A good business plan will always involve an analysis of the external environment first. PEST (political, economic, social, technological) provides one of these frameworks for such an analysis. We have often discussed, both in the media and on this thread, the first three elements and their potential effects. Should we be talking more about the fourth?
All medical fields have undergone significant subspecialization over the last 30 years. Fellowships have boomed. Technological advancements along with this fellowship training have undoubtedly allowed us to deliver better care than previously possible. But nothing lasts forever. Where are we on this arc where technological advancement begins to displace physicians, even those with such a narrowed training focus? We can all see the external threats to those generalists who follow a basic algorithmic approach to diagnosis and treatment. NPs and PAs as well as robots and apps have started their displacement. But subspecialization is supposed to be free of this worry, right? I'm not so sure.
Take a head and neck cancer surgeon for example. 90% of their work is focused on squamous cell carcinoma. Research on HPV (vaccines and optimal therapeutic regimens that are non-surgical) and non-HPV squamous cancer threatens their livelihood. Make no mistake. These things should be celebrated from a societal standpoint. But that's not to say things that are largely positive don't have side effects (see free trade and the 2016 election). My concern here is about those side effects, particularly in fields where physicians have narrowed their focus considerably. What capacity do we have for retraining if they are displaced? Are we as physicians set set up well for this eventuality? Paradoxically, the narrowed focus and research of subspecialists, while bringing societal good, will be part of their undoing. How we help them for having helped us will be, I believe, one of our greatest professional challenges over the lifetimes of our young physicians. What is currently anticipated as a physician shortage may prove to be anything but.
When will this occur? Each field will be different, and some will be unaffected for some time. But whether in 30 years or 15 we will all have to face this reality. Does this fourth external threat concern anyone? What insurance does a physician have for non-disability job loss? Are young physicians thinking about this or planning with any risk-control strategies (entrepreneurial endeavors, admin/MBA, etc.)? Curious to hear your all's thoughts.
All medical fields have undergone significant subspecialization over the last 30 years. Fellowships have boomed. Technological advancements along with this fellowship training have undoubtedly allowed us to deliver better care than previously possible. But nothing lasts forever. Where are we on this arc where technological advancement begins to displace physicians, even those with such a narrowed training focus? We can all see the external threats to those generalists who follow a basic algorithmic approach to diagnosis and treatment. NPs and PAs as well as robots and apps have started their displacement. But subspecialization is supposed to be free of this worry, right? I'm not so sure.
Take a head and neck cancer surgeon for example. 90% of their work is focused on squamous cell carcinoma. Research on HPV (vaccines and optimal therapeutic regimens that are non-surgical) and non-HPV squamous cancer threatens their livelihood. Make no mistake. These things should be celebrated from a societal standpoint. But that's not to say things that are largely positive don't have side effects (see free trade and the 2016 election). My concern here is about those side effects, particularly in fields where physicians have narrowed their focus considerably. What capacity do we have for retraining if they are displaced? Are we as physicians set set up well for this eventuality? Paradoxically, the narrowed focus and research of subspecialists, while bringing societal good, will be part of their undoing. How we help them for having helped us will be, I believe, one of our greatest professional challenges over the lifetimes of our young physicians. What is currently anticipated as a physician shortage may prove to be anything but.
When will this occur? Each field will be different, and some will be unaffected for some time. But whether in 30 years or 15 we will all have to face this reality. Does this fourth external threat concern anyone? What insurance does a physician have for non-disability job loss? Are young physicians thinking about this or planning with any risk-control strategies (entrepreneurial endeavors, admin/MBA, etc.)? Curious to hear your all's thoughts.
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