Two Recent Articles About Medical Practice Are Related and So Is AI

By Richard Hilburn, MD, FACP

Goals of Care, PLLC

. https://www.goalsofcaremd.com/

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Two Recent Articles About Medical Practice Are Related and So Is AI

Last week a neighbor shared with my wife a Washington Post article about physicians’ incomes.  This is a topic that seems to make headlines a few times a year.  The data is never quite accurate for a variety of reasons, but this most recent composition was among the better ones I’ve seen.  The author, Andrew Van Dam, waxed eloquently (and curiously) about why doctors make so much money.  He advanced several different explanations about that phenomenon and offered critical perspectives about it. 

A different subject appearing in media recently has to do with nurse practitioners gaining license to practice independently—a change in medical practice norms vehemently opposed by the American Medical Association (AMA).  Many physicians proselytize about the dangers of liberalizing the requirements for gaining a license to practice medicine.  I often hear the argument that it’s critical for “us” to protect the patient population from inadequately trained health care providers.

Regarding income, trust me: there are some doctors who work very hard and don’t make a lot of money.  For the most part, doctors who do make a lot of money genuinely earn it.  It’s not just the educational investment or the confounding, non-medical, agenda derived from regulatory bureaucracies that complicate modern practice.  Good doctors carry with them the weight of responsibility for things that are often beyond their control.  It is indeed a privilege and a high honor to be a physician but it’s an extremely demanding profession.

Regarding nurse practitioners:  I have worked with more than a dozen nurse practitioners (NP) over the last 30 years.  Historically, nurse practitioners gained some experience before advancing their education to become primary providers of health care.  In my experience, most nurse practitioners provide extremely good, compassionate care for their patients.   In recent times a few NP training programs have relaxed educational standards.  The NPs coming out of some of these schools are much less well-prepared than the ranks of the nurse practitioners who established the niche in our medical workforce.  I recommend that prospective patients seek out NPs who gained experience in traditional nursing roles before going back to school to become nurse practitioners.

Doctors who only work for concierge practices are inspired differently from those who work in traditional practice models.  Nurse practitioners who have experience before advancing their degrees are motivated differently from nurses who go through accelerated didactic pathways to a higher professional station.  I recommend seeking doctors who do not work for concierge conglomerates.  I recommend NPs who decided to advance their training after some time working in traditional nursing roles.

Artificial intelligence (AI) is bringing about a world-wide existential change in primary care and it will be for the better.   Most primary care will be handled more efficiently and with fewer mistakes by AI platforms.  In less than 10 years the remaining primary care doctors and nurse practitioners will be those with the humility to be excited about the benefits of AI technology.   They will be the doctors and NPs whose inspiration was about taking care of patients without territorial jealousy or fear of losing income.   You can find such providers now and it’s really worth your while to seek them out.  In fact, it should be one of your primary goals of care.