Between competence and warmth: the remaining place of the physician in the era of artificial intelligence

David Drummond

doi:10.1038/s41746-021-00457-w

Abstract

Competence and warmth are two essential dimensions of patient care. During the twentieth century, the industrial revolution in data collection, with the increasing use of machines and the division of labor that led to the development of many subspecialities, increased the overall competence of physicians at the expense of the warmth dimension. The spread of patient-centered care principles aimed to rebalance the two dimensions. In the twenty-first century, the industrial revolution in data processing with the emergence of algorithmic decision-making systems based on artificial intelligence is likely to disrupt further this balance. Competence will no longer be the prerogative of physicians, but a dimension to be shared between physicians and autonomous algorithmic decision-making systems, by contrast to warmth which should remain a human attribute. In this comment, we discuss the extent to which competence and warmth can remain the core dimensions of physician care in the era of artificial intelligence.

Highlights

We discuss how the relative places of competence and warmth have been disrupted by the industrial revolution in data collection, and how they are likely to be further disrupted by the industrial revolution in artificial intelligence (AI)
Other decisions cannot be standardized and/or require warmth, such as the announcement of a serious illness, or any choice requiring an in-depth discussion of the patient’s values such as a transition from curative to palliative care. These decisions must remain the prerogative of physicians
Physicians are overwhelmed by the high revolution will result in the definition of different levels of performance of autonomous algorithmic decision-making systems (AADMS) developed by the digital giants and decisions, with some levels of decisions allowing AAMDS and become hired by these companies to be at the interface between others not

Summary

INTRODUCTION

Patients need both competence, which refers to their physician’s ability to cure them using biomedical knowledge and scientific reasoning, and warmth, which refers to their physician’s ability to care for them by establishing an empathic relationship and considering them as unique individuals[1,2]. Even during the nineteenth century and the scientific revolution, the pure scientist Claude Bernard recognized that “the physician often finds himself obliged to take into account, in the treatments he prescribes, what is called the influence of morale on the physical body and a multitude of considerations of family or social position that have nothing to do with science”[4]. In this viewpoint, we discuss how the relative places of competence and warmth have been disrupted by the industrial revolution in data collection, and how they are likely to be further disrupted by the industrial revolution in artificial intelligence (AI). The increasing level of complexity in medical decisions due to the proliferation of data sources and the need to involve many different specialists has shifted medical decisions from an individual process made by physicians in the secrecy of their offices to a collective process made in multidisciplinary meetings (Fig. 1c)

Drummond Lab tests Imaging Genomics

Drummond emergence of multidisciplinary decisions, it is likely that the AI

Findings

CONCLUSION