Eric J. Topol, MD
Jul 01, 2013 Hello. I’m Dr. Eric Topol, Director of the ScrippsTranslational Science Institute and [Editor-in-Chief of Medscape]. In this series, The Creative Destruction of Medicine, named for the book I wrote, I’m trying to zoom in on critical aspects of how the digital world is creating better healthcare.

One of the big questions we have now is whether doctors will be replaced by algorithms.

This idea was really precipitated by Vinod Khosla [founder of Khosla Ventures] at the Rock Health Program on Health Innovation, when he said that 80% of doctors are going to be replaced by algorithms. That comes right in the face of all these projections about physician shortages, of hundreds of thousands of doctor shortages over the next 10 years because of the Baby Boomer problem and the aging of the population, as well as the chronic disease burden.

So, which is right? Are doctors going to be replaced by algorithms? We do know that there are such remarkable changes in the digital infrastructure that have given capabilities, for example, to such things as skin apps that are able to preempt the need to have biopsies by using a picture of a skin lesion through one’s phone. Then there is the ability to refract one’s eyes through an add-on to the phone, such as EyeNETRA, which costs a couple of dollars and gets your eyeglasses made through a text message. Why would we have to go to optometrists, for example?

Another example is a device that can take a picture of a child’s eardrum and have an algorithm detect whether or not there is infection, because the eardrum is magnified 10-fold. Why, then, would you have to go for a pediatrician visit or to an emergency room?

These are just some examples of how algorithms can be used to take the place of many of the things that have traditionally been in the healthcare professional’s or doctor’s domain. Of course, it’s just the beginning of this movement, and it’s threatening to physicians.

Actually, what I think is that there’s a very interesting issue that’s somewhere in the middle. That is, we don’t have an imminent physician shortage because the efficiency of physicians is going to be markedly increased in the digital era, just with some of those examples I’ve already given, and a whole lot more [new efficiencies] going forward. But the model for physicians is going to be remarkably different.

Because so much can be processed automatically, through artificial intelligence, the need for the processing will be reduced on the physician’s side. On the other hand, the humanistic compassion, communicative judgment, and experience [of providers] is going to be emphasized all the more. So, I think both of these projections are right. They are 2 different trends going in the opposite direction. It will be really interesting to see how it plays out over time.

Thank you for joining us for this segment, and stay tuned for more on The Creative Destruction of Medicine.

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