Why the ‘art of caring’ is so important in the age of AI

The rapid advancement of AI technologies has left the medical community in a state of flux, unsure of where to direct their efforts to deliver the best, most effective care. But to one dean the answer is simple: prioritize patients.

In an Academic Medicine editorial, S. Claiborne Johnston, MD, PhD, dean of the Dell Medical School at the University of Texas at Austin, acknowledged AI “is clearly a threat to the profession as it exists today,” forcing a readjustment of how medicine is practiced.

“The breadth of knowledge about medicine and the pace of its development has...grown exponentially, with the time needed to double medical knowledge decreasing from an estimated 3.5 years in 2010 to a predicted 0.2 years by 2020,” Johnston wrote. “This is further exacerbated by the large array of variables we collect about our patients, with the addition of detailed genetic information making it clear that our intellects can no longer handle the array and complexity of important data.

“Knowledge is much more plentiful and easier for us to access than ever before, but it is also impossible for the unaided physician to retain and process.”

AI will likely eclipse the need for physicians to memorize and analyze to the degree they do today, Johnston said. Trained neural networks can already diagnose melanoma from images of skin lesions more accurately than dermatologists and rival pathologists in catching metastatic cancer in images of lymph node tissue. That frees up time for physicians to engage in the nonanalytic, humanistic side of their profession, but many weren’t trained in shared decision making, empathy or bedside manner.

Johnston said the communication skills associated with effective caring can be taught, and they should be introduced at a college level. Still, medical schools are devoting more time in their curriculum to memorization and analysis that “will become less demanding as AI improves.” The “art of caring,” as Johnston calls it, is just a minor part of the syllabus, if it exists at all.

At Dell, Johnston said higher-ups have reduced the duration of basic science instruction to 12 months and tried to emphasize group problem-solving and deemphasize memorization, making time for instruction in caring, leadership and creativity. But not all schools have followed suit, and many are complacent in allowing their trainees to “learn” good bedside manner during their third- and fourth-year clinical rotations.

“As machines gain preeminence in the retention, access and analysis of knowledge, it has never been as important for physicians to recognize the particularly human aspects of the profession encapsulated in the art of caring,” Johnston wrote. “Listening, tone, touch and counsel are critical components of medicine and always have been. Our educational systems should rebalance the curriculum toward these components and create opportunities for practicing physicians to recalibrate and prepare for the future.”

He said the types of activities handled by computers right now are limited to certain areas and analytical tasks, but AI will inevitably become smarter and more developed, “dramatically changing the role of the physician.”  But Johnston views that as a good thing, since it could also dramatically improve physicians’ communication and care skills.

“One side effect of a rebalancing hastened by artificial intelligence may be a reintroduction of additional meaning and joy into our professional lives,” he wrote.