I've thought a lot about this, and I've also used ChatGPT pretty extensively for studying, writing, data analysis, and other menial tasks. I think physicians should be both excited and scared, but mostly excited.
Reasons to be excited:
1) Decreased administrative scut for physicians. People might say, "now physicians will be more productive and it will decrease wages," but that's very unlikely. Given a bit of breathing room, most physicians will take it rather than try to squeeze 20 minute visits into 10 minute visits, and patients will revolt if doctors start spending even less time with them. Look at the typical office worker's day. Work fills the time and expectations provided. Workforces as a whole relax once their menial tasks get automated. Expect a strongly buffered effect while completely cutting out lots of menial work.
2) Decreased administrative burden. Low level admins will undoubtedly be cut by this sort of technology, while physicians will remain essential for practical and legal reasons. Private practice will fall eventually, but in the meanwhile it will increase PP income, and it will also increase employed physician income, if only slightly.
3) Fewer lawsuits if you use the technology effectively.
4) Extra-clinical opportunities. This is probably the biggest thing to roll into healthcare in the last 20 years. At least as big as EMRs if not significantly bigger. If you are savvy, you can probably make some money as a consultant.
Reasons to be scared:
1) Your deep investment in the specific skills of a physician. Physicians are unique in the workforce in that our training is 7+ years, our skills are poorly transferrable, and our compensation is dependent on physician legal protections and scarcity. If Congress decides that AI + NP is as good as a physician (because it's more convenient for their campaign donations than actually taxing the wealthy to fund safe healthcare) then you're SOL. Physicians need to make ~2x the salary of their desired lifestyle to make up for opportunity cost of training. If you get rug pulled at 35+, you will never make up the income and you'll be solidly middle class despite over a decade of toiling and sacrifice.
2) You're young and work in pathology (and maybe radiology). Pathology is one area where faster charting and quicker reads will actually increase productivity. Unlike rads, it feels unlikely that we'll just increase biopsy frequency. Maybe in some cases we'll increase the amount of work (e.g., read the entire margin of a basketball-sized liposarcoma to assess margin status post-resection), but path seems troubled. The field is already a bit saturated, and professionally they've shown they don't have the sway to limit residencies and keep the job market decent. In 20+ years this could be trouble.
3) Medical education will fail to keep up with advances to keep us relevant. We're still memorizing the Kreb's cycle, and our licensing exams are still ~75% memorization. It will be on the individual to keep their skills relevant to the changing landscape.
Finally, reasons NOT to be scared:
1) Diagnosis/decision making takes basically no time for most physicians. M1s and M2s get freaked out because you can put a clinical vignette into a ChatGPT and it comes up with some scary good answers. However, the hard part isn't coming to the diagnosis, it's getting all the info from the patient, reading past the subjective/irrelevant nonsense, synthesizing it into a vignette/note, and then actually carrying out care. That's why even a 270+ step 2 MS4 is still bewildered and lost as an intern. Most of what a doctor does all day can't be emulated by an AI/ML model. Try putting in something closer to an unfiltered patient history into ChatGPT. It comes nowhere close to where it's supposed to be.
2) Physician is one of the safest jobs from automation. Few jobs combine empathy, subjective interpretation, rational thinking, and physical labor in such big way. When is the last time you spoke to an average person? Seriously, next time you're sitting in coach go ahead and talk to the person next to you. Most people think their jobs are tough/require tons of skill, but realistically just need a warm body to follow simple instructions. They harken back to times when life was "hard" in college because they had to study 5 whole hours to pass a statistics test. Idk if being a physician is the automatic ticket to a suburban McMansion and twice yearly trips to Hawaii that it used to be, but we've got a long way to fall and a lot of much easier targets below us.
www.medscape.com
www.deepscribe.ai
news.ycombinator.com
