A while ago my primary doctor showed me the newest version of his office software and said “Do you see this? They are trying to replace us.” My primary who is a D.O and is one of the few who buck the trend to stay in private practice is good at explaining, does not routinely push pills when there may be better options and is an excellent diagnostician. In today’s practice environment which is predominantly large systems of providers including many practitioners that were formerly in solo or group practice, diagnosis is algorithmic and the system has been dumbed down to Urgent care where everyone is given the same prescriptions for symptoms and they practice one size fits all emergency medicine light. If you have a primary doctor in the system, it often takes weeks or a month or so to get an appointment. You are constantly bombarded with texts and emails about the next vaccination and the next thing you should be getting done for yourself. Doctors are routinely rewarded for stars, staying on time, referring within the system to other providers and there are caring people but the system is uncaring and one size fits all. Diagnosis is algorithmic and patients often see the PA or the NP and may see their doctor too. When care becomes one size fits all and algorithmic, who needs a doctors when a chat gpt prompt can listen and fill out the record with the repetitive things everyone asks multiple times in the doctors office, yes, their jobs are in jeopardy. It may not happen today but everyone wants to maximize profits, and minimize costs. My friend who is an anesthesiologist was working per diem for more compensation than full timers until he found himself displaced by nurses trained to do what he did while he had to attend to 5 nurses working cases to improve case load follow-through. This ultimately was designed for the wall street company that now owned his group to make money and satisfy their financial needs. Patients were merely a widget in their product line in anesthesia. If you are not using your provider skills and everyone is treated the same, yes, a computer can outdo you in diagnosis. In the world I live in from a chiropractic perspective, a computer cannot perform or think how I do because we do not one size fits all patients who come in different sexes, sizes, histories and such. Hospitals and large systems are not hiring chiropractors in mass yet but musculoskeletal medicine is a thinking persons game. People are not algorithms and we must understand and properly holistically evaluate and treat them vs. manage them into chronicity which is what most physicians do now. When your professional art is commoditized as much of today’s medicine is, you are a widget taking care of widgets. If that is you, you may find yourself replaced by technology designed to do this better and cheaper than you can. Systems will always need doctors. The system needs competition and care must be patient based and not on algorithm. Our current system is based on this idea right now and healthcare is getting worse and more costly. There needs to be a better system than just profit margins and efficiencies. We need better care. Check out the article in the NY Times below A.I. Chatbots Defeated Doctors at Diagnosing Illness