It seems that at every major health care conference I attend these days, physicians are bracing themselves for the physician apocalypse—a world in which technology and artificial intelligence render our profession obsolete. These conversations tend to suggest that artificial intelligence tools such as Watson will do a much better job than physicians at accurately and efficiently diagnosing and treating patients. Indeed, the rate at which health care technologies are being churned out is astounding and one is right to wonder whether a physician's ability to correctly identify a patient's ailment will soon be eclipsed by these modern tools. But who said the physician's only role is to diagnose?
As a medical student, I often refer to the personal statement I wrote as part of my medical school application. I find it a useful exercise to remind myself why I entered this profession in the first place. In my statement, I quote a section of the Hippocratic Oath:
I will remember that there is an art to medicine as well as science and that warmth, sympathy and understanding may outweigh the surgeon's knife or the chemist's drug.
If we've reduced our role as physicians to diagnostic science alone, then I would argue that the physician apocalypse is already upon us.
This year, while completing my clerkship rotation in obstetrics and gynaecology, I met a patient who we'll call Kate. I followed Kate for the last six weeks of her pregnancy, which was quite difficult for her. I happened to be on call when she came into hospital for induction for being post-dates. Her eyes lit up as soon as she saw me. She exclaimed, "Oh I'm so happy you're here. I was hoping you would deliver my baby!" In that moment, I realized that she trusted me not because of my diagnostic acumen (of which I had little) but because of the rapport we had built over the short time we had known each other. That was my value. Watson could never do that better than I could.
I may be criticized for being a green-eyed, wet-behind-the-ears medical student, but I challenge the notion that a physician's sole purpose is to diagnose. The physician-patient relationship is sacred, and we must remember that humans are social beings. There's power in looking confidently in the eyes of a patient who has recently been diagnosed with a serious, but treatable cancer and assuring them it's going to be okay. There's no equivalent to being the first to console the parents that have just lost their only child right after you did everything to try to save her. There's no computer capable of sensing that the teenager who came to your office for a prescription refill is actually being bullied at school and needs your support. Furthermore, physician roles far transcend the four walls of a hospital or clinic. Physicians are policy developers, researchers and educators. They're the voice of the voiceless and the champions of the forgotten.
I'm so proud that I represent the physicians of tomorrow—a vibrant generation of medical students that are not fearful of a modernized health care system. Medical students are ready to practise the art of medicine as well as the science. The colleagues with whom I interact on a daily basis understand their roles as chief-consolers, health advocates and community leaders. In fact, many of them are already creating the very apps, software and other technologies that are poised to revolutionize the health care system. They, too, share my optimism. There will always be a role for them to play in society.
The era of "diagnose and adios" is over. The era of the new physician is just beginning. I encourage all physicians, young and old, to embrace the change.
Henry Annan
CMA Board of Directors medical student representative