The making of a moron

A dose of Idiocracy
A dose of Idiocracy

When I read Automation Makes Us Dumb in the weekend Wall Street Journal it immediately made me think of a blog post I wrote a few years back: Are decision support tools turning doctors into idiots?

The basic premise is that we are de-skilling ourselves as we turn over more and more tasks to computers. We forget how to do things we used to know –like landing a plane or diagnosing an illness– and are left as virtual slaves to the machines, pressing buttons and generally following the road trod by skilled factory workers who largely lost their jobs and livelihoods to industrial automation.

The writer –Nicholas Carr, author of The Glass Cage: Automation and Us, argues that the problem is we have emphasized the needs of technology over people. His prescription is “human-centered automation,” which uses automation to critique human judgment by pointing out biases and suggesting alternative hypotheses. In addition, “adaptive automation” shifts more responsibilities onto the operator when it senses the person is getting bored or spacing out.

I generally like this approach, but it still begs the question of whether people will be needed at all as the machines continue to improve. For example, who will need a pilot to take over in rough weather 10 years from now when the auto-pilot is always better?

In healthcare, as usual, we are behind. The current state of diagnosis is quite poor, with patients wandering from doctor to doctor on a diagnostic odyssey until they bump into one who happens to be familiar with their specific condition.

In medicine, care processes are inconsistent, and mistakes –including fatal ones– are common. Electronic medical records often turn clinicians into data gatherers for billers and insurance companies. I’m not sure they de-skill doctors so much as just as slow them down and force them through narrow process pathways.

If physicians want to have rewarding jobs a generation from now, they’ll need to figure out how to leverage automation and other technologies in order to do things technology can’t. They should start by embracing technology to do things that are beyond human faculties. For example, scientists don’t bemoan the microscope as a threat to their observational skills. They use it to see things that just can’t be seen with the naked eye. Similarly, we shouldn’t be afraid to use software to help diagnose rare diseases that a typical physician will never encounter in a lifetime, and doctors should not resist prompts that tell them to look beyond the obvious.

Doctors who don’t go down this path will eventually be threatened by patients, who bring their own automated tools to appointments to critique their doctors.

I spoke about the topic of automation recently with my business school section-mate Mike Maples, a “super angel” investor, as we contemplated whether our kids would be able to make a living in the brave new world. He suggested that there would be an increasingly stark divide between those who find ways to leverage technology to do bigger things and those who are displaced by technology.

Physicians and other highly-skilled professionals would do well to keep that thought in mind.

photo credit: Gwydion M. Williams via photopin cc

By healthcare business consultant David E. Williams, president of Health Business Group.

November 25, 2014

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