Adapt or perish.

Not literally, of course, but the concept of the “professional doctor” has not really changed since the 1960s. Other professions have figured out how to adapt and evolve, but the “professional doctor” has not figured this out yet. Some are starting to…as there is a Revolution brewing, but it is a long way from critical mass.

What is a doctor to do?

Beat Silicon Valley at their own game. 

No, this doesn’t mean that you need to start writing code.

Beating Silicon Valley at their own game means finding ways to create the second of the two most important and sought after concepts in Silicon Valley: value.

What value do you really offer to patients? 

What value can you give that an algorithm or robot cannot give to a patient?

If you don’t know, here is the answer: 

Relationship.

Without going into great detail in this blog post, patients want 2 main things from their physician: 

Time and Advice.

And until you can figure out how to give that to your patients, the world will continue to adapt and evolve without you.

If you think I’m wrong or would like to talk about how you can possibly adapt and add value, contact Impact Physician for a free, no obligation 30 minute consultation. Or, you can check out the following information:

  • The Impact Physician Blog – Topics that are relevant to doctors interested in becoming an Impact Physician, how to take the steps necessary to combine business ownership with the art of medicine to you find a better quality of life for you and your family, and much more.
  • Schedule a free, no obligation 30-minute phone call with an Impact Coach. Click here to send us a message. In the subject line state “I’m interested in becoming an Impact Physician.” In the message section, please tell us a little about your story, your current situation, and how to get in touch with you. We will respond within 24 hours to schedule a time to discuss how to become an Impact Physician.
  • Become an Impact Physician Member. It’s free, but requires a membership, as membership has its privileges. As a member of the Impact Physician Member group you will have access to a lot of great information and resources about being an Impact Physician and how to navigate the complexities of business ownership. Once you join, you’ll receive an early draft of our new eBook entitled The 4 Kinds of Physician-Business Owners (coming November 1, 2018).
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