The future is going to be full of disruption, and I don't think anyone is safe, despite feeling that medicine would be sheltered from it for a long time. I'll give you a few examples of what I've seen that helped change my mind.
I was a medical lab scientist for over 5 years before I became a nurse. When I started working in the lab running lab testing, we did 80% of the work by hand, with a remaining 10 percent with the help of automated systems that we had to monitor. When the machines spit out results, we reviewed them, and individually entered the results, or approved the results to be transmitted out. There was extensive prep work that went into a lot of the samples, and we did a lot of interpretation. There was a lot of visual observation of things like blood cells and urine, and blood banking was very hands on. Within 6 years, 95% of lab work in my particular lab was automated, even in blood banking, which was always a very stepwise, hands on process. I went down a month ago to my old lab and saw that most of the work now consisted of putting a sample on the machines and walking away. Most results were not even reviewed anymore, but an algorithm helped detect anomalies and automatically send the data on its way without a human ever knowing what the result was. The machines do most of their own quality assurance, and troubleshooting. A technologist doesn't detect an issue, but is summoned to most of the machines when the machine tells them to. The machines that caused me so much trouble back in the day now tell the techs exactly how to fix the problem. The technologist looking though a microscope at urine or blood is no match for a machine that can snap an image and compare that image to a library of tens of thousands of images to identify what is being looked at. Counting cells used to be a tedious task, but a computer can take a slide of a body fluid and count almost every cell in sight, negating the need for a human to take a very small sampling of the cells to confirm a result.
The same things are happening in fields such as radiology. AI can compare literally millions of xrays or MRI's in an instant, and actually come up with better results in many cases. And if a human eye is needed, telecommunications technology means that a radiologist in India can take a look at the films for a fraction of the cost of someone local. I think we will see the day when the argument will be made that patients are better off with the cold objective calculations of a computer rather than an overworked clinician.
So to me, I can't imagine it will be long before Wal-Mart, or Costco, or Amazon/whole foods pharmacy (its coming I'm sure), will realized that purchasing a half million dollar device that is supervised loosely by a pharmacist, is a better deal than hiring more pharmacists. Employees take breaks, days off, sick days, etc. So while I think that medical providers days of reckoning are coming, pharmacy will have their own day the very soonest. If you went to pharmacy school, you might even graduate in time to see the great culling of the herd, where pharmacists will be happy to make $80,000 if they are just provided benefits. They will be there to answer questions, supervise the pill sorter, and make sure the army of pharmacy techs load it correctly. Or maybe they will work in something like a call center and supervise 3 or 4 locations remotely. It sounds dystopian, but I feel like pharmacy will be the first domino to fall prey to AI.
I think it will also come for providers. Physicians are being substituted for PA's and NP's. AI will enable less experienced PA's and NP's to perform their job with management systems and decision making databases that will help make up for what the providers lack in experience (or will do a good enough job that the CEO's will be fine with the results). Or, using the miracle of modern communication, tele medicine will allow for far away contracted providers to diagnose remotely for cheaper than an on site employee. I could see maybe one provider being on site at a clinic, and several more seeing patients at that clinic, while they are far away looking at a computer screen and operating a remote camera.
People won't like it at first, but they will like it more than the alternative, which will be expensive or delayed care.
But you will see this everywhere. Folks will choose to ride on a passenger jet sized drone if the cost is significantly more affordable vs opting for a flight with a human pilot. I personally will feel more comfortable eating a hamburger made by a robot vs one prepared by someone who may or may not be washing their hands on trips back to the kitchen from the bathroom. Good results will be key to public acceptance. Imagine being able to fly the whole family to Disneyworld on a drone with a good safety record vs what it would cost to fly one person in a plane flown by two human pilots. If the trip is safe, or even safer than having a human pilot, then passengers will choose that. Its the same thing with their healthcare. So disruption is in the cards. Its going to happen.
I personally think that dentistry is one of the safer places to be. Its a skill that a robot can't do much to replicate at this point. Nursing care... like floor nursing... is another area that still requires dexterity and adaptation on the fly. And in the case of a medical provider like an NP or a CRNA, will be safe for a while. Our abilities will simply be augmented by technology. But what that means for the workforce is that with all the folks flocking to medical careers as a way to find stability, mobility, and be in demand.... those folks will find lots of other folks waiting there with them for jobs. Its already happening to varying degrees in the FNP and PA market. I've seen it in nursing, although nursing does a decent job of weeding folks out before long due to burnout. I remember even looking forward myself to the lifestyle of an RN... working 3 days a week and being able to find a job anywhere I wanted. Everyone else thought the same way during the economic downturn. Nursing has been really good to me, but I look around at all the RNs who are eager to move to the next level to be an NP or a CRNA, and I wonder how things are going to pan out.
To recap... I would suggest that pharmacy will be a lot different in 10 years than it is even now, because I've personally seen what technology did in the lab. I should note that the lab still has as many employees as it did when I worked there, so progress has not left folks behind in that regard. However, productivity is off the charts, and they process quite a bit more volume. If that were to change, you would see them let people go in droves, and R2D2 would be on deck every day.
I don't see CRNA going anywhere, but all it would take to disrupt that environment would be for FNP's not to find jobs (or not get paid enough to want to keep doing it), and those folks would flood the schools with their applications, and then we would see that industry change. All it would take would be for health systems to start initiatives lamenting a shortage of CRNA's, and pushing for expansion of CRNA schools to address a nonexistent problem, and we could see CRNAs being more and more common, thus depressing the market. This seems to be a stretch to me, though, so I'd say your best option between pharmacy and CRNA is definitely CRNA. For CRNA to reach the nightmare scenario would require quite a bit of movement, but the indicators for pharmacy are already in place. And the money is still there for CRNA. I know pharmacists that are making $80,000 per year, and not climbing very fast up the wages ladder. Experienced pharmacists are being dropped in favor of younger, cheaper new grads. Happened to a spouse of a friend of mine.
