"Fewer jobs, more machines"

If you are about my age, give or take a few years, you likely have watched an episode or two of the Hanna-Barbera television show, The Jetsons.  If The Flintsones and Fred Flintstone were about the past, the Jetsons and George Jetson were all about the future.  I remember watching an episode where the youngest member of the Jetson family, Elroy, was sick.  His doctor saw him virtually through a space age cartoon version of telemedicine (see my previous post, "What can health care learn from Uber?" for more) - except I'm not sure why the doctor needed to wear a mask in this case:

Amazing how so much has changed!  Several months ago, in the middle of the COVID-19 pandemic, I read an article in Time magazine by Alana Semuels entitled, "Fewer Jobs, More Machines".  The article focused on how automation is making certain jobs obsolete, citing the statistic that nearly 400,000 jobs have been lost to automation from 1990 to 2007.  Here's more evidence - the most valuable company in America in 1964 was the American Telegraph and Telephone Company (now known as AT&T), with 758,611 employees.  At the time that Semuels wrote her article, the most valuable company in America was Apple, Inc with just under 137,000 employees.  That's quite a difference!  And the difference is due to the changing and evolving technology landscape.

With these statistics in mind, it's easy to suggest that the major impact of automation on the labor market will be through job destruction.  However, the World Economic Forum argued that by 2025, technology will create 12 million more jobs than it destroys.  Ashley Nunes recently argued in the Harvard Business Review, automation doesn't just create or destroy jobs, it transforms them.  Regardless of whether the principle effect of automation will be creating versus destroying jobs, there is no question that technology will have a dramatic impact on how we work in the future.

It's tempting for those of us in health care to say that our jobs cannot be automated.  The patient-doctor relationship is sacrosanct and is critically dependent on a human-to-human connection.  The art of medicine requires human touch on the most personal of levels.  Or so we thought.  COVID-19 has changed how we practice medicine, and these changes are likely permanent.  Just think about it - the vignette I mentioned above about Elroy Jetson has more or less come true!  Shortly after the World Health Organization officially declared the start of the pandemic, most businesses (outside of health care) went virtual.  Elective surgical cases were canceled, and most doctor's visits also went virtual!  My own institution significantly ramped up the number of our telemedicine visits, which were more or less nonexistent before the pandemic.

Let's talk about artificial intelligence.  There are clinical studies showing that computer programs do better at diagnosing certain clinical diseases compared to humans (see for example the following reviews on the use of artificial intelligence in dermatology and medical imaging).  Will machines ever replace doctors and nurses?  I don't know the answer to that exactly, but I can say that it's almost certain we will be using some sort of artificial intelligence in our daily work.  It's exciting and scary at the same time.

It's also easy to say that the current generation of patients will drive the implementation of digital health options (telemedicine, remote monitoring, online scheduling - the list goes on).  We live in a world where consumers demand constant (24/7) access to information.  They also want easy access to care.  Ignoring the changing health technology landscape is simply not an option for leaders in health care.

I'm certainly not an expert in this area.  As most of the members on my team know, I am challenged by technology!  Things seem to break a lot when I use them!  Health care leaders really have two options - either become an expert in digital health technology or surround themselves with experts.  Thankfully, I've surrounded myself with a number of experts in the digital health domain.  And I am lucky to have two children who work in this field!  

I think that, rather than being afraid of how automation and technology will impact the health care workforce, we should embrace it.  It's really an exciting time to be in health care.  Digital health will improve the care that we provide to our patients, and for that reason alone, we should not be afraid of what the future may hold.