The Individual Physician
Burnout is everywhere in medicine—and I’ve felt it too. But what if tech could swing the pendulum back toward independent practice?
The topic of burnout has been a near-constant theme within the physician community for years. I certainly have not been immune (heh 😏). While the problem is multifaceted, I do constantly wonder if the current landscape of medicine, namely nearly every physician working for a giant corporation that continues to devour every medical group and practice, isn't heavily involved.
Can technology bolster the independent physician? If we get more specific, what would a physician need to be independently self-sustaining? To start, they would need a physical space to practice (or perhaps a place to take virtual visits from), a place to keep medical records (the electronic medical record), and a clinical decision support tool in order to be able to quickly query the unbelievably vast amount of medical literature and data (like UpToDate or DynaMedex). Newly added to the tool belt should be a way to have notes written for you (either a human scribe or an AI scribe). Additionally, a nice-to-have that should be becoming more common is a way to have AI summarize a patient's chart. Beyond that, tools of the trade: stethoscope, otoscopes, ophthalmoscopes. Finally, a handful of specialists to refer to and work with.
When it comes to products like the electronic medical record and AI tools, unlocking the individual practitioner could help the market. Being independent allows the individual practitioner to use what is the best product both on price and function for them personally. This may allow smaller competitors to pop up that cater to the individual physician market. Yet, I suppose the few players in the market now may adjust to address this market. On the other hand, the individual physician may be reticent to sign a long term contract, not feeling forced into it, and they may prefer to be nimble enough to switch (whether they can or not would be dependent on how easy it is to move data back and forth). This may allow for other players to thrive. A lot is still up in the air here, but I still lean slightly in the direction of a more healthy market.
When it comes to AI, rather than imminently replacing doctors, it should actually serve to help them quite a bit. The amount of medical data and literature is simply impossible for any individual doctor to keep up with. However, access to large language models (LLMs) make that data and literature accessible. More interestingly, it may be that the general practitioner can begin to extend themselves out, reaching further into the domain of the specialist. If you have access to guidelines and easily summarized evidence based literature, why not use it to practice deeper into other fields? Physical skills like surgery will still require referral to a specialist. However, a broader set of procedures may be able to be learned in our current technologically advanced society. The issue of certifying that those procedures can actually be done safely and effectively by the provider will be important to patients. This will not be appendectomies and cholecystectomies, but perhaps learning to be more skilled with more minor procedures like incision and drainage, when to perform, etc. The key here is time, which these tools may give back to us. If physicians gain back time, what types of things could they learn? In what ways can they serve their patients beyond what is possible now?
The medical field, like just about everything else, is in a period of upheaval. The pendulum has swung far away from the physician wielding any power or independence in their field. But that's the thing about pendulums, they swing. Might this upheaval allow for a swing back toward the individual doctor? We all romanticized that doctor when considering a career in medicine. Might we be able to become them?
