Can technology give physicians more time to practice medicine?

By Randolph Gordon, MD, MPH, director, Deloitte Consulting LLP

As a physician, I understand that doctors do much more than diagnose and treat illness and injuries. As we move into the future of health, the role of the physician is changing to align with an increased focus on health outcomes. In addition to practicing medicine, physicians should become data and informatics specialists, digital consultants, researchers, care integrators, complex-care managers, educators, proceduralists, and executives. To make this transition, they should embrace change and acquire new skills.

There is no question that physicians and other clinicians are most valuable to the health system and to patients when they practice at the top of their license—focusing their time, attention, and effort on providing care rather than entering data, for example. For every hour a typical physician spends providing direct care to a patient, two additional hours are spent on administrative tasks.¹ None of us went to medical school because we were excited about doing paperwork!

The technology turning point

About 80 percent of the work that physicians do today might be done by machines in the future, according to Deloitte estimates. Technology could automate many mundane processes not related to direct patient care. Automating administrative work, for example, could open new opportunities for physicians and could even reduce burnout. Moreover, artificial intelligence (AI) might help improve the efficiency and accuracy of a physician’s clinical activities. As my colleague Jennifer Radin noted in her blog, artificial intelligence can dramatically improve the efficiency of radiologists when it comes to reading scans.

Physician burnout and decreased satisfaction are major factors driving the change in the medical profession. Findings from the Deloitte 2018 Survey of US Physicians suggest that many physicians are frustrated with electronic health records (EHRs), particularly when it comes to the lack of interoperability and the burden of documentation. Although emerging technologies and interoperable data systems hold the promise of reducing administrative hurdles, these advances have been slow to change the existing system, which remains behind other industries. I believe that we are in a transformative period. At some point, most physicians will likely embrace the technology that can keep them from having to spend many hours each day entering data into machines.

Technology could extend the reach of physicians

A shortage of 124,000 physicians is projected by 2025, with primary care accounting for the largest share of the shortage at 37 percent.² A 2018 survey conducted by the Physicians Foundation found that nearly half of physician respondents intended to change their career path, and 17 percent said they were planning to retire.³

Consider this: Decisions made by primary care physicians (PCPs) influence almost 90 percent of total health care costs, through referrals, testing, and hospitalizations,⁴ and PCP supply is positively associated with decreased mortality rates.⁵ I believe that by utilizing technology to effectively support the work of physicians—especially PCPs—we can bend the cost curve and improve health.

Eight archetypes could define the physician of the future

As technology advances and systems become more automated, physicians should adapt. They should understand how to use technology and access data to guide their care decisions. Rather than relying largely on past experiences, AI-empowered specialists, for example, might make diagnoses and suggest treatment options based on millions of data points culled from vast patient databases. Surgeons aided by advanced robotics and nanotechnology could become more efficient and will make fewer errors.

As the role of the physician evolves to align with the future of health, we expect the following eight archetypes will define how physicians practice medicine 10 or 20 years from now (some physicians have already taken on many of these characteristics):

• The care integrator/complex care manager: These physicians are the closest to the patient. They bring the full weight of the health care ecosystem to care for individuals and populations. They manage the entire care team for patients who need individualized care and patient populations that benefit from health and wellness initiatives.
• The digital consultant: These physicians, who formerly specialized in visual pattern recognition, will use the higher resolution available through machine readings and take advantage of AI and other emerging technologies to improve efficiency and accuracy.
• The proceduralist These physicians will provide the highest level of skilled procedures. The diagnostic and/or therapeutic procedures they perform will be supported by robotics, enabling nanosurgery, remote, and other machine-enabled interventions.
• The analytic consultant: These physicians will provide specialized medical insight to the care team. They will use AI supported by deep learning and large patient data sets to develop complex diagnostic and therapeutic recommendations.
• The researcher: These physicians work in scientific and technological research and will help develop innovative treatments and methods to deliver the highest-quality care, which will be based on the latest medical knowledge. These physicians will help develop cutting-edge treatments that improve patient health and outcomes.
• The data and informatics specialist: These physicians will interpret, integrate, and apply large amounts of data. Their findings will help to strengthen the overall understanding of patient health and treatment effectiveness to improve individual and population health.
• The educator: These physicians will communicate and teach the latest technological and medical advancements to students, external audiences, and their peers. Basic curriculum will change. Educator physicians will also build learning platforms for professionals, the public, and external stakeholder groups.
• The executive: Some physicians will serve as a chief executive for the evolving health system and will help to lead the future health ecosystem. Along with caring for patients, these doctors will offer guidance to other caregivers and stakeholders and will make critical business and policy decisions to ensure high-quality clinical outcomes.

In the early part of the 20^th century, physicians routinely visited patients at home. During these house calls, they diagnosed, treated, and often collected payment from patients on the spot. Physicians were able to evaluate the patient’s surroundings and assess various factors that affected health. In the years that followed, as the health system became more complex, patients traveled to physician offices and hospitals to receive care and to benefit from the latest technologies.

As we enter the third decade of the 21^st century, the digitalization of health records is allowing health information to transcend time and space. Nanotechnology is enabling life-saving interventions, and AI is supporting cognitive tasks. These technologies, and others, might make it possible for physicians to once again care for patients in a holistic manner and return joy to the practice of medicine.

^{Endnotes
1. Allocation of physician time in ambulatory practice, Annals of Internal Medicine, December 6, 2016
2. The Complexities of Physician Supply and Demand: Projections Through 2025, Association of American Medical Colleges, November 2008,
3. Physicians Foundation 2018 Survey of America’s Physicians
4. Allocation of physician time in ambulatory practice, Annals of Internal Medicine, December 6, 2016
5. Association of Primary Care Physician Supply With Population Mortality, JAMA Internal Medicine, February 18, 2019}

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