Do you think there will still be prospects for doctors in the future, in light of the technological advancements of today that threaten to make humans redundant?
That is to say, is it useless for me to study medicine if I'm going to be replaced by a robot in the near, not so distant future?
Great question. I'm going to ramble a bit, so bear with me.
I think there's always going to be room for the human doctor. I'm a big believer of the patient-doctor relationship - it's a unique relationship that is therapeutic in and of itself. There's always going to be a role for the ritual that takes place in a doctor's clinic: the first impressions, the history, the physical examination, the explanation, the management. This ritual relies on several things that a robot can't do:
1. A human-to-human understanding and the human touch (highly recommend this
short TED talk by Stanford physician Abraham Verghese);
2. The ability to integrate all aspects of a patient to the betterment of the their health;
3. The ability to see each patient as unique.
I went to a Neurosciences Symposium recently, and there was a fascinating talk about neurorehabilitation in patients who have had a stroke ('heart attack' of the brain). The speaker described these robots they have introduced to their neurorehab ward that seek out patients to help them perform exercises, just like a physio would, but for a fraction of the cost. But why did they still employ the same number of physios? The human-to-human understanding and the human touch. These factors in themselves are inherently therapeutic, as has been well documented in medical literature, and can't be replaced so easily. I was later told by a prominent neurosurgeon over lunch that in Japan, they've found introducing robotic dogs (that look like real dogs) have had some benefit in Aged Care centers. But whether we could have a robot 'looking like a doctor/physio/nurse' to replace their role... that sounds unlikely to me.
Having said that, what role do robots have in medicine? There are certainly specialties that are at more risk of being made redundant. For example, there is a lot of work being done to have computers interpret x-rays, CTs, MRIs, and other imaging modalities through use of complex algorithms and pattern recognition, which could potentially replace Radiologists. This is worrying for them, especially with the breakthroughs in technology that can actually learn and improve (eg. the computer that plays Go and beat the world champ). However, these breakthroughs have limitations. A good case in point is the interpretation of electocardiograms (ECGs/EKGs). The machines that do the ECG often generate its own interpretation, and often it picks up all these subtleties, but the difference is: it doesn't have access to the patient to correlate some squiggly lines to the patient's clinical presentation. Thus, it often misses the bigger picture. Human doctors though, they have the benefit of having both the patient and the investigation in front of them. This is something robots just cannot do so well.
My final thought on this comes back to a question many AN'ers may be dwelling upon as we approach med interview season: what does it really mean to be a 'doctor'? Whilst many of us may scoff at the ridiculousness of that question, and assume the answer is something about treating patients, saving lives, or something along those glamorous lines, I think those responses miss the mark a bit. Doctor is said to derive from the Latin "docēre", which actually means "to teach". It doesn't mean "to heal", or "to cure", or "to save"; it means "to teach". And that's the third thing that I don't think robots can do so well. Do patients just want a diagnosis and a drug? No, what they want is to understand what's going on with their body, they want to be taught these things. And each patient is unique in that regard, they've all got different levels of education, they've all got different expectations, they've all got different concerns, they're all unique. It's the doctor's role to adapt to that uniqueness. As the Father of Modern Medicine Hippocrates once said (translated), "It is more important to know what sort of person has a disease than to know what sort of disease a person has". Two-and-a-half thousand years on, that quote still has a lot of relevance to medicine.
I think medicine today is still similar to that depicted by Luke Fildes in his 1891 painting
The Doctor, as shown above on the left. Here we have a doctor looking over a child, the child has TB and is inevitably going to pass away (treatment for this condition was not yet discovered!), but we can see clearly the patient has the doctor's undivided attention, and the doctor is thinking deeply about what to do next. The doctor, the patient, and the patient's family probably all know what is going to happen, but there's still a silent and powerful understanding between everyone present that everything that can be done is being done. This is demonstrated again in the picture on the right, which shows Sir William Osler, one of his four famous photographs at the bedside, in "contemplation". A robot can't do these things. There's just no connection it can make that could be as powerful and meaningful as the one between the doctor and the patient. Many would argue that giving these doctors a desk with a computer and too much paperwork would be a better representation of medicine today, and I'd agree, but the essence of Fildes' work and Osler's approach are still very much relevant and still forms the backbone of what medicine is all about, and what it should be all about.
So I think we can safely say that something like this is probably out of the question
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