Abstract
What is the craft of medicine? Even if we believe there is such a thing, is it necessary in a future to be dominated by artificial intelligence and robotics? For one, I ascribe to the view that there is a craft. 1 Medicine isn’t just learning facts and clinical algorithms. And when I say craft, I don’t exclude technical skills. The craft of medicine might be viewed as the clinical skills, practical techniques, interpersonal capabilities, and the broader world view that make a doctor. The craft of medicine must not be lost.
The opposite view seems attractive. Artificial intelligence can help with patient consultations. It can read an x-ray or a scan better than a human. It can instantly remember a care pathway or a treatment plan. It can manage a patient’s journey from first presentation to discharge with a human doctor gently course correcting as required. It can manage our precious time better than we can manage it ourselves. 2
Yet, there is something troubling in all this. There is much that artificial intelligence can do, but we know precious little about how artificial intelligence impacts on patient outcomes. Enthusiastic studies hail innovative use cases of artificial intelligence without thought for what really matters. And there is the human side of medicine, the compassion, people skills, and understanding the social determinants of health 3 that artificial intelligence will struggle to emulate. This before we talk about the inherent biases in the datasets that artificial intelligence is trained on or its love of confabulation.
Perhaps the greatest danger will be deskilling a skilled workforce. The primary skills of medical practice remain sharp history taking and purposeful clinical examination, and we risk losing these in the rush to defer our critical thinking and diagnostic acumen to machines. What good is a doctor who can’t examine a patient? What does such a doctor do when technology is unavailable or a total power cut, as happened recently in Spain, makes technology unusable? Does a doctor who loses their craft cease to be a doctor? Artificial intelligence is both a boon and a burden – unless we wisely judge the balance between the ancient craft and the futuristic technology.