Robots, artificial intelligence (AI), autonomous technology—all incredibly powerful buzzwords that are dominating the current realm of innovation. Moreover, these concepts are increasingly being discussed in the context of healthcare, alongside the growing curiosity of where and how technology will be integrated in the practice of medicine. Some nervously question—“will doctors be replaced by technology?”
For many generations, the answer to this question was an obvious no. How could a robot or computer be able to comprehend the large amounts of information that is required to deliver quality care? But eventually, computers became significantly more advanced, being able to process far more information than the average human.
Surgeons and other physicians involved in hands-on procedures were especially confident—even if a computer could somehow process theoretical medical knowledge, a human body is still required to do intricate procedures, or atleast drive a robot to do the procedure. For example, the Da Vinci surgical robot has become an integral part of surgery worldwide. The concept is simple—a trained surgeon sits in a console near the patient and controls 3 or 4 robotic arms that performs the actual surgery. This is especially useful in minimally invasive surgeries that often require extremely intricate hand movements and range of motion—as the developer of the system states, the Da Vinci offers “Precision beyond the limits of the human hand.” The system has been “Inspired by the human hand—but with a greater range of motion—[the] graspers, needle drivers, and energy instruments help enable surgical precision. With a variety of modalities, [the] instruments can be used for a range of procedures. [The] da Vinci system seamlessly adjusts hand-to-instrument ratios, and tremor reduction further enhances fingertip control.”
The market for high-tech surgical robots has only continued to expand; take for example Vicarious Surgical, a surgical robot company backed by notable names such as Bill Gates and Vinod Khosla, which just went public in a SPAC deal worth nearly 1 billion dollars. Another notable example is Neuralink, which is developing neural interface technology that embeds directly into a patient’s brain. According to the company, “The threads on the Link are so fine and flexible that they can’t be inserted by the human hand. Instead, [the company is] building a robotic system that the neurosurgeon can use to reliably and efficiently insert these threads exactly where they need to be.”
Although these examples instill confidence that physicians and surgeons still play a crucial in procedural medicine, an important question emerges: with how quickly this industry is expanding, how much longer before developers find a way to transform these robotic systems from being dependent to semi-autonomous to eventually, fully autonomous systems? Is it really that difficult to envision a world where even complicated surgeries will one day be performed autonomously by a robot?
With regards to non-procedural medicine, the question becomes even more interesting. Indeed, artificial intelligence is at the forefront of diagnostics. Developers have made incredible strides in how advanced AI has become, especially when it comes to predictive analysis, big data comprehension, and the use of historical data to make decisions. One of the most revolutionary names in this space is IBM’s Watson Health, which pioneered many of the fundamental uses of AI in medicine. This field has also exploded in the last decade in terms of innovation. I have written about how AI is being used to tackle massive problems such as malaria, and how other advanced AI systems and technology in general are revolutionizing cancer care. Even during the height of the Covid-19 pandemic when physicians were overrun with managing Covid cases, innovators found a way to use AI to help detect Covid-19 on chest x-rays. This helped physicians to atleast preliminarily sort out Covid cases from other pathologies to some degree of certainty, significantly improving their workflow.
But perhaps the real answer to the generalized fear of technology potentially replacing physicians is most evident in the last example. Although it is true that technology has come a long way, the focus on advancing healthcare technology should be in augmenting a physician’s workflow, rather than replacing the physician itself.
This is an important paradigm that physicians must advocate for, because no matter how advanced a robot becomes at surgery or how great an AI system is at predicting a diagnosis, there is a critical role that human physicians play and will continue to play for generations to come. A patient does not solely come to a physician for a straight-forward fix or single-layered answer to a medical problem; rather, the practice of medicine is an art which takes into account multiple layers of variables before making a medical decision.
While an AI system may be able to provide with some degree of confidence what treatment a cancer patient should take based on the million other data-sets it has analyzed, a physician can go 10+ steps further. A physician can ask other important questions that go beyond a simple, data-based answer: Can the patient afford this treatment plan? Will a patient really have the ability and means to take a medication as prescribed, 5 times a day? Or is that patient better suited for a medicine that just has to be taken once a day? Does this treatment plan create other medical or life inconveniences to the patient that may disincentivize the patient from seeing it through? Is the patient happy with this treatment plan? Do the benefits of the treatment plan outweigh the detriments medically, socially, and emotionally?
This is the fundamental fallacy of enthusiasts that believe they can completely replace physicians with technology. The art of medicine is intentionally not meant to be a solely algorithmic approach; while there are clinical guidelines and criteria that can lead to certain medical decisions, physicians take into account numerous variables unique to each patient, clinical situation, and social context when making a single clinical decision.
Indeed, technology may be useful in augmenting a physician’s workflow or perhaps improving the quality of decision making. But technology can never truly replace what it is to be a physician and the very crucial patient-physician relationship that is unique to each individual. After all, this humanistic approach to healthcare is why the practice is often described as the art of medicine.